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301 Narcissism – 8 seminars

Seminar Leaders: Ron Ruskin, Don Carveth, Charles Hanly, Jack Kohl, and Gary Taerk

Course Description

This three-part course focuses on clinical theories of narcissism derived from Freud, Klein, post-Kleinians, Kernberg, Kohut and contemporary self-psychologists/inter-subjectivists.

Part One of this series of seminars traces the history of narcissism in psychoanalysis from the seminal writings of Freud. In Part Two, the relevance of Kleinian and post-Kleinian theorists with Rosenfeld and Kernberg’s work on pathological narcissism will be addressed. In Part Three, 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. Clinical material will be a central feature in each seminar, linking theories of narcissism to psychoanalytic work. Symptom-formation, character-neurosis, therapeutic alliance, resistance, transference and counter-transference, fantasy, dream, and therapeutic action, will be reviewed from the perspective of narcissism. 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:

  1. (1a) a 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 with theoretical and clinical discussions of psychopathy
  2. (1.3c) explore/discuss clinical material in each seminar to review (1.d) major diagnostic categories applied to theory of change based on (1.2f) and (1.2g) psychological development where conflict and relational disruptions require (3.4a,b,c,d) critical self-reflection in the therapeutic process implementing appropriate interventions for psychoanalytic treatment.
  3. 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

Seminal 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, narcissism and masturbation, 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.

Supplementary Readings

Freud, S. (1924), Neurosis and psychosis. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 19, 149-153.

(1924), The loss of reality in neurosis and psychosis. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 19, 183-187.

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.

(1992), On narcissistic defenses. Psychoanalytic Study of the Child, 47, 139-57.

Seminar 2

Reflections on narcissistic and sexual libido based on clinical material.

Required Readings

McDougall, J. (1982). The narcissistic economy and its relation to primitive sexuality.  Contemporary Psychoanalysis, 18, 373-396.

Supplementary Readings

Chasseguet-Smirgel, J. (1984). Narcissism and perversion. In Creativity and Perversion. London: Free Association Books.

Part Two

Shifts from Classical Analysis to 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 narcissists. As a clinical paper by Kernberg is included elsewhere in this course, his integration of Kleinian and Freudian ego psychology is briefly addressed.

Seminar 3

Required Readings

Rosenfeld, H. (1964). On the psychopathology of narcissism: a clinical approach.  International Journal Of Psychoanalysis, 45, 332-337.

Supplementary Readings

Klein, M. (1952). The origins of transference.  International Journal of Psychoanalysis, 53, 433-438.

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.

Supplementary Reading

Kernberg, O.F. (2014). An overview of the treatment of severe narcissistic pathology.  International Journal of Psychoanalysis, 95, 865-888.

Part Three

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.

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