A psychoanalytic hermeneutic investigation of destructive narcissism
- Authors: De Wit, Estelle
- Date: 2013-06-04 , 2004
- Subjects: Narcissism Narcissism -- Treatment Psychoanalysis Death instinct Ego (Psychology) Self psychology
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:3180 , http://hdl.handle.net/10962/d1008055
- Description: The purpose of this research was to investigate the clinical phenomenon of destructive narcissism. Contemporary Kleinian and neo-Kleinian theoretical perspectives provided the interpretative perspective on the complexities of inaccessible personalities and subtle forms of internal destructiveness. Four research questions were formulated to interrogate the individual and collective experiences of three male patients whose internal worlds seem to be governed by rigid intrapychic structures organized around the dictatorship of a constellation of seemingly impenetrable defensive strategies. These questions were as follows: 1. What emotional states, actions and experiences of self and others characterize the clinical phenomenon designed as destructive narcissism and distinguish it from other forms of character pathology? 2. What early developmental experiences and relationships may have pre-disposed individuals to the development of this type of character pathology? 3. How are the psychodynamic processes of destructive narcissism structured and configured in the psychotherapeutic process and progress? 4. What are the transference/countertransference psychotherapeutic manifestations of the psychodynamics of destructive narcissism? The illustrative-didactic case study method was utilized to discuss pertinent aspects of each patient. This included their early developmental histories, inter- and intrapersonal relationships, their current mental state, defensive strategies and their stated reasons for commencing psychotherapy. In addition, the structure of the psychotherapeutic process with these patients was reviewed in depth. Various psychic and personality features, as unveiled through this process were discussed, as well as the implications of these for the therapeutic endeavor. The features chosen for discussion were: Firstly, the constellation of the internal object world, the capacity for symbolic thought and defensive organizations. Secondly, therapeutic ambivalence, which made psychotherapy untenable, was explored in conjunction with transference/countertransference issues. Thirdly, the shadow sides of psychotherapeutic change with these patients were considered and the issues of therapeutic failure and other treatment possibilities were examined. It was concluded that there need be an important shift with regard to the psychotherapeutic goals for those patients whose condition may be chronic, and for whom it appears that psychotherapy is of little benefit. In essence, the intent of psychotherapy with these patients is to reach the healthy sane patient of the patient within the pathological organization. Attempts to unravel the perverse gratification and protection derived from the domination of the narcissistic structure may not be enough, and the patient's collusion with the internal destructive gang should also be exposed. If this can be achieved, the patient may come to accept the existence of a part of himself as truly destructive. This, in turn, cannot be disowned, therefore the patient has to live with it. Thus, in destructive narcissism, the challenge for the therapist is the extremely difficult task of disentangling the patient's pain from the idealization of internal destructiveness. , KMBT_363 , Adobe Acrobat 9.54 Paper Capture Plug-in
- Full Text:
- Date Issued: 2004
- Authors: De Wit, Estelle
- Date: 2013-06-04 , 2004
- Subjects: Narcissism Narcissism -- Treatment Psychoanalysis Death instinct Ego (Psychology) Self psychology
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:3180 , http://hdl.handle.net/10962/d1008055
- Description: The purpose of this research was to investigate the clinical phenomenon of destructive narcissism. Contemporary Kleinian and neo-Kleinian theoretical perspectives provided the interpretative perspective on the complexities of inaccessible personalities and subtle forms of internal destructiveness. Four research questions were formulated to interrogate the individual and collective experiences of three male patients whose internal worlds seem to be governed by rigid intrapychic structures organized around the dictatorship of a constellation of seemingly impenetrable defensive strategies. These questions were as follows: 1. What emotional states, actions and experiences of self and others characterize the clinical phenomenon designed as destructive narcissism and distinguish it from other forms of character pathology? 2. What early developmental experiences and relationships may have pre-disposed individuals to the development of this type of character pathology? 3. How are the psychodynamic processes of destructive narcissism structured and configured in the psychotherapeutic process and progress? 4. What are the transference/countertransference psychotherapeutic manifestations of the psychodynamics of destructive narcissism? The illustrative-didactic case study method was utilized to discuss pertinent aspects of each patient. This included their early developmental histories, inter- and intrapersonal relationships, their current mental state, defensive strategies and their stated reasons for commencing psychotherapy. In addition, the structure of the psychotherapeutic process with these patients was reviewed in depth. Various psychic and personality features, as unveiled through this process were discussed, as well as the implications of these for the therapeutic endeavor. The features chosen for discussion were: Firstly, the constellation of the internal object world, the capacity for symbolic thought and defensive organizations. Secondly, therapeutic ambivalence, which made psychotherapy untenable, was explored in conjunction with transference/countertransference issues. Thirdly, the shadow sides of psychotherapeutic change with these patients were considered and the issues of therapeutic failure and other treatment possibilities were examined. It was concluded that there need be an important shift with regard to the psychotherapeutic goals for those patients whose condition may be chronic, and for whom it appears that psychotherapy is of little benefit. In essence, the intent of psychotherapy with these patients is to reach the healthy sane patient of the patient within the pathological organization. Attempts to unravel the perverse gratification and protection derived from the domination of the narcissistic structure may not be enough, and the patient's collusion with the internal destructive gang should also be exposed. If this can be achieved, the patient may come to accept the existence of a part of himself as truly destructive. This, in turn, cannot be disowned, therefore the patient has to live with it. Thus, in destructive narcissism, the challenge for the therapist is the extremely difficult task of disentangling the patient's pain from the idealization of internal destructiveness. , KMBT_363 , Adobe Acrobat 9.54 Paper Capture Plug-in
