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Book Forum: PSYCHOANALYSIS   |    
Kohut’s Freudian Vision
AARON ESMAN, M.D.
Am J Psychiatry 2000;157:1353-1353. doi:10.1176/appi.ajp.157.8.1353
View Author and Article Information
New York, N.Y.

By Philip F.D. Rubovits-Seitz. Hillsdale, N.J., Analytic Press, 1999, 234 pp., $49.95.

Heinz Kohut is now known as the founder of the school of self psychology, thought by some to be a parallel or tributary to the mainstream of psychoanalysis and by others to be a radical alternative, if once derivative, mode of psychological thought and clinical procedure. Whichever the case, it is characteristic of our increasingly ahistorical era that Kohut’s origins in and prolonged adherence to the classical Freudian mainstream have been largely forgotten and his innovative ideas seen as revolutionary rather than evolutionary revisions of traditional views.

Rubovits-Seitz, who was closely associated with Kohut for many years, takes it as his mission in this volume to correct these misconceptions and to demonstrate the continuity of Kohut’s thought with the classical Freudian corpus. His principal vehicle for doing so is the presentation of on-the-spot synopses of the series of lectures on psychoanalytic psychology given by Kohut to students at the Chicago Institute of Psychoanalysis in 1958–1960, several years before Kohut’s turn to self psychology. Already known as a gifted teacher and theoretician, Kohut sought in these lectures to explicate Freud’s evolving theoretical views and, in particular, to clarify the often confusing complexity of Freud’s metapsychological concepts. Considering as he did that Freud’s fundamental contribution was his demonstration of the nature and power of unconscious mentation and its relation to consciousness, Kohut traced with great clarity the progression and modification of these constructs from the treatment of Anna O and Studies on Hysteria(1) through The Interpretation of Dreams(2) to the final reformulation in "Inhibitions, Symptoms and Anxiety" (3).

Kohut’s Freudian Vision includes a paper, "Concepts and Theories of Psychoanalysis," jointly prepared in 1963 by Kohut and Rubovits-Seitz, that spells out, elaborates on, and clarifies the themes encapsulated in the preceding synopsis of Freud’s views. Rubovits-Seitz describes how Kohut’s precision of language and his insistence on absolute clarity of expression delayed the completion of this essay, in which one can see the seeds of Kohut’s later ideas beginning to sprout among the metapsychological thicket. In particular, he elaborates at some length his notion of optimal frustration as the key to healthy development and, far more than Freud, the direct correlation between the quality of parental response and formative childhood experience.

The book concludes with Rubovits-Seitz’ discussion of the continuities he perceives between the essentials of Freudian theory and Kohut’s later theories on narcissism and self psychology. Acknowledging the differences between the two, he, like Kohut himself, maintains that "at the level of basic methods and concepts the continuities between self psychology and traditional psychoanalysis are as significant as their differences" (p. 164). "Kohut himself stressed that self psychology adds something to traditional analysis; it does not substitute for it" (p. 165).

It is here, of course, that the locus of controversy lies. It is doubtless true that in certain respects Kohut’s mature work builds on Freud’s basic discoveries; in fact, Kohut’s depictions of particular patterns of narcissistic transference have been widely accepted and integrated into mainstream analytic thought. Kohut’s abandonment of Freud’s metapsychology, after years of struggle, was shared, and in some cases anticipated, by a number of more classically oriented analysts, notably George Klein, Merton Gill, and Roy Schafer. In his last statements, however, as Gedo (4) put it in his critical review, Kohut (and with him many of his followers) "put forth the claim that the appropriate end point of…psychoanalytic treatment…is the erection of compensatory mental structures" and stated that "he wished to replace insight with empathy as the primary goal of the therapeutic enterprise" (p. 416). Although Rubovits-Seitz maintains the position that Kohut restricted his technical innovations to the treatment of "narcissistic disorders," it seems clear that, at the end at least, Kohut included all manner of psychopathologies as "disorders of the self."

In the current ecumenical trend that seems to have invaded psychoanalysis, self psychology is being embraced, along with a number of other schools—interpersonal, intersubjective, object relational—once considered heretical or deviant by some. This may well prove to be for the good; it certainly opens possibilities for a more dispassionate exchange of views and collaborative investigational efforts. In this spirit, Rubovits-Seitz’ slender book may help to bridge some gaps and to remind members of the different psychoanalytic persuasions of their common roots.

Breuer J, Freud S: Studies on Hysteria (1895 [1893–1895]): Complete Psychological Works, standard ed, vol 2. London, Hogarth Press, 1955
 
Freud S: The Interpretation of Dreams (1900): Complete Psychological Works, standard ed, vols 4, 5. London, Hogarth Press, 1953
 
Freud S: Inhibitions, symptoms and anxiety (1926 [1925]), in Complete Psychological Works, standard ed, vol 20. London, Hogarth Press, 1959, pp 77–175
 
Gedo J: Self psychology: a post-Kohutian view, in Self Psychology: Comparisons and Contrasts. Edited by Detrick DW, Detrick SP. Hillsdale, NJ, Analytic Press, 1989, pp 415–428
 
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References

Breuer J, Freud S: Studies on Hysteria (1895 [1893–1895]): Complete Psychological Works, standard ed, vol 2. London, Hogarth Press, 1955
 
Freud S: The Interpretation of Dreams (1900): Complete Psychological Works, standard ed, vols 4, 5. London, Hogarth Press, 1953
 
Freud S: Inhibitions, symptoms and anxiety (1926 [1925]), in Complete Psychological Works, standard ed, vol 20. London, Hogarth Press, 1959, pp 77–175
 
Gedo J: Self psychology: a post-Kohutian view, in Self Psychology: Comparisons and Contrasts. Edited by Detrick DW, Detrick SP. Hillsdale, NJ, Analytic Press, 1989, pp 415–428
 
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