Full Course Description

Module 1: Narcissistic Abuse In-Depth Workshop with Ramani Durvasula

Narcissistic abuse is one of today’s most in-demand clinical topics … and the fallout of narcissistic abuse is one of the more challenging issues to manage.

Working with clients experiencing narcissistic abuse requires you to simultaneously understand the confusing nature of narcissistic behavior AND the deep and painful wounds of the abuse survivor.

To be effective, you must understand these personality styles inside out.

Because without a strong understanding of narcissism, you’ll end up feeling lost, confused, powerless, and frustrated when doing this work.

That’s why we’re excited to partner with Dr. Ramani Durvasula, the world’s most accomplished and highly recognized expert on narcissistic abuse and its impact on relationships.

Join us for this training that will dive DEEP into the what, why, and how of narcissism and other antagonistic styles …

… so you’re prepared with the essential insight you need to work with these challenging cases.

Program Information

Objectives

Distinguish the salient and defining patterns of “narcissism” and become familiar with the diagnostic criteria for narcissistic personality disorder, as well as trait-based models.
Apply etiological models of narcissism, realistic expectations for treatment, and techniques to employ in treatment with individuals with narcissistic patterns.
Incorporate appropriate assessment approaches, measurement tools, and theories when assessing narcissism and other antagonistic personality styles.
Recognize the different narcissistic subtypes, how these subtypes present, the core similarities between the subtypes, and the different treatment and interpersonal challenges raised by each of these styles.
Evaluate defenses and underlying dynamics of the narcissistic personality style, the resultant behaviors, and connect this to interpersonal and relational patterns that show up in intimate relationships, family systems, workplaces and other social and relational systems.
Demonstrate the ability to delineate and differentiate and recognize overlaps between narcissism, antisocial/psychopathy, borderline, and other similar phenomenology.
Identify and apply best practices for working with clients with narcissistic personality patterns, and to extract the higher order similarities across a range of treatment approaches with narcissistic clients.

Outline

An overview of narcissism beyond just DSM
The dangers of the NPD diagnosis
Where does narcissism really come from?
What’s really going on under the surface?
Important sub-types of narcissism
Assessments you need to know and how to use them
Comorbidities and overlaps – how narcissism can magnify other clinical conditions
Learning to Identify Narcissism by its Common Patterns
- The way they behave
- The way they think
- The way they feel inside
- Common physical patterns
- Common structural patterns
Treating narcissism: what works and what issues to consider
Identifying narcissistic patterns in your clients: Vignettes

Copyright : 08/21/2023

Module 2: Dynamics of Narcissistic and Antagonistic Relationships

In this module, Dr. Ramani Durvasula introduces her approach for working with narcissistic relationships. Using an in-depth case example, she’ll show you exactly how NA/ARS may reveal itself in the clinical setting and walk you through important things to consider as the client's therapist.

Next, Dr. Ramani provides an in-depth exploration of the dynamics of narcissistic relationships. You’ll discover the key characteristics of narcissistic relationships and explore important topics including betrayal trauma, trauma-bonding, attachment, enabling, and more. You’ll also examine the narcissistic family system and find out how each role results in mental, emotional, and relational vulnerabilities in the future. Expanding beyond the family, you’ll discover how the narcissistic system can play out in other relationships, including at work and with friends.

Program Information

Objectives

Describe the key issues in managing clients experiencing NA/ARS.
Identify and describe the different subsets of clients who may be experiencing NA/ARS and the differential clinical approaches to take with these clients.
Articulate the inherent asymmetry of narcissistic/antagonistic relationships behaviorally, emotionally and motivationally.
Define the concepts of DARVO, blindness, trauma bonding, and cognitive dissonance and discuss how they appear in narcissistic/antagonistic relationships.
Describe each phase of the narcissistic/antagonistic relational cycle.
Articulate the role of attachment in establishing and maintaining narcissistic/antagonistic relational dynamics.
Discuss the ways in which clients may be vulnerable to entering a narcissistic/antagonistic relationship.
Identify and examine the patterns typically observed in narcissistic relationships.
Recall the family and systemic roles people may fall into in a narcissistic/antagonistic family system or other relational systems.
Discuss the concept of “loss of subjectivity” observed especially in childhood narcissistic/antagonistic relationships.

