The Causes and Treatment of Backwardness by Cyril Burt

In this paper, self psychology is presented as a particular form of object-relations theory which directs the therapist to consider interactions within the group in the light of their effect on the sense of self of the individual. In traditional object-relations psychology the therapist works through defenses against the anxieties of expressing wishes for unacceptable forms of object-relations in the group, which are related to unconsciously warded off instinctual drives. In contrast, the therapist who adopts the framework of self psychology works through defenses against anxieties associated with expressing developmentally phase-legitimate self object needs. Thus, the individual's frustrated reactions to others are not interpreted as distorted and/or maladaptive, but as understandable reactions to the patient's experience of thwarted developmental needs for selfobject responsiveness which are repeated in the here-and-now interactions within the group. The selfobject transferences are described as well as the ways in which they may come into conflict with one another. Two clinical examples previously understood by the author from within a traditional object-relations framework are reviewed, and discussed from the perspective of self psychology.     

The Group Psychotherapy Literature 1958

This study applies Kohut's self-psychology toward an understanding of the self-functions that membership in a religious cult group (Divine Light Mission) provides for the narcissistic personality. It is proposed that there exists a psychosocial fit between the appeal of the cult group's structure and process and the needs of the narcissistic personality. The cult group offers reparative and substitutive functions to the follower who seeks an idealized selfobject to stabilize a defective sense of self. The special relationship of the follower to the Guru bears a close resemblance to the “idealizing transference” which arises between certain narcissistic patients and their group therapist. The therapeutic use and misuse of the “idealizing transference” in group therapy is explored and suggestions are made for its appropriate clinical management.     

The breadth and boundaries of a self‐psychological immersion in shame a one‐and‐a‐half‐person perspective

Shame colors other feelings and perceptions about the self. From reflections about his own personal experiences and observations regarding a particular manic‐depressive patient, the author discusses the evolution of his current clinical and theoretical understanding of shame. The framework of analytic self psychology is offered as a particularly useful perspective from which to consider shame, with its emphasis on the concept of selfobject to account both for shame's development (through selfobject misattunement and unresponsive‐ness) and for its amelioration (through empathic mirroring, idealization, and twinning). A developmental sequence for shame is advanced reflecting limitations in selfobject responsiveness, and problems are noted in the ability of current self psychology theory to fully account for the alleviation of shame. The self plays its part in the construction of those selfobjects needed to ease shame, representing the “one‐and‐a‐half‐person psychology”; of the paper's subtitle. Finally, the important role of countertransference shame is considered through a clinical example of therapist disclosure of his own shame to his patient, utilized in order to repair an interrupted kinship selfobject transference.     

Affective Experiences and Honesty in the Interaction: Discussion of Holly Levenkron's Paper

Anchoring her views in the work of Benjamin and other American relational authors, Levenkron asserts that intersubjective relatedness in which there is recognition of separate realities is essentially the only form of relatedness. Framing growth as coming about through the recognition of another's subjectivity provides a basis for “confrontation” and for a more direct injection of the analyst's subjectivity into the analytic encounter. More specifically, it fosters the expression of the analyst's subjectivity from what this author calls the “other-centered” and “self” perspectives.

In contrast, the recognition of selfobject and caretaking relatedness positions the analyst to express directly aspects of the analyst's subjectivity pertaining to mirroring, idealizing, and twinship selfobject needs. Kohut and classical self psychologists have delineated selfobject needs and the selfobject dimension of relatedness and transference and have emphasized the consistent use of the empathic listening/experiencing perspective. American relational theorists have delineated intersubjective relatedness and the usefulness of the other-centered listening/experiencing perspective. This author focuses on an integrative theory including three forms of relatedness and different listening/experiencing perspectives. Different listening/experiencing perspectives and forms of relatedness fundamentally influence analysts' affective experiences within the analytic encounter as exemplified in Levenkron's case.     

Book Review

Abstract

Case vignettes are offered to illustrate five principles of self psychological treatment the author believes are generally accepted by self psychologists. A sixth principle is included, contributed by self psychologists informed by intersubjectivity. They are:

1. The centrality of the empathic vantage point for analytic observation. This requires a shift in the listening stance from observing from the outside to observing from the inside. The analyst attempts to listen from within the context of the analysand's subjective reality in order to understand his experience.

2. Alterations in the sense of self must be recognized and understood.

3. When ruptures occur between patient and analyst (selfobject bond), such ruptures are analyzed.

4. From a technical point of view, the careful exploration of both the state of the selfobject bond, and the meanings to the patient of the analytic activity needs to be carefully examined and understood by both patient and analyst.

5. Defensive activities are thought to be undertaken in the service of psychological survival.

6. A deeply entrenched defensive structure may appear as a resistance to progress in treatment. Such pathological structures of accommodation function to dismantle progress in self delineation.     

