Pathological narcissism and addiction: A self-psychology perspective

Following Kohut's schema of self-psychology, addiction may be considered as a form of pathological narcissism. Narcissistic transferences stemming from an archaic and fragile self are frequently observed in the addictions. Such patients typically experience others as an extension of the self. A clinical example of the emergence of ‘mirror’ and ‘idealising’ transferences is presented with a patient who was dependent upon alcohol. Kohut's insights on narcissism provide an approach to both comprehension and therapeutic intervention in enabling such patients to develop a more cohesive self.     

The oedipus complex in the work of sigmund freud and heinz kohut: A post-modern critique

Abstract

The work of Sigmund Freud and Heinz Kohut in relation to the concept of the Oedipus complex is presented. A summary is given of post-modern assumptions about the nature and role of knowledge, and, on the basis of these assumptions, two questions are raised in relation to Freud's and Kohut's Oedipal theories. Provisional responses are made to these questions, which focus on the hermeneutical value and ethical-political implications of the concept of the Oedipus complex.     

Grandiosity,trauma and self

Distortions and inversions of Kohut's phase of grandiosity play a major role in multi-generational patterns of child-abuse and neglect. Such families are considered ‘upside down’ in their organization: parents enact unmet needs for mirroring and grandiose assertion, while the child experiences anxiety and endures a split between defensive compliance and a turbulent, trauma-ridden inner life. Within the space of this lonely inner life, the child fixates on atavistic power fantasies and dreams of possessing or controlling its objects. Hence, distortions of power and grandiosity replicate themselves from one generation to the next. The therapeutic play of children from upside down families typically passes through four phases: 1) re-enactment of trauma vignettes; 2) restoration of appropriate grandiose and mirroring themes; 3)restoration of rudimentary empathic abilities and empathy longing; 4) the search for an appropriate parenting object. Psycho-analytically based play therapy is effective when combined with other interventions to stabilize the child's milieu.     

Dual realities – The search for meaning: Psychodynamic therapy with physically ill people

Abstract

We summarize Kohut's (1971) bi-polar self which enables counsellors to understand and treat narcissistic behaviours and narcissistic personality disorders in a psychoanalytic framework. After Patton and Meara (1992), we describe Kohut's formulations regarding self-development and disorders of self and how such formulations inform critical components of psychoanalytic counselling with particular emphasis on the explicit and implicit strategies and characteristics the counsellor brings to the process. Finally, we suggest that a promising arena for future theorizing and applications of Kohut's ideas is consultation with parents, teachers and other community leaders to help prevent or remedy psychological self-injuries with systemic interventions outside short-term counselling or long-term therapy.

We have suggested that Kohut's self psychology is a good vehicle for understanding what brings a client to counselling: namely, disorders of the self or self-injury. We review strategies and ‘ways of being’ a counsellor must bring to and offer in the counselling encounter if the work is to succeed. We also examine implicit qualities (beyond the achievement of a mature bipolar self) we believe a counsellor or any facilitator must have if counselling or other helping relationships are to be effective. We purpose further conversations and empirical analyses which specifically and conceptually link critical components of psychoanalytic counselling to self psychology and to essential counsellor traits or virtues that seem intrinsic to good counselling practice.     

Ferenczi's “Confusion of Tongues” Theory and the Analysis of the Incest Trauma

Abstract

The tender-mother transference of Ferenczi's humanistic analytic orientation was as important an advance in pioneering times as was Kohut's selfobject transference in contemporary psychoanalysis. Ferenczi's clinical theory and method began a focus on pre-oedipal experiences, which eventually became an alternate to the oedipal theory. Freud was critical of Ferenczi's formulation, leading a successful attempt to suppress his work and remove it from mainstream psychoanalysis because he believed it was “regressive.” In actuality, Ferenczi's “Confusion of Tongues” theory and “Relaxation Therapy” were prophetic and pioneering attempts to understand and treat the incest trauma (ironically the clinical data upon which Freud founded psychoanalysis 100 years ago). In the case of Miss T., Ferenczi's ideas are applied to the contemporary analysis of the incest trauma.     

“It's A Long Way …” to Contemporary Psychoanalysis: Training Experience in Self Psychology,Intersubjectivity, and Relational Psychoanalysis

The successful experience with a Jungian analyst, research work on international economic interdependence, and the failure of a classical analysis were the preliminary steps toward the discovery of Kohut's self psychology. The comparison of epistemological principles in Jung and in Kohut and the discovery of the relational nature of experience formed the background of my professional attitude as an analyst. After an unsatisfactory, but “orthodox” supervision, training in self psychology, intersubjectivity, and relational psychoanalysis at Isipsé made it possible to integrate all previous experiences in a complex and, at the same time, clinically coherent framework.     

