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Now he worships at an altar of a stagnant pool
And when he sees his reflection, he’s fulfilled
Oh, man is opposed to fair play
He wants it all and he wants it his way.
Bob Dylan: License To Kill
Narcissism has a reputation for being notoriously difficult to engage with in therapy, for a variety of good reasons, not least because the very idea of ‘needing’ therapy is a humiliating insult to the grandiose self. As one of the key modern ‘disturbances of the self’, narcissism has replaced Victorian repression as the psychological disease of the age, which means that the original theories of our discipline from 100 years ago no longer quite apply. As a dominant collective issue, as exhibited by the celebrity culture all over the world and all over the media, the term ‘narcissism’ has entered pop psychology and lost all precision and meaning. In order to be clinically useful, we need to have a clear, circumscribed definition of narcissism, and its origins and manifestations.
Beyond commonplace over-simplifications, the various therapeutic traditions have widely divergent ideas and theories about narcissism, leading to quite contradictory recommendations for therapists. More than many other issues, therefore, narcissism requires an integrative stance, that can draw insights and understanding from the various approaches and combine them, to provide a comprehensive understanding and therapeutic response.
Because the narcissist tries to approximate an image of perfection (attempting to manifest a grandiose self), this leads to a chameleon-like disconnection from the body, and an objectifying, ‘perfecting’ treatment of it. For many celebrities, the body becomes an advertisement of the False Self, treated like one more fashion accessory. More than many other issues, therefore, narcissism calls for an embodied therapy, reconnecting the person to pleasurable, ordinary human reality, rather than pursuing the delusions of a disembodied virtual self.
Because the narcissist was emotionally ‘used’ by their parent(s), their individuality was never fully seen and mirrored. Therefore, in the moment where we apply a generic diagnostic label and put the narcissist into the same category with many others, we are re-inflicting a lack of individual mirroring. More than any other issue, narcissism reveals some of the shadow aspects and weaknesses of our discipline. In order to make therapy possible, we cannot afford to rely on a reasonable and supposedly realistic ego-ego alliance: we need a working alliance both with the wounded, insignificant self as well as the inflated grandiose self.
This course will provide condensed understanding extracted from the various therapeutic approaches, specifically drawing from and integrating the various psychoanalytic, the humanistic-embodied and the Jungian traditions. We will combine the theoretical input with practical, experiential work, based upon vignettes and case illustrations volunteered by participants, to explore how these ideas may be applied in practice.
We will be drawing on the following literature:
- Jacoby, Mario (2013, Reprint edition) Individuation and Narcissism: The Psychology of Self in Jung and Kohut. Routledge.
- Johnson, S. M. (1987) Humanizing the Narcissistic Style. W.W. Norton.
- Johnson, S. M. (1994) Character Styles. W.W. Norton.
- Kohut, H. (2009) The Analysis of the Self: A Systematic Approach to the Psychoanalytic Treatment of Narcissistic Personality Disorders.
- Kohut, H. (2009) The Restoration of the Self.
- Kernberg, O. (1984) Severe Personality Disorders: Psychotherapeutic Strategies. Yale University Press.
- Kernberg, O. (1996) Borderline Conditions and Pathological Narcissism. Jason Aronson.
- Otto Kernberg, On Narcissism: https://www.youtube.com/watch?v=pyP92WLLqIU ; https://www.youtube.com/watch?v=GeVMtZns5Pw
- Lowen, A. (2004) Narcissism: Denial of the True Self. Touchstone.
- Schwartz-Salant, N. (1982) Narcissism and Character Transformation. Inner City Books.
- Shaw, D. (2013) Traumatic Narcissism: Relational Systems of Subjugation. Routledge.
- Twenge, J.M. & Campbell, W.K. (2010) The Narcissism Epidemic: Living in the Age of Entitlement. Free Press.
A comprehensive course for experienced counsellors and psychotherapists
A series of 8 one-day CPD-workshops at Fulcrum House, Bristol, with Michael Soth
The significance of the breath for any kind of psychotherapy which does not exclude the body
In recent attempts to include the body in psychotherapy, the importance of breathing and the breath as one main regulator of the intensity of feeling has been increasingly recognised. If we want to bring the two bodies into the consulting room, we need to not only understand, but learn to actively work with the breath, the client’s and our own, and the connection between them, as part of the emotional, psychological and intersubjective encounter.
In this learning, we can draw from a wide range of different traditions, both Eastern and Western, many explicitly holistic, some psychological and a wide range of complementary therapies and practices, which have been exploring and using the breath, some of them for several decades, some of them for millennia.