Mourning analysis: the post-termination phase

One hundred twenty-one analytic candidates who had completed training analysis responded to a survey about their post-termination experience. Seventy-six percent of respondents experienced a mourning process that lasted on average between six months and a year, while 24 per cent experienced no discernible sense of painful loss. Twenty candidates were interviewed to obtain a deeper understanding of the mourning process that follows analysis. During the post-termination phase, the analysand's self-analytic capacity is tested in the struggle to contain and understand feelings about the loss of the analyst, as well as transference reactions triggered by that loss. After a "good-enough analysis," the analysand internalizes not only the analyst's functions and attitudes toward him or her, but also a sustaining, positive internal image of the analyst. Four cases illustrate unexpected difficulties that may emerge during the post-termination phase when the loss of the analyst is experienced as a repetition of earlier, traumatic losses or as a rupture of an unanalyzed, selfobject transference.     

“The unbearable embeddedness of being”: Self psychology,intersubjectivity and large group experiences

Studying the large group from a self psychological perspective is a new area of exploration. The purpose of this work is to consider an expansion of the selfobject concept to include experiences in group. The groupobject is conceived as a function which addresses the inherent group needs of the individual. Just as the selfobject serves to fill in missing aspects of the self, the groupobject fills in missing aspects of the group self. The development of this concept emerged from an ongoing large group experience. It has its roots in the idea that effective group treatment can result from the recognition and support of groupobject as well as selfobject needs.This phrase, first coined by Stolorow and Atwood (1993) represents their attempt to clarify the fallacy of the isolated mind.Contexts of Being. Hillsdale, NJ: Analytic Press, 1993.     

Dreams as portraits of self and group interaction

Dreams presented in group psychotherapy portray different aspects of the dialectic between the group and the individual. A self psychology perspective emphasizes the interplay between the current self-state of the group-as-a-whole and the selfobject needs of the individual. With this focus in mind, the therapist should help the group to deepen its awareness and capacity to reflect on emerging new abilities ("forward edge") which dream imagery conveys and the needed human responsiveness that can actualize these abilities and thus help the individual and the group to break and transform chains of repetition compulsion. We illustrate this approach with two clinical examples.     

The group as selfobject: brief psychotherapy with women

This article applies the theory of self psychology, which was developed by Heinz Kohut, to brief group psychotherapy. The article discusses the significance of the group as an expanded selfobject for individuals who do not have appropriate, available selfobjects in their environment. The article addresses the rationale for developing a 12-week women's group from a self-psychological perspective and illustrates key theoretical concepts in the beginning, middle, and end phases with group process. The role of the therapist in each phase of group development is emphasized.     

Therapist Self Disclosure in Group Psychotherapy from an Intersubjective and Self Psychological Standpoint

The history of therapist self disclosure is traced from the early struggles of Ferenczi and Burrow to its valued, yet still ambivalent, contemporary status. The symmetry of self disclosure by therapist and group members is differentiated from the parity of their different roles and responsibilities. Using a case example, the process is discussed through which a therapist's self disclosure fosters task-appropriate satisfaction of selfobject needs as it also helps group members articulate and loosen archaic selfobject binds. The therapy group is described as a transitional space within which a therapist's disclosure offers members an intersubjective bridge to the therapist as well as a model for members' own active participation in the group's work.     

The patient's transference experience of the analyst's gender: Projection,factuality, interpretation,or construction

The constructivist/relational perspective has challenged the analyst's emotional superiority, her omniscience, and her relative removal from the psychoanalytic dialogue. It at first appears to be antithetical to treatment approaches that emphasize the analyst's holding functions. In this essay I examine the holding model and its resolution from a relational perspective. I propose that the current discomfort with the holding function is related to its apparent, but not necessarily real, implications. I discuss the analyst's and patient's subjectivity during periods of holding. I believe that the holding process is essential when the patient has intensely toxic reactions to “knowing”; the analyst and is therefore not yet able to stand a mutual analytic experience. During holding, the patient experiences an illusion of analytictic attunement. This requires that the analyst's dysjunctive subjectivity be contained within the analyst, but not that it be abandoned. Ultimately, it is the transition from the holding position toward collaborative interchange that will allow analyst and patient explicitly to address and ultimately to integrate dependence and mutuality within the psychoanalytic setting and thereby engage in an intersubjective dialogue. The movement toward mutuality will require that the analyst of the holding situation begin to fail in ways that increasingly expose her externality and thus her subjectivity to the patient.     

From Dead to Alive: Desire,Dissociation and Passion in the Analytic Dyad

When patients present in a deadened state, the analyst may feel a sense of futility and shame in his efforts to have impact. This may cause him to withdraw and contribute to an enactment in which both participants purge themselves of wanting anything from the other, sapping the treatment of purpose and aliveness. The author presents a model in which the analyst can reawaken his desire for recognition and connection and utilize it to introduce the patient to his or her own dissociated longings. This involves fortitude on the therapist’s part, since he must withstand the rejection that had caused him to withdraw in the first place, and also be sensitive to the patient’s fear of retraumatization. But if the analyst can do this, he can not only break through the impasse, but enliven the patient and infuse the treatment with a sense of purpose and hope.     

