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Books, Part XXXXI
Heinz Kohut: The Making of a Psychoanalyst
Charles B. Strozier (2001)
Chapter 19- The Analysis of the Self
It is a curious fact of Kohut's creativity that his major theoretical work came in the second half of his sixth decade. Kohut was just beginning when many people are preparing for retirement. Perhaps he was delayed by all those years spent laboring in the vineyards as Mr. Psychoanalysis, storing up impressions, doing his clinical work, preparing for something original. But that is not how Kohut himself understood his own experience, at least from the vantage point of 1980. The best work in psychoanalysis, he said then, comes when you are fairly old. Physicists do their best work at twenty, mathematicians at nineteen. But in depth psychology, he said, you have to live long enough to "become detached from the intensity of the experience," to be able to remain close enough to it and yet detached. Besides, there are two kinds of psychologies. One kind remains immersed in experience—"mysticism and excitement, and cure through love and what have you"—and then the "totally detached ones." Neither is right absolutely. You have to do both at the same time, he says, but you cannot really do that until you get a little older.
One wonders, as well, whether something in Kohut's location in Chicago nourished his insights into narcissism. As Napoleon came from Corsica, Genghis Khan from Siberia, or even Lincoln from Springfield, great nation builders are often from the periphery. The same principle may work in some analogous form in scientific fields. The distance from the center brings freedom and clarity, particularly for someone as insecure and needing of constant affirmation as Kohut. Had he been a part of the New York psychoanalytic scene he might well have been stifled. He could never have been the star he was in Chicago. Toward the end of his life Kohut was once asked whether there was something about the ambience in the Chicago Institute that encouraged his work on narcissism. His reply was curious. He said that he did not really "live in Chicago," for his commitments lay elsewhere and he was always part of "psychoanalysis as a whole." But his point was to impress his interviewer. For then he described in detail how Anna Freud stayed with him for ten days in 1966.2 His name-dropping proves the point. Had he been any closer geographically to Anna Freud, Heinz Hartmann, or even Kurt Eissler, he might never have become Heinz Kohut.
But however one locates his life within his work, the culmination of Kohut's reflections on narcissism came with the publication of his first book, The Analysis of the Self, in the spring of 1971. He was just shy of his fifty-eighth birthday. Typically, he had embraced the project in fits and starts, but by 1967, if not sometime late in 1966, he had firmly committed himself to a book. Paul Ornstein recalls Kohut pulling out pages from a drawer to read to him in supervision as early as 1966, but that manuscript was surely the 1968 paper that he was then writing to Anna Freud about.3 All this suggests the key moments of creation of Analysis were his months of vacation in Carmel during the summers of 1967 and 1968. He wrote in his study above the garage but also found it useful to take extended trips to the library at Berkeley. By April 1969 Kohut told Anna Freud his book was "nearing completion," and in June he reported to Rene Spitz that he was "putting on the finishing touches" to the manuscript. By that Christmas he was "more or less finished," though "there are always new thoughts to be added."4 In the spring of 1970 he finally let go of the manuscript and submitted it to International Universities Press.
Analysis is a difficult book, with meanings that can seem contradictory. It employs the abstract and highly technical language of Freudian ego psychology but describes a landscape of the self that (if one really takes it in) allows the jettisoning of drive theory while retaining the idea of multiple perspectives; opens up a new approach to development that makes the Oedipus complex irrelevant; defines trauma without libido; and develops a new set of clinical ideas about dealing with a sicker class of patients from those usually treated by psychoanalysts. The book has three parts: an important introduction; a long discussion of idealization, followed by another of grandiosity; and a concluding section on special clinical issues of treating "narcissistic" patients. No one before Kohut had broken down the problem of the self in such terms. His theory is in equal parts phenomenological and developmental. The book is not what it appears to be. Kohut presents Analysis as a monograph for specialists on healing more disturbed patients and merely claims the modest goal of defining narcissism as a "line of development" (as opposed to relatedness, or "object love"). All that, however, was a mere cover to keep the orthodox off guard. Certainly, he succeeded. The major reviews of the book at the time, continuing through to more recent discussions, repeat with mind-numbing regularity Kohut's ostensible purpose, as though it makes a difference.5
In fact, Analysis is only superficially about narcissism as a line of development. It is a book about the self. Implicit in its framework is a new psychological paradigm freed from the fragmented model of the soul as broken up into an id, an ego, and a superego. Analysis furthermore is for the self what Freud's The Interpretation of Dreams is for the unconscious. Analysis creates an idea of the self as a separate, holistic concept for contemporary psychological thought. The instincts fade away as Kohut embraces human beings rather than victims of drives. A radically altered therapeutics as well emerges logically from Analysis, one that is engaged, flexible, open-ended, mutual, and empathic. Analysis makes possible the pure gold of psychotherapy.6
Narcissism, as the ostensible topic of The Analysis of the Self, presents many problems of definition. As an amorphous term in psychoanalysis, narcissism included ideas of self-love and selfishness (as Kohut discussed in his 1966 essay, "Forms and Transformations of Narcissism") but was also understood to be the key to explaining the more serious forms of mental illness, including the psychoses, which had always been at the outer edge of the theory.? Most commonly it was assumed that the "narcissistic illnesses" were simply more severe versions of what were more accessible for study in the neuroses. But that was a troubling and rather simpleminded assumption for anyone who thought seriously about these issues. Following Heinz Hartmann, Kohut defines narcissism in his book as the "cathexis of the self" and says that it occupies "half of the contents of the human mind—the other half being, of course, the object." But what is this matter of a "cathexis"7 As the instinctual charge derived from the libido, narcissism for Kohut apparently only makes sense as the state one can describe when the cathexes are directed onto the self. The absurdity of such discursive acrobatics is readily apparent, and leads Kohut to say, for example (in italics), that "narcissism . . . is defined not by the target of the instinctual investment . . . but by the nature or quality of the instinctual charge."8 It is as though electricity can be good or bad, depending on whether it strikes a bridge or is harnessed for human service. But there is an important idea in Kohut's unfathomable prose if one can extract it from the drive theory in which it is buried. He is concerned with the quality of the way we relate to others, rather than the mere fact of otherness.
That distinction lies at the heart of Kohut's contribution to psychoanalytic thought. Freud spent much time describing the complicated ways in which we relate to others and retain representations of them and their symbolic substitutes within what he called the ego. But he always assumed that self and other were separate and that the goal of development was some marked degree of autonomy. These ideas, which embody an entire value system, directly influenced all later thinkers in psychoanalysis, including the "object relations" school that attempted to find ways of using Freud's language (and perspective) to describe early states of engagement with the world. Melanie Klein, for example, talks of "introjects" and very early states (or positions) of envy, depression, and paranoia.9
Kohut took a different approach and altogether shifted Freud's focus, even as he used his language. What matters, Kohut stresses, is the quality of how we relate to others, not the fact that to an outside observer our world may be peopled or even variously represented in the self. What matters is our experience of these others. Perhaps Kohut's key point is that there is no self except in that context. Others (and their symbolic equivalents) are used to form the fabric of our beings and at the same time are experienced as part of the self. These are the "self-objects." Furthermore, as Kohut would clarify later, the end point of development, that is, normality and happiness, is not autonomy and separation but a more profound engagement. We never lose our need to retain our self-objects, or our complex, often self-involved, relationships with them. It is, in fact, through those relationships that the self is formed and continues to exist.
The task of Analysis, however, is not to pursue in any systematic way such general psychological issues. Kohut's project in the book is the narrower and more clinical one of attempting to understand, and offer clinical recommendations on how to deal with, a new class of patients in psychoanalysis (or at least an older category seen very differently). The subtitle of the book is "A Systematic Approach to the Psychoanalytic Treatment of Narcissistic Personality Disorders." These "NPDs" are patients suffering from "specific disturbances in the realm of the self" stuck at early stages of development and weighted down by the "archaic configurations" of their selves, "though it is important to emphasize not only the deficiencies of the psychic organization of these patients but also the assets."10 NPD symptoms tend to be ill-defined. These patients initially have trouble focusing on their essential problems and instead often describe secondary manifestations like work inhibitions or fantasied (or actual) perverse sexual activities. In their personalities they usually lack humor or proportion, as well as empathy for the needs of others. They brood about their bodies and are often filled with psychosomatic symptoms. What NPDs cannot see is the secondary quality of all such experience. "The eye, as it were, cannot observe itself," Kohut says. In treatment the NPD patient is able to articulate pervasive feelings of emptiness and depression that are relieved when the transference is established. When that tie is broken or interrupted, however, the patient often feels not fully real, loaded down by dulled emotions, lacking in zest, and generally depleted. In contrast with the psychoses or borderline states (which Kohut thought of as "covert psychoses")," these symptoms are not rigidly established. A pervasive hypochondriacal brooding, for example, may alternate with a sudden period of feeling alive and happy, which in turn is followed by a period of chronic dullness and passivity. Any rebuff, even the absence of expected approval, quickly leads to a state of depletion.12
The central issue is always self-esteem. NPDs are highly vulnerable, prickly, and volatile. They cannot regulate their self-esteem and maintain it at normal levels. Any disturbance in their fragile equilibrium results in a range of experiences extending from anxious grandiosity and excitement, to mild embarrassment and self-consciousness, to severe shame, hypochondria, and depression. Much lies deeply imbedded with these patients. Their overt complaints are not a reliable guide to their real problems. Behind a vague description of a lack of zest, for example, may well lie a diffuse vulnerability and defects in self-esteem regulation, along with disturbances in the maintenance of a system of ideals. Screens and covers are pervasive. One can only get to the deeper knowledge of the real disturbance in the "spontaneously developing transference." The presenting symptomatology cannot, in itself, be fully trusted.13
The "self-object transferences," as Kohut describes them in Analysis, depart sharply from the conventional understanding of "transference" in psychoanalysis. Initially, as part of his work on dreams in 1900, Freud defined transference as the attachment of an unconscious thought to some preconscious idea with which it has a symbolic connection. Intensities get transferred and the unconscious thought is "covered." It is, he says, like an American dentist who wants to practice in Austria. He needs a medically qualified practitioner to serve as a stalking-horse for him. As a result of his (awful) treatment of Dora the next year, however, Freud came to understand a much broader meaning for transference: "They are new editions or facsimiles of the impulses and phantasies which are aroused and made conscious during the progress of the analysis; but they have this peculiarity, which is characteristic for their species, that they replace some earlier person by the person of the physician." It is a given in Freud's drive theory that those infantile "facsimiles" reproduced in treatment in relation to the analyst via the transference are libidinal in nature."
