Working with Individuals with Schizoid and Paranoid Dynamics

Nancy McWilliams, Ph.D.,

Dr. McWilliams will explore the personality organization, affective experience, defenses, conflicts, and organizing cognitions of individuals with schizoid and paranoid dynamics, respectively, emphasizing the continuum of severity from high-functioning to psychotically troubled in each kind of psychology. In summarizing psychoanalytic conceptions of schizoid and paranoid dynamics, she will compare and contrast this inferential, contextual and dimensional understanding with the trait-based, descriptive diagnoses available in the DSM, focusing on the clinical implications of such a conceptualization. She will present in detail her own treatment of a deeply schizoid woman and give clinical vignettes of patients she has worked with who have suffered from paranoid tendencies.

Objectives: Upon completion of this workshop, participants will be able to: l Infer the presence of paranoia from the themes and defenses evident in the patient’s story, not simply from traits like suspiciousness and distrust; l Identify not only the familiar persecutory paranoid psychology but also less familiar paranoid syndromes, including erotomania, paranoid jealousy, megalomania, and paranoid hatred; l Differentiate the psychoanalytic conception of schizoid dynamics from the DSM description of schizoid personality disorder; l Summarize the suspected etiologies of both schizoid and paranoid dynamics; l Identify countertransference reactions that commonly occur with each orientation; l Conceptualize and implement two or more clinical attitudes/interventions appropriate for individuals with schizoid psychologies and two or more that are more specifically helpful with patients with significant paranoia.

Nancy McWilliams, Ph.D., ABPP, is Emerita Visiting Professor at Rutgers University's Graduate School of Applied & Professional Psychology. She is the author of Psychoanalytic Diagnosis, Psychoanalytic Case Formulation; and Psychoanalytic Psychotherapy, and Psychoanalytic Supervision. She is Associate Editor of the Psychodynamic Diagnostic Manual. She is a former president of the Division of Psychoanalysis (39) of the American Psychological Association and is on the editorial board of Psychoanalytic Psychology.

Dr. McWilliams is the recipient of many awards including the Gradiva Award for Best Psychoanalytic Clinical Book; the Goethe Scholarship Award; the Rosalee Weiss Award for contributions to practice; the Laughlin Distinguished Teacher Award; the Hans Strupp Award for teaching, practice, and writing; and the Division 39 awards for both Leadership and Scholarship.

Dr. McWilliams specializes in psychoanalytic psychotherapy and supervision; the relationship between psychodiagnosis and treatment; alternatives to DSM5 diagnostic conventions; integration of feminist theory and psychoanalytic knowledge; the application of psychoanalytic understanding to the problems of diverse clinical populations; altruism; narcissism, and trauma and dissociative disorders.

Dr. McWilliams is an honorary member of the American Psychoanalytic Association and a member of the Board of Trustees of the Austen Riggs Center in Stockbridge, MA. Her writings are available in 20 languages.

8:30 a.m.–8:45 a.m.