Background: This presentation will discuss modern psychodynamic and systemic theories when working with the narcissistic patient - including such key concepts as emotional communication, resistances, detachment, and the narcissistic transference. How these ideas interact and how they affect the therapist will be discussed. The presentation will be interactive, didactic and process-oriented.
Course Content Outline:
I. Modern psychodynamic and systemic concepts.
II. Contemporary view of defensive systems.
III. "Emotional conversations" with a narcissitic patient in contrast with cognitive: Rationale and methods.
IV. Theories of Kernberg, Kohut, Spotnitz and Meadow and how they conceptualized complex cases and treatment.
V. Systemic thinking and how it is important in working with the patient and his/her family - including ways to integrate this with dynamic process.
VI. The narcissistic defense and its relevance in understanding the emotionally damaged person.
VII. When therapists feel battered, tortured or worse and think seriously about changing careers.
VIII. Case presentations and discussion
IX. Special techniques and strategies.
X. Integration.
XI. Final discussion, questions and answers.
Proposal Abstract:
This presentation will address narcissism and how it is conceptualized and managed in the treatment of eating disorders and other complex behaviors. The integration of modern psychodynamic theory and technique, with well-established systemic principles, can enhance "the talking cure" and the clinical progress of the patient and his or her family and significant others. Understanding and even grappling with a patient's strong defenses can bring about complex and challenging countertransference responses ... even to the most seasoned clinicians, especially when treatment is protracted or when other interventions are ineffective or at best disappointing.
It is a truism that "talking" is vital to the recovery of the person with an eating disorder. Whether in private outpatient treatment or in an inpatient facility, a person with an eating disorder, with complex personality features, demands different care; and in this case "demands" also means "requires." However, "talking" with such persons also demands different skills, strategies and case conceptualizations - as well as the emotional capacity on the part of the therapist to be able to tolerate the intense feelings and thoughts that may be induced in the work.
Modern psychodynamic theory offers exciting pathways to working with this population of complex patients. Systemic thinking further helps the treatment team to see the patient and his or her history in a broader context. Together they offer a hopeful highway to understanding and working with the patient's resistances to progress and insistance on maintaining the status quo.
This presentation is designed to be interactive and experiential, with didactic material woven into the fabric of the work. Attendees are encouraged to share their own experiences with such complex cases.
Biographical Statement Dr. S. Roy Erlichman is a Certified Eating Disorders Specialist, an Approved IAEDP Supervisor, and has served as president of the board of directors of IAEDP. Currently he is a member of the board of directors and the conference planning and awards committees. Dr. Erlichman graduated from the Philadelphia School of Psychoanalysis and completed training in the Department of Family Psychiatry at Eastern Pennsylvania Psychiatric Institute. He is a member of Phi Beta Kappa and has been noted in Who’s Who In The East, Who’s Who In The South, Who’s Who In The World, and Men of Achievement.
