Personality disordered patients pose a unique challenge to any therapy and in this category the narcissistic patient is amongst the most difficult to engage. Their demanding interpersonal style often threatens the therapeutic alliance thus endangering the most effective factor in the treatment process. Therefore, treatments of these clients often fail. The intention of the workshop is to offer clinicians therapeutic tools to navigate these challenges better by drawing on the wealth of recent developments in treatments of personality disorders (PD) and integrating these advances to the specific pathology of the narcissistic client.

Outline:

Understanding the narcissistic pathology: This part will be concerned with a general understanding of difficulties in the treatment of PD and NPD, which stems from issues like their ego-syntonic nature, motivational aspects and issues that result from the pathological character and their implications for treatment. Further we will take a look at the developmental aspects of NPD and aetiology, taking into account attachment theory, developmental psychology, and theories of narcissism that range from psychodynamic conceptualizations (e.g. Kohut, Kernberg Transference Focused Therapy) to modern CBT developments (like Schema Therapy). The aim is an integration of these different sources of knowledge, in order to help gain a deeper theoretical understanding.

Diagnostic Considerations of Personality Disorder and NPD: Common difficulties in assessing NPD that rely on self-reporting are discussed and other ways of assessing pathological divergence are introduced. Subtypes of the NPD (e.g. grandiose and vulnerable types) are introduced to capture the different presentations that NPD can take on. Questions of classification vs. a dimensional approach are explored and ways to correlate this to the NZ “mild-moderate” and “moderate-severe” stepped care are introduced. Differential diagnostic aspects are discussed as well as tools to guide clinical diagnosis. Changes in the diagnostic manuals and their implications will also be considered (DSM-5 and ICD 11).

Treatment of NPD: We will start by exploring different ways to conceptualize the pathological patterns with the client. For each treatment phase (initial contact, the change process and ending therapy) the unique challenges and possible solutions will be discussed. Key strategies of interventions will be modelled and practiced. The specific utilisation of the therapeutic alliance to bring about an interpersonal corrective experience will be demonstrated. We will look at how to deal with narcissistic blows as well as at emotion focused interventions that aim to stabilize the self-worth dysregulation. While we will go through much “hands-on” demonstrations during this part we will always return to the prior theoretical discussion to guide the clinical work, so that participants can gain a deeper understanding of how change in the NPD actually comes about. You don’t just end up with a “magical” bag of tricks but with a sound understanding why these actually do the “trick”.

Intention of the Workshop:

Build a solid understanding of the narcissistic disordered client and their suffering. Provide knowledge of treatment options and give “hands on” solutions for typical problems. Build therapist confidence and create a degree of excitement in working with these clients

Presenter:

Tobias Schulze, Clinical Psychologist: I received post graduate training in CBT and was licensed as psychological psychotherapist in Germany. Working many years in MH inpatient units I have developed a focus in my work on treating Personality Disorders and specifically on Narcissistic PD, as well as recurrent and chronic mental health conditions. I work from an integrative perspective combining Schema Therapy, ACT and psychodynamic understanding.

Registration:

Venue: Hawke’s Bay Club, 53 Marine Parade, Napier 4110

Times: 9 am to 5 pm on both days

Catering: full catering provided (morning lunch, tea) for all dietary needs

Fee: $365 - early bird available until 31st of March, after that $425. Credit card payments possible but will incur a $15 surcharge.

Registration: Please register at talktherapy.co.nz, your registration will only be final once the full fee has been received. All cancellations 30 days or less before the event cannot be reimbursed, but you are free to transfer your spot to a person of your choice.