Until the end of 1960, Kohut was highly respected within traditional psychoanalysis. But gradually he started to disagree with some of the fundamental concepts in this theory, which resulted in a new direction within the psychoanalytic tradition, self psychology3. This approach is seen to have been established in 1977 after Kohut published his second book: “The restoration of the self’ (Schluter & Karterud, 2002, p. 39).
(3 This way, self psychology is often characterized as psychoanalytic. But, to avoid confusions, when psychoanalytic or psychoanalysis is referred to in this work, what is meant is the traditional Freudian psychoanalysis.
2.4.1. A theory about the self
What Kohut emphasized when explaining personality and its pathology, was the phenomenon of the self and how it is developed. Kohut (1990) defines the self as “…the centre in the individuals psychological universe”. (p. 216). The self makes it possible to experience one self as oneself The sense of being the owner of the self is often taken for granted. This is because the crucial and excellent capacity of the self to bear with it feelings, thoughts and history is more an automated processes than something one reflects upon. But the psychological structure, self is indeed something that should be valued, as it makes consistency in life possible. Because of this structure, one does not need to learn about oneself and the rest of the world whenever a new day begins Kohut does not pay much attention to the term “personality”, as he sees it as a more general and superficial term where the self is essential as it is the nuclear core of the personality (Consolini, 1999; Kohut, 1984, p. 99; Schluter & Karterud, 2002, p. 43). As for the psychoanalytic psychic apparatus (id, ego and superego), he sees it as a rather distant abstraction, in which he does not reject, but neither pays very much attention to. He sees the id, ego and superego as totally different systems that can not be compared to the structure of the self. However, he did state that the different systems could somehow complement each other. Thus, he considers both of these systems, but structure of the self is the key word in Kohut’s theory and he underlines that this is not a psychological instance, but a structure in the psyche that is not as abstract as the psychic apparatus (Kohut, 2000, p. 10; Karterud, 2000, p. 15).
In self psychology, “self cohesion” is the ultimate condition, and refers to the opposite from “fragmentation in the self”. What is necessary in developing self cohesion is a “consolidated core self’. If the core self is somehow injured, the fragmentation can be so serious that dissolution of the self might be the result, where a psychosis is possible. This can lead to the experience of being in an alien and destroyed body and/or the experience that others direct ones thoughts, feelings and actions (Kohut, 2000, p. 15; SchlUter & Karterud, 2002, p. 43). Kohut talks about three classes of mental disorders, where the functional freedom of the self is impaired. The first is the psychoses. He claims that this disorder has developed as a consequence of that there has never been developed a nuclear self in the early development. Narcissistic personality and behavior disturbances have, oppositionally developed a specific core self in the early development. But the pattern of the self has remained incomplete, with the result that the self reacts to narcissistic injuries with temporary break-up, enfeeblement of disharmony. The last disorder is what he terms “the classical transference neuroses” or “the structural-conflict neuroses” (Kohut, 1984, pp. 8-11).
The aim with the following pages is to give an elucidation of the most significant self psychological terms that are essential in the development of self.