In the realm of the self, on the other hand, transferences mobilize early experiences of the other in two basic forms: the grandiose self (as Kohut now calls it to avoid the "tautology" of the "narcissistic self") and the idealized parent imago. In the core of our beings we retain the tightly interwoven notions that "I am perfect" and "you are perfect, but I am part of you." These early "configurations," or "central mechanisms," coexist from the beginning in the stage of the cohesive self, but their mostly "independent lines are open to separate scrutiny."15 Under "optimal developmental conditions," grandiosity is gradually tamed and integrated into the personality, grounding one's ambitions and purposes and the enjoyment of one's varied activities. As such, grandiosity comes to provide important aspects of self-esteem. Analogously, idealization becomes the basis of our deepest values, which we hold up to ourselves for guidance and direction and which also help maintain our self-esteem. Trauma disrupts the process of integration of both grandiosity and idealization into the more mature structures of the self. Instead, the earliest and most primitive aspects of the self continue to exist unaltered and unchanged. It is these damaged self structures that then get mobilized in the self-object transferences.16
The "self," in turn, that Kohut analyzes in his book lies close to the immediacy of experience. It is in a different realm from personality or identity, concepts that he feels lie in a "different theoretical framework more in harmony with the observations of social behavior." What Kohut is really saying (not very convincingly, one might note), of course, is that notions of "personality" and "identity" are superficial and the products of observation from the outside, rather than the result of the empathic investigations of psychoanalysis. The self, on the other hand, is a "low-level" abstraction that emerges within the psychoanalytic situation. It is a "content of the mental apparatus" but not one of the agencies of the mind. The self is, however, a "structure within the mind" because it has energies (it is "cathected") and has "continuity in time" or endures. This self Kohut imagines has a psychic location, while at the same time many, often inconsistent, self representations are present within the agencies of the mind (id, ego, superego).17
Such a definition of self, which was consistent with Kohut's thinking in the last half of the 1960s, contains within it a number of contradictions, including that of location together with dispersal, of structure and more elusive representations, and of differing levels of abstraction. Kohut goes well beyond talking about an amorphous "sense of self, " but no sooner has he located a place for the self and suggested its formal structures than he returns immediately to the idea of self representations dispersed throughout the psyche. Kohut's definition of self, in fact (as opposed to his more nuanced use of the concept in context), is quite elusive and almost no definition at all, for the simple reason that he is trying to make the self subservient to Freud's model of the mind, which is in turn dependent on drive theory. The advantage of Kohut's definitional vagueness, on the other hand, is that it reflects honestly the ambiguities of the very idea of self in twentieth-century psychology up to that time. William James noted that the question of life is "Who am I?" But we cannot focus on "I." It is evanescent and slips away. We can only talk of self, which is necessarily the object of our subjectivity. The self is what I can conceive. "Whatever I may be thinking of," as James puts it, "I am always at the same time more or less aware of myself, of my personal existence.18
The first major theme Kohut discusses in his book is idealization. In the Freudian schema, idealization is suspect. It is said to mask envy, hatred, aggression. Interpretation in treatment consists of disclosing the reality that lies behind the patient's tendency to raise the analyst to exalted heights of wisdom and kindness. Shrouded in the noise of present feelings are always the "deeper" truths of the oedipal drama. Kohut argues against the very assumptions behind that approach to the meaning of idealization. He feels that the lost experience of perfection assigned to the other returns as the central experience of the self in relation to the analyst during treatment. One feels empty and powerless when separated from that other. Developmentally, Kohut argues, the baby initially merges into the dimly perceived "mother-breast" that becomes a connection to a person whose functions are taken on as one's own. The subsequent "taming, neutralization, and differentiation" of these first expressions of idealization occur because the real figure of the mother (for the most part) inevitably comes up short in her concrete emotional responses. In the best of circumstances, the child makes increasingly realistic assessments of that figure, which involves a measure of disappointment, and leads to an emotional redirection of feelings from the figure to an internalized imago that sustains the same functions in the self.
This process of structure building in the self Kohut calls "transmuting internalization," which is an idea he adapts (with full credit given) from Freud's 1917 paper, "Mourning and Melancholia." Freud argued that the withdrawal of feelings from lost others occurs in a fractionated way, bit by bit, in order to carry out effective mourning, and that the crucial consequence of this process is the regressive identification with the lost object. Kohut argues analogously that first there must be a developmental readiness for the formation of structure in the self (or a "receptivity for specific introjects"). There is then an "optimal frustration" with the idealized other that prompts an emotional retreat from her or him and an internalization of some functions that had previously been performed by the idealized other. The reason the process is dosed (or "fractionated") is so that the child can relinquish aspects of the other in stages without having to be rendered helpless by a sudden, traumatic loss of the omnipotent other, which Kohut says is usually due to the early experience of the mother's unreliable empathy, or her depression, or physical illness, or absence or death. Such trauma interrupts the process of optimal internalization. As a result the child remains fixated on the primitive images of the other, and will be forever dependent on substitute figures in what can only be described as an "intense form of object hunger." The hunger is intense because such people are looking for "missing segments" in their psychic structure. The people and things sought after are not longed for but needed "in order to replace the functions of a segment of the mental apparatus which had not been established in childhood."20
Kohut argues that traumatic disruptions in the relationship with the idealizing other in general lead to three categories of disturbance, depending on when the original trauma occurred. In the earliest disturbances a diffuse vulnerability is the result. It is difficult for such people to establish any kind of permanent homeostasis in their personality. Somewhat later trauma—Kohut is intentionally vague about the exact timing here—results in a basic interference in the processing of sexual desire in the self and creates a readiness toward sexualization. In such patients one often encounters perverse fantasies or acts, which clearly suggests Kohut's ideas on the developmental self origins of the perversions. Finally, when the trauma occurs in later infancy, when there is a degree of cohesiveness established in the self, what results is a core defect in the capacity for idealization. Such people strive constantly for external leader figures to provide approval and soothing that their internal psychic structures cannot provide.21
These stages of possible failure in the structure of idealization in the self can be extremely difficult to ascertain retrospectively because of what Kohut calls the "telescoping of genetically analogous experience [his italics]." The tendency of the mind is to superimpose later, noncritical experiences over the earlier, pathological ones. For Freud, of course, such processes of substitution were entirely defensive and based on the ego's attempt to ward off unconscious thoughts and impulses. Kohut, while not disagreeing that symbolic substitution may serve important defensive functions in the psyche (at least at this point in his thinking he was willing to concede that), stresses instead that telescoping more importantly is a manifestation of the "synthesizing power of the mind" and expresses early trauma in analogous images that are less conflicted.22
Self-esteem, as always, is central. "Anything that deprives the patient of the idealized analyst creates a disturbance of his self-esteem: he begins to feel lethargic, powerless, and worthless." What precipitates such states may seem to the uninitiated (or the clinically obtuse) to be minute and unimportant. The sensitivity of the patient is exquisite and the nature of the response to minor failings on the part of the analyst so out of proportion that adult logic cannot be used to explain it. Only if one constantly remembers the extent to which the patient has grafted an archaic self onto the omnipotent figure of the analyst can one begin to understand (and empathize with) what is happening in the therapy.
Once mobilized, however, the idealizing transference may stabilize for prolonged periods, during which the patient feels "whole, safe, powerful, good, attractive, active so long as his self experience includes the idealized analyst whom he feels he controls and possesses with a self-evident certainty that is akin to the adult's experience of his control over his own body and mind." Sooner or later, however, this state of grace is bound to be disrupted by external events, whether from a major empathic breakdown in the treatment, or, more commonly, failures to appreciate the full impact on the patient of minor irregularities in schedule, weekend separations, slight tardiness, or vacations. The response on the part of the patient is usually one of rage and, most importantly for someone in an idealizing transference, despondency, followed immediately by temporary regression to various archaic forms.
The working-through process with the idealizing transference involves a gradual withdrawal of primitive attachments to the analyst and the establishment of "psychological structures and functions" that give the patient greater freedom of choice and action. The path, however, is customarily stormy. Over and over again there will be regressive swings in response to disappointments in the idealized analyst. For some, such swings will involve a retreat into perverse activities from which a rescue is only possible through "appropriate interpretation." Others might reexperience such activities in memory—as, for example, the recall of a voyeuristic search for the absent mother's underwear and putting it on in an attempt to reestablish a symbolic union with a depressed mother who had been hospitalized.23 At other times, patients will recall (and be grateful for now understanding) childhood attempts to revive some feeling of being alive: putting one's face against the cold floor in the basement; staring in the mirror to assure oneself of being whole; smelling things, including oneself; various masturbatory activities; and any number of grand and sometimes dangerous athletic feats. Memory and understanding in therapy work together in a process of healing.
Mr. A. serves to illustrate Kohut's ideas about the idealizing transference.24 A young man in his mid-twenties. A.'s initial complaint was that ever since adolescence he had felt sexually stimulated by and attracted to men. It quickly became apparent, however, that A.'s homosexuality was "not prominent" and "occupied a rather isolated position in his personality." What mattered were the indications of a "broad personality defect" that manifested itself in his depression and lack of zest, along with an extreme sensitivity to criticism that profoundly affected his self-esteem. A. was forever in search of guidance and approval from others in positions of authority over him. As long as he felt their approval, he was okay. But at the slightest sign of their discontent with him he would feel drained and depressed. Then he got enraged, became cold and haughty, and could no longer work effectively.
Mr. A.'s key childhood experience was his traumatic disappointment in the "power and efficacy" of his father. The family had fled Europe when A. was nine. The father, once prosperous, failed repeatedly at various business ventures in America, always seeming to sell out in panic at just the wrong moment. A. came to feel overwhelmed by the contrast between his father's ambitions and the desperate disappointment he felt when his father failed. Important precursors in this idealization– disappointment sequence stirred A.'s feelings. The father had owned a flourishing business in eastern Europe before the war and had been especially close to his son, whom he often took to his factory and playfully asked for advice on how to run things. This paradise was suddenly lost when A. was six. The family, which was Jewish, relocated from the eastern European country where they moved to another country to escape the invading German armies, then three years later fled Europe altogether, first for South America and later for the United States.
Mr. A., in other words, could be considered a kind of Holocaust survivor, a fact of his early experience virtually ignored in Kohut's account of the case. Some have criticized Kohut for what they consider an unconscious avoidance of this issue that may be related to his personal ambivalence about his own Jewish identity. Some years after the publication of The Analysis of the Self, psychoanalyst Martin Bergmann was leading a workshop in New York on second-generation Holocaust survivors.25 Everyone in the group was keenly interested in talking with Kohut about the Holocaust-related themes in the case of Mr. A. Psychoanalyst Judith Kestenberg was designated to contact Kohut. His initial (written) reply to her request warned, "One might say that he [A.] belongs into the category that your group is investigating—but perhaps not quite." For his own reasons, he would "rather not write about the details of the case," though he was perfectly willing to talk with her, more than once if that would help. The only thing he could not do was come to New York. Shortly after that he and Kestenberg had a phone conversation in which he politely but adamantly refused to give a presentation at the workshop, because, he said, "the case had nothing to do with the Holocaust." She was left with the feeling that he was "totally oblivious to an important dimension of the case."26
Of course, Kohut had a point about Mr. A. not being really either a second-generation or a first-generation Holocaust survivor. At the same time, Kohut's distinction may have been splitting hairs. Certainly A. was a Jewish survivor of Nazi violence. His early experience was directly and profoundly affected by the invading German armies between 1939 and 1941, even though neither he nor his parents were touched directly by the tragedy of the Holocaust. A. experienced the full force of prejudice in his prewar eastern European country (from the context it seems to be Poland). There were two other issues for Kohut. First, he distrusted what he considered the ideological (that is, Freudian) orientation of the Bergmann workshop. He was also a very sick man in 1977 and refusing all presentations marginal to his creative life.27
In any event, Kohut's emphasis on the role of the father in Mr. A.'s psychology in no way slights the significant pathology of the mother that he felt lay buried, or telescoped, in the noisy issues around the father. A.'s mother was "deeply disturbed," someone who, despite her apparent calm, tended to "disintegrate with terrible anxiety and unintelligible (schizoid) excitement when she was exposed to pressure." She was shallow, unempathic, and unpredictable and "must have" contributed to A.'s broad insecurity and diffuse vulnerabilities. But Kohut's focus, and what he strongly argues was central to A., was his profound disappointment in his idealized father. In the transference, A. expressed that disappointment in two insatiable demands he placed on Kohut. One was that Kohut had to share A.'s values and goals and thus imbue them with significance. The other was that he had to confirm that he felt the patient had lived up to his values and goals. Otherwise, A. felt that all his successes were meaningless and he became depressed.
Three general theoretical issues of importance occupy Kohut's attention in the last few pages of his discussion of Mr. A. One is his stress on the significance of the actual personality of the parents, rather than gross external events, in shaping the self. Freud was ambivalent about the role of the parent in personality formation. He felt parents are the carrier of ideals and trauma, to be sure, but there is something flat and two-dimensional about the figures in the oedipal drama, who serve for the most part simply as a projective screen for the child's instinctual investments. In putting self at the center of experience, Kohut returns people to the developmental story. Events, of course, like war, Holocaust and seduction, matter a great deal, especially when they coincide with a prolonged absence of empathy from caretakers. The external event, however, never, in and of itself, determines a specific, predictable psychological response. It is probably fair to say Kohut underestimated the potential traumatic impact of extreme situations, irrespective of psychological context. At the same time, he may have reestablished a more balanced relationship between self and society in his deep distrust of what he considered the fatuous language of much of social psychology.
