On Empathy 论共情
This article, a reprint of the transcript of Heinz Kohut’s last public address, is Kohut’s final attempt to clarify the role of empathy in psychoanalysis. Kohut defines empathy as a method of psychoanalytic investigation, and then explores the ways in which empathy itself can be a therapeutic response. He describes how empathy’s role has been misinterpreted and misunderstood, and he describes the various forms in which empathic understanding may be communicated to the patient.
Keywords: Kohut; empathy; vicarious introspection; method of investigation; psychoanalysis; self psychology
Kohut, H. . (2010). On empathy.International Journal of Psychoanalytic Self Psychology, 5(2), 122-131. DOI: 10.1080/15551021003610026
I will summarize in my own way. I would think that many of those who spoke during these meetings, belonging to the intimate circle of my friends and collaborators, have already begun to digest some of my work during the last year or two that is still far from publication, and is not——I'm very persnickety about such things——in that final form that I try to insist on. But I do believe that among the things that I have been writing about, in a book called How Does Analysis Cure? a 150-page essay on the concept of defenses and resistances seen in the light of self psychology, and a broad statement on issues of empathy on various levels of meaning of this term, are the most important ones. And I will address myself to the issue of empathy despite the fact that some couple of years ago I kept saying I'm sick of that topic. It seems to be nonproductive. I hear over and over again the same arguments, and they are so far off my meaning that I had the impression that I was wasting my time, my emotions, my energy that I could use on new ideas and new work. But idiot that I am, I still don't know, despite a fairly long life, and hopefully some attainment of wisdom, that when people keep asking you the same damn question, something must be wrong!
Something is wrong. What is wrong is not what I said in 1959, in this pivotal paper of mine on "Introspection and Empathy," an investigation or an examination of the relationship between mode of observation and theory. This [as the subtitle clearly indicates] was the paper; [it was] not on empathy, on being empathic as an act; [but] only on empathy as a definer of a field, [which is] therefore a field of pure psychology, a field that relates to the inner life of man, the complex mental states—a definition of psychoanalysis that I have proposed many, many years ago already. I think even in one of my presidential addresses, when I was still Mr. Psychoanalysis and in the center of the psychoanalytic movement, even then I said that [psychoanalysis was] the science of complex mental states, [a definition] which bypassed this specific theory, or that specific theory, however important theories may be. It is just as important to realize [the necessity of omitting specific theories from defining our own field of] investigations, as it would be in [connection with defining], let us say, the physical sciences as the sciences that work with the theories of causality, time, and space. By no means is that [explicit inclusion of specific theories in the definition] necessary. There are physical sciences that do not work with the theories of causality, time and space, and yet they are physical sciences. So the same is true for psychoanalysis.
There is another reason why I want to go back to empathy—namely, that I have a sense of responsibility about the abuse of this concept. The fact again that people have acted as if I were abusing it makes me go up on a high horse, and say, "These idiots, they don't read what I write!" But again I should have listened. If they misunderstand (undoubtedly there are also irrational motivations, probably narcissistic ones, competitiveness, God knows what, I don't know, and I don't really want to make these dumb interpretations); the point is that if they misunderstand, other people must misunderstand, too. They will claim that empathy cures. They will claim that one has to be just "empathic" with one's patients and they'll be doing tine. I don't believe that at all! What do I believe?
Before I go into the more exact practical statements aimed to contribute a little bit of antidote to the sentimentalizing perversions in psychotherapy about curing through love, through empathy, through kindness, through compassion, to just being there and being nice and "Yes, I understand you"; before I go into that, I think what I need to do, if I take you seriously, and I think I should, is to define empathy on the various levels on which this concept can be used. And having done that, I believe I can come back again and make clearer what I said in my most recent writings.
