Seminar Leaders: D. Traub-Werner, G. Fogarty, M. Mitchell and S. Thomson
Course Description
Part One: Narcissism is a common and overused term with multiple meanings in both professional and lay literature. This course focuses on clinical theories of narcissism derived from the classical and contemporary literature on the subject. The course includes the seminal writings of Freud, Klein and post-Kleinian theorists, including Rosenfeld and Kernberg’s work on pathological narcissism. Clinical examples will provide an opportunity to link the different theories of narcissism. Symptom formation, character neurosis, therapeutic alliance, resistance, transference, counter-transference, fantasy, dream, and therapeutic action will be addressed from the perspective of narcissism.
Part Two: Kohut’s development of introspection and empathy, self-object and self-object transferences, dealing with narcissistic issues of will be discussed, including intersubjectivity/relational psychoanalysis. Because narcissism has become such a common and overused term used with multiple meanings in both professional and lay literature, the seminars will focus on its individual developmental lines, from childhood to old age, as well as the influence of the group on the ego. These seminars will stimulate comparison of theoretical approaches in clinical psychoanalytic work with patients struggling with narcissistic/developmental issues and lead to further discussions on relational psychoanalysis in year four.
Course Objectives
Candidates will learn:
- (1a) The theory of human psycho-biosocial functioning from childhood to adulthood, based on the development of the mature ego/self and other from a perspective of narcissism.
- (1.3c) Explore/discuss clinical material in each seminar to review major diagnostic categories applied to the theory of change based on psychological development.(1.d,1.2f, 1.2g)
- Critical self-reflection in the therapeutic process, implementing appropriate interventions for psychoanalytic treatment (3.4a,b,c,d).
- Self-psychological techniques attempt to maintain (4 a, b) empathic, respectful, and authentic client rapport while establishing a treatment direction (4.5i) and (4.5n) judiciously exploring problematic affective states [anger, shame, humiliation, self-defeat, omnipotence] in intrapsychic and interpersonal functioning. Self psychological approaches necessitate (4.5s) reviewing therapeutic process and progress with the client periodically to deal with disruptions and therapeutic repair and thereby recognizing (4.5t) when to appropriately continue/discontinue therapy.
Part One
Seminar Leaders for Seminar 1-4: D Traub-Werner & G Fogarty
Seminars 1 and 2: The Classical Papers on Narcissism
Topics include narcissism in psychosis and Neurosis, primary and secondary narcissism and their quantitative relation, the line of narcissistic ego development, narcissistic and anaclitic object relations and contributions of narcissism to psychopathology and health.
Seminar 1
Required Readings
Freud, S. (1914). On narcissism: an introduction. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol.14, 69-102.
Freud, S. (1924), Neurosis and psychosis. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 19, 149-153.
Freud, S. (1924), The loss of reality in neurosis and psychosis. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 19, 183-187.
Seminar 2
Required Readings
Grunberger,B, (1971). Introduction pp 1- 34 in Narcissism: Psychoanalytic Essays. International University Press. New York
McDougall, J. (1982). The narcissistic economy and its relation to primitive sexuality. Contemporary Psychoanalysis, 18, 373-396.
Seminars 3 and 4: Melanie Klein and the post-Kleinians
For Melanie Klein, narcissism is a feature of the paranoid-schizoid position; hence, pathological narcissism reflects regression to this position or failure of development toward depressive position functioning. Rosenfeld describes the role of primitive aggression in narcissism, Steiner the role of psychic retreats, and Britton differentiates “thin” and “thick” skinned narcissism. Kernberg integrates Kleinian and Freudian ego psychology.
Seminar 3
Required Readings
Klein, M. (1952). The origins of transference. International Journal of Psychoanalysis, 53, 433-438.
Rosenfeld, H. (1964). On the psychopathology of narcissism: a clinical approach. International Journal Of Psychoanalysis, 45, 332-337.
Steiner, J. (1987). The interplay between pathological organizations and the paranoid-schizoid and depressive positions. International Journal of Psychoanalysis, 68, 69-80
Seminar 4
Required Readings
Britton, R. (2004). Narcissistic disorders in clinical practice. Journal of Analytical Psychology, 49(4), 477-490.
Kernberg, O.F. (2014). An overview of the treatment of severe narcissistic pathology. International Journal of Psychoanalysis, 95, 865-888.
Supplementary Readings for Seminars 1-4:
Chasseguet-Smirgel, J. (1984). Narcissism and perversion. In Creativity and Perversion. London: Free Association Books.
Fernando, J. (1998). The etiology of narcissistic personality disorder. Psychoanalytic Study of the Child, 53, 141-158.
Grunberger,B, (1989). The monad: Narcissus and Oedipus; From monad to perversion. In New Essays on Narcissism. London: Free Association Books.
Hanly, C. (1984), Ego ideal and ideal Ego. International Journal Of Psychoanalysis, 65, 253-261.
Hanly, C. (1992), On narcissistic defences. Psychoanalytic Study of the Child, 47, 139-57.
Kernberg, P. (1971). The course of the analysis of a narcissistic personality with hysterical and compulsive features. Journal of the American Psychoanalytic Association, 19, 451-471.
Kohut, H. (1959). Introspection, empathy, and psychoanalysis – an examination of the relationship between mode of observation and theory. Journal of the American Psychoanalytic Association, 7, 459-483.
Kohut, H. (1979). The two analyses of Mr. Z. International Journal of Psychoanalysis, 60, 3-27.
Mitchell, S.A. (1986). The wings of Icarus – Illusion and the problem of narcissism. Contemporary Psychoanalysis, 22, 107-132.
