Psychoanalytic Treatment of Narcissistic Personality Organization

with Avedis Panajian

Dr. Panajian will discuss through clinical case presentations patients with severe narcissistic organization, who are dominated by fragile psychotic structures and narcissistic organizations with less fragile structures. Patients with severe fragile structures deny desires, sexuality, and emotions. They seek anesthesia and non-existence. They deny awareness of inner world and mental contents. Mental life is expelled. They defend themselves from intrusions of living. Murderous conscience dominates them. They are very frightened due to being unaware of their defenses. Relationships become very intense due to their own fragility and functioning mechanically. The lack of healthy narcissistic filters causes them to keep us out. They live in massive withdrawal and disconnections. The denial of needs, including the need for food lead some of them hide their anorexia. Patients with less fragile structures seek unity with others. Impossibility of unity leads one to seek pacified merger. Such pacification triggers unpredictable rage, intellectual overstimulation, and exploitation of others. Their destructive aspects generate propaganda against dependency on the analyst. Psychic deadness dominates them when they face aloneness.

Dr. Panajian will demonstrate how the analyst oscillates between environment mother and object-relations. In order to construct healthy structures, the analyst’s narcissism and seeking power must be at minimal. Generating a rhythm of partnership with the patient is a must for building healthy structures. Deconstructing oneself and showing that one is capable to think and differentiate is a must. The analyst needs to be supportive in allowing the patient to choose the distance between them. Shared subjects and interests that are not sexualized help the patient to build healthy narcissistic structures. This type of playful space allows the internalization of a non-defensive analyst. Healthy structures are built in the transitional area of open dialogue.

Learning Objectives

• The course will demonstrate through clinical case presentations the similarities and the differences between narcissistic personality organization with severe fragile psychotic structures and the narcissistic personality organization with less fragile structures in their early development.
• The course will explore through clinical case presentations the therapist’s role in interpreting, empathizing, and containing the patient’s destructive and non-destructive modes of communication including non-verbal communication.
• The course will demonstrate through case presentations the therapist’s narcissism obstructing his wholistic ways of understanding his patient. Including, the significance of the therapist’s deconstructing himself in order to help build healthy structures in these patients.

Online via Zoom

Sessions will be Recorded

Saturdays at 9:30 – 11:00 am  (Pacific/Seattle)

Class dates: 10/17, 11/21, 12/12, 1/16 [2026-27]

CEUs: 1.5 per class, 6.0 total

Fee: $330

Member Fee: $280.50