Fons et Origo:A Darwinian View of Selfobject Theory and the Arts

Four important themes in self psychology as developed by Heinz Kohut are remarkably congruent with current theoretical constructs in the field of evolutionary (Darwinian) psychology: (1) the concept of narcissism, (2) the claim for the innate human capacity for empathy, (3) the recognition of the importance of group cohesion, and (4) the belief that individual psychological distress is produced by a changed environment rather than a dysfunctional self. By recasting Kohut's themes in a Darwinian framework and interpreting them with personal views of the phylogenetic origin and nature of the arts (Dissanayake, 2000), I describe and make clear the central importance of art experience to the developing selfobject relationship as well as to the evolution of the human species.     

A spectrum of shadowed mirroring

The central focus of this paper is to explore and extend Kohut's theory of maternal mirroring and to place it within the current context of psychoanalytic thinking. Kohut believed a child must experience "positive" mirroring from his or her mother in infancy and beyond to ensure development of a healthy self. Kohut alludes, however, to a possible situation in which the mother's face, metaphorically a mirror, can appear "faceless" to her child. From this I have inferred the concept of what I shall call "shadowed mirroring." Clinical and literary examples show that distorted, "shadowed" mirroring appears on a spectrum, with passive mirroring at one end and hostile (either verbal or nonverbal) mirroring on the other; some individuals experience both. I then consider how "shadowed mirroring," especially hostile mirroring, can be understood within the twin contexts of the overall mother-child relationship and present-day Intersubjective/Relational thinking that is both bidirectional and co-constructed. Shadowed mirroring can lead to severe personality dysfunction along the borderline-narcissistic range, as well as to difficulties in the areas of identity formation, failure of self-cohesiveness, and the blunting of certain humane qualities like empathy.     

Sibling rivalry,separation, and change in Austen's Sense and Sensibility

The paper explores a process of growth represented in the interplay of Jane Austen's characterizations of Marianne and Elinor Dashwood in Sense and Sensibility, approaching the text through the lens of psychoanalytic theories on oedipal sibling rivalry, separation, and processes of change. A close reading of Sense and Sensibility tracks Marianne Dashwood's repudiation of any ‘second attachment’ as the surface of an unconscious fantasy, denying a rival for the mother's love. A psychoanalytic view contrasts Marianne's lack of separation from her mother, her use of denial and projection, and her near death after losing the man she loves, with her older sister Elinor Dashwood's capacities for depression, reflection, and greater acceptance of loss and separation. The narrative portrays Mrs. Dashwood's identification with and idealization of her daughter Marianne, which contribute to her oedipal sibling ‘victory’. In the language and structure of the novel, the projections, identifications, aggressions, and separations (conscious and unconscious) of the sisters in the vicissitudes of their adolescent loves and rivalries constitute a process of growth. Austen's novel brings to life, with the vividness and coherence of great literature, forces and fantasies in oedipal sibling rivalries, inspiring renewed attention to their subtle presence in the transference and countertransference of the psychoanalytic process.     

RICOEUR'S PHILOSOPHY AND ITS IMPLICATIONS FOR PSYCHOANALYSIS

In differentiation of early and mature shame, the phenomenological content of shame changes with the development of a stable self-state. In this hypothesis, early shame refers to a person's dependence upon mirroring himself and in being mirrored by an outer object, while mature shame refers to introspection and self-reflection. From a developmental psychological point of view, the connection between self-development and mirroring is expounded. Mirroring is defined as a psychic dialectic process between the inner psychic reality and the outer reality. Early shame is connected to dyadic mirroring, which refers to attachment and empathy. Mature shame is connected to triadic mirroring, which refers to separation and reflection. Early shame emerges from discrepancies between the infant's expectations of a complementary affective response and the mother's response, and is defined as an early marker of differences in the mother/infant unit. It is argued that early shame in smaller ‘doses’ has a regulating function on self-development by maintaining the psychic dialectic process, while in larger ‘doses’, it has a disturbing effect on the self-development, resulting in pathological shame. In the therapeutic process, early shame appears as shame scenarios illustrated in the text by a clinical vignette.     

