16-222b Listening with Purpose: New Applications in Treating Shame and Narcissism – 6
Hour Seminar
Patricia Gianotti, Psy.D.
Friday, June 24, 2016 9:00 a.m. – 4:00 p.m.
Course Description
Effective treatment of the spectrum of narcissistic injury must include an integrated understanding of
narcissistically based thoughts and behaviors, ranging from expansive self-enhancement to crushing selfcriticism, from devaluation of others to over-idealization and hero-worship, from standards of perfectionism to
an often defiant or flagrant disregard of rules and laws. This workshop will address how these often
contradictory facets of distorted self-presentation form a tightly constructed defensive organization to keep
feelings of shame and inadequacy at bay. Through lecture, cogent video-taped case demonstrations, small group
discussion, and shared case material we will examine how therapeutic listening and intervention techniques can
be effectively used to penetrate narcissistic defenses of vertical splitting, grandiose expansiveness, cognitive
distortions, self-destructive behaviors, and revenge enactments. Participants will be introduced to an integrated
Four Quadrant Model that explains how often contradictory parts of the psyche create a complex homeostatic
balance. In order to see how these parts connect to the whole, participants will learn how to attend to what is
being said as well as listening for what is being kept hidden from view and thus disconnected from the potential
of emerging authenticity. Special techniques such moment-to-moment tracking, part-whole analysis, and the
use of language as entry-points will help clinicians deepen their listening and intervention skills as the treatment
unfolds.
Faculty: Patricia Gianotti, Psy.D., is a licensed psychologist, clinical supervisor, and founding member of
Woodland Professional Associates, a group private practice in North Hampton, NH. Dr. Gianotti, a seasoned
lecturer and facilitator, has taught at Washington University and the University of New Hampshire and has
presented at various professional conferences, including Division 39 and SEPI. She has recently co-authored a
book with Jack Danielian entitled Listening with Purpose: Entry Points into Shame and Narcissistic
Vulnerability.
Learning Objectives
1. Define the concept of a “character solution”, including beliefs and learned behavioral over-compensations, as it pertains
to the broad spectrum of narcissistic injury.
2. Explain how the conceptual framework of the Four Quadrant Model is a fluid, changing picture of a person’s
defensively-driven attempts to maintain a homeostatic balance while keeping feelings of shame and inadequacy at bay.
3. Apply the Four Quadrant Model from the perspective of an intra-psychic, interpersonal, and systemic vantage point
simultaneously.
4. Understand the relationship between attachment and trauma theories as they apply to shame and narcissistic injury.
5. Demonstrate the use of therapeutic techniques such as moment-to-moment tracking, entry points, and forecasting in the
service of developing deeper listening and intervention techniques.
Bibliography
• Blatt, S. J., and Blass, R. B. (1990). “Attachment and Separateness – A Dialectic Model of the
Products and Processes of Development Throughout the Life Cycle”. The Psychoanalytic
Study of the Child, Vol. 45:107-127.
• Danielian, J. and Gianotti, P. (2013). Listening with Purpose: Entry Points into Shame and
Narcissistic Vulnerability. Lanham, Maryland: Jason Aronson.
• Howell, E. F. (2005). The Dissociative Mind. New York: Routledge.
• Luyten, P. and Blatt, S. J. (2013). “Interpersonal Relatedness and Self-Definition in Normal
and Disrupted Personality Development”. American Psychologist, Vol. 68, No. 3, 172-183.
• Orange, Donna M. (2011). The Suffering Stranger: Hermeneutics for Everyday Clinical
Practice. NY: Routledge.
• Stern, D. N. (2004). The Present Moment: In Psychotherapy and Everyday Life. New York:
Norton.
• Summers, Frank. (2013). The Psychoanalytic Vision: The Experiencing Subject,
Transcendence, and the Therapeutic Process. NY: Routledge.
• Wachtel, Paul L. (2008) Relational Theory in the Practice of Psychotherapy. New York:
Guilford.
• Wallin, D. J. (2007). Attachment in Psychotherapy. New York: Guilford Press.