2.4.2. Narcissism and selfobiects
Kohut’s disagreement with the traditional psychoanalysis was among other things, based on the different view they had on the nature of narcissism. Kohut defines narcissism as an obsession of the self and he adds importance to narcissism, as he sees it to concern one half of the content in the human psyche (Kohut, 2000, p. 9). Kohut did not, however, invent the term narcissism. This has been used by mainstream psychoanalytics as well. But it is said that Kohut did the same for narcissism as Freud did with sexuality. This is as Kohut suggested that, instead of judging narcissism and try to make it disappear, like the traditional psychoanalytics did, narcissism should be studied and understood. Kohut saw narcissism as something everyone has and develops in one’s own way. Narcissistic needs would, in his eyes, always be present. But they would optimally develop from an immature to a mature fashion. He later renamed narcissistic needs to selfobject needs. This renaming gave a more accurate description of what was meant by the term. This was based on Kohut’s experiences of the intense needs for recognition from others his narcissistic patients had (Schluter & Karterud, 2002, pp. 41-42). Selfobjects are, according to Kohut (2000, p. 10), objects that are experienced as parts of the self. The consequences of an empathic selfobject that provides its functions unconditional, is the child’s experience of totality, harmony and vitality. Karterud (2000) defines a selfobject as: “… the function and meaning another individual, an animal, a thing, a culture manifestation or a tradition has for the maintenance of ones feelings of being a coherent and meaningful self”. (p. 16. My translation). Individuals can such have several selfobjects and they can be practically everything, but most often it is another human being and most frequently ones parents. What characterizes a selfobject is its ability to cause another person to experience either a strengthened or a weakened sense of self. Selfobject needs are attached to the sense of self, which is the most fundamental of all emotional qualities. If this staggers, fragmentation in all emotional experiences will occur. This might happen if the individual has experienced failures of selfobjects (Kohut, 200, p. 10; Schltiter & Karterud, pp. 41, 45, 51). As for what can cause a fragmented, weakened or disharmonious self during maturity, Kohut has stated that it does not usually have to do with singular episodes (unless perhaps the most severe forms of traumatization in concentration camps or other inhumane experiences) (Kohut, 1984, p. 70). Instead he states: “What creates the matrix for the development of a healthy self in the child is the self-object’s capacity to respond with proper mirroring at least some of the time; what is pathogenic is not the occasional failure of the self-object, but his or her chronic incapacity to respond appropriately.”(Kohut, 1977 in Messer and Warren, 1990, p. 386).
2.4.3. The bipolar self
Kohut described the self as consisting of tree different poles, in which he termed “The tripolar self’. Kohut sees these three poles as having their own healthy fundamental needs. One of them is the need to experience sameness or likeness with another person (twinship or alter ego). With a confirmation from others similar to one self, the individual will feel accepted and as a part of a unison. An example of this is the very normal behaviour of finding a best friend. Without a confirmation from this similar other, the individual might feel odd, isolated, different and alone and this lack of a twinship might lead to frequent fantasises about a similar other.
The two other configurations in the self are more frequent used in Kohut’s theory. He paid much more attention to these two poles, which he named the “bipolar self’. One of them is related to the need to be acknowledged and admired and mirrored by selfobjects (the grandiose self). Children have by nature expectations about being empathically mirrored and recognized by others. Kohut refers to children’s immature need of being mirrored as exhibitionistic. This is as they early in life have wishes about being admired and praised, and that they fantasize of being the centre of the world, like for instance a princess or a king. One of the selfobjects’ functions is to mirror and confirm the child’s grandiose fantasies in an adequate and balanced way. If this does not happen, a healthy and mature development of the grandiose self is threatened. The consequence of this is that immature, exhibitionistic and grandiose fantasies of being almighty, perfect and admired will potentially endure as the child grows up. The failure of adequate responses from selfobjects to the grandiose self’s needs might also cause difficulties with self-regulation. This means that the individual will not develop a mature way to regulate the self. If this happens, the individual will continue to be dependent on being acknowledged and confirmed by others, and self-assertion will such be essential in its behaviour while growing up. This way, the self does not developed into a coherent self, and the individual is not able to obtain meaningful responses from its self (Kohut, 1984, p. 193; Kohut, 1990, p. 127; Schluter & Karterud, 2002, pp. 47-50).
As children have the fundamental need to be recognized as perfect by selfobjects, they also have a natural need to experience selfobjects as perfect. This is the other part of the bipolar self that is concerned with the need to admire others (idealized self). This need is, just like the grandiose self often related to the parents, which is why this is named “the idealised parent imago”. Attributing characteristics that one does not have, but wishes to have, to another, idealised person is a way for the individual to compensate for its own constraints. The purpose with this structure is, like with the grandiose self, to maintain perfection. This is as the idealized other can contribute to the child’s assumption: “You are perfect, but lam a part of you”. (Kohut, 2000, p. 33. My translation). By getting to maintain this idealization of the selfobjects, the need for idealized others will develop maturely. The two other selfobject needs (grandiose self and alter ego), will in a similar fashion develop maturely if the need is met in a balanced manner, and the exaggerated selfobject needs will cease. If the idealized self develops in a healthy way, safety and trust will develop maturely. However, the idealized almighty selfobject sometimes fails. These failures can be due to their neglect, absence, instability, mistreatment, illness or death. If the selfobject is not able to meet the fundamental needs of the child, the needs will continue to be present and, he will continue to strive to fulfil its archaic goals as he grows up.