Second, Kohut describes a general relationship between disappointed idealization and the eruption of grandiose feelings and behaviors (or technically what he calls in Mr. A. the "propensity toward a reactive hypercathexis of the grandiose self"). Whenever A. was disappointed in figures of authority in his life, or in Kohut himself in the transference, he became cold and haughty, adopted certain odd speech patterns, and combined a manifest sense of superiority with self-consciousness, shame, and hypochondria. These self expressions are what Kohut later describes in general as clinical examples of the "grandiose self. " He mentions them briefly in this case because of A.'s tendency to fall back on such manifestations as a secondary response to his disappointment in his idealizations. A.'s grandiosity, in other words, is "reactive," something that is very common in cases like A.'s, especially in the early stages and much later when for prolonged periods he felt unreal in the newness of his self adjustments that came as a result of progress in his therapy.
Finally, Kohut deals with Mr. A.'s homosexual fantasies and their relation to his self disorders. Perversions, which without question include homosexuality for Kohut, are always tricky. They can so completely enslave the personality that they call forth widespread regressions that cover up the central pathology. Kohut's strong impression, however, is that in most cases "specific circumscribed disturbances" in the self form the nucleus of the perversions. In the case of A. his homosexuality had never proceeded beyond fantasy. He had engaged in some sexually tinged wrestling in adolescence and often purchased magazines of male body-builders. In his fantasies he would enslave a strong man and make him helpless. Sometimes he ejaculated at the fantasy of masturbating a physically strong man and thereby draining him of his power, and he probably nurtured a less conscious fantasy of swallowing the man's semen.28 As the analysis progressed, the fantasies receded and eventually they disappeared altogether. Kohut's idea is that A.'s homosexual tendencies represent "sexualized statements about his narcissistic disturbance." Perversions, in other words, are sexualizations of self pathology. Kohut is not convinced the self issues can always be unraveled from the perversion, but he would seem to believe that in general homosexuality and other perversions are secondary elaborations of the self.
Kohut extends his clinical examples of the idealizing transference with the case of Mr. B., who was seen by a female analyst in regular consultation with Kohut.29 The patient established a very deep idealizing connection to the analyst. For the most part, the analyst was able to stay attuned to the patient and prevent his fragmentation. But inevitable disruptions like vacations threatened the cohesiveness of his personality. He would then become extremely cold and imperious. During one extended vacation break from the analyst, B. was able with great difficulty to stabilize himself by withdrawing into lonely but reasonably satisfying intellectual activities. As he put it later, he "rowed out alone to the middle of the lake and looked at the moon." When the analyst returned, B. at first resisted reconnection. He was full of rage for a long time and remained, he said, "unplugged." The sequence of psychological reactions B. experienced around the separation from his analyst repeated crucial events from his childhood. His mother, who was highly involved in all aspects of his life, had supervised and controlled his every move. His feeding time was regulated by a timer. B. felt he had no mind of his own. As he got a little older he would withdraw to his room and close the door to create some private space. At that point his mother had a buzzer installed in his room to summon him to her side whenever she wanted. As Kohut says, it is not surprising B.'s first reaction to the return of his analyst was rage after he had managed to find some peace by rowing out to the center of the lake to look at the moon.
Such a case suggested to Kohut the power of the split-off fantasy. Mr. B.'s psychological sense of his mother simply could not be modified or integrated into his personality (without analysis). It lay behind a wall, entirely separate and split off. B. could only search for substitute external omnipotent powers from whom he hoped to gain strength and temporary support. In the case of Mr. A., his idealizing transference related more specifically to his father, though telescoped into those feelings was much to do preverbally with his mother and his early fixations to aspects of her pathology. It is also significant that such telescoping of early and highly regressed feelings in the idealized transference with later experiences may manifest itself in "vague and mystical religious preoccupations." The transference stirs feelings in the analysand that the idealized analyst is full of boundless power and knowledge and wise to the point of perfection. Once this state of equilibrium is reached in treatment with such patients, there is generally a decline in the vague depression, irritability, shame propensities, and hypochondria that had constituted the patient's original symptomatology.
Kohut also drew several conclusions about the characteristic ways in which patients reveal they are entering an idealizing transference. They may dream, for example, of climbing a soaring mountain while looking for secure footing on some path. Details in such dreams can be quite telling. Is the mountain icy and cold, suggesting much about the early self-objects? Another indication of the early stages in the activation of an idealizing transference is that the patient may sink into philosophical and religious preoccupations about the meaning of existence, and of life and especially death, suggesting fear of extinction by one's own deep wish for merger with the analyst. Later, on the cusp of a retreat into haughtiness (a reactive grandiosity), there are often dreams of falling, which seem to be an intentional contradiction of the most common narcissistic fantasy of all, that of flying.
The best response of the analyst to a patient in the process of establishing an idealizing transference, Kohut says, is to help define these resistances with "friendly understanding," but otherwise simply to let the regressive processes unfold without interruption and the transference establish itself spontaneously. In the early stages, one must avoid making premature transference interpretations, which the analysand experiences mostly as "prohibitions or expressions of disapproval." Nothing should be hurried. The patient moves into the transference in response to an inner need, not because of some special activity of the therapist. As treatment proceeds, it is also wrong to be unusually friendly in order to establish a good therapeutic alliance, or to nudge along an idealizing transference, or, as Freud cautioned against, to play prophet, savior, or redeemer.30 For the most part patients experience such behavior of the analyst as seductive or patronizing. On the other hand, a false distance behind what Freud called the "mirror" blocking out the "opaque" doctor is equally inappropriate, especially the ludicrous conventions of analytic coldness that were developed (mostly) by American psychoanalysts in the decades following the Second World War.31 As Kohut comments in a footnote, "To remain silent when one is asked a question, for example, is not neutral but rude."32
The idealizations of narcissistic patients, however, are not always easy for analysts to accept. It can disrupt the analyst's own sense of self by falsely stimulating his or her grandiosity. The analyst then rejects the patient's warm praise, Kohut says, feeling embarrassment, self-consciousness, shame, and in more extreme cases hypochondriacal preoccupations. The uneasiness of the analyst is also most likely to occur early in treatment when the idealization erupts rapidly and the analyst is caught off guard and unable to prepare emotionally for what is often intense (and quite unrealistic) adulation. The values of the culture furthermore reinforce the analyst's vulnerability. We are taught to turn away from praise and not to listen to it.
Kohut, for example, was once consulted by a colleague about a prolonged stalemate that had developed in his analysis of a young woman, Miss L. For some time Kohut was perplexed about why treatment was going nowhere. When it became clear that the stalemate had been present from the beginning, Kohut went back with the analyst to the first few sessions of treatment. It then came out that L., a Catholic, had presented a series of dreams in the early hours of her analysis that contained the figure of an inspired, idealistic priest from her childhood. During her associations, the analyst remarked that he was not a Catholic, ostensibly to sharpen her hold on reality. The comment had halted any further progress in the analysis. His rebuff touched on a central issue in her psyche. She clung to some early idealizations, including that of the priest, that had been "an attempt to escape from the threat of bizarre tensions and fantasies caused by traumatic stimulations and frustrations from the side of her severely pathological parents." L.'s understanding of the analyst's comment was that he would not allow himself to be a good and idealized version of herself.33
It hardly matters how subtle the rejection is of the patient's idealization on the part of the analyst. One early comment stalemated Miss L.'s analysis for two years and would have killed it altogether but for the intervention of Kohut. Sometimes, the rejection may take the form of a "slight over-objectivity" or "coolness" in the analyst's voice. Perhaps the most common form of rebuff, however, and one easily rationalized, is when the analyst disparages the patient's idealization with humor and sarcasm. No patient misses the meaning of such communications. Kohut, in the end, while empathetic about the difficulties analysts often face with the idealizations of narcissistic patients, is categorical that the only proper stance to assume when one becomes the target of an idealization by a narcissistic patient is to "accept the admiration." At the same time, one has to recognize how difficult it can be in the later stages of treatment when a patient who once grandly admired the analyst now suddenly belittles him or her. Endless patience and a grasp of the underlying dynamics will carry the sensitive analyst through these trials and significantly enhance the working-through process.34
Miss F. is the archetypal case of a patient in what Kohut calls the second major "self-object transference," that of mirroring.35 At twenty-five F. sought analysis because of "diffuse dissatisfactions" despite her professional success, social contacts, and series of love relationships. She felt she was different36 and isolated, unable to be intimate with anyone. In treatment she suffered from sudden shifts of mood associated with "pervasive uncertainty about the reality of her feelings and thoughts." She easily alternated between states of anxious excitement about her "preciousness" with states of depletion and immobility. Her relations with people were empty and served primarily as an escape from her painful inner tensions.
Miss F.'s mother had been deeply depressed at critical periods in F.'s childhood. Nothing she did as a girl evoked pleasure or approval. On the contrary, the mother had an uncanny way of deflecting onto herself any attempt by F. to express her needs or seek attention. When F. came home from school as a girl she would joyfully anticipate telling her mother of her activities and play and successes. The mother would appear to listen but "imperceptibly the topic of the conversation shifted and the mother began to talk about herself, her headache and her tiredness and her other physical self-preoccupations." Because F. was deprived of that "optimal maternal acceptance," she had no way of transforming her own needs for affirmation into adaptably useful self-esteem. F.'s older brother compounded her trauma with his sadistic treatment and grabbing of the family limelight. The father, it seems, was an emotional cipher in the family and would vacillate between involvement with his daughter and emotional withdrawal over long stretches.
For an extended period in the early phase of the analysis, Kohut was completely baffled by Miss F.'s needs. She began each session with a friendly and calm manner, reporting on her life and dreams with appropriate affect. Things seemed on track, except that Kohut reluctantly had to admit to himself he was bored and had to struggle to remain attentive. He seemed outside of F.'s psychological universe—except, ironically, she could not tolerate his silence. Regularly, about halfway through the session, F. would suddenly get violently and inexplicably angry at him for being silent and not providing her with any support. At these moments, Kohut learned in time he could calm her by summarizing or repeating what she had already said, serving as a mirror reflecting back her communications. But if he went beyond that and added an interpretation, even if minor, she went into a rage and would "furiously accuse" Kohut in a "tense, high-pitched voice" that he was undermining her, destroying all she had built up, and was "wrecking the analysis."
Kohut is frank about his emotional difficulty at first with being reduced to a mere mirror in the primitive world of Miss F. He acknowledges that some "specific hindrances" in his personality kept him for a prolonged period from responding appropriately to the extreme demands of this very difficult patient. Besides, F. was the first, and breakthrough, case in his understanding of narcissism. She taught him the centrality of the need for empathy from the analyst and the relative insignificance of formal psychoanalytic interpretations. F. taught Kohut to listen. Furthermore, her insistent needs, her whining and noisy complaints, made no (good) sense in terms of the theory Kohut had been taught and in which he so completely believed. Freud's structural model could not explain F. Kohut had his own emotional difficulties with F.'s whining, it is fair to say, but he also lacked a conceptual framework within which to understand her.
And yet Kohut, without full awareness of what he was doing or what Miss F.'s tirades meant, created an empathic environment that allowed her to emote loudly and relentlessly manipulate him in the transference. Everything in a part of him must have rebelled against letting her continue analysis in such a disruptive way. He struggled personally with feelings of boredom that alternated with anger at her refusal to let him do what he did best—make interpretations. His Freudian side, furthermore, must have half-suspected F. was in a strong "defense transference" that could only be broken down by getting through to her about the oedipal meanings of her behavior. Failing that, she should have been shifted from analysis into psychotherapy, perhaps with someone else. A more conventional analyst, in other words, might well have banished F. for her refusal to listen to him. Kohut, on the other hand, drew on some deep resources to remain empathically connected to his difficult patient.
