A theory introduced by Heinz Kohut in the early 70's with the publication of his now famous monograph,The Analysis of the Self(1971), self psychology has burgeoned into the most significant analytic theory since Freud first introduced psychoanalysis to the scientific world in the early 20th century.
Having been trained in the theories of American ego psychology, Kohut established a reputation as a staunchly conservative Freudian analyst, winning him in 1964 the presidency of the American Psychoanalytic Association.
Yet it was his integrity, not his politics, and his deep concern for the many stalemated or premature terminations among his patient population, that eventually prompted him to question the very theories upon which he had staked his scientific surety and built his reputation.
When asked by a fellow scientist what had caused him to alter his thinking, he readily admitted that he "had more and more the feeling that my explanations [to patients] became forced and that my patients's complaints that I did not understand them...were justified" (Kohut, 1974, pp.888-889).
Setting aside his classical theory, Kohut took the lead from his patients in discovering his theory of the self. In particular, it was the case of Ms. F., a woman in her mid-20's, who insisted that he be perfectly attuned to her every word.
This taught Kohut (1968, 1971) about empathy as experience-near observation, the clinical stance from which he would make his major discoveries.
For example, whenever Kohut strayed from Ms. F.'s experience by offering an intervention that reflected even a slight revision to what she had arrived at on her own, she became enraged that he was ruining what she had accomplished and "wrecking" her analysis.
By relinquishing his clinical assumption that her anger was an expression of her resistance to the analysis, which he recognized was impeding his ability to grasp the fullness of Ms. F.'s experience, Kohut learned to see and understand things exclusively from her viewpoint.
He termed this mode of observation,experience-near.
Thus, in these moments when he captured her feeling of being misunderstood and offered a response that more or less reflected what she was thinking and feeling, he observed that her previous sense of well-being was quicklyquickly restored.
In time Kohut hypothesized that this sequence of disruption and reparation of the empathic connectedness between analyst and analysand is an inevitability in any effective treatment; at the same time, he suggested that if these disruptions of empathy are kept to an "optimal" (vs. "traumatic") level, they are not harmful but, in fact, are an essential ingredient in the development of psychic structure and analytic cure.
These initial observations from an experience-near empathic perspective led to Kohut's understanding of Ms. F.'s need for recognition, a need he viewed as a "developmental arrest" due to empathic failures of childhood and that he later theorized to be a mirror selfobject transference.
Thus, it is this experience-near mode of observation that Kohut viewed as empathy.
Probably no term or concept that Kohut (1959, 1971, 1975, 1977, 1981, 1984) wrote about has been more misunderstood by friends and foes alike than that of empathy.
As has been frequently noted, he was so exasperated by those who felt he was advocating the use of empathy as some sort of "psychotherapeutic perversion," - some way of being "nice," "kind," and "curing one's patient's through love" - that he dedicated his final address just days before his death to a fuller clarification of the term.
In essence he spoke of empathy on two different levels: the abstract and the operational.
Abstract EmpathyBy the abstract definition of empathy he meant the role of empathy in defining the science of psychoanalysis.
In other words, any science is defined by an object of study and a method by which the data of that science is collected.
For example, the physical sciences have as their object of study the discernible world that can be observed via the senses and those instruments that enhance the senses.
On the other hand, psychoanalysis has as its object of study the inner life of man (the data of human experience) while the method by which the analyst makes his observations is introspection into oneself and vicarious introspection or empathy into another.
In other words, empathy is nothing more than the "tool" or "instrument" that permits psychoanalysts to collect their data, which over time can be translated into explanations in the clinical setting and abstract constructs in the theoretical realm.
It was this methodology that made it possible for Freud to discover transference, countertransference, defenses, and resistance.
As Freud moved away from the empathic mode of data collecting, he introduced constructs and assumptions that belong to other sciences.
One example is that of the "drive," which was assumed to be on the borderland between the psyche and the soma. Thus "drive theory" psychoanalysis could no longer be viewed as a pure psychology but rather as an amalgam of psychology and biology, that is, a psycho-biology or bio-psychology.
Operational EmpathyBy the operational definition of empathy Kohut is referring to the clinically relevant definition of empathy as"the capacity to think and feel oneself into the inner life of another person"(Kohut, 1984, p. 82).
Derived from the German termEinfuhlung, empathy evolved in its meaning to connote "feeling into" or "searching one's way" into the experience of another (Basch, 1983).
For Kohut, empathy is simply what allows an individual to know another's experience without losing one's objectivity.
In other words, empathy is experience-near observation and nothing more. Return to top
THE SELF
Through his experience-near empathic mode of observation during psychoanalysis, Kohut traced the development of the self not as a concept or representation of the mind as in object relations theory but as a "supraordinate" construct that comprises the entire psychic structure, that is, an inner experience that has continuity in time and space.
The particular patients he observed, such as the previously described Ms. F., were termed narcissistic personality disorders - later referring to them as self disorders - who presented with a clearly defined syndrome.
Characterized by unusually labile moods and extreme sensitivity to failures, disappointments, and slights, these patients are ultimately diagnosed not so much b much by the symptoms as by the emergence in treatment of certain unresolved needs he termed selfobject transferences.
THE SELF OBJECT
By selfobject Kohut (1971, 1984) means the experience of another – more precisely, the experience of impersonal functions provided by another – as part of the self.
Selfobject transference, therefore, is the patient's experience of the analyst as an extension or continuation of the self, that is, as fulfilling certain vital functions that had been insufficiently available in childhood to be adequately transformed into reliable self structure.
He came to discover that within the empathic treatmenteatment milieu unmet infantile needs for recognition, idealization, and twinship reemerge in the form of mirroring, idealizing, and twinship selfobject transferences.
Transmuting Internalization
The growth-producing process by which these patients are able to internalize the needed selfobject functions and to acquire the missing self structure is termed transmuting internalization.
Kohut (1984, p. 70) came to recognize that this process occurs through this two-step process.
- First, there must be a basic empathic intuneness between the self and its selfobjects.
In the therapeutic setting this intuneness between the self and its selfobjects or bond is the emerging selfobject transference. - Second, manageable and minor nontraumatic failures of the empathic bond must occur.
Kohut referred to these failures as "optimal frustratiostrations" and viewed them as inevitable, not because they are brought about by some technical manipulation on the part of the analyst to facilitate cure, but because the analyst's task is to understand and explain the patient's needs, not to meet them.
"There is never any need–and by never, I mean never – there is never any need to be artificially traumatic.
Simply to give the best you can give is traumatic enough, because you cannot fulfill the real needs."(p. 91).
Treatment
It is the empathic process of understanding and explaining - paralleling the therapeutic process of traditional analysis - that allows the treatment to go forward and the self to acquire the missing structures in what Kohut (1984) describes as a three-step movement.
- First, there is the analysis of defense and resistance against the emergence of the new editions of the selfobject transference.
- Second, there is the unfolding of the various selfobject transferences and their working through.
- Third, there is the making possible the establishment of an empathic intuneness between the self and the selfobject on a more mature adult level.
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