Let me first talk about empathy very, very briefly in the way in which Iused it in the epistemological sense in 1959. In 1959 I used it, as the beautifulword goes (I never quite understood t, I looked it up sixteen times alreadyin the dictionary; I think by now I do know). In other words, in themost broadly based theorizing about a science, (and these are my words, Ialways like concrete and palpable words) in a most experience-distant way,a theorizing in the most experience-distant way about a science. As such,that may not be easy for many people to understand. And I thought aboutwhy. As such, it is a definer of the field and nothing else. External realityand the sciences that deal with external reality are defined by the operationalstance of the observer—namely, extrospection, and I will add fortheoretical reasons (although it plays a very small role in the physical sciences)vicarious extrospection, corresponding to empathy. In other words,we not only look at things theoretically, but we also listen to reports of peoplewho have looked at things that we can’t se either because we weren’tthere, we couldn’t be there, or because it is totally or forever impossible tobe there. Let us say, for example, scientists will instruct nonscientific astronautswhat to look for on the moon, what to keep their eyes open for, whatparticularly clearly to report about. When the astronauts come back, theygive their report (free association there is called debriefing), and the scientistevaluates now what he should do with the data. This is vicariousextrospection. [Regarding] events, I mean physical events for example, inthe ancient world, we have to rely on eye-witness accounts. When was thateruption of Vesuvius? Two different reports come in with slightly differentdates to e deducible from them. Now we can think “where is the greater evidence?”
It seems to me that's very, very similar to what the analyst does about the vicarious introspection of his patient. We cannot see what's going on in him. We instruct him to report what's going on in his inner life. Introspection, pursued in a very particular way, for prolonged periods, with due attention paid to all kinds of obstacles to reporting of things that are unpleasant to report. People in [history], let's say the Greek historians Herodotus, Xenophon, Thucydides, they had axes to grind. You know one was conservative, pro Sparta; the other one was liberal, pro Athens. We have to know that, and then we'll take with a grain of salt what we read and what we really believe. So outpatients of course have axes to grind. Now mind you, I don't want to overdo analogies. I know tremendous differences [exist] too. I'm not suddenly forgetting my whole life as a listening psychoanalyst. I know how to listen to patients. So the analogies [should not be] overdrawn. But they have basic validity, I think. So really introspection and empathy are, in that sense, definers of the field. That means that they are defining our field as the inner life of man and therefore that we are psychologists.
I do not believe, however hard it was tried, that there is a possibility to create such a misalliance as psychobiology, or biopsychology, or something on that order. It was tried and the results of this attempt led to the worst distortions of the perception of man that psychoanalysis is guilty of: the introduction of the drive (not the experience of being driven, not a self lusting and wishing to kill—that's psychology); but "the drive," being processed by an apparatus, being tamed via influences of civilization on the ego that filters the drive. You know, I know my classical analysis so well; and that. . . [There was some laughter in the audience which interrupted Kohut, but then he responded to it] . . . no, I mean that, because I do think that my colleagues don't. They don't even know anymore what I am arguing about. But they have made compromises in a vague way. 1 never do that anymore, I never think that way anymore. I believe all that. But nobody has ever faced up to the issue as the issue deserves. Freud was a genius. This is no way of treating Freud—to by-pass him. Freud has to be respected for what he gave us, and what we can see about the shortcomings of what he did, from our vantage point. And I think that is the respectful attitude toward a genius of some time ago.
Secondly, I would say that introspection and empathy should be looked at as informers of appropriate action. In other words, if you understand, "put yourself into the shoes of," think yourself appropriately into the inner life of another person, then you can use this knowledge for your purposes. Now I don't know how many times I have stressed that these purposes can be of kindness, and these purposes can be of utter hostility. If you want to hurt somebody, and you want to know where his vulnerable spot is, you have to know him before you can put in the right dig. That's very important. When the Nazis attached sirens to their dive bombers, they knew with fiendish empathy how people on the ground would react to that with destructive anxiety. This was correct empathy, but not for friendly purposes. Certainly we assume on the whole that when a mother deals with her child, and when an analyst deals with his patient, correct empathy will inform her appropriate maternal and his appropriate therapeutic analytic action. So [empathy] is an informer of appropriate action, whatever the intentions may he. That's clear, and I don't think it needs any further elaboration, I'm sure.