- Full Text:
- Date Issued: 2004
The adaptation of the 'Clinical Outcomes in Routine Evaluation-Outcome Measure' (CORE-OM) from English into a valid Xhosa measure of distress
- Authors: Campbell, Megan Michelle
- Date: 2013 , 2013-06-06
- Subjects: Psychometrics -- Research -- South Africa Psychology -- Mathematical models -- Research -- South Africa Psychological tests -- Research -- South Africa Mental health services -- Research -- South Africa Health services accessibility -- Research -- South Africa Language disorders -- South Africa
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:2894 , http://hdl.handle.net/10962/d1001538
- Description: In South Africa access to mental healthcare resources is restricted for a number of reasons including language barriers that prevent suitable communication between mental healthcare professionals and African language speaking South Africans. The translation of psychometric tools into African languages has been identified as one method in improving access to psychological services for African language speakers. The Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) has demonstrated its clinical utility within the United Kingdom (UK) National Healthcare Service (NHS) as a standardised psychotherapy outcome measure that evaluates the degree of psychological distress individuals present with at the start of psychotherapy treatment, and the degree of change that has been effected at the termination of therapy. A measure like the CORE-OM holds valuable clinical utility for the South African context. This thesis argues that the availability of a valid Xhosa version of the CORE-OM would allow for improved access to psychotherapy resources for Xhosa speaking individuals, and allow for the evaluation of the effectiveness of psychotherapy interventions conducted in Xhosa. The CORE-OM developers have provided a translation design and set of guidelines to standardise the translation of the CORE-OM into different languages. However this thesis argues that these guidelines are incomplete. Instead International Test Commission (ITC) guidelines are recommended as a culturally sensitive method to supplement current CORE-OM translation guidelines, in order to generate a valid Xhosa measure of distress. A mixed methods approach is applied which first investigates the construct equivalence and bias of the CORE-OM English version within a South African student population sample, both qualitatively and quantitatively, in order to establish the degree of adaptation required to generate a valid Xhosa version of distress. Next the CORE-OM English version is translated into Xhosa using the five-stage translation design prescribed by the CORE System Trust, supplemented by ITC guidelines. All changes made to the CORE-OM during translation into Xhosa are documented. The CORE-OM Xhosa version is then investigated for reliability and validity. This investigation reveals low internal reliability within the subjective wellbeing domain indicating that these items are less meaningful as depictions of distress within the Xhosa language. A reduced version of the CORE-OM demonstrates strong psychometric properties as a valid Xhosa measure of distress.
- Full Text:
- Date Issued: 2013
- Authors: Campbell, Megan Michelle
- Date: 2013 , 2013-06-06
- Subjects: Psychometrics -- Research -- South Africa Psychology -- Mathematical models -- Research -- South Africa Psychological tests -- Research -- South Africa Mental health services -- Research -- South Africa Health services accessibility -- Research -- South Africa Language disorders -- South Africa
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:2894 , http://hdl.handle.net/10962/d1001538
- Description: In South Africa access to mental healthcare resources is restricted for a number of reasons including language barriers that prevent suitable communication between mental healthcare professionals and African language speaking South Africans. The translation of psychometric tools into African languages has been identified as one method in improving access to psychological services for African language speakers. The Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) has demonstrated its clinical utility within the United Kingdom (UK) National Healthcare Service (NHS) as a standardised psychotherapy outcome measure that evaluates the degree of psychological distress individuals present with at the start of psychotherapy treatment, and the degree of change that has been effected at the termination of therapy. A measure like the CORE-OM holds valuable clinical utility for the South African context. This thesis argues that the availability of a valid Xhosa version of the CORE-OM would allow for improved access to psychotherapy resources for Xhosa speaking individuals, and allow for the evaluation of the effectiveness of psychotherapy interventions conducted in Xhosa. The CORE-OM developers have provided a translation design and set of guidelines to standardise the translation of the CORE-OM into different languages. However this thesis argues that these guidelines are incomplete. Instead International Test Commission (ITC) guidelines are recommended as a culturally sensitive method to supplement current CORE-OM translation guidelines, in order to generate a valid Xhosa measure of distress. A mixed methods approach is applied which first investigates the construct equivalence and bias of the CORE-OM English version within a South African student population sample, both qualitatively and quantitatively, in order to establish the degree of adaptation required to generate a valid Xhosa version of distress. Next the CORE-OM English version is translated into Xhosa using the five-stage translation design prescribed by the CORE System Trust, supplemented by ITC guidelines. All changes made to the CORE-OM during translation into Xhosa are documented. The CORE-OM Xhosa version is then investigated for reliability and validity. This investigation reveals low internal reliability within the subjective wellbeing domain indicating that these items are less meaningful as depictions of distress within the Xhosa language. A reduced version of the CORE-OM demonstrates strong psychometric properties as a valid Xhosa measure of distress.
- Full Text:
- Date Issued: 2013
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