Psychoanalysis · 1971
Self psychology (Kohut)
The self recovers cohesion when its selfobject needs are understood and worked through in an empathic transference that allows regulating functions to be internalised.
Heinz Kohut's self psychology is a psychoanalytic reformulation born of the treatment of patients whose narcissistic vulnerability, emptiness, shame, rage and tendency to fragmentation were not well explained by drive conflict and defence. It places at the centre a self that needs selfobject experiences of mirroring, idealisation and twinship in order to achieve and preserve cohesion, temporal continuity, self-esteem, vitality and initiative. Chronic or traumatic failures of those responses can arrest development and leave structural deficits that show themselves as archaic grandiosity, a compulsive search for approval, dependence on idealised figures, a sense of unreality or collapse in the face of narcissistic injury. In analysis, these needs reappear spontaneously as selfobject transferences. The analyst investigates them through vicarious introspection or empathy, understands their function from within and interprets them genetically and dynamically without reducing them from the outset to resistance. Repeated work on tolerable interruptions of the transference makes possible optimal frustrations and transmuting internalisation: functions previously deposited in the selfobject gradually come to constitute more stable psychic capacities. The expected outcome is not an independence without ties, but a more cohesive and flexible self, able to sustain realistic ambitions, orienting ideals, talents, mature relationships and healthy forms of narcissism.
Theory of change
Change occurs through understanding and working with the selfobject transferences until tolerable, worked-through interruptions allow functions of cohesion, regulation and self-esteem to be internalised.
Core ideas
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Narcissism has a developmental line of its own
Kohut held that narcissism is not merely an immature stage that must be transformed into object love. Grandiosity and idealisation can evolve into ambitions, creativity, ideals, humour and empathy, so the clinical task is to favour their mature transformations rather than to eradicate all narcissistic investment. This thesis made it possible to recognise a healthy narcissism and to reconsider as arrested development what had previously been interpreted exclusively as regression or resistance. Reference: Kohut, H. (1966), Forms and Transformations of Narcissism; Kohut, H. (1971), The Analysis of the Self.
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The self is constituted and maintained within a selfobject matrix
The cohesion of the self depends on functions provided by others who are experienced as part of one's own psychological equilibrium. Development does not lead to an independence free of selfobject needs, but to more flexible, mature and diversified forms of mirroring, idealisation and twinship. Pathology appears when serious failures prevent those functions from being internalised or leave cohesion tied to archaic, perfect responses. Reference: Kohut, H. (1971), The Analysis of the Self; Kohut, H. (1984), How Does Analysis Cure?
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Empathy is the method that defines psychological data
For Kohut, empathy is vicarious introspection: the way of observing an experience that can only be known from an internal perspective. It does not in itself guarantee kindness or cure and does not oblige one to agree with the patient; it provides the data from which psychoanalytic explanations are subsequently built. This methodological priority protects theory from imposing distant categories before understanding how a need or an injury is lived. Reference: Kohut, H. (1959), Introspection, Empathy, and Psychoanalysis.
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Disorders of the self require thinking in terms of deficit as well as conflict
A person may suffer not only because wishes and prohibitions come into conflict, but because they lack sufficiently consolidated functions for preserving cohesion, self-esteem or regulation. In disorders of the self, interpreting conflict without attending to the deficit can increase fragmentation. The formulation must decide which part of the suffering corresponds to missing structure, which to defence and compensation and which to constituted neurotic conflict. Reference: Kohut, H. (1977), The Restoration of the Self; Kohut, H. & Wolf, E. S. (1978), The Disorders of the Self and Their Treatment.
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Selfobject transferences are the principal route of observation and change
Archaic needs are spontaneously reactivated in the analytic relationship as demands for recognition, union with an idealised figure or likeness. Instead of treating them at once as resistance, the analyst lets them take shape, observes what each one sustains and studies their interruptions. Working them through yields genetic knowledge and creates the conditions for the functions deposited in the analyst to become more internal. Reference: Kohut, H. (1968), The Psychoanalytic Treatment of Narcissistic Personality Disorders; Kohut, H. (1971), The Analysis of the Self.
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Cure requires both empathic understanding and interpretation
Self psychology does not replace analysis with unspecific support. The therapist first understands the experience from within and then explains the relation between the present event, the transference configuration and its history. An explanation without understanding becomes alien or humiliating; an understanding that never turns into interpretation limits insight and working through. Sequence and timing integrate both components. Reference: Kohut, H. (1984), How Does Analysis Cure?