Self and Talent—Treatment Considerations

The clinical pursuit of patients' experiences of talent, in their current life and in their developmental years, has broadened the clinical field considerably and provided more lanes and latitude in the “royal road to the unconscious.” Interest in patients' talents has been experienced as an invitation to bring in their created works, not just as a display of aesthetic interest but, much more importantly, as another pathway through which the analyst can access an understanding of the deepest and most meaningful levels of selfexperience. This article explores some of the meanings of talent for the self and suggests that there is a developmental line for the maturation of one's relationship to one's talent. I provide discussion that illustrates the coextensiveness of the inner experience of talent with the selfobject surround throughout growth and maturation. Finally, I provide illustrations of how talent can be experienced and how exploration of experiences of talent can play a quintessential role in psychoanalytic treatment.     

The effects of therapist-client age similarity on pretherapy expectations

The present study investigated the effects of similarity between psychotherapist age and client age on client's preference for a therapist, willingness to disclose, expected therapeutic climate, and perceptions of therapist competence. Similarity theory provided a rationale for the hypothesis that prospective clients would perceive a psychotherapist similar in age more favorably than a therapist dissimilar in age. Support for the hypothesis was obtained on the dimensions of client preference, willingness to disclose, and therapist competence. Also, consistent with previous research, high experienced therapists were viewed more favorably than low experienced therapists.This research is based on a doctoral dissertation submitted by Kathleen M. Tall under the direction of Michael J. Ross to Saint Louis University.     

Coping with the Angry Patient

This patient is enacting two chronic maladaptive patterns. In one he alternates between the role of victim and abuser while inducing the therapist to play the counterrole. He tries to master the abuse he suffered passively as a child by becoming abusive with the therapist and having her experience what it feels like to be mistreated. My effort would be to interpret this pattern even while acknowledging and absorbing some degree of his anger. In a second pattern he acts like an angry, demanding child in an effort to extract nurturance and special treatment from the therapist. I would help him explore this posture in terms of his deprived background and its maladaptiveness in his current life. Finally, I present vignettes from my own practice to demonstrate how I work with patients' anger when it is expressed indirectly rather than in Mr. P's very direct manner.     

Masks and Faces in the Setting at the Time of Coronavirus

The “health emergency” forced analysts to seek new ways of continuing with analysis. The article focuses, in particular, on the changes brought about in the setting by the presence of the sanitary mask, following a line that begins with the theme of the “mask” in the collective uses of human cultures, and develops through the Jungian concept of persona, as opposed to the “face” that may convey an authentic image of oneself. A clinical vignette illustrates the issues that the mask raises in the setting by obstructing the communication of emotions. When there is no transformative processing of concrete data, “unmasking” can also lead to an uncanny encounter and to moments of darkness and confusion in analysis, when the analyst experiences the kind of “unconscious identity” between therapist and patient that Jung defined as nigredo. The article is intended as a contribution to the analytic community's current reflections on the new and unforeseen challenges encountered in analysis at the time of the Coronavirus. It is possible to learn from these experiences with a view to integrating new elements and thus modify one's own internal setting, the compass with which each analyst orientates himself.     

Trauma, Regression, and the Intensive Group Experience

Ferenczi contributed a theory of trauma and regression that has application in the contemporary practice of group therapy. This article seeks to present an extension of these seminal ideas in the form of interventions based on therapist induced regression. The Intensive Group Experience (I.G.E.), a time extended group format found to be necessary for extensive emotional reliving and working through of trauma is described. A clinical case example is then discussed in detail and concludes this report.     

Rage and aggression in youth: A self psychological perspective

The conceptual development of self psychology has emphasized that traditional psychoanalytic drives (sexuality, aggression) become pathological in their expression when self-selfobject ties at crucial developmental periods are problematic, flawed or damaged. This theory was derived from Kohut's psychoanalytic work with adult patients and not from direct observation of behaviorally and emotionally disturbed youth. This paper examines the experience of the self and its relationships in the development of aggressive behavior in children and adolescents. It argues from a largely self psychological perspective that rage and aggression in many youth may be conceptualized as reactions to actual or threatened loss of tenuously held selfobject relationships that render the self feeling anxious, helpless and without value. The aggression attempts to restore cohesion and self-value by punishing the deficient selfobject, nullifying its actions and/or by compelling the selfobject (or substitute) to reverse the behavior or deed that produced the initial self-selfobject rupture.     

Phases of Group Development: A View from Self Psychology

This paper delineates four phases of group development from the standpoint of self psychological theory. The author contends that a stable sense of groupself develops over time and that the groupself has a distinct number of phases, each of which has a therapeutic impact on members. The individual patient's selfobject experiences include a relationship to the group-as-a-whole, a transference state of which the leader is but one part. Thus, rather than dilute the transference, group analysis offers a unique opportunity to help the individual experience him or herself within a selfobject matrix that extends beyond the dyad. Group analysis leads to a strengthening of the self, especially as it enables the self to experience itself as part of a group identity, which provides alter-ego selfobject experiences, as well as a sense of acceptance within a larger community. This paper attempts to clarify how different selfobject experiences may be highlighted within the groupself at different stages of group development.