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Feb 23

Dr. Nancy McWilliams – The Continuum of Madness

February 23, 2019 @ 10:00 am - 4:00 pm

The Continuum of Madness, with Special Attention to Narcissism

Guest Presenter: Dr. Nancy McWilliams, Ph.D.

OISE Auditorium, University of Toronto
252 Bloor St. W., Toronto, M5S 1V6


In this day-long event Nancy McWilliams, Ph.D., will explore the contemporary conceptualization of psychosis, emphasizing the clinical value of construing psychopathology dimensionally. The evolution of the concept of pathological narcissism will be reviewed, with emphasis on the dangers of malignant narcissism.

Morning Session:
Rethinking Madness: The Therapeutic Value of a Dimensional Conception of Psychotic Processes

The intentionally “neo-Kraepelinian” orientation (categorical concepts, with present-versus absent criteria) of the current DSM and ICD taxonomies are in some ways inconsistent with clinical experience. In the DSM, for example, there are only a limited number of conditions labeled as psychotic. Many diagnosticians and psychotherapists, in contrast, have viewed psychopathology dimensionally rather than categorically, using the term “psychotic” in the broader sense of loss of contact with consensual reality. Dr. McWilliams will argue that there is a psychotic level of many psychological conditions, not merely the schizophrenic illnesses and psychotic mood disorders. She will emphasize the clinical value of construing psychopathology dimensionally, with specific implications for the psychotherapy process.

Afternoon Session:
Problematic Versions of Narcissism: Clinical and Social Implications

In contemporary conversations, the term “narcissism” is much in vogue. This talk will review the evolution of the concept of “pathological narcissism,” especially as it infuses personality structure. It will touch on both the more arrogant presentations of Narcissistic Personality Disorder (per the DSM) and the extensive literature on converse versions of narcissistic preoccupation (“covert,” depressed-depleted,” “hypervigilant,” or “closet” narcissism, as depicted in the 2017 Psychodynamic Diagnostic Manual, 2nd ed. Dr. McWilliams will discuss the range of narcissism from healthy to seriously disturbed psychologies, putting emphasis on the dangers that malignant narcissism poses to personal relationships, family connections, workplace and institutional functioning, and political processes.


This program has been approved by the Ontario Psychological Association to offer continuing education for psychologists and psychological associates. This program meets the criteria for 4 Continuing Education Credits.


This event is an accredited group learning activity (section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada, and approved by the Canadian Psychiatric Association (CPA). The specific opinions and content of this event are not necessarily those of the CPA, and are the responsibility of the organizer(s) alone

Learning Objectives
Participants will:

  • Compare and contrast a dimensional, inferential, and contextual conceptualization of psychosis with contemporary descriptive and categorical diagnostic conventions;
  • Name three psychopathologies for which there is evidence of their existing along a spectrum from healthy to psychotic;
  • Apply to their clinical work several consequences of viewing psychotic processes as on a continuum with more normal psychologies;
  • Construe narcissistic and psychopathic psychologies in terms of underlying themes rather than observable, present-versus-absent traits;
  • Describe the continuum from normal narcissistic preoccupations through malignant narcissism to frank psychopathy and the DSM’s Antisocial Personality Disorder;
  • Describe how issues of socioeconomic and political trends, gender, sexual orientation, culture, ethnicity, and religious background may affect the diagnosis and treatment of putatively narcissistic disorders.

Click here to download the full conference brochure.

Schedule for the day

10:00 am Introduction of speaker (Dr. Judi Kobrick)
10:10 am “Rethinking Madness: The Therapeutic Value of a Dimensional Conception of Psychotic Process ” Dr. Nancy McWilliams
11:00 am Dialogue between audience and Dr. McWilliams
12:00 pm Lunch (on your own)
2:00 pm “Problematic Versions of Narcissism: Clinical and Social Implications” Dr. McWilliams
3:00 pm Audience Discussion and dialogue with Dr. McWilliams
4:00 pm Closing remarks (Dr. Kobrick)


February 23, 2019
10:00 am - 4:00 pm
Event Category:


OISE Auditorium, U of T
252 Bloor St. W
Toronto,, Ontario M5S 1V6
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