So, we go to the next of the levels in which we can examine empathy. Empathy serves also, and this is now the most difficult part—namely, that despite all that I have said, empathy, per se, is a therapeutic action in the broadest sense, a beneficial action in the broadest sense of the word. That seems to contradict everything I have said so far, and I wish I could just simply bypass it. But, since it is true, and I know it is true, and I’ve evidence for its being true, I must mention it. Namely, that the presence of empathy in the surrounding milieu, whether used for compassionate, well-intentioned therapeutic, and now listen, even for utterly destructive purposes, is still an admixture of something positive. In other words, there is a step beyond an empathy-informed hatred that wants to destroy you; and an empathyless environment that just brushes you off the face of the earth. The dreadful experiences of prolonged stays in concentration camps during the Nazi era in Germany were just that. It was not cruelty on the whole. (The Nazis were not sadistic or cruel in those camps. There were exceptions of course, it couldn’t be otherwise, there are always some exceptions; but that was clearly punished, that was clearly frowned on.) They totally disregarded the humanness of the victims. They were not human, either fully not human, or almost not human (there was a little shift between, I think, the Jews and the Poles, or something like that, in that respect). That was the worst.
There is a touching story—again I come back to the astronauts, you may remember it—of the astronauts when their spaceship, before landing on the moon, was hit by a meteorite, that's the theory. And they seemed to have lost control over it. And they had the choice, if there was indeed a loss of control, to go on circling for many, many weeks with their supplies, or to go back to Earth and—because they couldn't slow down—get scorched and burned up upon entering. As they were discussing this issue among themselves—there was no question in their minds: "We would never want to have our remains circle forever in empty space. Even if we burn up, it's Earth, it's our home." And that, I submit, stands for an empathic human milieu. There are many other examples that I could give you. I will not.
I will at this moment go a little bit on a side [trip] and talk about an aspect of my book that 1 consider to be quite an important one, namely, my differentiation between castration anxiety and disintegration anxiety; between the [fear of] loss of a prized part of the body and the [fear of] wiping out of the [whole] self. I won't talk about castration anxiety, everybody knows what that is. But disintegration anxiety is not so easy. Disintegration anxiety means the loss of empathy, the loss of an empathic milieu, the loss of an understanding milieu, not necessarily of the correct action, but the loss of any understanding. There are children with horrible mothers and fathers, misunderstanding their kids, reacting to them in horrible ways (oh. of course, they show the scars when they grow up); but the worst suffering I've seen in adult patients is in those very subtle, and difficult to uncover, absences of the mother—because her personality is absent. Nothing will be told about it, because the patient assumes this is the milieu in which people grow up. He had been made to feel guilty all his life for yearning for something else, for making demands. And the mother rightly made him [feel] guilty because he demanded something that just wasn't in her to give. It is the hidden psychosis of the mother, a much more frequent early circumstance, than has been understood. It is a psychosis of the mother that Kafka described so well in The Castle—the attempt to come close and yet there is absolutely no response; or in The Trial—the wish to know what he's guilty about. There is no guilt, he's just disregarded, the knife turns and he's—that's the end of him. Metamorphosis—the changing to an ugly insect because the parents in the next room speak of him in the third person singular—he's doing that, he's doing that, clearly excluding him. Sometimes the reports are very subtle and you have to be very, very perceptive to grasp them. In one of my patients, it was the mother's hiding behind bridge cards. Whenever he came, there were those bridge cards between him and her. But she had nothing to give. It is this emptiness that leads to the worst sufferings later in life.
