Listening with Purpose

Entry Points into Shame and Narcissistic Vulnerability

Jack Danielian and Patricia Gianotti

This manual has been written for a wide range of dynamic practitioners involved in treating patients with narcissistically-infused issues. The treatment model and case material presented in Listening with Purpose cover the spectrum of narcissistic vulnerability and may be applied to the relatively intact patient as well as to the relatively impaired patient. Throughout, it refers to issues of narcissistic vulnerability, from a perspective that assumes narcissistic mechanisms are implicated in all levels of personality functioning and in all people. They exist both in therapists and clients differing only in the level of prominence and degree of disturbance in the personality.

Cutting across several schools of thought, this treatment manual places shame and its derivatives at the very center of narcissistic vulnerabilities, vulnerabilities which create character splits and dissociative phenomena in their wake.

One can wonder if therapists have avoided looking at shame because of its contagious qualities. Human experience has demonstrated that shame is a ubiquitous emotion, yet when individuals encounter shame it places them in a seemingly paradoxical position which looks much like a dissociated limbo state with no way out. We experience it and yet don’t experience it, we see it and don’t see it, we feel it and don’t feel it.

Therapists and mental health professionals cannot adequately treat unexamined shame from within its core unless he or she finds a compatible language for the theory that informs the interventions. In particular, the theory cannot replicate pre-existing splits embedded within a treatment paradigm and cannot be weighted with theoretical underpinnings that are distancing, objectifying, or removed.

The authors have proposed instead an innovative paradigm-shifting model that is very explicit in recommending an experience-near, moment-to-moment immersion in the conflicted and often disoriented life of patients. Unlike existing volumes in the field, Listening with Purpose: Entry Points into Shame and Narcissistic Vulnerability is by design replete with copious down-to-earth examples to help guide one’s systemic shift in treatment focus, treatment emphasis, and treatment posture. The shift involves healing on many levels and opens up for re-examination and re-assessment heretofore difficult-to-treat cases of trauma, dissociation, character disturbances, and addictive disorders.

Jason Aronson, Inc.

Pages: 366 • Trim: 6⅜ x 9½

978-0-7657-0878-6 • Hardback • April 2012 • $143.00 • (£110.00)

978-0-7657-1021-5 • Paperback • December 2013 • $60.00 • (£46.00)

Subjects: Psychology / Psychotherapy / Counseling, Psychology / General, Psychology / Clinical Psychology, Psychology / Psychotherapy / General, Psychology / Research & Methodology, Psychology / Consultation

Listening with Purpose

Entry Points into Shame and Narcissistic Vulnerability

Hardback

Paperback

Summary

This manual has been written for a wide range of dynamic practitioners involved in treating patients with narcissistically-infused issues. The treatment model and case material presented in Listening with Purpose cover the spectrum of narcissistic vulnerability and may be applied to the relatively intact patient as well as to the relatively impaired patient. Throughout, it refers to issues of narcissistic vulnerability, from a perspective that assumes narcissistic mechanisms are implicated in all levels of personality functioning and in all people. They exist both in therapists and clients differing only in the level of prominence and degree of disturbance in the personality.

Cutting across several schools of thought, this treatment manual places shame and its derivatives at the very center of narcissistic vulnerabilities, vulnerabilities which create character splits and dissociative phenomena in their wake.

One can wonder if therapists have avoided looking at shame because of its contagious qualities. Human experience has demonstrated that shame is a ubiquitous emotion, yet when individuals encounter shame it places them in a seemingly paradoxical position which looks much like a dissociated limbo state with no way out. We experience it and yet don’t experience it, we see it and don’t see it, we feel it and don’t feel it.

Therapists and mental health professionals cannot adequately treat unexamined shame from within its core unless he or she finds a compatible language for the theory that informs the interventions. In particular, the theory cannot replicate pre-existing splits embedded within a treatment paradigm and cannot be weighted with theoretical underpinnings that are distancing, objectifying, or removed.

The authors have proposed instead an innovative paradigm-shifting model that is very explicit in recommending an experience-near, moment-to-moment immersion in the conflicted and often disoriented life of patients. Unlike existing volumes in the field, Listening with Purpose: Entry Points into Shame and Narcissistic Vulnerability is by design replete with copious down-to-earth examples to help guide one’s systemic shift in treatment focus, treatment emphasis, and treatment posture. The shift involves healing on many levels and opens up for re-examination and re-assessment heretofore difficult-to-treat cases of trauma, dissociation, character disturbances, and addictive disorders.