Ultimately, Kohut felt, what led him to understand F. was the needy and vulnerably fragile tone of her voice. It represented the insistence of the young child who has never been listened to. There was little of the adult in F., and certainly none of her preoccupations with Kohut seemed drive- or object-related. She began to make some sense to him, however, when he thought of her unusual needs in terms of primitive narcissistic states. Kohut's mirroring thus calmed her. But when he was quiet or most of all when he went beyond providing simple approval or confirmation, he instantly became her depressed mother, who deflected all of F.'s needs onto herself. Once he was clear about what he represented to her, Kohut was able to make interpretations that aided F. He explained how he felt she related to him as a replica of her depressed mother. The "correctness" of the interpretation led her to recall many episodes of the way her mother had treated her, as with her return from school. Then F. would feel "drained of energy" and "empty." After much analytic work, however, F. managed to reinsert the transference rage against Kohut into those memories and feel and understand (and thus cure) her despair.
The most important theoretical question that F. raised for Kohut was the meaning of her primitive grandiosity, which got activated in a mirroring transference. Freud understood grandiosity as a defensive ego process, a libidinal retreat from failure in love (or loss). This state of "secondary narcissism" sets up the ego in a condition of brittle self-assertion.37 Kohut, on the contrary, came to believe that the primal state of the self is one that concentrates absolute perfection onto oneself and disdainfully assigns imperfections to the outside world. He calls this state, or process, the "grandiose self. " Optimally, the completely self-centered child learns to accept realistic limitations and relinquishes crude expressions of exhibitionism, replacing them with "ego-syntonic goals and purposes." The actual early figures who empathically mirror the child's grandiosity linger symbolically in the self's specific goals and purposes. But these same goals and purposes, as well as many crucial aspects of our self-esteem, bear the mark of our original grandiosity, however effectively integrated. Traumatic interruptions, however, split it off, which makes the grandiosity no longer subject to realistic influence.38
It is a given that the gradual relinquishment of the most outrageous demands of the grandiose self is essential to the cure of people like Miss F. Such a process of therapeutic change for the place of grandiosity in the self is thus parallel to that of idealization. But not entirely. For someone with an "ego of average endowment," the grandiose delusional claims of the self can be highly disruptive and need taming in the analysis. For a gifted person, however, it is precisely their grandiosity that pushes them to the best use of their capacities and thus to a "realistically outstanding performance." In this context Kohut mentions Winston Churchill, Goethe, and Freud. Surely, at some level and probably one not far out of consciousness, Kohut would include himself in that list of gifted people for whom grandiosity stimulates their creativity. Kohut felt that idealizing needs support productivity, but that grandiosity is the essential engine of creativity. It is therefore "adaptive" for certain people in ways that would be pathological for ordinary mortals.
Clinically, Kohut breaks down the transference expressions of the grandiose self into three forms, depending on the severity of the regression. The most archaic form renders the analyst a mere extension of the patient. This transference relationship with the analyst assumes a quality that might be called a kind of primary identity or a merger. In this form of the mirror transference, there is a regressive diffusion of boundaries in which the analyst is experienced as part of the patient's essential being, rather like an amoeba. Such incorporation of another self creates security for the disturbed patient, which allows therapy to proceed. But for the analyst as the target of these needs the work can present special problems. The analysand in the throes of this deepest form of the mirror transference comes to expect "unquestioned dominance" over the person of the therapist. Many analysts find such tyranny oppressive. There is no question that patients who fall into this first category of the mirror transference are the most difficult and challenging of all those with self disorders to work with in therapy, other than those who are actually psychotic.39
A somewhat less regressed form of the mirror transference occurs when the patient experiences the analyst as being very similar to himself or herself. In dreams and especially fantasies, such a patient will frequently imagine the therapist is a twin or some kind of alter ego. In time Kohut was to separate out "twinship" as an altogether separate self-object transference. At this point in his thinking, however, he argues that twinship is simply a kind of intermediate form of mirroring. What is most surprising about his discussion of twinship in this section of The Analysis of the Self, however, is how remarkably undeveloped it is, suggesting either that he had not had extensive clinical experience with its expressions or that he was not then particularly interested in the phenomenon of patients creating alter egos in the person of the analyst. It seems not to have been a subject he had thought much about in depth.40
The most frequently encountered form of the mirror transference—for which the term itself really should be reserved—is the relatively more mature mobilization of that early state of blissful self-centeredness. This "mirror transference proper" replays the normal phase of development in which the "gleam in the mother's eye" reflects back the child's exhibitionistic display, confirms it, and provides the grounding for a secure sense of self-esteem. As with the mother then, so with the analyst later, the self-object only matters to the extent that he or she is "invited to participate in the child's narcissistic pleasure and thus to confirm it." Kohut uses the image of the mirror to capture the ways in which patients experience analysts as extensions of themselves and therefore need to have their feelings reflected back to them. Only rarely is that reflection experienced literally. Few patients, for example, dream (or fantasize) of looking at the analyst as if seen in an actual mirror, and it would be foolish indeed to repeat back to a patient exactly what he or she said.40
There is, however, something very powerful about the image of the mirror. Visual contact represents some of the most significant interactions between a mother and child, and when disturbed the need to be looked at and to gaze at in return can be sexualized. Mr. E., for example, one of the preeminent cases in self psychology, had a mother who recoiled from her son because of her chronic malignant hypertension (from which she died when he was fifteen) and depression. It was only through looking intently at her face that E. could locate her within his constricted universe. E.'s father had long since withdrawn as a self-object substitute. In treatment with a candidate who was in supervision with Kohut, E. was afraid of looking at his analyst because of a fear that he would overburden him with his gaze. As Kohut notes, that gaze was the "carrier of the wish to be held" and probably suckled by the mother. Over weekend breaks E. began painting pictures of his analyst in which he would draw himself in the place of the eyes of the analyst. In moments of the greatest stress he had what might be called psychotic bodily delusions, as, for example, when he was a child and thought a goldfish was looking at him and another time during therapy when he felt he was taking on the bodily or facial features of his dead mother. Not surprisingly, E.'s visual investments were sexualized and his life was full of perverse fantasies and actions. He engaged in repeated and often dangerous voyeuristic activities in public toilets. He sought to take in the power of the male penis with his penetrating gaze. His perversion had begun one day at a carnival when he was eleven. He was on a swing and wanted his very sick mother to admire his skills. When she could not get interested, he turned away from her and for the first time went into a public toilet to stare at a man's penis. In time during therapy, E.'s perversion receded as he developed a keen interest in photography (disguised as painting in the published case), at which in time he truly excelled, winning prizes and becoming an artistic and commercial success. E.'s journey from despair to creativity is one of the most moving in all of self psychology.42
It is true in general that adult experiences in the transference are never the direct replicas of normal development phases. They are, instead, the "regressively altered editions" of early experience. For the most part, however, Kohut is struck by the relative absence of distortion in the ways early grandiosity needs enter the transference. The infantile, one might say, is insistently and noisily present in the therapy of a patient in a mirroring transference.43 Mr. B., for example, ostensibly sought therapy because of sexual disturbances and problems in his marriage. In fact, he suffered from a much more diffuse personality disorder that included feelings of emptiness and frequent rage. Within weeks after adjusting to analysis, he reported experiencing treatment as soothing and "like a warm bath." During sessions and soon throughout the week his feelings of emptiness subsided, he felt whole, and he became more productive. On weekends, however, he would become so distraught and full of rage that he began to worry about his sanity. An epiphany came in his treatment when the analyst prefaced one of her interpretations with the phrase "As you told me about a week ago . . ." B. was intensely pleased that the therapist could remember something from that long before and experienced a new sense of cohesiveness. The remark by the analyst reconnected B. along a time axis, locating him meaningfully within his own narrative."
In the normal course of therapeutic events, the mirror transference follows naturally from what is usually a brief period of idealization.45 This typical expression of the mirror transference is an important and therapeutically useful phase of treatment. What seems to be occurring, Kohut says, is that the initial idealization of the analyst is a kind of "intermediate step on the backward path of the analysand's not yet completed therapeutic regression." In such cases, the period of idealization gives way quickly to the much longer and otherwise dominant phase of the mirror transference. Mr. K., for example, began his analysis with a brief period of idealizing his analyst's appearance, behavior, and capabilities, which re-created his attempt at about three and a half to establish his father as an admired figure after a rejection by the mother. The father, however, was unable to respond to his son's needs and turned away from him. The boy then sought some renewal of the solace he had once experienced with his mother. That activated the full force of his grandiosity in the mirror transference and occupied the attention of the analyst and patient for most of the treatment. The initial phase of idealization in such cases is actually a good prognostic sign, just as the mirror transference that follows it offers possibilities for healing 46
It can be a challenging experience, Kohut explains at some length in Analysis, treating patients deeply immersed in a mirror transference. It is easy, among other things, for the analyst to be bored by the patient's need to make him or her a mere reflection. The patient's "demands for attention, admiration, and a variety of other forms of mirroring and echoing responses" are not, in and of themselves, intellectually challenging. The total focus is on the minutiae of the patient's life and feelings and memories without any real input from the analyst. For prolonged periods the analyst is there simply as an empathic echo. The analyst "as an independent individual" tends to be blotted out. The process is one that does little to gratify the analyst's own narcissistic needs. Such objectification can lead the unwary analyst toward subtle forms of rejection and emotional numbness. Close listening may stop and responses become canned. In some cases, there may even be overt anger leading to exhortation that reflects the analyst's impatience. It is only through understanding the therapeutic process in the mirroring transference that these dangerous responses of the analyst can be mitigated. As Kohut himself came to feel in his own work, it is, in fact, enormously stimulating and difficult to track the minute swings of feeling and there is much to interpret—if the analyst grasps the actual dynamics of what is going on. After Analysis, Kohut himself stopped talking about the analyst's boredom while treating a patient in a mirroring transference, because he himself stopped feeling bored or upset any more and came to believe his own earlier reactions were simply a byproduct of the discovery process.47
But even in the monograph Kohut shows that much of what one encounters in treating disorders of the self is fascinating and engrossing. Many of the fantasies, for example, are only seemingly trivial. The most commonly encountered such fantasy is that of being able to fly, but there are many others. Mr. C. had a dream in which the question arose of finding his successor. He thought, "How about God?" His associations—against much resistance—led to a childhood fantasy that he actually was God. Mr. D. recalled with great difficulty his childhood fantasy that he ran the streetcars through thought control emanating from his head, which furthermore existed disconnected from his body above the clouds. Mr. H. reported an early fantasy that everybody he encountered was his servant or slave and though everyone knew it they never talked about it. Kohut stresses that all such fantasies are surrounded by shame, and that it takes a great deal of patient therapeutic labor to uncover them. The results may seem unworthy of all the effort and quite disappointing for the analyst. "Parturient montes,"Kohut says, quoting Horace, "nascitur ridicules mus"("Mountains in labor give birth to a ridiculous mouse").48
Expressions of split-off grandiosity are exceedingly asocial. Acting out, for example, can be dangerous and illegal. Mr. E., with his voyeuristic activities in public toilets when he was separated from or disappointed in his analyst, frequently risked arrest. Kohut's conceptualization of what happens in such circumstances is that the patient temporarily regresses from the mirror transference to the much more primitive level of a merger. Such regressions can also occur in fantasy. Mr. I. at one point during treatment brought in some of his childhood diaries and read them in their entirety. The analyst tried to remain interested but in fact betrayed, ever so slightly, his feelings of boredom and annoyance at being excluded from the active analytic process of direct communication. That night the patient dreamed, first, of catching a big fish and showing it proudly to his father, who was disappointed. In the second scene of the dream I. saw "Christ on the cross, suddenly slumping; the muscles suddenly relaxing, dying." I. had hoped for an approving acceptance of his childhood self in reading the diaries. Feeling rebuffed, he retreated to a fantasized merger with Christ, who in death reunites with God.49