Diverse traditions, contradictory principles, a multitude of techniques
One problem with the recent fashion of drawing body-oriented traditions into psychotherapy and appropriating them, is that the differences and contradictions between these traditions get ignored.
We then end up with a smorgasbord of techniques which are all presumed to work towards a common goal, but are actually profoundly contradictory, and end up pulling the process into different directions. The client’s bodymind then feels uncontained, confused, not sure whether it is coming or going.
All the different traditions, of course, each have their wisdoms and gifts, but we cannot arbitrarily mix and match them, even if it is for the valid purpose of including the body.
What are some of the key tensions and contradictions between the different orientations and principles?
Centering versus expression (charge/discharge)
Generally speaking, the Eastern traditions including yoga, meditation and the martial arts focus on belly breathing, and mindful centeredness in the ‘hara’ (the centre of the body, just below the navel) and are therefore oriented towards a calming, steadying effect. They were never designed to deal with the degree of disembodiment, traumatised dissociation, repressed feelings, neurosis or the vicissitudes of the modern psyche.
In contrast, the more recent Western traditions of working with the breath, starting with Reich's vegeto-therapy in the 1930’s, were focused precisely on addressing disembodiment, repressive character armour and primarily emphasised catharsis in order to counteract chronic inhibition. There has been a host of humanistic approaches descending from that origin (or at least pulling in the same direction, e.g. primal therapy, rebirthing, Grof’s holotropic breathing and many other cathartic techniques.)
The tensions between these two kinds of traditions continue, although these days of course many hybrid forms have developed. But this dichotomy (charging, ‘mind’-less expressive catharsis versus mindful, calming centering) is not the only contradiction.
Changing the breathing pattern through the mind versus attending to it as it is
When we recognise somebody's restricted, flawed, incomplete, ‘pathological’ way of breathing, different approaches have different aims and corrective techniques, and all of these have their purpose. But in the context of psychotherapy, what are we trying to do? Are we trying to educate the client to change their way of breathing towards a ‘healthier’ breathing pattern? There may be good arguments for that. Or are we trying to understand how this breathing is part of their characterological bodymind condition? In which case there is a rationale for attending mindfully to the ‘unhealthy’ breath pattern without trying to change it.
One essential feature of the breath is that it is mostly automatic or at most semi-conscious. But if we want to, we can be very deliberate with it and conscious of it. Can we use our minds and mindfulness to change our spontaneous breath pattern? Yes, in the present moment we can, but how does this impact on the breath the rest of the time when we do not make an effort to attend to it?
The psychological limitations of a ‘one-size-fits-all’ approach to the breath
Many guidelines and systems advocating supposedly correct breathing, whether it is belly or chest or diaphragm, in- or outbreath, energetic or calming, fail to take into account individual psychology. Frequently, they advocate a ‘one-size-fits-all’ notion of healthy breathing which the client is then expected to consciously, deliberately approximate.
Many clients have at some time in their lives been involved with activities or situations (quite apart from complementary therapies and breathwork techniques e.g. singing lessons, swimming or diving, illness, children holding their breath) where they learnt or were explicitly taught how to breathe. These methods have become automatic or become injunctions or ‘rules’ in people’s minds, affecting the way they organise themselves when they start paying attention to their breath.
In practices such as Tai Chi or Yoga, this may be fine. But in psychotherapy, this often becomes another ‘super ego’ injunction, usually exacerbating the contortions that are already present.
Calm, controlled breathing can be a very good idea when somebody is in an overwhelmed, traumatised state. It can also be a symptom of freezing and dissociation. It may exacerbate a depressed condition. At the other end of the scale, many people are scared of ‘hyperventilation’ which can indeed be a symptom of a habit of hyper-arousal, constantly leading to emotional overwhelm. On the other hand, it can be argued that most of the population systematically and chronically under-breathe – they are hypo-ventilating. So an experiment in deliberately breathing more deeply might be needed in order to balance this, or to just get an experience of the edge of their comfort zone or ‘window of tolerance’.
Sustained mindfulness of breath can constellate fears of regression
Lying on the mattress to breathe conjures up a host of associations. Experimenting with how the breath affects the intensity of one’s felt sense and experience can draw attention to implicit control mechanisms. If these mechanisms are challenged – not necessarily by the therapist, but more often by internal forces – regression can occur. This can have both damaging and transformative elements, and the history of psychotherapy provides ideas and reference points for both.
