WHAT IS SELF PSYCHOLOGY?
“If there is one lesson that I have learned during my life as an analyst, it is the lesson that what my patients tell me is likely to be true — that many times when I believed that I was right and my patients were wrong, it turned out, though often only after a prolonged search, that my rightness was superficial and their rightness was profound.”
(Kohut, 1984. How Does Analysis Cure. p. 93)
Heinz Kohut wrote these profound words toward the end of his life. With the introduction of his theory of Self Psychology he transformed psychoanalytic thought and practice. The Self Psychological approach to psychoanalysis and psychoanalytic psychotherapy has evolved significantly since Kohut, but the essence of his thinking is captured in what is now referred to as “Contemporary Self Psychology” of which the following is a summary.
THE ESSENTIALS OF CONTEMPORARY SELF PSYCHOLOGY (Kindler’s List)
- Self Psychology privileges the patient’s subjective experience. To this end it maintains a perspective that at all times privileges the patient’s point of view. The therapist’s goal is to engage and illuminate subjective experience so that aspects of it may be transformed.
- Rather than attending solely to the subjective world of the patient, contemporary Self Psychology appreciates that the subjectivities of both patient and therapist, along with their impact on one another, must be considered to fully comprehend the therapeutic process.
- The focus on understanding subjective experience has given rise to two fundamental concepts to capture its essential elements. These are the “Self” and the “Selfobject experience”. The Self, (or subjective sense of self), refers to the person’s experience of their own unique subjectivity which may vary in its qualities of cohesion, agency, continuity and vitality. A selfobject experience is one in which the person experiences themselves to become more cohesive and enlivened.
- Selfobject experiences are of various kinds including mirroring (affirming, approving), idealizing (strengthening, calming), or twinship (sameness, like-mindedness). Many other kinds have been described and the possibilities are endless. These experiences may exist in the foreground (conscious) or background (non-conscious unless disrupted) of the relationship with the therapist. They may be healthy (development enhancing) or pathological (development restricting) in nature; e.g. drug addiction
- To apprehend the subjective experience of an individual at any time, we pay particular attention to affect. Hence, affect is key to our understanding of subjective experience. This includes the affect actually being experienced and the affect being sought.
- In addition to recognizing and exploring beneficial effects of selfobject experiences, the therapist also explores the patterns of aversiveness when selfobject needs are not met.
- Emphasis is placed on positive (leading edge) strivings that are found alongside maladaptive or problematic (trailing edge) patterns.
- We attend closely to the self-regulating and self-righting qualities of problematic behavior for the individual while still recognizing its problematic impact on others.
- Disruption-repair sequences are explored in an experience-near manner (empathically) because they provide opportunities to understand the patient (and therapist and their relationship) in greater depth. This often includes the precise nature of the selfobject needs being frustrated and the repetitive patterns of response to these frustrations (selfobject failures).
- Careful attention is paid to the sequence of events in the patient-therapist interaction (the “what happens next?” in the therapeutic process), particularly as it applies to the patient’s subjective experience, (sense of self). This provides an essential guide to the effect of the therapist’s participation at any moment.
- Knowledge of past “lived experiences” is used to help understand present clinical experience (exchanges, events, enactments etc.) rather than the opposite as has been the practice in more traditional models.Hence there is a strong developmental perspective in which the co-construction of “model scenes” (prototypical lived moments in development) makes past experiences alive and current.
- In order to explore who we have become to the patient (precisely how we evoke the patient’s experience of us) the therapist tries to accept the patient’s attributions as a point of departure for inquiry.
- Contemporary self psychology acknowledges a wide range of shifting motivations (needs for attachment, physiological regulation, sensual and sexual experience, assertion and exploration, and aversiveness) all contributing to the fundamental need to sustain, protect and strengthen the vulnerable self.
This work in progress was initiated by Alan Kindler, Joe Lichtenberg and Frank Lachmann at a Sunday breakfast in Toronto in 2005.
Further contributions have been made by Jim Fosshage and Shelley Doctors.