Such dreams reflect, in general, in their totality the central psychological issues in focus at that moment within the self. Unlike Freud, who treated the "manifest content" of the dream as a mere symbolic carrier of the deeper and unconscious latent thoughts, Kohut focuses on the dream itself as enormously illuminating. The implicit distinction Kohut makes at this point in his thinking (that is, in 1971) is that the direct reflection of one's psychological state in the dream is most characteristic of narcissistic patients, while the more familiar neurotic has dreams with all the elaborate disguises Freud described. Kohut's idea is that the focal issues in the self at the moment find symbolic expression in the dream (or fantasy) in ways that are relatively undisguised and certainly free of the elaborate "dream work" processes familiar to Freud.50° That does not mean such dreams are simple. Mr. J., for example, began treatment with frequent flying dreams. As he got better, J.'s flying dreams subsided, as did the disruptive expressions of his grandiosity in his life and work. Once, however, Kohut detected a slight regression on the part of J. and forcefully interpreted the continuing role of grandiosity in his work, despite his significant progress otherwise. In response J. had a dream of walking, but in an exaggerated way—and a tiny distance off the ground. Mr. K., when breaks occurred in the analysis, dreamed of spinning wheels to represent his "regression to bodily tensions." A patient in termination dreamed of swallowing a clarinet, which Kohut understands partly as representing the analyst's penis but more importantly his voice, for the clarinet kept playing music from the patient's stomach.51
Kohut also acquired new clinical perspectives on color in dreams from his work with narcissistic patients. Mr. A., toward the end of his analysis when he was in fact much better, even though his gains were recent and fragile, dreamed in color of people as toy soldiers. At the same time in his life A. was experiencing a mild sexual disorder (premature ejaculation) in his relationship with his wife. Kohut interpreted both the dream and the sexual disturbance—"always such a sensitive indicator of the equilibrium of the personality"—as temporary intrusions of A.'s old anxieties. His new self forms were not completely stable. He was still in the process of accepting the new image of himself. This interpretation led Mr. A. to recall that in fact the dream had not only been in color but in technicolor, exaggerated and artificially sharp and clear. Kohut concludes that in general color in dreams signifies the "intrusion of unmodified material," or a flooding of the self that is experienced as unbearable tension.52
The vulnerable self can easily be flooded, which is one way of stating Kohut's definition of trauma, a subject in which he was deeply interested and that he wrote about all his life. In this technical study, his focus is on clinical issues and the characteristic ways NPDs succumb to traumatic states. Sexualization, for example, of their "needs and conflicts" is one typical response. They are also easily hurt, they "become quickly overstimulated," and their excessive fears spread and become "boundless." Much work in analysis is spent on interpreting traumatic states. A patient, for example, especially early on, will report feeling flooded with shame and humiliation at having told a joke in some social setting that fell flat, or having talked too much at a dinner party, or having been dressed inappropriately at some event. What makes the shame traumatic is that the patient experienced humiliation at exactly the point of expecting to shine and gain acclaim. The unraveling of such scenes in all their tortured detail can be "important moments in the analysis of narcissistic patients." For long periods the analyst must "participate empathically" in the patient's acute pain and anger that the humiliation cannot be undone. Then gradually the dynamics of shame and flooding, including their childhood origins, can be interpreted.53
Later in the treatment, in the middle and even final stages, traumatic states of the patient can be prompted paradoxically by correct and empathic interpretations.54 Mr. B., for example, had gotten to the point of tolerating separations better and no longer needed to masturbate to induce sleep. In one session he reported that his mother seemed not to like her own body and recoiled from touching B. The analyst made the interpretation that as a result B. had never been able to experience himself as "lovable, loving, and touchable." B. was quiet, then said: "Crash! Bang! You hit it!" and recalled how his mother and former wife made him feel "like vermin and filth." Then he cried to the end of the session. For the next week B. slipped into a deeply regressed state. He was disheveled, had trouble sleeping, and felt overwhelmed by disturbing dreams of eating breasts. He no longer felt alive. He said he was like a broken radio with tangled wires. At first baffled at what was going on, the analyst came to understand that the patient's traumatic state resulted from his feeling overwhelmed with excitement at the very correctness of her interpretation. Once that became clear, the analyst could help B minimize the extent and power of future reactions to her (correct) interpretations.
The voice of The Analysis of the Self is decidedly off-putting. The Analysis is filled with technical, clinical instructions for fellow analysts on the treatment of deeply troubled patients. It is written as a monograph, not a book, intentionally restricting his audience to "experts." Readers are not welcomed in but pushed away. Repetitions abound. Whole chapters are out of place. Gems of insight are buried in otherwise long, turgid paragraphs. Digressions proliferate. Anna Freud once advised Kohut to avoid his tendency toward Einschachtelungen (insertions) that "break the flow of thoughts." 55
But the worst is the language. There is much talk in Analysis about "narcissistic cathexes" and of "libidinal cathexes passing through the object" on their way to an "idealization of the superego." There are "mergers with archaic objects" and "grandiose self-objects" that divide and subdivide. "Mirror transferences" can be found in their actuality and in a "narrower sense." And everything Kohut says about narcissism is compared with the classical Freudian view of the "transference neurosis" in which the "central psychopathology concerns structural conflicts over (incestuous) libidinal and aggressive strivings which emanate from a well-delimited, cohesive self and are directed toward childhood objects which have in essence become fully differentiated from the self. " A common occurrence in the treatment of narcissistic patients, Kohut says, in italics, is the "propensity toward a reactive hypercathexis of the grandiose self" Kohut's text is an unrelieved meditation in the grand and almost incomprehensible tradition of psychoanalytic metapsychology.56
The Analysis of the Self in some ways the realization of that tradition. Early on Freud committed himself to an instinct theory. The crucial assumption of that theory, grounded in nineteenth-century psychology, is that it takes psychic energies, or cathexes, to run the self. Without this energy, so went the logic of the metaphor, the operations of the "psychic apparatus" made no sense. Without drives there appeared to be no explanation for motivation. For about two decades Freud's thinking about psychoanalysis and the nature of libidinal development remained relatively simple. The most interesting of his attempts to think further about drive theory came with his 1905 book on sexuality, in which he distinguished between the source of an instinct at the border of the body and self; the aim of the drive, whether outward or back onto oneself; and the object of the drive. In the theory there is a continuously flowing source of libidinal pressure (those cathexes) requiring satisfaction that can oscillate rapidly between seemingly contradictory aims (sadism and masochism) and easily substitute objects of gratification. Most importantly, sexuality has a history in its development through various "erotogenic zones" in the body. We are shaped psychologically and spiritually, one might say, in the wake of that early history.57 Freud's theory brought together in original ways all kinds of loose strands in the air at the time, from fascination with the problem of bisexuality to various ideas on homosexuality. If he had written nothing else, Freud would have made a mark for his short book on sexuality in 1905.
In the teens Freud extended his drive theory in two directions that were to be of great consequence. First, he developed his ideas about narcissism in 1914 as an extension of libido theory, in part to clarify his disagreement with Carl Jung. Second, in his 1917 paper "Mourning and Melancholia," Freud notes the apparent similarity between the two states, which serves to heighten the significance of their subjective differences. "In mourning it is the world which has become poor and empty; in melancholia it is the ego itself. " In melancholia, or depression as we would say now, there is no object to relinquish. The ego itself is impoverished. Self-esteem plummets. But it is the murky conclusion to the essay that is most important for Kohut's work. There Freud asks about the quality of the object choice that preceded the depression. Filled with (perhaps constitutional) ambivalence toward the object, the libido is detached and forced into the unconscious, "the region of the memory-traces of things (as contrasted with word-cathexes)." This unconscious position continually attracts libidinal cathexes to itself and forces "the regression of libido into the ego."58 Narcissistic object choices, in other words (as Kohut would clarify), are the precondition for depression.
By the early 1920s Freud elaborated his structural theory of id, ego, and superego, which became the cornerstone of drive theory. He had worried for some time about an important contradiction in his earlier topographical model of the mind: Why cannot all preconscious memories become conscious if we shine on them the light of attention? Indeed, it seemed, the more he thought about it, most important memories and ego functions were dynamically unconscious without being repressed and a formal part of what he had always called the "system Unconscious." The unconscious was more complex than he had realized and ego functions were infinitely more varied in their operations than could be understood simply in terms of their relation to consciousness. So he devised his new model to address these basic concerns. His new id encompassed all of what was in the old "seething cauldron" of instinctual impulses, repressed material, and archaic states of relatedness. The new ego emerged out of this id and its elaborate system of defenses warded off the dangers of instinctual annihilation. The crucial developmental step in this model comes with the disintegration of the Oedipus complex when the superego is formed out of the regressive identifications he had first begun to think seriously about in "Mourning and Melancholia."59
The rest were glosses on this complex story of the fate of the drives. Essays such as "The Economic Problem of Masochism" (1924) address the peculiar issue of moral masochism. Two years later Freud's short book Inhibitions, Symptoms, and Anxiety returned to the central significance of castration dread and most of all stressed that the task of repression was to distort or displace the "instinctual representative" and to transform the "instinctual impulse" or libidinal charge into anxiety. This affective signal, which is the economic consequence of repression, becomes the motive force for the basic functioning of the psyche in the theory. Anxiety warns us of danger and prompts the ego to act in some way to protect the self. Freud's most important and interesting extension of these ideas was his attempt to explain the motive forces in civilization itself and what he calls its pervasive "discontents" in Das Unbehagen in der Kultur (1930). To become civilized means to deny our desires, which given the economic consequences of repression means excessive anxiety and unconscious guilt, which in turn only feeds more repression. Life in culture, he thought, was an unceasing round of despair and denial."'
There was very little of substance added to this theory in the years after Freud. Anna Freud described the ego's "mechanisms of defense" in clear terms in 1936 but really only reformulated her father's writings between 1924 and 1926.61 Heinz Hartmann wrote about the important question of adaptation to one's environment in 1939; the early Erik Erikson deepened this work with historical and anthropological considerations.62 But even Erikson clung to drive theory in his ideas about epigenesis and development. A long section in Childhood and Society (1950), for example, restates in fond terms the key ideas of Freud about infantile sexuality.63 In general, in fact, most of what seemed like important advances at the time read now like minor quibbles. No one was questioning the assumptions of the theory. To glance at the pages of the leading journals in psychoanalysis during the 1950s and 1960s, for example, is a mind-numbing experience. It was a standard joke in those years among the most orthodox thinkers in psychoanalysis that no one had really done anything in the field except Freud. In retrospect, such views were not far off the mark.
But the one important area that had been left undeveloped by Freud was how drive theory could explain narcissism and, by extension, the self. Kohut had no pretensions that he was extending psychoanalytic understanding (and treatment) to the psychoses, but he did claim to be articulating a theory that made it possible to treat psychoanalytically a much more disturbed class of patients. He was also, he thought, rounding out Freud's theory, completing it. To carry out that project required a warm embrace of Freud's language of metapsychology. Kohut was certainly aware of the political issues involved. He was much more likely to have his ideas accepted by the mainstream if he expressed them in the language of drive theory. But surely the issues involved in his (often confused) form of expression in his 1971 book lay deeper. To speak in the language of metapsychology was, for Kohut, the most general, the purest level of theory in psychoanalysis. To clarify an important issue like narcissism at that level, he felt, was to contribute to the history of ideas in a fundamental way.
