Appalachian Psychoanalytic Society
a local chapter of the Division 39 of the American Psychological Association
presents a
Fall Conference
with
Nancy McWilliams, PhD,
and Michael Garrett, MD,
on
Helping Patients with Nonpsychotic
and Psychotic Paranoid Conditions
Click here for Dr. McWilliams' slides on Rethinking Madness.
Click here for Dr. McWilliams' slides on
Helping Patients with Nonpsychotic and Psychotic Paranoid Conditions.
Click here for Dr. Garrett's slides on Psychotherapy for Psychosis.
Saturday, November 2, 2019
8:30am - 4:30pm
University of Tennessee Medical Center
Wood Auditorium (note location)
1924 Alcoa Highway
Knoxville, Tennessee 37920
Click here for directions to venue.
Description of Program
The term “paranoia,” whose roots suggest "a mind outside itself," refers to states in which a person finds it hard to distinguish what is inside from what is outside the self. Although DSM criteria for diagnosing paranoia involve externally observable traits such as suspiciousness, this program construes paranoia as an intrapsychic process marked by disavowal and projection, often related to inadequate psychological separation from caregivers to whom the paranoid person was anxiously attached. Although most visible in patients with psychosis, paranoid states of mind are common in others. Dr. McWilliams will review theory and research on paranoia and will make related recommendations for therapists working with paranoid patients. Dr. Garrett will review theoretical, empirical, and clinical work on psychotherapy with psychotic paranoid patients, emphasizing the integration of CBT approaches with psychodynamic understanding.
Presenters
Nancy McWilliams, PhD, teaches at Rutgers University’s Graduate School of Applied & Professional Psychology and has a private practice in Lambertville, NJ. She is author of Psychoanalytic Diagnosis (1994; rev. ed. 2011), Psychoanalytic Case Formulation (1999), and Psychoanalytic Psychotherapy (2004), all with Guilford Press, and is Associate Editor of the Psychodynamic Diagnostic Manual (2006; 2nd ed. 2017). A former president of the Division of Psychoanalysis (39) of the American Psychological Association, she is affiliated with the National Psychological Association for Psychoanalysis and the Center for Psychotherapy and Psychoanalysis of New Jersey. She is featured in three APA videos of “master clinicians,” the latest being a remake of the classic film, “Three Approaches to Psychotherapy.” Dr. McWilliams is an honorary member of the American Psychoanalytic Association, the Moscow Psychoanalytic Society, the Institute for Psychoanalytic Psychotherapy of Turin, Italy, and the Warsaw Scientific Association for Psychodynamic Psychotherapy. Her writings have been translated into twenty languages.
Michael Garrett, MD, is Professor of Clinical Psychiatry and Director of Psychotherapy Education at SUNY Downstate Medical Center in Brooklyn and teaches at the Institute for Psychoanalytic Education, affiliated with NYU Medical Center. He is author of Psychotherapy for Psychosis: Integrating Cognitive-Behavioral and Psychodynamic Treatment (Guilford, 2019). Most of his professional career has been spent in public psychiatry, first at North Central Bronx Hospital, where he became Medical Director in 1995, then at Bellevue, where he was Deputy Director, responsible for clinical services, until 2003, when he became Vice Chairman for Clinical Services at SUNY Downstate. His time is divided among patient care, supervision of psychotherapy, teaching, and clinical research. He has an abiding concern for the problems clinicians confront when trying to develop relationships with psychotic individuals who have a fundamentally different view of reality than that of the therapist. Trained in both psychoanalysis and CBT for psychosis, he combines these approaches in treating psychotic patients.
Schedule
8:30am Registration and Continental Breakfast
8:50am Welcome and Introduction
9:00am Nancy McWilliams: Paranoia and the continuum of personality and psychopathology
*The value and rationale for thinking dimensionally about psychopathology and personality
*Historical context: From Kraepelin to dimensional diagnosis to the neo-Kraepelinian DSM to the dimensional PDM
*Some psychopathologies with a paranoid and/or psychotic version
*Personality at the psychotic end of the health-to-illness continuum
*Empirical evidence for a severity dimension
*Problems for "evidence-based" practice
*General implications for psychotherapy
10:30am Break
10:45am Michael Garrett: Melanie Klein and psychoanalytic object relations theory
*The paranoid-schizoid position
*Persecutory psychological objects
*The depressive position
*Internal objects and story narratives
*The fable of "The Fox and the Grapes"
*Internal objects in ordinary mental life
*Clinical examples:
1. non-psychotic: Charity, who believed her boyfriend might murder her
2. near psychotic: Melissa, who believed that two men were the same person
3. psychotic: Amy, who believed that her cat planned to murder her
12:15pm Lunch
Participants will have the option to purchase a catered lunch or dine "on your own.” Catered lunches will be ordered from Tropical Smoothie Cafe and will be delivered to the venue in time for the 12:15pm break.
Catered lunch will consist of assorted wraps and sandwiches, chips, fruit and iced tea. There is a vegetarian option.
For those interested in lunch "on your own," Morrison’s Cafeteria will be open or you may "brown bag" a meal.
Registrants interested in catered lunch MUST order lunch at the time of registration; the $15 cost of lunch will be added to the total registration cost. The catered lunch option is NOT AVAILABLE for registrations after October 28, 2019.
A section of the cafeteria will be designated for APS participants to eat as a group.
As always, APS graduate student members will supply coffee and snacks throughout the day. Contributions to GSAF are greatly appreciated.
