The Narcissistic Dilemma: A Perspective from Relational and Integrative Psychotherapy: Video Course

The Narcissistic process may be based on a client’s low self-esteem and incessant hunger for validation, which is often masked by excessively intense pseudo-vitality. Similarly, a client who presents as timid, ineffective and powerless may actually have a split-off image that is grandiose, powerful and erotic. How do we work effectively with such presentations?

The dynamics of transference meanwhile add to our challenges:

• We may have a client who sees himself or herself as all-important and requires us, as therapists, to reflect-back that importance, or
• We may have a client who wants to be in the presence of someone powerful, or
• The client may want to do, or even to be, the same as the other person, or
• Our client may be defining or herself through criticism, dissension or antagonism

At this workshop, we first distinguish between a narcissistic style, pattern and a personality disorder. We also discuss the closet narcissist – the client who is covertly self-centred while acting shy, timid and ineffective. Using case studies and examples, Dr Erskine explains the aetiology, intra-psychic conflicts and the relational methods necessary in an effective psychotherapy of clients with narcissistic manifestations.

Drawing on object relations and integrative approaches, we look at four transferential processes in detail, considering the practical implications for therapy in each case:

• Mirroring Transference
• Idealizing Transference
• Twinship Transference and
• Adversarial Transference

We then consider the role of narcissistic fantasies and evaluate how such fantasies constitute Narcissistic- Moments that may be filled with a lot of emotional energy.

The workshop explains the implications for therapeutic interactions, in light of such narcissistic dynamics, processes and fantasies – with a view to explaining how a therapeutic cure may not be attributable to insight or interpretation, but instead to, the quality of involvement that emphatically responds to both the client’s current and archaic relational needs.

About the speaker

Richard G. Erskine, Ph.D., is a Clinical Psychologist and Training Director of the Institute for Integrative Psychotherapy (New York City and Vancouver).  Originally trained in client-centered child therapy, Dr Erskine also studied Gestalt therapy with both Fritz and Laura Perls.  He is a certified clinical Transactional Analyst and a Licensed Psychoanalyst who has specialized in psychoanalytic self-psychology and object-relations theory.  His work is an integration of these concepts and more than forty years of clinical experience, which has included working with disturbed children, inmates in a maximum security prison, borderline and narcissistic clients, post-traumatic stress and dissociative identity disorders.  Recently his research and clinical practice have focused on the treatment of the schizoid process and on the psychotherapy of obsession.

He is the author of several books and scores of articles on psychotherapy theory and methods.  His best-selling book (with Jan Moursund and Rebecca Trautmann) is Beyond Empathy: A Therapy of Contact-in-Relationship (1999, Brunner/Mazel) and in 2015, he has published Relational Patterns, Therapeutic Presence (Karnac). His latest book Early Affect Confusion: Relational Psychotherapy for the Borderline Client is being released in January 2022 by nscience publishing house.

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