Self Psychology is a school of psychoanalytic theory and therapy created by Heinz Kohut and developed in the United States at the Chicago Institute for Psychoanalysis. Self psychology explains psychopathology as being the result of disrupted or unmet developmental needs. Essential to understanding Self psychology are the concepts of empathy, self-object, mirroring, idealising, alter ego/twinship and the tripolar self. Though self psychology also recognizes certain drives, conflicts and complexes present in Freudian psychodynamic theory, these are understood within a different framework.
Origins
Kohut came to psychoanalysis by way of neurology and psychiatry in the 1940s, but then ’embraced analysis with the fervor of a convert…[and as] “Mr Psychoanalysis”‘ took on an idealizing image of Freud and his theories. Subsequently ‘In a burst of creativity that began in the mid-1960s…Kohut found his voice and explored narcissism in new ways that led to what he ended up calling a “psychology of the self”.’ Thus the publication of ‘his book The Analysis of the Self[1971]…was what Kuhn would call a new paradigm.’
Kohut argued that therapy should be more involved with the patient than with analytical theories. In other words, to make therapy work, one needs to address the patient’s self.
Concepts
Self
Beginning by ‘applying general psychoanalytic principles to narcissistic transferences, he [Kohut] went on to inventing a whole “psychology of the self”.’ Kohut’s concept of self, and “defects” in it, is the core variable of self-psychology, where superego/ego/id and oedipal conflicts could be considered to be the core of Freudian theory. Kohut came to distinguish four key components in the development of the self: the nuclear, virtual, cohesive and grandiose selves.
‘Kohut argued that normal human infants are born with a nuclear self already in place (a biologically determined psychological entity).’ That self then encountered what he called ‘the virtual self (an image of the newborn’s self, which resides in the minds of the infant’s parents).’ In optimal circumstances, the interaction of nuclear and virtual selves would ‘lead to the child’s gradual organization of a cohesive self’ – to the point where ideally ‘a living self in depth has become the organizing center of the ego’s activities .’ Along the way, however, would be the appearance of ‘the grandiose self…the self that emerges out of the normal infantile experience of oneself as the centre of all experience, omnipotent’ – in Freud’s words, ‘ His Majesty the Baby, as we once fancied ourselves.’
For the self-psychologist, psychopathology is viewed in regard to how the self adapts and reacts to other objects; and in the therapy, the patient’s self is also examined for indications of to how to approach the patient.
Empathy
Kohut maintained that parents’ failures to empathize with their children and the responses of their children to these failures were ‘at the root of almost all psychopathology.’ For Kohut, the loss of the other and the other’s self-object function (see below) leaves the individual apathetic, lethargic, empty of the feeling of life, without vitality, in short, depressed.
For the infant to move from grandiose to cohesive self and beyond, meant a slow process of disillusionment with phantasies of omnipotence, mediated by the parents: ‘This process of gradual and titrated disenchantment requires that the infant’s caretakers be empathetically attuned to the infant’s needs’.
Correspondingly, to deal in therapy with earlier failures in the disenchantment process, Kohut ‘highlights empathy as the tool par excellence, which allows the creation of a relationship between patient and analyst that can offer some hope of mitigating early self pathology.’
Kohut describes human empathy as a therapeutic skill. When a patient acts in a certain way, “put yourself in his/her shoes” – and find out how it feels for the patient to act in this manner.
Using the skill of empathy, the therapist is able to reach conclusions sooner (with less dialogue and interpretation), and there is also a stronger bond between patient and therapist, making the patient feel more fundamentally understood. For Kohut, the implicit bond of empathy itself has a curative effect; but he also warned that ‘the psychoanalyst…must also be able to relinquish the empathic attitude’ to maintain intellectual integrity, and that ’empathy, especially when it is surrounded by an attitude of wanting to cure directly…may rest on the therapist’s unresolved omnipotence fantasies.’
The conceptual introduction of empathy was not intended to be a “discovery.” Empathic moments in psychology existed long before Kohut. Instead, Kohut posited that empathy in psychology should be acknowledged as a powerful therapeutic tool, extending beyond “hunches” and vague “assumptions,” and enabling empathy to be described, taught, and used more actively.