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Book Forum: HEINZ KOHUT   |    
The Chicago Institute Lectures
Mariam Cohen, M.D.
Am J Psychiatry 1998;155:439-440.
View Author and Article Information
Scottsdale, Ariz.

by Heinz Kohut. ; edited by Paul Tolpin and Marion Tolpin. Hillsdale, N.J., The Analytic Press, 1996, 432 pp., $49.95.

From 1972 through 1976, Heinz Kohut gave a series of lectures, actually informal talks, to advanced candidates at the Chicago Institute for Psychoanalysis, and these lectures, "lightly edited" by his students Paul and Marion Tolpin, are collected in this book. Few of us have the opportunity to learn from someone whose ideas are in the process of transforming psychoanalytic thinking. Reading the transcripts of these talks may provide some of the sense of what it must have been like for his students when Kohut was making his major contribution to the field. This experience comes with advantages and disadvantages.

These talks were given between the publication of The Analysis of the Self in 1971 (1) and The Restoration of the Self in 1977 (2), and it is evident that Kohut's conceptualization of the role of the self, "selfobjects," and the narcissistic transference is in process. In these lectures, Kohut is evidently not trying to present his new ideas in an organized fashion; rather, he seems to be engaging with his audience and trying to relate his concepts to the dominant trends in analytic thinking that the candidates have been taught. Much of the content of the talks is taken up with questions of the relationship between the self and the drives, between the structural neuroses and narcissistic problems, between the centrality of oedipal conflicts and the cohesiveness or fragmentation of the self. The editors point out that at this stage in his thinking, Kohut saw his ideas as enriching the understanding of oedipal conflicts rather than supplanting the centrality of the structural neuroses. Kohut is explicit:

My answer to the question that was asked—Are the narcissistic and structural disorders separate or are they mixed?—is that they are bothThere is no doubt in my mind that there are forms of personality development, character formations, psychological illnesses, a set of psychological phenomena that fall into place when one thinks in the terms I have tried to describe: a childhood of intense involvement, a childhood of perhaps overintense involvement, a childhood of such involvement, particularly in the narrow family situation, that culminates in the tragedies and successes of the Oedipus complex and leads to particular types of unsolvable conflicts, particularly structural conflicts, and these formed in such a way that part of the formation is unconscious and leads to defense mechanisms, symptoms—to the classical neuroses. However, there is another kind of childhood and another kind of basic trauma that one could not possibly understand in its essence by looking at it in the way I have just described. It is not the overstimulated child, it is not the overinvolved child, it is not the child whose psychological organization partially comes to grief by being overly involved in the passions of grownups. It is the child who lacks the responses of others, who is deprived of the interest of his surroundings. Again, I do not have to tell you that the complexities of evaluating that child's situation are just as great as the complexities of evaluating the situation that leads to the unsuccessful solution of the passions of early lifeBoth have to be handled in a sophisticated way. And one can't necessarily rely on a patient's historical report. What the patient immediately remembers may not convey the essential story. What the external observer sees may by no means tell the truth. (p. 123)

The essential elements of self psychology—one of the perspectives essential to an analytic understanding of psychiatric patients—are here in this book, and in a form that may be more accessible in some ways than Kohut's more formal presentations and the more organized formulations of those who have followed and adapted his thinking. These lectures are chatty and filled with references to patients Kohut worked with directly or in supervision. He illustrates his concepts clinically and clarifies his ideas informally.

The book cannot stand on its own as a textbook of the tenets of self psychology, however. These are unprepared talks and therefore ramble at times. The language is that of someone speaking, putting together his sentences as he follows a train of thought rather than presenting a thesis. The titles given to each of the lectures by the editors are often not clear indications of the content. Kohut is obviously thinking out loud at times. None of the lectures constitutes a concise statement about Kohut's fully developed thinking on a specific topic. On the other hand, the editors have done an excellent job in providing an index; each time I checked to see if the index referred me back to a topic, the relevant word or phrase had an entry citing the pages I was interested in. There are also occasional sparkling gems. In lecture 15, a candidate begins with a question regarding "the relationship among ego, ego ideal, and superego," and another candidate asks about "the affects mobilized in respect to superego or ego ideal, the shame-guilt aspect." Kohut begins with "consciousness and unconsciousness in the establishment of the self" and meanders through the role of empathy and introspection in life as well as clinical encounters, the development of the self and its relationship to consciousness, and differences between healthy self-functioning and the disturbances that manifest themselves as narcissistic disorders. His thinking is expansive, and the lecture shows his grasp of psychoanalysis as a description of human nature.

I have two personal observations about these lectures. First, most of the lectures begin with a question or two from a candidate, and all of the questions seem to have been well thought out in advance, what many of us would ask if given one chance to ask "the master" for his wisdom. None of the candidates is identified, and—except for a few interjected questions—the candidates disappear from the scene. There is only minimal exchange between the speaker and the audience. I wonder if the reality was just that these analysts in training sat at the feet of the master and listened. I would have liked to have read some discussion, if it occurred, to see how these candidates digested the ideas Kohut was expounding. Second, Kohut has been criticized for presenting his ideas as his sole product and neglecting any attribution to psychoanalytic thinking that preceded and contributed to his ideas. In these lectures he seems to do just that. There is no sense of the history of his thinking and no mention of anyone who helped form his ideas. I found no mention of other concepts of a psychology of the self, nothing of Winnicott or Sullivan, and no discussion of the interface of self psychology with object relations theories.

I do not recommend this book for those who are looking for a self psychology textbook. It may be a historical document, showing us Kohut in the midst of creating self psychology. For a reader with some knowledge of classical psychoanalysis and some acquaintance with self psychology as one point of view among several in modern psychoanalysis, it is certainly interesting and worth dipping into from time to time. As a glimpse of a master thinker and teacher working through his own thinking, it is invaluable.

Kohut H: The Analysis of the Self: A Systematic Approach to the Psychoanalytic Treatment of Narcissistic Personality Disorders. New York, International Universities Press, 1971
 
Kohut H: The Restoration of the Self. New York, International Universities Press, 1977
 
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References

Kohut H: The Analysis of the Self: A Systematic Approach to the Psychoanalytic Treatment of Narcissistic Personality Disorders. New York, International Universities Press, 1971
 
Kohut H: The Restoration of the Self. New York, International Universities Press, 1977
 
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