Little Hans and the thought police: the 'policeman fantasies' as the first reported supervisory transference fantasies

The ‘policeman fantasies’ in Freud ’s case of Little Hans, famous for being Freud ’s most direct evidence for specifically sexual oedipal desire by Hans for his mother, are reconsidered. The Hans case is the first recorded instance of psychoanalytic supervision, and recent studies suggest that it is common for patients in supervised treatment to experience fantasies about the supervisor. It is argued that the policeman fantasies are the first recorded instances of such transference fantasies about psychoanalytic supervision and the patient–therapist–supervisor triangle. The explanatory power of this interpretation is supported by the nuances of the features of the fantasies themselves, as well as by the context in which they occurred that might serve as ‘day residues’. Moreover, this interpretation provides an answer to the central mystery of the two fantasies, which goes unaddressed by Freud ’s oedipal interpretation: Who is the policeman?     

Contacting a 19 month‐old mute autistic girl: A clinical narrative

Conveying that psychoanalysis offers rich opportunities for the very early treatment of autistic spectrum disorders, this clinical communication unfolds the clinical process of a 19 month‐old ‘shell‐type’ encapsulated mute autistic girl. It details how, in a four‐weekly‐sessions schedule, infant Lila evolved within two years from being emotionally out‐of‐contact to the affective aliveness of oedipal involvement. Following Frances Tustin's emphasis on the analyst's ‘quality of attention’ and Justin Call's advice that in baby–mother interaction the infant is the initiator and the mother is the follower, it is described how the analyst must, amid excruciating non‐response, even‐mindedly sustain her attention in order to meet the child half‐way at those infrequent points where flickers of initiative on her side are adumbrated. This helps attain evanescent ‘moments of contact’ which coalesce later into ‘moments of sharing’, eventually leading to acknowledgment of the analyst's humanness and a receptiveness for to‐and‐fro communication. Thus the ‘primal dialogue’ (Spitz) is reawakened and, by experiencing herself in the mirror of the analyst, the child's sense of I‐ness is reinstated. As evinced by the literature, the mainstream stance rests on systematic early interpretation of the transference, which has in our view strongly deterred progress in the psychoanalytic treatment of autistic spectrum disorders.     

Bowlby's ‘yearning and searching’ phase of mourning as seen in adult psychotherapy

SUMMARY

This paper was given at a conference to celebrate Dr. John Bowlby's 80th birthday. The conference was organised by the External Organising Committee of the Association of Child Psychotherapists and was held at the London Zoological Society on 28th February 1987. The theme of the conference was ‘Clinical Applications of Attachment Theory’. In the paper I outline Dr. Bowlby's theory of mourning with particular reference to the processes of the second phase described by him as ‘yearning and searching’. A clinical account of once weekly psychotherapy with an adult patient is given in order to illustrate work on disordered mourning in which the patient had remained imprisoned in a suspended state of searching for her lost parent. Some resolution of this state is described together with the ensuing feelings of anger, sadness and depression as loss is comprehended.     

Social mirrors. Tove Jansson’s Invisible Child and the importance of being seen

This article examines the experience of being seen and analyzes its central role in the formation of a coherent sense of self. Tove Jansson’s short story from 1962, ‘The Invisible Child’, serves as the red thread of the article, and the story is analyzed in the light of Donald Winnicott’s work on social mirroring. The analysis is enriched by the psychoanalytic insights of Veikko Tähkä and Heinz Kohut, and complemented by Axel Honneth’s philosophical elaborations as well as by recent developmental findings as presented by Vasudevi Reddy. The article is divided into an introduction and three sections. After summarizing Jansson’s story in the introduction, the first section elaborates and examines different senses of social invisibility. The second section assesses developmental factors that promote social invisibility and highlights the importance of being seen. The third and final section interprets Jansson’s story as an analogy to an intensive therapeutic process, while pinpointing those elements that facilitate the restructuring of a disturbed sense of self. As a whole, the article thus discusses an issue that is often simply taken for granted in discussions of empathy and interpersonal experience: social visibility.     