Outline

Introduction to Treating Narcissistic Abuse/Antagonistic Relational Stress (NA/ARS) and crucial insights for therapists

An overview of NA/ARS treatment: What works
The critical role of the therapist
Working with clients with other mental health concerns
Theoretical foundations of NA work
Current limitations in the field

The dynamics of narcissistic/antagonistic relationships

The cycle of betrayal cycle
How our clients get stuck
The trauma-bonded relationship and co-dependency
The narcissistic relationship cycle
The role of attachment in narcissistic relationships
Patterns within antagonistic relationships and how they impact clients
Who enables the narcissist and why do they do it?
Understanding narcissistic family systems
Working with marginalized groups and those with less power
How to best support different personality styles
The roles in a narcissistic system: work, family, social relationships and more

Target Audience

Counselors
Social Workers
Psychologists
Marriage & Family Therapists
Addiction Counselors
Physicians
Physician Assistants
Nurses
Nurse Practitioners
Other Mental Health Professionals

Copyright : 10/01/2023

Module 3: Trauma and Narcissism: Personality Disorders as Trauma-Related Disorders

In this module, world-renowned trauma specialist, Janina Fisher, shares critical insights about the relationship between trauma and narcissism. You’ll discover the devastating impact of trauma on the brain and find out how these changes manifest as symptoms of mental health diagnoses, including narcissistic and antagonistic personality styles. Janina will then share her revolutionary conceptualization of narcissism and reveal what really drives antagonistic behaviors. Finally, you’ll discover how to use parts language to drastically improve your clinical work with both narcissists and those experiencing narcissistic abuse.

Program Information

Objectives

Explain the ways trauma impacts the brain and discuss the connection between these neurological changes and the emergence of trauma-related symptoms.
Analyze the connection between negative early attachment relationships and the challenges individuals may face in leaving an abusive partner.

Outline

The Living Legacy of Trauma

The biggest mistake we can make as trauma therapists
How the brain remembers trauma
The traumatized brain and how it can keep clients stuck in the past
Legacy of traumatic attachment

Trauma and Narcissistic Relationships

Why it is so difficult for some to leave frightening and abusive partners
Narcissistic behavior and traumatized parts
How unblending and integration can help narcissistic relationships

Target Audience

Counselors
Social Workers
Psychologists
Marriage & Family Therapists
Addiction Counselors
Physicians
Physician Assistants
Nurses
Nurse Practitioners
Other Mental Health Professionals

Copyright : 10/01/2023

Module 4: Working with the Fallout of Narcissistic Abuse

It’s essential that clinicians understand not just the phenomenon of narcissistic abuse/antagonistic relational stress (NA/ARS) but the fallout from it. In this workshop, you’ll discover the core characteristics of NA/ARS relationships and take a deeper look at the unique dynamics that appear in familial, romantic, occupational, and social relationships. You’ll explore these relational patterns using case examples and see the true impact they have on real-life clients. In the workshop, you’ll also discover how to:

Spot the signs of NA/ARS relationships and identify the fallout of these dynamics in your clients
Help your clients recognize how their subjective experiences relate to the patterns occurring in their relationship
Differentiate between NA/ARS and other mental health concerns such as PTSD, anxiety disorders, and other mental health issues.
Develop a treatment plan that includes a framework for guiding your clients from awareness of their experiences to readiness for change

Program Information

Objectives

Catalogue the core characteristics of NA/ARS relationships.
Recognize common patterns of behavior that manifest in clients experiencing NA/ARS.
Summarize the continuum of severity of the fallout and effects of NA/ARS.
Differentiate the fallout of NA/ARS from other mental health conditions.
Articulate the specific consequences of childhood and adult onset of NA/ARS.
Define all elements of the concept of gaslighting and apply this to understanding the psychological impacts of narcissistic/antagonistic relationships for clients.

Outline

Recognizing the patterns and dynamics of Narcissistic Abuse/Antagonistic Relational Stress (NA/ARS)
Key differences between childhood, adult and combined onset of narcissistic abuse
Beyond families and partners: Recognizing NA/ARS patterns in social and occupational relationships
The seven types of fallout from NA/ARS and how to recognize them in your client
How to differentiate between NA and other mental health conditions
Making the connection: Helping your client connect their subjective experience to the unhealthy patterns in their relationship
The most common pitfalls in working with clients experiencing NA/ARS and how to respond effectively
Developing a treatment plan for your clients in NA/ARS relationships
Limits of the current research and potential risks

Target Audience

Counselors
Social Workers
Psychologists
Marriage & Family Therapists
Addiction Counselors
Physicians
Physician Assistants
Nurses
Nurse Practitioners
Other Mental Health Professionals

Copyright : 10/01/2023

Module 5: Being Culturally and Intersectionally Informed When Working with Clients Experiencing NA/ARS

Narcissistic Abuse and Antagonistic Relational Stress (NA/ARS) does not occur in a vacuum. There are countless cultural, intersectional, and systemic factors that influence the experience and behavior of both the perpetrator and the one being abused. For therapists to be able to truly help their clients experiencing NA/ARS, they must ensure that they are accounting for the many facets of their clients’ entire biopsychosocial context. In this module, Dr. Ramani Durvasula will share with you her social-ecological model and give you everything you need to practice as a culturally and intersectionally informed therapist. In this section, you’ll discover how to:

