The Continuum of Madness, with Special Attention to Narcissm


Innis Town Hall Theatre, 2 Sussex Ave., Toronto
Saturday, February 23, 2019
Innis Town Hall Theatre, 2 Sussex Ave., Toronto, M5S 1J5
10:00 a.m. – 4:00 p.m.

About The Day
Morning Session:
Rethinking Madness: The Therapeutic Value of a Dimensional Conception of Psychotic Processes
The intentionally “neo-Kraepelinian” orientation (categorical concepts, with present-versus absent criteria) of
the current DSM and ICD taxonomies are in some ways inconsistent with clinical experience. In the DSM, for
example, there are only a limited number of conditions labeled as psychotic. Many diagnosticians and
psychotherapists, in contrast, have viewed psychopathology dimensionally rather than categorically, using
the term “psychotic” in the broader sense of loss of contact with consensual reality. Dr. McWilliams will argue
that there is a psychotic level of many psychological conditions, not merely the schizophrenic illnesses and
psychotic mood disorders. She will emphasize the clinical value of construing psychopathology dimensionally,
with specific implications for the psychotherapy process.
Afternoon Session:
Problematic Versions of Narcissism: Clinical and Social Implications
In contemporary conversations, the term “narcissism” is much in vogue. This talk will review the evolution of
the concept of “pathological narcissism,” especially as it infuses personality structure. It will touch on both the
more arrogant presentations of Narcissistic Personality Disorder (per the DSM) and the extensive literature on
converse versions of narcissistic preoccupation (“covert,” depressed-depleted,” “hypervigilant,” or “closet”
narcissism, as depicted in the 2017 Psychodynamic Diagnostic Manual, 2nd ed. Dr. McWilliams will discuss the
range of narcissism from healthy to seriously disturbed psychologies, putting emphasis on the dangers that
malignant narcissism poses to personal relationships, family connections, workplace and institutional
functioning, and political processes.
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