Pentheus rather than Oedipus: On perversion,survival and analytic ‘presencing’1

Following an introductory review of the main developments in the psychoanalytic thinking on perversion, the author focuses on her own understanding of perversion and its treatment, based on the psychoanalytic treatment of patients with severe sexual perversions. This paper uses the term ‘autotomy’ (borrowed from the fi eld of biology) to describe perversion formation as an ‘autotomous’ defence solution involving massive dissociative splitting in the service of psychic survival within a violent, traumatic early childhood situation; thus, a compulsively enacted ‘desire for ritualised trauma’ ensues. The specifi c nature of the perverse scenario embodies the specifi c experiential core quality of the traumatic situation. It is an actual repetition in the present of the imprint of a past destructive experience which is pre‐arranged and stage‐managed; it thus encounters haunting scenes of dread or psychic annihilation while, at the same time, controlling, sanitising and disavowing them. Hence, the world of severe perversion is no longer oedipal, but rather the world of Pentheus, Euripides's most tragic hero‐a world dominated by a mixture of a mother's madness, devourment, destruction and rituals of desire. According to this view, the (diffi cult) psychoanalytic treatment of perversion focuses on patient‐analyst interconnectedness‐brought about by the analyst's ‘givenness to being present’ or ‘presencing’‐at a deep, primary level of contact and impact (the emphasis being on the ontological dimension of experience). This evolving therapeutic entity creates and actualises a new, alternative experiential‐emotional reality within the pervert's alienated world, eventually generating a change in the perverse essence. The author illustrate this approach with three clinical vignettes.     

A father to love: eros and identification in boys – an emendation of Freud on the male oedipal drama

The relationship between a son and his father is usually characterized as primarily one of rivalry. In this emendation of classic oedipal theory, what has traditionally been referred to as the ‘negative oedipal relation’ is given prominence as a boy’s first emotionally significant relationship in which he initiates affection with another human being, his father. Such love is in the service of identification but is also as important as the template for a male’s later relationships with women (sexual), other men, and his children. A peculiarity of Freud’s relationship with his own father is suggested as the source of oversight of this element of the oedipal drama. A boy’s emotional reactive response to his mother is primarily one of gratitude in response to her love. Proactive loving is first experienced with his father.     

The problem of real trauma and the future of psychoanalysis

Abstract

Contemporary psychoanalysis emphasizes the role of “real” trauma, as it is well shown by recent sociological and theoretical developments (such as Kohut's Self psychology, object relation theory, renewed interest in Ferenczi's and Sullivan's contributions, etc.). To understand more clearly these developments, the author traces again the steps laid down by Freud in building the psychoanalytic edifice. The renewed interest in the environment, in real traumas, and in the vicissitudes of object relations could be a “paradigm change” in psychoanalysis: a return to Freud's original seduction theory. This development is seen as related to the difficulties of Freud's drive theory.     

The application of self-psychology to short-term counselling

Abstract

This article explores how key aspects of Heinz Kohut's self-psychology can inform short-term counselling work. Initially a summary is offered of Kohut's developmental theory, his understanding of the nature and causes of psychopathology and his view of the analytic cure. The application of his ideas to short-term counselling is then discussed. Specifically, it is suggested that short-term therapeutic work based on self-psychology involves a stronger emphasis on the curative aspects of the selfobject transference between client and therapist, a more limited notion of the role of interpretation, and a different understanding of working through to that of long-term self-psychological analysis.     

The analyst: His professional novel1

The psychoanalyst needs to be in touch with a community of colleagues; he needs to feel part of a group with which he can share cognitive tension and therapeutic knowledge. Yet group ties are an aspect we analysts seldom discuss. The author defi nes the analyst's ‘professional novel’ as the emotional vicissitudes with the group that have marked the professional itinerary of every analyst; his relationship with institutions and with theories, and the emotional nuance of these relationships. The analyst's professional novel is the narrative elaboration of his professional autobiography. It is capable of transforming the individual's need to belong and the paths of identifi cation and deidentifi cation. Experience of the oedipal confi guration allows the analyst to begin psychic work aimed at gaining spaces of separateness in his relationship with the group. This passage is marked by the work on mourning that separation involves, but also of mourning implicit in the awareness of the representative limits of our theories. Right from the start of analysis, the patient observes the emotional nuance of the analyst's connection to his group and theories; the patient notices how much this connection is governed by rigid needs to belong, and how much freedom of thought and exploration it allows the analyst. The author uses clinical examples to illustrate these hypotheses.     

Love and death in the transference: The case of the Hungarian poet Attila József

SUMMARY

This paper gives an account of working as psychoanalytic psychotherapist in a GPs' surgery from a base within a local Psychotherapy Department. Particular attention is paid to how the GPs regard the therapist's work, as evidenced by their referrals and other contact with the therapist. An evolving relationship between the therapist and the GPs is described, and material from clinical work and meetings with the GPs is used to illustrate this. The idea of ‘Practice as patient’ is introduced as a model whereby the therapist considers how most usefully to engage with the GPs, and how this can enhance the understanding of the clinical task.