Details

Jason Aronson, Inc.

Pages: 366 • Trim: 6⅜ x 9½

978-0-7657-0878-6 • Hardback • April 2012 • $143.00 • (£110.00)

978-0-7657-1021-5 • Paperback • December 2013 • $60.00 • (£46.00)

Subjects: Psychology / Psychotherapy / Counseling, Psychology / General, Psychology / Clinical Psychology, Psychology / Psychotherapy / General, Psychology / Research & Methodology, Psychology / Consultation

Author

Jack Danielian, PhD, is a licensed psychologist, supervisor, and Dean of the American Institute of Psychoanalysis of the Karen Horney Center. He is a training and supervising analyst and on the faculty of the Institute. Dr. Danielian has lectured internationally and nationally on psychoanalytic issues, intercultural communication, and intergenerational effects of genocide. He is the author of numerous professional publications and is a contributing author to several books. He and his wife live in Exeter, NH.

Patricia Gianotti, PsyD, is a licensed psychologist, clinical supervisor, and a founding member and managing partner with Woodland Professional Associates, a group private practice in North Hampton, NH. Dr. Gianotti is a seasoned lecturer and facilitator and has taught at Washington University and the University of New Hampshire. She has presented at various professional conferences, including Division 39 of the APA. Her most recent publication appeared in The American Journal of Psychoanalysis. She lives in North Hampton, NH with her husband, Stephen.

Table of Contents

Table of Contents
List of Figures
Preface
Chapter 1: Fundamental Principles of Therapeutic Listening
Chapter 2: An Overview of the Therapeutic Model
Chapter 3: Compulsive Resolutions: Idealization, Loyalty, & Revenge Enactments
Chapter 4: Resonating Between Part and Whole: Therapeutic Systemics
Chapter 5: The Four Quadrants & Part-Whole: Uncovering Dominant Solutions
Chapter 6: Shame, Splitting, & Trauma: Vicious Cycles
Chapter 7: Trauma: The Violation of Self
Chapter 8: Re-imagining Transference: An Update
Chapter 9: Loyal Waiting Unpacked
Chapter 10: Consolidation of Gains
Bibliography
Index
About the Authors

Reviews

Listening with Purpose is a superb training manual for practitioners, students, and trainees in the field of dynamic psychotherapy. In presenting and richly illustrating an experience-near, intersubjective perspective on the therapeutic process, the authors succeed admirably in their effort to close the gap between therapeutic theory and therapeutic practice. Their emphasis on phenomenological inquiry into the interacting subjective worlds of patient and therapist, with a sensitivity to the shame-proneness and emotional vulnerabilities of both participants, will be of great value to therapists at all levels of professional experience.
— Robert D. Stolorow, Ph.D., author, Trauma and Human Existence

For years, the contributions of Karen Horney, and her prescient anticipation of much in the contemporary relational point of view, have been largely unrecognized or unappreciated. With the publication of this very valuable book, that should no longer be the case. Danielian and Gianotti illuminate the role of shame, dissociation, problematic characterological solutions, and integrative, experience-near theory with admirable clarity and clinical relevance. This is a wonderful teaching tool both for beginners and seasoned practitioners.
— Paul L. Wachtel, distinguished professor of psychology, City University of New York at City College

Danielian and Gianotti offer this book as an antidote and means to stimulate growth, competency, and therapeutic optimism. In an era of rationed treatment emphasizing quick fixes, the authors provide a liberating and enabling model for internal repair and integration. Their book helpfully holds the reader to the tension of integrating “objective theory and subjective experience of our work.” The focus on shame and narcissistic vulnerability provides valuable insights and tools to address the range of characterologic problems and symptoms with which our patients suffer. Listening with Purpose will be of great benefit for trainees and early career clinicians as well as seasoned therapists.
— Edward J. Khantzian M.D., Harvard Medical School; associate chief of psychiatry emeritus, Tewksbury Hospital

Few contemporary writers have tackled clinical work with shame and its vicissitudes as thoroughly as Jack Danielian and Patricia Gianotti in their new book, Listening with Purpose. ... They saw a need for a training manual that helps clinicians move beyond quick fixes by deepening their understanding of how psychodynamic therapy works in a way that can be applied to a variety of treatment approaches. The result is a well-written book that illuminates the interplay of shame, narcissistic vulnerability and dissociation. ... The tone of the book captures the warm and collegial manner of two senior clinicians eager to share their wisdom with a broad audience. THe writing is clear and. . . concepts are well-defined. This [is a] highly recommended work.
— New England Psychologist