And yet Kohut so completely used drive theory as to hopelessly abuse it. He ran it into the ground and revealed its absurd character and false assumptions about human nature. The contradiction in Kohut's thinking here curiously parallels the early struggles of Freud himself. As Erikson has noted, Freud found himself in a kind of "desperate obedience to physiology" at the very moment of his early clinical insights into hysteria, which suggested a much more supple and complex model of the mind. Psychological truth for Freud at the time lay only in explanations about the physiological substrate of processes within the psyche. Such forms of conceptualization were what he knew after years of training, especially in the lab of his mentor, Ernst Brucke. Confronted with some challenging clinical material that he was actually beginning to understand in new ways, Freud retreated to the old and familiar as he attempted to formulate a general psychology in pure physiological terms. In his "Project for a Scientific Psychology," which he wrote as a long letter to his friend, Wilhelm Fliess, in 1895, Freud described "material particles" of the nervous system that were organized in ways to manage "qualities and quantities of excitation" in response to external stimuli. As Erikson puts it: "Physical concepts are combined [in Freud's "Project"] with histological concepts to create a kind of neuronic Golem, a robot, in which even consciousness and thought are mechanistically explainable on the basis of an overall principle of inner constancy."64 Within weeks Freud had recanted his theory to Fliess, then forgot about it altogether, and when presented with the discovered document late in his life tried to have it destroyed. But in fact Freud's physiological language in the "Project" was not so forgotten and carried over significantly to his early thinking in psychoanalysis. The more dense sections of Chapter 7 of The Interpretation of Dreams only make sense in terms of the "Project." Erikson's conclusion is that a creative thinker's complicated relationship to his early training illustrates "the pains to which a discoverer will go not to haphazardly ignore the paths of his tradition, but to follow them instead to their absurd limit, and to abandon them only when the crossroad of lone search is reached."65
So it was with Kohut. The Analysis of the Self stands ironically as a profound indictment of the very drive theory it attempts to bolster. Kohut was hardly the first to challenge drive theory. No one, however, had ever offered a clinical psychoanalytic alternative to the theory that clarified the actual data of observation within a new frame. That this new vision was partly disguised, even for Kohut himself, is one of the wonders of the discovery process. Kohut could not think about the new forms of transference he had named, for example, except in libidinal terms. The idealizing structures in the self as he first formulated them result from the peculiar consequences of the dissolution of the Oedipus complex. Narcissism in general is defined as one kind of libido distribution. The very term "self-object," so central to Kohut's theory, rests in its initial formulation in Analysis on the idea of libidinal incorporation of the object by the self. Kohut's theory, in fact, is so pervasively grounded in drive theory that it seems to require it. From the vantage of 1971, it appeared to Anna Freud, Heinz Hartmann before he died (as best we can tell), Kurt Eissler, and most other leaders in the field, and certainly to Kohut himself, that drive theory had reached a new level of sophistication. In fact, Kohut demonstrated how ridiculous the theory really was. The Analysis of the Self is an ending just as much as a beginning. By some kind of inner logic Kohut needed to write the book as a footnote to Freud. In the process, however, he discovered just how far that note came to supplant the text itself. Its language—which is, after all, the voice of the self—implodes with contradictions.
And yet The Analysis of the Self is a masterpiece that transformed psychoanalysis, proving what Erikson said in another context: "True insight survives its first formulation."66
In terms of intellectual influences, part of Kohut's framing of Analysis was to make clear his debt to those who had previously touched on questions of narcissism. His thirteen-page bibliography at the end of the book includes 273 references to everyone from August Aichhorn, to Sandor Ferenczi, to Freud and Hartmann (of course), to Phyllis Greenacre, to Otto Kernberg, to Melanie Klein, to Susanne Langer, to Joseph Sandler, and to D. W Winnicott. It would be difficult to imagine a more complete list of relevant publications on the subject of narcissism in 1971 (though any bibliography can be artificially extended almost indefinitely), just as it is unlikely the widely read Kohut was not familiar with the sources he cites. The third paragraph of the "Preface" to Analysis, furthermore, summarizes the most important ideas leading up to his own work: Hartmann's separation of the self from the ego, Erikson's work on identity, Margaret Mahler's idea that a "separate psychobiological existence" emerges out of the union of the mother and child, and the theoretical formulations of Edith Jacobson and Annie Reich, both of whom he probably mentioned as nods to the orthodox, not as genuinely important sources of his ideas.67
Kohut's approach to the existing scholarship on narcissism in his monograph is not unreasonable. He clearly establishes the tradition within which he is writing, but then largely dispenses with an elaborate scholarly apparatus. There are few internal references and most footnotes are substantive, though Kohut hardly ignores any writer of significance. He writes his book not primarily in relation to what others have said but in response to his own clinical experience and what was inside of him, because he felt strongly that everything in psychoanalysis up to that point dealing with narcissism was in a conceptual jumble. One cannot read the monograph closely and claim its ideas are borrowed directly from anyone or from any specific school. One way to think of Kohut's contribution is that he made the paradigm shift that gave new meaning to what had until then existed half-said in the margins." In retrospect and in something of a reversal of chronology (though typical in intellectual history), Ferenczi, Fairbairn, and many others now seem prescient and relevant in ways they never did before Kohut. After 1971 one could begin to understand what people were trying to say before that. In some cases, on the other hand, as with Erikson or some in the British "object relations school," it might well be said that Kohut needed to close himself off from influence, or he might have discovered just how common were their concerns. He might have lost his particular focus and compromised his own creativity. As a result, it can be fairly said that Kohut was probably less familiar with some relevant writings than he might have been. But it cannot be claimed that anyone had already written up everything Kohut said in The Analysis of the Self.
It was therefore startling and enormously upsetting for Kohut when the charge of plagiarism emerged in a crucial review of his book in 1973. A young British analyst, Martin James, had been assigned The Analysis of the Self for the International Journal of Psycho-Analysis. James had actually been in touch with Kohut during the previous year and expressed his great enthusiasm for the book. But his actual review was mostly negative, calling Analysis "less a scholarly work and more a work of popularization" and objecting to Kohut's apparent attempt to keep the orthodox Freudians happy with his metapsychological language. But it was his concluding sentence that really threw Kohut: "It seems that, since unconscious plagiarism is an endemic force in psychoanalytic writing and theorizing, this is really a synthetic book much influenced, in fact but not in attribution, by those preoccupied by the theory of development in the earliest mothering period."70 James apparently sent Kohut a copy of the review prior to publication including that sentence but decided the next day to delete it from the version he actually submitted to the journal. Kohut, not knowing of James's decision to delete the offending passage, reacted with fury. He telegrammed both James and Joseph Sandler, the IJPA editor, that he was "deeply disturbed by allusion to plagiarism, especially in last paragraph." Kohut then wrote an angry and hurt letter to James and another to William H. Gillespie, a member of the editorial board of IJPA, imploring him for the sake of fairness to intervene. He copied both letters to Anna Freud.71
At this point Sandler called Kohut to explain the confusion about the drafts James had submitted and to report that all was settled. He assured Kohut that he need not worry. Kohut was relieved but immediately wrote Anna Freud to discover the real story (and surely, as subtext, to keep her lined up on his side in the dispute). He explained what had happened and noted that at least with the offensive sentence deleted, "I am not greatly disturbed about the rest even though I find that neither Dr. James's criticism nor his praise are hitting the mark." He did express some doubt about Sandler's account but was willing to exonerate him What he could not figure out was why James had sent him the old version of his manuscript. Kohut remained full of doubts and questions. Anna Freud wrote back that she had also talked with Sandler and was glad the matter was settled. She added that the person James was probably trying to "defend" (her sarcastic quotation marks) was Winnicott, "to whom he was very devoted." She had also had a similar experience with Winnicott himself. He once wrote such a nasty review of one of her books that the journal actually refused to publish it. He later apologized, said he did not know why he had done it, and even claimed he liked the book. She concluded, "So that is how it is."72
The plagiarism charge, however, has hung in the air ever since the publication of The Analysis of the Self. It is commonly muttered that Kohut took his ideas from Winnicott, Ferenczi, Fairbairn, Mahler, or whoever, or that he never read them and should have, for they had long since formulated his essential ideas. These are different charges, of course. The first—actual plagiarism—is the easiest to dispense with. Analysis is an original and important work of scholarship in psychoanalysis. It consolidates a number of loose conceptual strands in the field and establishes the conceptual basis for what is now the main focus in psychoanalysis on relational issues, intersubjectivity, and the self. Before Kohut, psychoanalytic theory talked about patients in ways that objectified their experience. A theory of self is of necessity connected, mutual, interdependent. There are many contending views at present in what can be very generally called relational psychoanalysis, from the constructivists to the postmodern to the intersubjectivists. What they share, however, is a basic sense of experience (which is to say, self) that first entered psychoanalytic thinking in a coherent way with Kohut.
Analysis is also the turning point in the history of drive theory. Before 1971 most respected analysts clung to the theory with some degree of respect, if with ambivalence. Few felt really comfortable with words like "cathexis" or concepts like libido, or could figure out the intricacies of superego formation as opposed to that of the ego ideal. They stumbled on, however, muttering their incoherent phrases, because the theory seemed to capture a larger human truth. After Kohut, on the other hand, and a psychoanalytic theory of the self, only the troglodytes would continue to speak of "cathexes" and "libido distribution."
It is a different issue whether others formulated certain of Kohut's essential ideas before him, even if vaguely and not as part of a coherent theory, and whether he failed adequately to acknowledge their work. He never questioned that there were many in psychoanalysis who were interested in some of the same problems he was. He learned from many people and knew the work of the key figures well. Paul Ornstein thought Kohut had insomnia and stayed up half the night reading, as he certainly seemed to know everything about anything.73 Kohut's interest in Ferenczi, for example, dated back to the 1940s. Ferenczi was something of a clinical genius who carried through a number of radical therapeutic experiments with empathy. What he lacked was a theory. Kohut was particularly interested in two of Ferenczi's papers, "Four Stages in the Development of Reality" and "The Confusion of Tongues." Kohut did have scorn for Ferenczi's later therapeutic experiments and his "simplistic view" that one could belatedly compensate for early deprivations. No therapist, Kohut felt, can make up for love that is missing in a patient's childhood.74
Kohut was even more intimately familiar with the work of Melanie Klein and her followers in Britain and throughout the world. In the case of Klein, however, familiarity bred contempt. Kohut had first encountered Klein's early work when he was a young psychiatrist at the University of Chicago. In the 1950s and 1960s he followed her publications closely, as he did nearly everything in the field. In his administrative work with the American, especially during his term as president, he often had discussions, both theoretical and clinical, with Kleinian analysts. He came to understand their perspective from the inside. He was impressed with Klein's close clinical attention to early pathological states. He was appalled, however, with her explanations, which he found odd and essentially wrong. He felt, among other things, that Klein's theories imposed adult categories of development on young children, whom she imagined as calculating, driven, intentional. He also thought there was something perverse about the way Klein regarded the baby as evil. She argued, for example, that the nursing infant typically harbored violent fantasies toward the mother's breast. He wrote Anna Freud once how astonished he was to find how Kleinian everyone was in a visit he made to South America. And he was quite disdainful. "I have often predicted that they will finally die out because of the sheer boredom which their formulations must cause them." In another letter to Freud two weeks later, he called Klein herself "pathological," though he hoped her followers might become more normal with her death (in 1960). Kohut's views of the Kleinians remained unchanged during the rest of his life. In the late 1970s Bernard Brandchaft, himself trained as a Kleinian, remarked on how deep was Kohut's knowledge of their work, despite his disagreements with their conceptualizations.75
The mystery is Donald W. Winnicott, the English analyst who had written beautiful clinical vignettes about children and grasped the openness of their psychological boundaries. It was Winnicott who first talked of the "transitional object." Most of those close to Kohut have always assumed he simply did not read Winnicott and was unaware of any points of convergence between his work and that of Winnicott. Such, for example, is the strong view of Thomas Kohut.76 Paul Ornstein is rather more cautious. He says Kohut surely knew about Winnicott but "ignored and bypassed him" as someone with interesting clinical ideas but not an important theoretician.77 Ornstein's view is supported by Kohut's comments on Winnicott in his University of Chicago lectures to the Mental Health Clinic during the academic year 1969-1970, or just as he was putting the final touches on his manuscript. Someone (the names are not provided in the published text) in the seminar asked Kohut about the relationship between "primary narcissism" and the "transitional object." Kohut first examined his understanding of primary narcissism and then turned to its relationship with what Winnicott calls the transitional object. He noted that Winnicott came up with the term—and the crucial paper is in the bibliography of Analysis—but that the concept was really from Freud's "Beyond the Pleasure Principle" (1920). In that paper Freud gives the "first" account of a transitional object in the game of "fort-da" with the spool of thread that he played with his grandson.78 In other words, Kohut reduced Winnicott's best-known concept to a footnote of an idea that began with Freud. It is not surprising Kohut never read much more widely in Winnicott's other writings. In other ways, as well, Kohut ignored Winnicott. He felt that Winnicott, like Ferenczi, was good on empathy at the clinical level but remained locked in drive theory. Winnicott's useful stray insights were not therefore part of a coherent theory of empathy.