Under normal circumstances, the archaic grandiose and exhibitionistic self will be controlled, and the idealized self will be adequately satisfied. If this happens these two structures will be integrated and a consolidated core self can be said to have developed (Schluter & Karterud, 2002, pp. 48-50; Kohut, 2000, pp. 33-34).
2.4.4. Narcissistic rage
Kohut describes two different types of aggression. One of them is of an elementary, healthy and non-destructive character, which occurs as a reaction to delays of reactions from selfobjects. This form for aggression will optimally develop from an immature form, where self-assertion is primitive, to a form that is characterized by mature self-assertion where aggression no longer is significant. Aggression will, both in its primitive and mature form decrease when the aggression-provoking stimuli, is found (Kohut, 1990, p. 93).
The other kind of aggression that Kohut describes is “narcissistic rage”. He defines narcissistic rage as: “The need for revenge, for righting a wrong, for undoing a hurt by whatever means, and a deeply anchored, unrelenting compulsion in the pursuit of all these aims, which gives no rest to those who have suffered a narcissistic injury”. (Kohut, 1978, pp. 637-638). He states that this aggression is derived from a narcissistic imbalance, and is the result of lack of empathy or control of selfobjects in childhood. Narcissistic rage appears when an insult to the self is experienced. The function with this aggression is to repair the insulted self by getting back on the offender. This is because the insult is experienced as a threat of a destruction of the core self (Kohut, 1978, p. 616 & 645; Kohut, 1990, p. 90-95).
Most people have experienced to, for example, tell a joke without getting feedback or to ask someone a question or a favour, without getting a reply. Most people that experience this are somehow affected by this (embarrassment or shame). But if they have a sufficient enough coherent self, they will, despite some emotional reactions, be able to give the gratification to its self from its self, and forget about the episode. However, if an individual with a fragmented and vulnerable self is experiencing this lack of recognition, the reaction is, according to Kohut connected to the biological term “fight-flight reaction”. When a vulnerable and fragmented self is exposed to the narcissistic injuries like that of a lack of gratification, the reaction will be either a flight reaction with shame and withdrawal, or with a fight- reaction with narcissistic rage. When the fight-reaction occurs, it is because the experienced insult causes regression to earlier stages in life when mirroring and idealizing selfobjects were markedly absent. The present situation is this way representing what was experienced earlier in life. The only way to handle the situation is to re-establish control of the archaic selfobjects, meaning that other individuals in the present situation are experienced as being representative of the archaic selfobjects (selfobject transferences) (Kohut, 1978, pp. 636-637 & 645).
The narcissistic rage that is based on damages in the self is what causes destructivity and is, according to Kohut essential in all forms for destructive behaviour. He sees the Nazi extermination of Jews as an example of narcissistic rage, as he points that Hitler and his main followers were possessed with chronic, narcissistic and destructive rage (Kohut, 1978, pp. 634635).
Kohut was one of the first analytics to recognize the major role empathy and support had when working therapeutically with psychopathology (Karterud, 2000, p. 12). Kohut’s definition of empathy is: “The capacity to think and feel oneself into the inner life of another person.” (1984, p. 82). He stated that only when one is able to step into the shoes of the patient, and see the world through the eyes of the other, is one able to really understand the patient. This, he stated, was the way to be able to respond in an authentic, accurate, and fitting way in therapy (Kohut, 1990, p. 216; Kohut, 1984, p. 82). Though empathy is generally seen as essential in therapy today, the introduction of this term was an issue of controversy. This is as the traditional psychoanalytics like, for example, Otto Kemberg, finds the support strategies of Kohut, as causing maintenance of the pathology. Instead Kernberg uses a more confronting style in his therapy (Consolini, 1999).
Kohut did not only relate the importance of empathy to the therapeutic setting. The crucial role he placed to empathy in the therapeutic setting was based on his general assumption that a person’s mental health depends on how empathic other people are to its needs. This is as he saw it as essential that the selfobjects in the individual’s life are empathic. If not the potential to develop a coherent self, might be challenged (Kohut, 1990, p. 19).