WORKING WITH LIFE AND DEATH INSTINCTS:
Understanding the Nature and Consequence of Destructive Narcissism
The focus of this class will be on learning to work more effectively with chronically destructive patients. These are patients whose destructive response to opportunities and treatments in their lives often puts them at great risk. While these individuals’ destructiveness expresses itself in a variety of ways – including self-harm, dangerous acting out, and addiction – there is often a common psychic organization underlying these behaviors: a particularly virulent type of pathological narcissism. Therapists often struggle to keep their own balance as they work to understand and reach these patients. The purpose of this class is to introduce clinicians to a theoretical lens that can help them see more clearly into the underlying dynamics expressed in these patients’ dangerous behaviors. Through focused readings and clinical examples, we will explore the delicate equilibrium between life and death instincts as a means of refining and enhancing our clinical capacity with these challenging patients.
- Participants will be able to differentiate fusion and diffusion of life and death instincts in Freud’s thought, so as to facilitate the use of this insight in their clinical work with patients.
- Students will be able to assess the meaning of Rosenfeld’s ideas about the libinization of the death instinct, so to ensure their ability to use this knowledge about the domination of the life instinct in their clinical work with patents.
- Students will be able to utilize Joseph’s main themes of the masochistic pull towards destructive behavior and thinking so as to better be able to differentiate those areas of real suffering from the exploitation of misery which these patients continually try to impose on themselves and their treatments.
- Students will assess the Joseph’s description of the way destructive patients use their supposed thinking (chuntering) to avoid real thinking about their real situation, so as to better be able to apply her ideas to their own clinical work with patients.
- Students will discuss Freud’s idea that all pain comes from living and that the death instinct aims at dissolution of larger units. Through this discussion of the qualities of the death instinct students will create their own perspective of the manifestations of the death instinct so as to better deploy this knowledge in their clinical work.
- Students will compare Segal’s description of the manifestation of the death instinct in repetition-compulsion, sado -masochism and the severity of the melancholic superego with their own clinical experience and assess their own work, through their new thinking about the death instinct, so as to improve their clinical work with patients.
- Students will discuss the clinical consequences of destructive narcissism though clinical examples so as to better utilize these concepts in their clinical work.
- Students will evaluate the nature of destructive narcissism on the object relations between the ego and superego, so as to better apply these insights in their clinical work with patients.
Ellison, W. D, K. N. Levy, N. M. Cain, et al. (2013). The Impact of Pathological Narcissism on Psychotherapy Utilization, Initial Symptom Severity, and Early-Treatment Symptom Change: A Naturalistic Investigation. Journal of Personality Assessment, 95(3), 291–300. doi: 10.1080/00223891.2012.742904.
Robert Bartner, Ph.D., MFT, is a faculty member and personal and supervising psychoanalyst at PINC and adjunct faculty member at SFCP. Dr. Bartner has a private practice in Oakland where he practices psychoanalysis and psychoanalytic psychotherapy with individuals and couples. He teaches widely, provides clinical consultation, and leads private study groups.
This course is for licensed clinicians with moderate to extensive experience. Some background in analytic theory is necessary as is some clinical experience working with narcissistic disorders.
Enrollees who cancel at least SEVEN DAYS prior to the event date will receive a refund minus a $35 administrative charge. No refunds will be allowed after this time. Transfer of registrations are not allowed.
For program related questions contact Morgan Lloyd at morganlloyd.lcsw@gmail.com or 510-852-9013.
For questions related to enrollment, locations, CE credit, special needs, course availability and other administrative issues contact Michele McGuinness by email or 415-496-9949.
Education Committee
The Education Committee is responsible for the development of a variety of courses and workshops given throughout the year in San Francisco and the East Bay.