In our culture - dominated as it is by metaphors of development which emphasise progress, growth and ascent – any hint of regression constellates primitive and for many people catastrophic fears. The client’s ego scans vitality affects and the energetic weather in the body for signs that threaten regression, and anticipates, counterbalances and manages – in some sort of approximation of self-regulation – regressive tendencies as they arise. In order to do that, the ego needs to monitor the breath as the main regulator of intensity and charge in the system, usually automatically and outside awareness. Bringing awareness to the breath can reveal the presence of this monitoring and control process in action. It is only when the smooth operation of this pre-conscious mechanism is attended to, that the underlying body-mind split – in whatever idiosyncratic way it manifests in the client’s system – becomes more apparent. This split or battle between mind and body, reflection versus spontaneity tends to be experienced as an either-or, all-or-nothing battle around control. Within the split, surrender to the somatic processes and letting go into the body is equated with loss of control and regression (which mythologically corresponds to a descent into the underworld). Inbreath and outbreath are intimately linked to these movements of consciousness and the habitual conflicts which are structured into the client’s bodymind system.
How to recognise and engage with the complex matrix of the client’s bodymind via attention to the breath and the relational dilemmas which then arise for the therapist, especially when fears of regression are evoked, will constitute key questions throughout the course. For each participant, these fears and reactions need to be attended to and processed in the context of their own history of control versus regression.
Depth of intra-psychic bodymind focus at the expense of interpersonal awareness
Traditionally, the profound potential of breath work in terms of spontaneous and regressive experience was - generally speaking – achieved by focussing on the client’s intra-psychic and bodymind dynamic. This focus on the client’s internal experience – their body awareness including sensations, internal movements and impulses, their emotions and stream-of-consciousness - can move into the foreground at the expense of attention to the relational dynamic between client and therapist. Traditionally, body-oriented therapists working with the breath paid no attention at all to transferential dynamics. This is ironic, as our theory tells us that during states of regression early experience tends to come to the fore and then maybe even outweighs ego consciousness, thus intensifying transferential projections, often reaching back into pre-verbal and primitive states. The consequent conclusion from the theory is that when we invite regressive experience, we should be more alert than ever to unconscious processes.
Therefore, providing a relational container for regressive states, primarily by the therapist recognizing and attending to transferential pressures and countertransferential reactions and responses whilst engaged in the breath work, is one of the key integrations which are generally lacking and which we want to develop.
Traditional concepts and models of transference and countertransference tend to not be very helpful in the immediacy of breath work because of their implicit paradigm bias towards the mind and mental representations, privileging reflection over spontaneity.
However, following in Reich’s footsteps, we can consider transference and countertransference not just as having somatic aspects or being reflected in right-brain-to-right-brain interactions, but engage in them as intersubjective bodymind processes. In this perspective, psychology and biology become inseparable polarities - differentiated, but mutually related: body, emotion, psyche and mind as fractal parts of a dynamic, integral whole in relationship.
During the course, we will aim to work in such a way that these abstract notions remain alive and experience-near, through attending to the detail of the charged bodymind dynamics occurring in the therapeutic relationship and how these are reflected holographically between the various sub-systems, levels, parts and the whole via parallel process.
In the highly charged, potentially regressive context of lying down on the mattress, spontaneous and reflective, somatic and mental, habitual and emergent processes become tangibly constellated, and open into a way of working that can range across all the bodymind levels of subjective experience.
This places high demands on the therapist’s own capacity to be present between such intimate and existential extremes as wholeness and fragmentation, integration and conflict, authority and woundedness and a unified sense of self versus multiplicity. This course aims to deepen, widen and enhance therapists’ perception, understanding and creativity in these areas of intersubjective intensity and vicissitudes.
An integrative, broad-spectrum approach to the breath
These are just some brief examples to illustrate that this whole area is a minefield. It is a minefield that we cannot afford to ignore or sidestep, but we want to approach it with an understanding of the contradictions, tensions and the opposing as well as complementary principles, theories and practices.
Content of the Course
This course aims to work towards a comprehensive understanding and practice of breath work, which draws from the diverse traditions , trying to integrate them on the basis of a holistic bodymind psychological understanding. Specifically, it will include mindfulness, meditative and yoga breathing, Grof's holotropic breathing, rebirthing, vegeto therapy, and an integrative relational form of breathwork developed at the Chiron Centre focussing on bodymind and relational ‘charge’.
with and without touch, with and without focus on the breath, with various stances from allowing (biodynamic ‘impinging from within’) to challenge (bioenergetic or vegetotherapy).
Format of the Course
As all of these techniques depend upon the moment to moment engagement with the body’s spontaneous processes, an important part of the learning will be live sessions which participants will have with each other, in pairs or triads, or in the middle of the group.
As a closed group for the duration of the course, we will together build the relational container necessary for such work to become possible in an authentic way. This course will probably be offered only once and is unlikely to be repeated in this form in the future. It provides an unusual context for intensive work over a period of 18 months.