Part Two
Seminar Leaders for Seminars 5-8: M Mitchell & K Dougherty
Shifts from Classical Analysis to Self-Psychology
These next four seminars will discuss key concepts of Self-Psychology derived from Heinz Kohut focusing on: 1] the relationship between mode of observation to theory and 2] the centrality of introspection and empathy in Self-Psychology as essential factors in therapeutic change. The core theoretical approach in Self-Psychology utilizes this observational method through introspection [in oneself] and empathy in one’s clients [vicarious introspection]
Introspection: [1677] derived from Latin: introspicere: to look into, esp. with the mind, the action of looking within one’s own mind. OED. Oxford Univ. Press. (1955)
Empathy: rendering of G. einfühlung (ein-in +fuhlung feeling, the power of projecting one’s personality into, and fully understanding the object of contemplation. OED (1955)
Selfobject [selfobject function]: A selfobject is neither self nor object, but the subjective aspects of a self-sustaining function performed by a relationship of self to objects who by their presence or activity evoke and maintain the self and the experience of selfhood. As such, the selfobject relationship refers to an intrapsychic experience and does not describe the interpersonal relationship between the self and other objects. [Wolf, E. 1988, Treating the Self: Elements of Clinical Self Psychology, Guilford Press, p. 182 for further detailed references see: Akhtar, S. on selfobject and self psychology p259; In: Comprehensive Dictionary of Psychoanalysis: Karnac Books, London 2009]
Seminar 5
The fundamental position in Self Psychology: After the initial theoretical presentation, a case will be discussed using Self Psychology using either a relevant current clinical case or the clinical case of Gayle in the supplementary readings.
Required Reading
Kohut, H. (1959). Introspection, empathy, and psychoanalysis – an examination of the relationship between mode of observation and theory. Journal of the American Psychoanalytic Association, 7, 459-483.
Supplementary Readings
Bacal H., Newman, J.M., and Kohut, H. (1990). In Object Relations to Self Psychology, (pp. 223-283).
Baker, H.S. and Baker, M.N., (1987). Heinz Kohut’s Self Psychology: An Overview. American Journal of Psychiatry, 144(1), 1-9.
Ipp, H.R. (2001). The case of Gayle: Progress in self psychology: A clinical account of self-psychological analysis with a narcissistic personality. International Association for Psychoanalytic Self Psychology, 17, 47-56.
Doctors, S.R. (2001). Clinical notes on the self-psychological/intersubjective “contextualization of narcissism”: A discussion of Hazel Ipp’s clinical case. Progress in Self Psychology, 17, 65-71.
Seminar 6
How does the clinician observe and listen attentively to the analysand? Here we review Kohut’s pivotal clinical paper which suggests that self-psychology may offer an alternate and therapeutically more effective perspective to a classical psychoanalytic approach. We will discuss the clinical material in Kohut’s case and compare it with another case.
Required Reading
Kohut, H. (1979). The two analyses of Mr. Z. International Journal of Psychoanalysis, 60, 3-27.
Supplementary Readings
Stolorow, R. and Atwood, G. (1987). Affects and self objects. In Psychoanalytic Treatment: An Intersubjective Approach, (pp.66-87). Hillsdale, NJ: The Analytic Press.
Schwaber, E. (1990). Interpretation and the therapeutic action of psychoanalysis. International Journal of Psychoanalysis, 71, 229-240.
Seminar 7
What is the intersubjective vision of psychoanalysis and psychotherapy? Marian Tolpin discusses an alternate version of Freud’s case of Anna O from a self-psychological perspective.
Required Reading
Tolpin, M. (2010). The un-mirrored self, compensatory structure, and cure: The exemplary case of Anna O. In B. Magid (Ed.) Freud`s Case Studies, Self-Psychological Perspectives (pp. 87-106). Hillsdale, NJ: Analytic Press.
Supplementary Reading
Bromberg, P. (1992). The difficult patient or the difficult dyad? – Some basic issues. Contemporary Psychoanalysis, 28, 495-502.
Brandschaft B., Doctors, S, and Sorter, D. (2010). Chapter 2. In Towards an Emancipatory Psychoanalysis: Brandschaft’s Intersubjective Vision (pp. 9-27). New York, NY: Routledge.
Fernando, J. (1998). The etiology of narcissistic personality disorder. Psychoanalytic Study of the Child, 53, 141-158. (An excellent theoretical paper from a modern Freudian perspective).
Kernberg, P. (1971). The course of the analysis of a narcissistic personality with hysterical and compulsive features. Journal of the American Psychoanalytic Association, 19, 451-471. (An earlier excellent clinical paper taken from an ego-psychological perspective, to be read as a comparison to self-psychological perspectives).
Seminar 8
Analytic third, intersubjectivity, the relational in clinical work.
How does the analyst recognize and relate to his/her own subjectivity and [narcissistic] failure in psychoanalysis, in order to repair the analytic relationship.
Required Reading
Frankel, S. A. (1997). The analyst’s role in the disruption and repair sequence in psychoanalysis. Contemporary Psychoanalysis, 33, 71-87.
Supplementary Readings
Mitchell, S.A. (1986). The wings of Icarus – Illusion and the problem of narcissism. Contemporary Psychoanalysis, 22, 107-132.
Ogden, T.H. (2004). The analytic third: Implications for psychoanalytic theory and technique. Psychoanalytic Quarterly, 73, 167-195.
Benjamin, J. (2009). A relational psychoanalysis perspective on the necessity of acknowledging failure in or to restore the facilitating and containing features of the intersubjective relationship (the shared third). International Journal of Psychoanalysis, 90, 441-460.