Determine the intersectional cultural and systemic factors that may be impacting your client’s experience with NA/ARS
Foster a therapeutic stance of humility and flexibility so that you are best able to provide culturally and intersectionally informed care
Identify and manage your own unique intersectional identities to minimize the impact they may have on client care
Develop a treatment plan that accounts for intersectional factors and structural inequities

Program Information

Objectives

Articulate how power and structural issues can negatively impact the experiences of clients experiencing NA/ARS.
List at least three of the APA’s multicultural guidelines and describe how they can be used to enhance clinical work with clients experiencing NA/ARS.
Evaluate one’s own intersectional identity and determine the potential impact of those identities on clinical work with clients who have experienced NA/ARS.
Conduct an culturally-informed assessment of the intersectional and systemic factors impacting your client and utilize those factors to inform the development of a treatment plan.

Outline

The vital role of cultural, intersectional, and systematic awareness in treating NA/ARS

A Social ecological model
Structural issues in NA/ARS: Looking beyond the individual model
The realities of mental health access
The many contexts of client experiences
How NA/ARS can impact efficacy and capacity to navigate these symptoms

Cultural competency

Fostering humility and flexibility
Accounting for power: Navigating the asymmetric therapeutic relationships
Why therapy approaches cannot be easily moved between cultural groups
The culturally competent counselor
RESPECT: A Mnemonic for Cultural Responsiveness
What is positionality?
Case examples: Positionality in the therapy room
APA Multicultural Counseling Competency: A framework culturally-informed care

Clinician Self-awareness

What to watch out for and how to avoid personal agendas
Acknowledging the societal patterns occurring around the client
Managing frustration: Knowing what clients need but can’t get
Discrimination and how to account for it in case formulation
Avoiding the reinforcement of emotional suppression
APA’s Aspirational guidance for navigating systems issues

How to Think Systematically

Which systems fail to support those experiencing NA/ARS?
Working with clients across the developmental/historical spectrum
Understanding trauma within a sociocultural framework
How to guide clients through systemic conversations
Conducting a self-assessment
Accounting for intersectional factors and structural inequities in treatment planning
Breaking down the social-ecological framework: A case example

Target Audience

Counselors
Social Workers
Psychologists
Marriage & Family Therapists
Addiction Counselors
Physicians
Physician Assistants
Nurses
Nurse Practitioners
Other Mental Health Professionals

Copyright : 10/09/2023

Module 6: Working with Clients Experiencing NA/ARS: An antagonism-informed treatment approach (Part 1)

Copyright : 10/07/2023

Module 7: Working with Clients Experiencing NA/ARS: An antagonism-informed treatment approach (Part 2)

In this module, Dr. Ramani Durvasula shares an essential framework for treating clients who have experienced Narcissistic Abuse or Antagonistic Relational Stress (NA/ARS). From the conceptual to the practical, she will provide you with all the knowledge and skills you need to successfully navigate this challenging work. You’ll discover what it means to provide antagonism-informed care. Through detailed case discussions, Dr. Ramani will demonstrate how to apply this approach with a broad range of clients experiencing NA/ARS. You’ll also learn about the best practices for treating NA/ARS and discover how to utilize key interventions yourself. You’ll discover how to:

Conduct a comprehensive assessment of NA/ARS with a broad range of relationship types including familial, romantic, social and occupational
Set treatment goals based on your client’s specific NA/ARS-related situation
Help clients overcome the fallout of their abuse and begin to heal from the inside out
Exactly what you need to do in-session including what to focus on, what strategies to use, and how to navigate the biggest challenges of this work, including both legal and ethical issues

Program Information

Objectives

Describe the key tenets of what it means to be “antagonism informed.”
Apply the working model of working with clients experiencing NA/ARS, including each of the 10 elements.
Apply frameworks to address ambivalence and decision making, as well as fostering recovery capital in clients experiencing NA/ARS.
Demonstrate effective strategies to facilitate rapport building with clients experiencing NA/ARS.
Describe key elements of assessment when working with clients experiencing NA/ARS.
Understand key treatment issues raised by clients with co-occurring mental health issues including antagonistic personality issues and are also experiencing NA/ARS.
Describe the role of psychoeducation when working with clients experiencing NA/ARS, best approaches, and how to apply it in treatment with these clients.
Describe the concept of radical acceptance and explain the role it plays in therapy with clients experiencing NA/ARS.
Articulate the role of grief in the therapeutic process with a client experiencing NA/ARS.
Identify the key adjunctive considerations when working with clients experiencing NA/ARS.
Describe the “CORE” framework that can be employed in working with clients experiencing NA/ARS.
Apply techniques that foster individuation and growth in clients experiencing NA/ARS.
Outline how process work can be utilized when working with clients experiencing NA/ARS.
Differentiate how to clinically approach clients experiencing NA/ARS in different types of relationships (e.g., intimate relationship, parental, other familial, workplace, other social groups).
Construct a treatment plan for a client experiencing NA/ARS.