1:15pm Nancy McWilliams: Non-psychotic paranoia and paranoid personality disorders
*Psychodynamics of paranoia subtypes: persecutory paranoia, paranoid hatred, erotomania, paranoid jealousy, megalomania
*Etiologies of paranoia
*Case material
*Treatment implications: What not to do
*Treatment implications: What to do
2:45pm Break
3:00pm Michael Garrett: Persecutory objects in paranoia; treatment of psychosis
*Phenomenology of psychosis
*Psychotherapy of psychosis: combining CBTp and psychodynamic treatment
*The case of Ariel
*Other patient examples (as time allows)
4:30pm Complete Evaluations and Adjourn.
Learning Objectives
After attending this intermediate-level program in full, participants will be able to:
1. Describe the more familiar persecutory paranoid dynamics (projection and denial of anger) as well as those involving projection and disavowal of other feelings (e.g., erotomania, paranoid jealousy, megalomania, paranoid hatred).
2. Summarize the suspected etiologies of paranoid dynamics.
3. Describe the relationship between paranoid thinking and inferred early modes of normal cognition.
4. Avoid therapeutic attitudes that have been found to threaten paranoid patients (e.g., excessive sympathy, efforts to be neutral or abstinent to a degree that strikes the patient as inauthentic, efforts to prove one's goodness).
5. Convey attitudes that allow paranoid patients to elaborate their experience and reduce the shame that underlies paranoid adaptations (e.g., unwavering respect, ruthless honesty, clarity about boundaries, acknowledgement of the grain of truth in projections).
6. Demonstrate skills in psychotherapeutic approaches to the treatment of patients with schizophrenic disorders, based on research from both CBT and psychodynamic perspectives.
Participants
This program is open to all APS members and other interested mental health professionals who may not be members. It is not limited to individuals practicing in a predominately psychoanalytic mode. The material will be appropriate for clinicians with intermediate levels of experience and knowledge.
Registration Fees and Policies
BY October 28, 2019:
Members and Scholars: $90
Non-members: $125
Early-Career Professional Members: $45
Graduate Student Members: $10
AFTER October 28, 2019 and at the door:
Members and Scholars: $105
Non-members: $140
Early-Career Professional Members: $60
Graduate Student Members: $25.
Online registration will close on November 1, 2019.
Although walk-ins will be accepted, please register online at www.aps-tn.wildapricot.org in advance to assure adequate food and seating.
If you prefer to pay by check, please print the Conference Registration form, and mail with your payment to:
Scott Swan, PhD
APS Treasurer
1005 Kenesaw Avenue
Knoxville, TN 37919.
Refunds honored with written/electronic notice at least 24 hours before date of conference. Contact Scott Swan, PhD.
Contact the APS President Joyce Cartor, PhD to negotiate fees, if needed.
Facility is accessible to persons who are physically challenged. If participants have special needs, we will attempt to accommodate them. Please address requests, questions, concerns and any complaints to Joyce Cartor, PhD.
APS Membership
Eligible professionals can join APS or renew their membership for the 2019-2020 program year for $80. Scholars can join/renew for $50 and Early-Career Professionals can join/renew for $45. Graduate students may join or renew for $25.
American Psychological Association Approval Statement
Division 39 is approved by the American Psychological Association to sponsor continuing education for psychologists. Division 39 maintains responsibility for this program and its content.
Continuing Education
This program, when attended in its entirety, is available for 6 continuing education credits. With full attendance and completion of a program Evaluation and Learning Assessment, a certificate will be issued. Psychologists will have their participation registered through Division 39.
APS and Division 39 are committed to conducting all activities in conformity with the American Psychological Association’s Ethical Principles for Psychologists. APS and Division 39 are also committed to accessibility and non-discrimination in continuing education activities. Participants are asked to be aware of the need for privacy and confidentiality throughout the program. If program content becomes stressful, participants are encouraged to process these feelings during discussion periods.
Selected References/Recommended Reading
Garrett, M. (2019). Psychotherapy for psychosis: Integrating cognitive-behavioral and psychodynamic treatment. New York, NJ: Guilford.
Garrett, M. (2017). Individual psychodynamic psychotherapy and cognitive-behavioral therapy for psychosis. In B. Sadock, V. Sadock & P. Ruiz (Eds.), Kaplan and Sadock’s comprehensive textbook of psychiatry 10th Ed. (pp. 2866-2886). Philadelphia, PA: Wolters Kluwer.
Korver-Nieberg, N., Berry, K., Meijer, C. J., & de Haan, L. (2014). Adult attachment and psychotic phenomenology in clinical and non-clinical samples: a systematic review. Psychology and Psychotherapy, 87 (2), 127-154. doi: 10.1111/papt.12010
Lingiardi, V., & McWilliams, N. (2017). Psychodynamic Diagnostic Manual, 2nd ed. (PDM-2)(pp. 48-49, 139-154). New York: Guilford Press.
Marcus, E. (2017). Psychosis and Near Psychosis, 3rd Edition. New York: Routledge.
Norcross, J. C., & Wampold, B. E. (2018). A new therapy for each patient: Evidence-based relationships and responsiveness. Journal of Clinical Psychology, 74(11), 1889 – 1906. doi: 10.1002/jclp.22678
Contact
If participants have special needs, we will attempt to accommodate them. Please address requests, questions, concerns and any complaints to the APS President Joyce Cartor, PhD.
There is no commercial support for this program nor are there any relationships between Division 39, APS, presenter, program content, research, grants or other funding sources that could reasonably be construed as conflicts of interest. During the program, the validity/utility of the content and risks/limitations of the approaches discussed will be addressed.