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15
Nov 25th Discussion: Psychoanalytic Diagnosis by Nancy McWilliams
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This week's discussion will include the following chapters from Psychoanalytic Diagnosis:

November 25th

  • Part II Introduction (151-155)
  • Chapter 7: Psychopathic (Antisocial) Personalities (157-175)
  • Chapter 8: Narcissistic Personalities (176-195)

Readings for next week: 

December 2nd

  • Chapter 9: Schizoid Personalities (196-213)
  • Chapter 10: Paranoid Personalities (214-234)

Podcast episode on Spotify, Apple, or elsewhere (search sick lit girl)

Discussion Questions:

  1. Did reading about psychopathic or narcissistic personalities change how you thought about them compared to how they are discussed in pop culture? Were you able to identify yourself or others in them?
  2. As McWilliams states, "it can be disastrous... to misunderstand a hysterical woman as fundamentally narcissistic, or a narcissistic man as essentially obsessive, or a person with pervasive dissociation as schizophrenic. And yet all of these mistakes are made all the time because the DSM checklist approach to diagnosis lends itself to such errors" (p. 153). How do you understand psychoanalytic diagnosis after reading these chapters, especially in light of the above quote? Has it shaped how you now see the DSM and a lot of contemporary psychological thinking?
  3. How did you feel about how psychopathic and narcissistic personalities were portrayed, including the therapeutic responses to them?

Please feel free to ask your own questions as well in the comments!

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Please don't sever the relationship and keep going! Very glad to hear that you're in analysis. Thanks for sharing your thoughts.

Psychopathic personalities are not particularly treatable, as it's really more about trying to convince them that behaving in a socially appropriate way (eg. sublimating) is going to be beneficial for them. I haven't worked with these clients (and would not, as it requires a very particular therapeutic style) though I do talk about my experiences with narcissistic clients on the podcast ep.

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