Well now, how does all this fit with what probably is the most important point that I made in Hmv Does Analysis (hire? I submit that the most important point that I made was that analysis cures by giving explanations—interventions on the level of interpretation; not by "understanding," not by repeating and confirming what the patient feels and says, that's only the first step; but then [the analyst has] to move on and give an interpretation. In analysis an interpretation means an explanation of what is going [on] in genetic, dynamic, and psychoeconomic terms. I, for some reason, don't want to open the can of worms of Hartmann's adaptive point of view now—which I believe is a foreign body in analysis, however, brilliant this bridging concept to sociology may be. But I believe that the move from understanding to explaining, from confirming that the analyst knows what the patient feels and thinks and imagines (that he's in tune with his inner life), and the next step of giving of interpretations is a move from a lower form of empathy to a higher form of empathy. Interpretations are not intellectual constructions. If they are, they won't work; [they might work] accidentally, but not in principle. A good analyst reconstructs the childhood past in the dynamics of the current transference with warmth, with understanding for the intensity of the feelings, and with the fine understanding of the various secondary conflicts that intervene as far as the expression of these [childhood wishes and needs] are concerned. The paradigm, or should I rather say (because that's now a loaded word too, for some crazy reason), the prototype, the prototype of this shift—this two-step move from understanding to explaining—is, in childhood, a particular situation that I described, hopefully with feeling, in my new work, How Does Analysis Cure? I [cited there the example of] a child and his mother in the park. The child, as a young child always [does], clung to the mother. But the sun was shining, pigeons were walking around there. All of a sudden, the child felt a new buoyancy and daring and he moved away from the mother, toward the pigeons. He went three to four steps, and then he looked back. The general interpretation of that is that the child is anxious; he wants to be sure he can come back to be encased by the mother's arms again, cradled, etc. I think all that is true. But something much more important is true. He wants to see the mother's proud smile of his achievement. He wants to see her pride, "look at him moving out now, on his own, isn't it wonderful?" And at this moment something extremely important has happened. A low form of empathy, a body-close form of empathy, expressed in holding and touching and smelling, is now expressed only in facial expressions and perhaps later in words, "I'm proud of you, my boy." Now that's an interpretation, or at least it is the parallel to the interpretation in psychoanalysis. How? I told you already—there is understanding that is sort of like the bodily holding, a merger, and then that is given up later on (in some sick people it might take a long time before one can actually make the next step); and then as the next step is made, it is on a much higher form of empathy, empathy in a complex way, with [explanation of] the past and how the present repeats it, all the forces that are involved—and given careful expression, it's still empathy. It's still psychological (and in that sense on a higher level), [it is now an] understanding [of] the message. I think that's extremely important, and shows you that what you really need to investigate carefully is what I've come to call the developmental line of empathy—from its early archaic beginnings, to such high levels as barely touching, as barely still having any trace of the original holding that communicates the empathic understanding. So that essentially tells you what I think about empathy. It is something that I could talk about for a long, long time.
But as I said, and with that I want to close, I bring this up for many, many reasons. But one of the main reasons is the responsibility that I feel that you must not abuse the concept of empathy for vaguely supportive measures, but grasp the idea of what empathy is, in fact, on various levels of its development. Certainly I'm not stodgy, and I think the more one knows, the greater one's freedom. The more one knows, the less important some ritual that one sticks to anxiously, because no one knows what is appropriate and what is inappropriate. There is always the question of how to treat people with very serious self disturbances, who cannot possibly benefit from interpretations. I believe. It's too soon, and for many years, they do need an empathic understanding on the closest level that we can muster. And it does not mean that one cannot move naturally, slowly, and gradually into higher forms of empathy and explaining, much, much, much later on.