Other, more tangential influences on Kohut's thinking in these years include the cognitive developmental theorist Jean Piaget (though Kohut specifically denied that Piaget had any impact on his thinking).79 Kohut was also so oblivious to Carl Rogers that he never once mentions his name in anything written that has survived, or in the extant lectures that have been transcribed and published, even though Rogers was for a time in the 1960s at the University of Chicago.80
One has to wonder, however, about the influence of the most important of the early psychoanalytic thinkers on Kohut's work (with the exception of Freud himself), Carl Jung. By far the best and most balanced discussion of Jung and Kohut is by Mario Jacoby, who sees many areas of overlap between the two thinkers and much simultaneous discovery of similar things but expressed in quite different terms.81 The evidence, as very intelligently laid out by Jacoby, is that Kohut and Jung were coming at some common problems from quite different traditions and that each spoke within his own, exclusive discourse. Jacoby, a respected Jungian, thinks that charging Kohut with a simple recycling of Jung's best ideas is neither fair nor accurate. Kohut's studied avoidance of Jung, however, may reflect the politics of psychoanalysis more than any real intellectual ignorance of what that wily Swiss analyst was up to. Jung was the first to talk systematically about the self in psychoanalysis, the first to object to drive theory, and he had many specific ideas of great relevance for a deeper understanding of narcissism. But Jung was always controversial after his noisy break from Freud, and much of his later behavior, especially his obliging stance toward the Nazis after 1934, has tainted him in other ways.82 Kohut never talked about Jung in his lectures or conversations and Jung is conspicuously absent from the bibliographies of his books. Kohut was probably aware of some aspects of Jung's ideas about the archetypes, but in general he seems not to have read Jung's writings and was only interested in Jung's correspondence with Freud as a part of Kohut's deep fascination with the master.83
In some respects, the debate about attribution of The Analysis of the Self is tedious and entirely predictable. William James once commented on the "classic steps" in the life of a theory. First it is attacked as utterly absurd. Then it gets accepted as obvious and insignificant. Finally, it is understood as so important that its opponents claim that they had said it all before."
2. "Self Psychology and the Psychoanalytic Movement: An Interview with Dr. Heinz Kohut," Psychoanalytic and Contemporary Thought 5(1981): 492-493.
4. The first quote is from Kohut to Anna Freud, April 6, 1969, Curve, 235-236; the second from Kohut to Rene Spitz, June 6, 1969. "new thoughts to be added": Kohut's notes on his holiday card to a former patient, Wilda Daley, December 1969, a copy of which she gave me on October 22, 1987.
5. The two major reviews of Analysis were Hans Loewald, in PQ 42 (1973): 441-451, and Martin James, in IJP 44 (1973): 363-368. Loewald puts more emphasis on its ideas as defining a separate line of development for narcissism and is critical of Kohut for his "forced dichotomies." A few years later, C. Hanley and G. Masson, "A Critical Examination of the New Narcissism," IJP 57 (1976): 49-66, return to the contrast between narcissism and object relatedness but with a sharper note of criticism of Kohut. Stephen Mitchell, "Twilight of the Idols: Change and Preservation in the Writings of Heinz Kohut," Contemporary Psychoanalysis 15 (1979): 170-171, adds the unhelpful point that Kohut leaves unanswered the relation of his new ideas to classical theory. More recently, writers—even those close to self psychology—continue to read Analysis as basically concerned with narcissism and defining a separate line of development. See Leon Batter, "Observation and Theory in Psychoanalysis: The Self Psychology of Heinz Kohut," PQ 6o (1991): 361-389, and Lynne Layton, "A Deconstruction of Kohut's Concept of the Self," Contemporary Psychoanalysis 26 (1990): 42o-429.
6. The ideas in this paragraph have been developed during many discussions with Robert Jay Lifton over the years. The specific idea that Freud's model imagines the self as the victim of drives is from a conversation on November 30, 1999.
7. Freud's only real attempt to think about the psychoses was in his important essay on Daniel Paul Schreber, "Psycho-Analytic Notes on an Autobiographical Account of a Case of Paranoia (Dementia Paranoides)" ( 1911), SE 12: 3-82.
8. Analysis, 26.
9. Note, among her other works, Melanie Klein, Envy and Gratitude, and Other Works, 1946-1963 (London: Hogarth Press and the Institute of Psycho-Analysis, 1975); Love, Guilt, and Reparation, and Other Works, 1921-1945 (London: Hogarth Press, 1975); and The Psychoanalysis of Children, tr. Alix Strachey, rev. with H. A. Thorner (New York: Delacorte Press, 1975). A biography that includes a good summary of her work is Phyllis Grosskurth, Melanie Klein: Her Life and Work (Cambridge, MA: Harvard University Press, 1986).
10. Analysis, 3.
11. Kohut to Joseph Lifschutz, June 4, 1971, Curve, 255.
12. Analysis, 16-17, 23. Compare Jonathan Lear, Love and Its Place in Nature: A Philosophic Interpretation of Freudian Psychoanalysis (New York: Farrar, Straus & Giroux, 1990), 37: "Archaic mental functioning knows no firm boundary between mind and body, and so archaic mind is incarnate in the body."
13. Compare Lectures, 243-257; "and depression": Analysis, 20.
14. See also Freud, "The Dynamics of Transference," SE 12: 97-108, and Lecture 27 of the New Introductory Lectures, SE6 16,: 431-447, esp. 443-447; "of the physician": Freud, "Fragment of an Analysis of a Case of Hysteria" (1905), SE 7: 116; "stalking-horse for him": Freud, The Interpretation of Dreams (1900), SE 5: 562-563.
15. Analysis, 25, 27, 32. Kohut actually writes of the "grandiose or exhibitionistic image of the self" (25), but the context reasonably allows one to extend that to the idea of "self images" as representing his understanding of one way of talking about the grandiose self and the idealized parent imago. His discussion of the "cohesive self" is on 32.
16. Ibid., 26-32. See esp. 28: "If the child, however, suffers severe narcissistic traumas, then the grandiose self does not merge into the relevant ego content but is retained in its unaltered form and strives for the fulfillment of its archaic aims. And if the child experiences traumatic disappointments in the admired adult, then the idealized parent imago, too, is retained in its unaltered form, is not transformed into tension-regulating psychic structure, does not attain the status of an accessible introject, but remains an archaic, transitional self-object that is required for the maintenance of narcissistic homeostasis." Kohut elaborates further at some length on the conceptual difference between transference in drive theory and his understanding of transference; see 203-220. Note 210-211 on the analogy of transference in analysis with the theater (which is borrowed without credit from Freud, SE 12: 154); on his ideas versus those of Melanie Klein, 212-218; Margaret Mahler, 218-220; and Michael Balint, 220.
17. Analysis, xiv—xv.
18. William James, Psychology: Briefer Course (London: Macmillan, 1892), 176. I was led to this quote by Russell Meares, The Metaphor of Play: Disruption and Restoration in the Borderline Experience (New York: Jason Aronson, 1993), 22. Note Erik Erikson's interesting elaboration on the "I" experience in "The Galilean Sayings and the Sense of `I'," Yale Review 70 (1981): 34-56.
19. Kohut calls this process "passage [of the narcissistic cathexes] through the idealized self-object [Kohut's italics]," Analysis, 42; cp. 39.
20. Ibid., 46-47 and 51-52. One example Kohut provides of such needing is that of addicts, a group of patients that had always interested him; see Kohut, Discussion at the meeting of the American Psychiatric Association in 1956 of Thomas Szasz's paper, "The Role of the Counterphobic Mechanism in Addiction," Search 1: 201203. Addicts, Kohut says, are usually traumatically disappointed in the mother, who failed to provide the necessary empathy for the child's needs. As a result of that early failure, the child is deprived of the experience of being optimally soothed, and is especially vulnerable around issues of sleep. The drug the addict turns to replaces the "defect in the psychological structure," which can at least temporarily create sufficient self-soothing to insure sleep and a modicum of chemically induced self-esteem. In analysis such patients often become quickly addicted to the therapeutic process itself. "The transference-like condition which establishes itself in such analyses is indeed the reinstatement of an archaic condition." The patient turns to the analyst to perform crucial functions to maintain a "narcissistic homeostasis which his own psyche is unable to perform." The profound depletion of the addict's self is best illustrated in the craving he experiences when separated from the soothing therapist, who is in turn intensely idealized.
21. Analysis, 47-49.
22. Ibid., 53-56.
23. Ibid., 98. This passage is actually a reference to a detail in the case of Mr. E. The use of Mr. E. seems out of place in this context, as he is the classic example of the therapeutic mobilization of the grandiose self in a mirror transference, while here Kohut uses him to illustrate something about the idealizing transference.
24. Ibid., 57-73. All quotes about Mr. A. in this and the next few paragraphs are from this section of Analysis.
25. Martin Bergmann and Milton E. Jucovy, eds., Generations of the Holocaust (New York: Basic Books, 1982).
26. Judith Kestenberg to Kohut, December 7, 1977, and Kohut to Kestenberg, December 14, 1977; my interview with Judith Kestenberg, September 30, 1990.
27. PO. Ornstein talked with Kohut at length at the time about attending the workshop and Ornstein agreed it would be a waste of Kohut's time.
28. This detail Kohut added in a seminar with Candidates at the Chicago Institute for Psychoanalysis; see Lectures, 9.
29. Analysis, 74-101, esp. 8off. For a more detailed discussion of this case, see "A Case of Chronic Narcissistic Vulnerability," The Psychology of the Self: A Casebook, ed. Arnold Goldberg with the collaboration of Heinz Kohut (New York: International Universities Press, 1978), 363-437.
30. Freud, The Ego and the Id, SE 19: son.
31. Freud wrote in "Recommendations to Physicians Practising Psycho-Analysis," SE 12: 118: "The doctor should be opaque to his patients and, like a mirror, should show them nothing but what is shown to him." The heart of Kohut's clinical and theoretical work was to oppose the conventions of coldness that had become almost mandatory within psychoanalysis.
32. Analysis, 89. The question of the analyst's relation to a patient's idealization is a topic of great concern to contemporary "relational" or "postmodern" psychoanalysis. See Judith Guss Teicholz, Kohut, Loewald, and the Postmodern: A Comparative Study of Self and Relationship (Hillsdale, NJ: Analytic Press, 1999), 112-113.
33. Analysis, 26o-262.
34. Ibid., 264, 267.
35. The following discussion of Miss F. is taken from Analysis, 283-293.
36. Sheldon J. Meyers, "On Supervision with Heinz Kohut," Progress in Self Psychology: Learning From Kohut, ed. Arnold Goldberg (Hillsdale, NJ: Analytic Press, 1988). I also interviewed Meyers on April 1, 1996.
37. SE 14: 100-102.
38. Analysis, 105-108.
39. Ibid., 114-15.
40. Ibid., 115.
41. The "mirror" in this transference can be confusing, especially given the work of Jacques Lacan and his idea of the "mirror stage." Kohut's and Lacan's ideas were converging but not entirely overlapping. See Elizabeth Roudinesco, Jacques Lacan, tr. Barbara Bray (New York: Columbia University Press, 1997); Mikkel Borch-Jacobsen, Lacan: The Absolute Master, tr. Douglas Brick (Stanford: Stanford University Press, 1991); and Paul Hamburg, "Interpretation and Empathy: Reading Lacan with Kohut," IJP 72 (1991): 347-361. Kohut himself refers to the work of P. Elkisch, "The Psychological Significance of the Mirror," JAPA 5 (1957): 235-234‑
42. The full case history of Mr. E. appears in The Psychology of the Self A Casebook, 263-296. Except for Kohut's own case of Mr. Z, the case of Mr. E. is the most interesting and elegant in self psychology and certainly one of the best cases written up by anyone in psychoanalysis in the last half century. This discussion of Mr. E. draws on Kohut's vignettes from Analysis, 10, 15, 117-118, 130-132, 136, 158— 159,173,313-315; on one of my published interviews with Kohut (March 12, 1981) in Humanities, 251 (the goldfish eyes and looking like his mother); and on an unpublished part of the same interview (the detail that Mr. E. had become a noted and talented photographer). Kohut makes very interesting use of this case in his long paper "Creativeness, Charisma, Group Psychology: Reflections on the Self-Analysis of Freud," Search 2: 793-843, esp. 800-813. Cp. Lectures, 45-46 and 80-83. Mr. E.'s actual analyst also provided useful details, but for reasons of confidentiality his name cannot be revealed.