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Frustration is structure-building only when it is optimal and workable
Every relationship contains limits, separations and failures. When the selfobject interruption is not traumatic and can be understood, the patient tolerates a fractional loss of the external function and begins to take it on. The concept does not prescribe manufacturing deprivation or refusing repair: it designates the difference between an assimilable disappointment that promotes structure and a traumatic repetition that intensifies defence or fragmentation. Reference: Kohut, H. (1971), The Analysis of the Self.
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Transmuting internalisation links development and treatment
The same principle explains how structures are formed in childhood and how an analysis can reopen arrested development. Through gradual, fractional and depersonalised withdrawals of selfobject functions, capacities for calm, esteem, orientation and control become one's own organisation. The cure does not literally reproduce parenting, but creates a transferential matrix in which a structural acquisition that remained incomplete can continue. Reference: Kohut, H. (1971), The Analysis of the Self; Ornstein, P. H. (1978), Introduction to The Search for the Self.
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Narcissistic rage protects a threatened self
The intensity and persistence of certain kinds of rage are understood through the injury to an organisation that expects perfect control, recognition or union. Analysing the narcissistic matrix and the selfobject precipitant makes it possible to restore equilibrium and reduce the need for revenge. Understanding its function does not exonerate harmful acts or remove limits; it avoids responding to wounded grandiosity with a fresh humiliation that would reinforce the cycle. Reference: Kohut, H. (1972), Thoughts on Narcissism and Narcissistic Rage.
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Health integrates ambitions, talents and ideals
A firm self is not defined only by the absence of symptoms, but by a living relation between purposes, capacities and values. Ambitions transform grandiosity into direction; ideals transform idealisation into orientation; and talents make it possible to traverse the arc between the two poles. Psychopathology can appear when one pole is defective, when the connection breaks or when a compensation sustains cohesion at the cost of rigidity. Reference: Kohut, H. (1977), The Restoration of the Self.
Influences
- Freudian psychoanalysis
- The theory of narcissism
- Ego psychology
- The introspective-empathic method
- Clinical observation of narcissistic disorders
- The humanities, literature and music
Key references
- Freud, S. (1914). On Narcissism: An Introduction.
- Kohut, H. (1959). Introspection, Empathy, and Psychoanalysis: An Examination of the Relationship Between Mode of Observation and Theory.
- Kohut, H. (1966). Forms and Transformations of Narcissism.
- Kohut, H. (1968). The Psychoanalytic Treatment of Narcissistic Personality Disorders.
- Kohut, H. (1971). The Analysis of the Self: A Systematic Approach to the Psychoanalytic Treatment of Narcissistic Personality Disorders. New York: International Universities Press.
- Kohut, H. (1972). Thoughts on Narcissism and Narcissistic Rage.
- Kohut, H. (1977). The Restoration of the Self. New York: International Universities Press.
- Kohut, H. (1979). The Two Analyses of Mr. Z.
- Kohut, H. (1984). How Does Analysis Cure? Chicago: University of Chicago Press.
- Kohut, H., & Wolf, E. S. (1978). The Disorders of the Self and Their Treatment: An Outline. International Journal of Psycho-Analysis, 59, 413–425.
- Ornstein, P. H. (Ed.). (1978/2011). The Search for the Self: Selected Writings of Heinz Kohut, Vols. 1–4. London: Karnac/Routledge.
- Miller, J. P. (1985/1995). How Kohut Actually Worked. In A. Goldberg (Ed.), Progress in Self Psychology, Vol. 1. Hillsdale, NJ: Analytic Press.
- Ornstein, P. H., & Ornstein, A. (1985/1995). Clinical Understanding and Explaining: The Empathic Vantage Point. In A. Goldberg (Ed.), Progress in Self Psychology, Vol. 1. Hillsdale, NJ: Analytic Press.
- Baker, H. S., & Baker, M. N. (1987). Heinz Kohut's Self Psychology: An Overview. American Journal of Psychiatry, 144(1), 1–9.
- Siegel, A. M. (1996). Heinz Kohut and the Psychology of the Self. London: Routledge.
- Strozier, C. B. (2001). Heinz Kohut: The Making of a Psychoanalyst. New York: Farrar, Straus and Giroux.