I remember, and I think I'll close my remarks this morning with this, I believe, telling story. About fifteen years ago I was engaged in a long, long analysis with a woman who was extremely vulnerable. She lay down on the couch the first time she came, having interrupted a previous analysis abruptly. She said she felt like lying in a coffin, and that now the top of the coffin would be closed with a sharp click. I'm telling it to you that way, because it expressed so well what she felt. She was deeply depressed, and at times I thought I would lose her—that she would finally find a way out of the suffering and kill herself. But I didn't. At one time at the very worst moment of her analysis, during the first year or perhaps year and a half, she was so badly off I suddenly had the feeling [and said]: "How would you feel if I let you hold my fingers, for a little while now while you are talking? Maybe that would help you." Doubtful maneuver. I am not recommending it, but I was desperate. I was deeply worried. So I gave her two fingers, moved up a little bit in my chair, gave her two fingers. And now I'll tell you what is so nice about that story. Because an analyst always remains an analyst. I gave her my two fingers. She took a hold of them, and I immediately made a genetic interpretation to myself. It was the toothless gums of a very young child clamping down on an empty nipple. That was the way it felt. I didn't say anything. I don't know whether it was right. But I reacted to it even there, to myself, as an analyst. [After this one occasion] that was never necessary anymore. I wouldn't say that it turned the tide, but it overcame a very, very difficult impasse at a given dangerous moment, and gaining time that way we went on for many, many more years with a reasonably substantial success.
So with that I think I will now close. I'm very glad you waited for me. I'm quite sure this will be the last self psychology meeting that I will attend, but I wanted to do my utmost to be able to go through with my promise. So, let's all hope for a good future for the ideas embodied in self psychology.
This article has been reprinted here with the kind permission of Paul H. Ornstein, Thomas Kohut, and the International Universities Press, for which the International Journal of Psychoanalytic Self Psychology is deeply grateful：Kohut, H. (1981), On empathy. In: The Search for the Self: Selected Writings of Heinz Kohut: 1978–1981, Vol. 4, ed. P. H. Ornstein. Madison, CT: International Universities Press, pp. 525–535.
本文经Paul H. Ornstein、Thomas Kohut和国际大学出版社的同意在这里转载，对此，《国际精神分析自我心理学杂志》深表感谢。
Footnote as it originally appeared inThe Search for the Self.(Editor’s note: The following was transcribed from a recording of extemporaneous remarks made by Heinz Kohut at the 5th conference on Self Psychology at Berkeley, CA, in October 1981. This was Kohut’s last public address before he died just a few days later. These remarks would undoubtedly have been carefully edited by him afterward, to meet his standards for publication. They have only been minimally edited here [in brackets], to enhance clarity by deleting some repetitious phrases, a few extraneous asides, and to maintain proper grammatical standards. Editing was also held to a minimum, so as to retain the immediacy, informality, and emotional impact of Kohut’s delivery, even at the expense of some “inelegance” of style. An earlier transcript, prepared by Robert J. Leider,M.D., in September 1983, for the exclusive use of the Self Psychology Workshop at the Chicago Institute for Psychoanalysis, was helpful in the preparation of his version.)
最初出现在《自我的追寻》中的脚注。（编者按：以下海因茨·科胡特于是1981年10月在加州伯克利第5届自体心理学会议上即席发言的录音。这是科胡特最后一次公开演说，几天之后他便去世了。这些话语无疑是他后来精心编辑的，以符合他的出版标准。这里[括号内]只对它们进行了最低限度的编辑，以通过删除一些重复的短语、一些无关的旁白来提高清晰度，并保持适当的语法标准。作为一种“非正式”的表达方式，即使是为了保留“非正式”的表达方式，也是为了保留“非正式”的表达方式。本版参考了医学博士罗伯特·莱德（robertj.Leider）在1983年9月为芝加哥精神分析研究所（Chicago Institute for Psychology analysis）的自我心理学研讨会专门准备的一份更早版本。
[Editor's note: Neither the search of the literature nor eve-witness accounts substantiate either the absence of sadism or their punishment when these did occur. In fact, all eye-witnesses report frequent and most brutal sadistic acts without evidence of attempts to curb these or to punish the offender. Nevertheless. Kohut's basic thesis that the Nazis aimed at total dehumanization of camp inmates, before and during their extermination, is I hereby not altered.