43. Kohut provides two further brief case illustrations of this conceptual point with Mr. G. and Mr. O., Analysis, 93 and 95n.
44. Analysis, 126-128. On pp. 80-82 of Analysis Kohut uses Mr. B. as an example of a patient in an idealizing transference. In this section, on the other hand, Kohut mentions Mr. B. as a good example of someone in a mirroring transference. It seems to me there are two possible explanations for this sloppiness. One is that Kohut simply confused case material from another patient and substituted it for that of Mr. B. Kohut would not be the first psychoanalyst to get confused by his own disguises. The other, more intriguing, possibility for the double use of Mr. B. is that for all of Kohut's elaborate distinctions between the idealizing and mirroring transferences, in the end both merge in the earliest psychological experience of the self. Whatever is the case, I use vignettes from the analysis of Mr. B. in two sections of this chapter because they are so relevant for explaining Kohut's ideas.
45. Kohut confusingly calls this form of the mirroring transference "secondary," because it follows a period of stable idealization. It also happens that a mirror transference can be replaced by a stable idealizing transference, either as the "third phase in instances of secondary mirror transference or at the end of a primary mirror transference." Analysis, 174.
46. Ibid . , 137-140.
47. Ibid., 176 ("demands for attention"), 271 ("as an independent"), 272 (gratify analyst's needs), 273 (reflects analyst's impatience).
48. Ibid., 148-150. I have made my own translation of the Horace quote.
49. Ibid., 159-160.
50. SE 5: 339-508.
51. Analysis, 168; "off the ground," 169; "bodily tensions," 243.
52. Ibid., 170-172. Kohut's full quote (172) is that "They [dreams in color] often appear to signify the intrusion of unmodified material into the ego in the guise of realism, and the ego's inability to integrate it completely. One might say that the technicolor expresses the ego's subliminally experienced anxious hypomanic excitement over certain intrusions of the grandiosity and the exhibitionism of the grandiose self." Needless to say, in using the example of Mr. A. at this point Kohut is once again collapsing his otherwise sharp distinction between the idealizing and mirroring transferences. He covers himself in the text by talking about "narcissistic transferences" in relation to color in dreams, but the section of the book is that dealing with the mirroring transferences.
53. Ibid., 229-232.
54. Ibid., 232-234. The subtext of Kohut's point here is his disagreement with classical psychoanalytic theory, which would interpret reactions like that of Mr. B. as expressions of his unconscious guilt. As Kohut says, in narcissism it is always shame that matters, that is, "they [NPDs] react to the breakthrough of the archaic aspects of the grandiose self, especially to its unneutralized exhibitionism." See ibid., 232.
55. Anna Freud to Heinz Kohut, December 10, 1967, Curve, 182-184, esp. 183.
56. Analysis, 19, 67. One of the most relentless and most interesting criticisms of the language of ego psychology is Nathan Leites, The New Ego: Pitfalls in Current Thinking About Patients in Psychoanalysis (New York: Science House, 1971).
57. Freud, "Three Essays on the Theory of Sexuality," SE 7: 123-245.
58. SE 14: 246, 256-258.
59. Freud, The Ego and the Id (1923), SE 19: 3-66.
60. SE 21: 57-145; "charge into anxiety": SE 20: 75-175, esp. 1o9; "moral masochism": SE 19: 157-170, esp. 165-166.
61. Anna Freud, The Ego and the Mechanisms of Defense, trans. Cevil Baines, rev. ed. (London: Hogarth Press, 1968 ).
62. Heinz Hartmann, Ego Psychology and the Problem of Adaptation, trans. David Rapaport (New York: International Universities Press, 1958 ); Erik H. Erikson, Childhood and Society (New York: Norton, 1950).
63. Erikson, "The Theory of Infantile Sexuality," Childhood and Society, 48-108.
64. Erik Erikson, Insight and Responsibility (New York: Norton, 1964), 29.
65. Ibid. Erikson makes something of the same argument about what he calls Martin Luther's moratorium; Young Man Luther: A Study in History and Psychoanalysis (New York: Norton, 1958); "have it destroyed": James Strachey, Introduction to "Project for a Scientific Psychology," SE I: 29o; "inner consistency": Erikson, Insight and Responsibility, 3I; "external stimuli": SE 1: 281-397; "of the mind": Erikson, Insight and Responsibility, 30.
66. Erikson, Childhood and Society, 64.
67. Analysis, xiii-xiv. The influence of some, like Sullivan, remained on the margins; see Search 1: 218-219, and Kohut to Arnold Goldberg, November 3, 1972, Curve, 273.
68. Kohut himself had some reluctance to talk about his work as representing a paradigm shift--though he certainly believed it--and left it to the group to make such claims, which he could then modestly disavow. Marian Tolpin, personal communication, August 25, 1998, clarified that the members of the group talked all the time about a paradigm shift in self psychology, but Kohut himself seldom did. Cp. Search 4: 514-515.
69. There is a good deal of interest in connecting Kohut with other thinkers, especially in object relations. The best recent work is Judith Gass Teicholz, Kohut, Loewald (1999). The standard collection of essays comparing Kohut to other thinkers is Douglas W. Detrick and Susan P. Detrick, eds., Self Psychology: Comparisons and Contrasts (Hillsdale, NJ: Analytic Press, 1989). Among the British in particular, Kohut got to know Michael Balint personally through his junior colleague, Paul Ornstein. They met at a conference in 1969 and had dinner together with their wives. Later they exchanged friendly letters (Michael Balint to Kohut, September 16, 1969, and Kohut to Balint, September 23, 1969), though Kohut told Ornstein he could not read The Basic Fault (or anything else for that matter right then) before he finished Analysis; PO. Kohut's great idol among English analysts was Edward Glover, whom he once described to Ornstein as his "analytic ideal"; "he learned more from Glover than from anybody else" ( PO). Glover is granted an astonishing three references in the text of Analysis (29, 206, and 215) besides mention in the bibliography. Kohut repeated the phrase that he "learned more from Glover than from anyone else" in "Greetings," Reflections, 17. As Ornstein notes, it is hard to figure out why he would say such things about Glover. Note also Howard A. Bacal and Kenneth M. Newman, Theories of Object Relations: Bridges to Self Psychology (New York: Columbia University Press, 1990); Robert M. Galatzer-Levy and Bertram J. Cohler, The Essential Other: A Developmental Psychology of the Self (New York: Basic Books, 1993); Michael Robbins, "Current Controversies in Object Relations Theory as Outgrowth of a Schism Between Kohut and Fairbairn," IJP 62 (1980): 477-492; and Robert J. Marshall, "Hyman Spotnitz and Heinz Kohut: Contrasts and Convergences," Modern Psychoanalysis 23 (1998): 183-196.
70. Martin James, IJP 54 (1973): 363-368. James did, however, praise Kohut, who he said has done for narcissism what Dickens did for poverty in the nineteenth century. Everybody knew each existed and was a problem. All suffered pangs of conscience that more was not done to study it, and existing sources were rich for understanding it But the "undoubted originality" of Dickens and Kohut was to put together what everybody knew "in a form which carries appeal to action."
71. Kohut to Martin James, June 18, 1973, Curve, 278-280; Kohut to William H. Gillespie, June 20, 1973, Curve, 280-284. That Kohut copied his letters to Freud is inferred from her letter to him July 2, 1973, Curve, 285, which begins, "Even though you told me to keep the information in your first letter to myself . . ." Kohut may have written her a separate letter that has been lost.
72. Kohut to Joseph Sandler, June 23, 1973, Curve, 284-285, and Anna Freud to Kohut, July 2, 1973, Curve, 285.
74. Kohut told John Gedo, who did some early work on Ferenczi in the 1960s, of his respect for several of Ferenczi's papers, but distanced himself from Ferenczi's "flights of fancy" and "later restlessness." He also told Gedo how unfortunate it was that candidates no longer studied Ferenczi in detail. See Kohut's after-dinner speech at his sixtieth birthday celebration, June 2, 1973, tape in collection of Ernest Wolf; Kohut to John Gedo, October 26, 1966; Arnold Rachman, "Sandor Ferenczi and the Evolution of a Self Psychology Framework in Psychoanalysis," Progress 13 (1997): 341-366; and John Gedo to me, March 15, 1996.
75. BB; Kohut to Samuel D. Lipton, June 5, 1964; on the baby as evil, see Seminars, 103-104; Kohut to Anna Freud, October it, 1966, Curve, 147; Kohut to Anna Freud, October 28, 1966, Curve, 151-152. At a meeting of the American in Paris in 1973, for example, Kohut goes into the Kleinian perspective to disagree with it at some length. See the tape collection of Ernest Wolf.
78. Seminars, 53-59, esp. 56 and 57. See Donald W. Winnicott, "Transitional Objects and Transitional Phenomena," IJP 34 (1953): 89-97.
80. See Edwin Kahn and Arnold Rachman, "Carl Rogers and Heinz Kohut: A Historical Perspective," Psycho. Psychology (in press). Arnold Rachman, personal communication, pointed out to me the geographical/institutional proximity between the two men. It is a long and arduous journey, however, from the University of Chicago Department of Psychology to the Department of Psychiatry and an even longer trek across rough terrain to the downtown Institute for Psychoanalysis.
81. Mario Jacoby, Individuation and Narcissism: The Psychology of the Self in Jung and Kohut (New York: Routledge 1990 ). Cp. Lionel Corbett and Paul K. Kugler, "The Self in Jung and Kohut," Progress 5 (1989): 189-208.
82. The issue of Jung's complicated relationship to the Nazi regime in Germany between 1933 and 1939 has deeply divided those who have written about him. The sharpest criticism has come from Richard Noll, The Jung Cult (Princeton: Princeton University Press, 1994) and The Aryan Christ (New York: Random House, 1997); see also the earlier work of Paul Roazen, Freud and His Followers (New York: Knopf, 1975). For the other side of the argument, see Jay Sherry, "Jung, the Jews, and Hitler," Spring (1986): 163-175; and Aniela Jaffe, "C. G. Jung and National Socialism," From the Life and Work of C. G. Jung (Einsiedeln, Switzerland: Daimon Verlag, 1989), 78-102. Thomas Szasz (Kohut's old friend) has also weighed in with some interesting observations: "Freud and the Freudians have deprived Jung of many of his best ideas and, to boot, have defamed him as an anti-Semite. Actually Jung was far more candid and correct than Freud in identifying psychotherapy as an ethical rather than technical enterprise; and Freud was far more anti-Christian than Jung was anti-Semitic." See Heresies (Garden City, NY: Anchor Press, 1976), 136. One might note, regarding Szasz's last point, that the Jews in Europe lacked hegemonic power, which makes Jung's anti-Semitism quite different politically and ethically from Freud's reserve regarding the Christian world. Jung also positioned himself to benefit from the Nazis after 1933—at the expense of his disdained Jewish colleagues.
83. For Kohut's awareness of Jung's ideas, see Search 3:225. For his interest in the Freud-Jung relationship, see Search 2: 823n, 881, and 893.
84. William James, Lecture VI of Pragmatism's Conception of Truth (1997), The Works of William James, ed. Frederick H. Burkhardt, Fredson Bowers, and Ignas K. Skrupskelis, 16 vols. (Cambridge, MA: Harvard University Press, 1975), 2: 95.