Outline

An antagonism-informed approach to working with clients

The key phases of NA/ARS treatment
What does trauma-informed really mean?
Case example: Navigating divorce
Creating the treatment map
What other treatments miss when working with NA/ARS
A multifaceted working model for treating NA/ARS
Do I stay or do I go?: What to do when your client is stuck

Best Practices for working with NA/ARS

The fundamentals framework
Rapport building, the therapeutic relationship and what to never ask your clients
Case example: How to start with a new client
The primary areas of assessment
Working with clients with an antagonistic personality style
Managing severe symptomology
Case example: Working with an antagonistic personality style and NA/ARS
Setting goals to set clients up for success
The real purpose of psychoeducation-- It’s not what you think!
Tools for fostering radical acceptance

Grief: The constant baseline of NA/ARS therapy

What does a client lose when they heal?
Leaning into rumination
Guilt, self-blame and shame
Case example: The multiple layers of grief
What comes after grief?
What does grief look like in other types of relationships?
The narcissistic grief subtypes
Case Examples

Adjunctive considerations for treatment

Psychopharmacology
Psychosocial and legal guidance
Other therapies
Complementary Therapeutic Modules and which modules to be mindful of
Other resources

Healing from the core

A framework for healing from the inside out
Types of core work: From wounds to hopes
Case example: Doing core work

Addressing Fallout in Shaping Treatment and Intervention

A brief review of the fallout of NA/ARS
How to address the fallout in treatment

What to do in session: Clinical foci and effective tools

Key principles: Collaboration, safety, validation and affirmation
A parts model for addressing fragmentation and self-alienation
Fostering autonomy and ungaslighting the client
Working with a range of attachment styles
Addressing here and now fears
Betrayal blindness-informed frameworks
When Leaving isn’t possible: Supporting clients in disengagement
Fostering new narratives and schemes
Developing new skills for managing ongoing NA/ARS relationships
What about forgiveness?
Different ways to approach boundaries in the NA/ARS relationship
Triangulation and how to work around it
Working through relationship fear and fears of trust
Breaking the trauma-bonded cycle
Case Example: Working with client narratives
Pulling the true self out of the weeds
Enhancing strengths and protective factors
How to facilitate post-traumatic growth and resilience
Case example: Fostering post traumatic growth
Process issues: What might come up and how to handle it
Safety issues and post-separation abuse
Working with different relational types
Treatment planning overview
Termination, long-term follow up and defining therapeutic success

Target Audience

Counselors
Social Workers
Psychologists
Marriage & Family Therapists
Addiction Counselors
Physicians
Physician Assistants
Nurses
Nurse Practitioners
Other Mental Health Professionals

Module 8: Legal and Ethical Considerations for Working with Narcissism and NA/ARS

Program Information

Objectives

Summarize the six steps of safety planning with a client experiencing suicidality.
Discuss potential risks to maintaining confidentiality when working with a client experiencing narcissistic abuse and coercive control.
Describe at least two ways therapists can support their clients during custody proceedings and at least one thing therapists cannot do to support them.
Articulate guidelines for determining a therapist’s competency in treating NA/ARS.
Summarize the guidelines for using client information in social media posts and testimonials.

Outline

Narcissistic Abuse: What clinicians need to know

Common mistakes and how to avoid making them
Risk factors and barriers to treatment clinicians must be aware of
Trauma-informed care: How to treat patients safely and ethically
Tips for assessment and diagnosis
Cultural considerations around abuse dynamics
How to help clients still in an NA/ARS relationship
Leaving the relationship: no contact and minimal contact
Working with Narcissistically Abusive Parents
Suicidal Ideation: How to assess and protect

Navigating the legal and ethical challenges of working with NA/ARS

Documentation and accessing records
Working with collateral contacts: other clinicians, evaluators and more
Navigating confidentiality and privilege
Consultation: Getting support and protecting your client’s identity
Tips for working with attorneys and the courts
Malpractice insurance and how to best protect yourself
Navigating mandated reporting using an ethical decision-making model
Multicultural dynamics: understanding cultural diversity within the law
Recognizing different types coercive control and what to do to best support your clients
Guidance from APA ethical codes: Competency, scope of practice, supervision and more
The impact on therapists: Avoiding burnout, helplessness, and secondary trauma
Navigating the ups and downs of your client’s readiness for change
Guidance for providing testimony and treatment summaries
The use of social media and testimonials: how to keep the anonymity of our clients

Target Audience

Counselors
Social Workers
Psychologists
Marriage & Family Therapists
Addiction Counselors
Physicians
Physician Assistants
Nurses
Nurse Practitioners
Other Mental Health Professionals