Listening With Purpose:

Now available in paperback from

Listening with Purpose is a clinical treatment manual for seasoned practitioners, post-doctoral training institutes, graduate students, and psychiatric residents who are interested in advancing their skills in therapeutic listening and psychodynamic interventions. 

The approach to training is distinct and original. It offers a rich sampling of case examples, explicit trainee dialogue, and a diagrammatic model illustrating how recent theoretical advances can facilitate understanding of the often subtle nuances of treatment interventions from intrapsychic, interpersonal, and systemic perspectives.

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In-depth description

This manual has been written for a wide range of dynamic practitioners involved in treating patients with narcissistically-infused issues.  The treatment model and case material presented cover the spectrum of narcissistic vulnerability and may be applied to the relatively intact patient as well as to the relatively impaired patient. We refer to issues of narcissistic vulnerability throughout this manual, although our references do not necessarily conform to historical DSM diagnostic categorizations.  We begin with the assumption that narcissistic mechanisms are implicated in all levels of personality functioning and in all people.  They exist both in therapists and clients differing only in the level of prominence and degree of disturbance in the personality. 

Cutting across several schools of thought, our treatment manual places shame and its derivatives at the very center of narcissistic vulnerabilities, vulnerabilities which create in their wake characterological splits and dissociative phenomena.

One can wonder if therapists have avoided looking at shame because of its contagious qualities.  Human experience has demonstrated that shame is a ubiquitous emotion, yet when individuals encounter shame it seems to place them in a seemingly paradoxical position which looks much like a dissociated limbo state with no way out.  We experience it and yet don’t experience it, we see it and don’t see it, we feel it and don’t feel it.

One cannot adequately treat unexamined shame from within its core unless one finds a compatible language for the theory that informs our interventions.  In particular, the theory cannot replicate pre-existing splits embedded within a treatment paradigm and cannot be weighted with theoretical underpinnings that are distancing, objectifying, or removed.

We have proposed instead an innovative paradigm-shifting model that is very explicit in recommending an experience-near, moment-to-moment immersion in the conflicted and often disoriented life of patients.  Unlike existing volumes in the field, this manual is by design replete with copious down-to-earth examples to help guide one’s systemic shift in treatment focus, treatment emphasis, and treatment posture.  The shift involved is healing on many levels and opens up for re-examination and re-assessment heretofore difficult to treat cases of trauma, dissociation, character disturbances, and addictive disorders.

Copyright (C) 2013 Jack Danielian and Patricia Gianotti

All rights reserved.