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Book Forum: Life Stories   |    
Heinz Kohut: The Making of a Psychoanalyst
RICHARD D. CHESSICK, M.D., Ph.D.
Am J Psychiatry 2001;158:1944-1945. doi:10.1176/appi.ajp.158.11.1944
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By Charles B. Strozier. New York, Farrar, Straus & Giroux, 2001, 495 pp., $35.00.

The author of this meticulously documented biography is a professor of history at John Jay College and the Graduate Center, City University of New York, and a training and supervising psychoanalyst at the Training and Research Institute for Self Psychology. In his preface he says that, having finished a "psychoanalytic study of Lincoln," he was looking for a new project and decided to write about Heinz Kohut (pp. xi–xii). Strozier tells us he was trained at the Chicago Institute for Psychoanalysis, where he became a convert to the Kohutian approach.

In writing this book over several years, Strozier seems to have interviewed everyone he could find among the colleagues, students, patients, family, and friends of Kohut in an effort to write a portrait of this very complex man. He apparently leaned heavily on Kohut’s only son, Thomas, for certain assumptions that underlie the structure of this biography.

The first of these assumptions is Thomas’s conviction that the famous case history of Mr. Z (1) is a disguised autobiographical study by Kohut (pp. 310–312). Strozier admits that it will never really be possible to know for certain if the famous paper on Mr. Z was autobiographical or not; "the proof is all circumstantial" (p. 314). Kohut never said that this case was autobiographical. Strozier amasses arguments for and against Thomas’s conviction at various places in the text. One must keep in mind that whether the case history of Mr. Z was autobiographical or not, it was written for rhetorical purposes. Kohut used it in an attempt to demonstrate the superior efficacy of a self psychological analysis over a traditional Freudian analysis. According to Kohut, Mr. Z’s first analysis, which was traditional, was unsuccessful and was superseded by a successful self psychological analysis. In the first hundred or so pages of this book, Strozier leans heavily on the Mr. Z publication as if it reliably gave details of Kohut’s life.

The second assumption requires accepting a number of anecdotes about Kohut’s unpleasant behavior, including some reported by his son that are quite depreciating of his father. The philosopher and historian Collingwood warned us against historical study based on collecting and reporting statements and anecdotes; he called this "scissors-and-paste history" (2, p. 77).

There is a great deal of mother-bashing at several places in the book, based on Kohut’s discussion of the cases of Mr. A and Mr. Z and Thomas Kohut’s remarks, as well as on the experiences of others that involved Kohut’s unusual mother, Else. Strozier concludes, for example, that Kohut "seemed unable to escape the toxic influences of his own ‘bad mother’ " (p. 265). Mother-bashing is somewhat out-of-date in psychoanalytic thinking, as Strozier himself is aware, and he recognizes that Kohut’s mother was a remarkably capable woman. Like her son, she immigrated to the United States and built a successful life for herself. Kohut’s relationship with his mother was extremely complicated, and we do not have sufficient information about his early life to get a convincing picture of it. The assumption that the case history of Mr. Z is reliably autobiographical is not above suspicion, and so the first hundred pages of Strozier’s biography must be read with a certain skepticism.

The issue of Kohut’s personality comes up repeatedly. At times Kohut seems so grandiose in this biography that he is almost psychotic, as, for example, in the description of his behavior in the hospital reported by a nurse (pp. 323–324) and his behavior at social gatherings, especially after he became ill (p. 234). In other situations described here he shows extraordinary empathy with patients and students. Kohut could be very cruel and destructive at times, and at other times he could be very empathic and supportive. Everyone seems to agree that he had a certain charisma; using this, he engaged in the questionable procedure of gathering disciples around him, many of whom were his analysands or students, and, at least in some cases, exploiting them rather ruthlessly and publicly humiliating them. When I saw him at meetings he appeared to be a self-satisfied and highly effective speaker.

The central lesson of Strozier’s biography and of my own text on self psychology (3) is that no analyst or psychodynamically oriented psychotherapist who has studied self psychology will ever practice in quite the same way as before, even if he or she rejects the theoretical postulates and principles of infant development that Kohut evolved in his later life. There is something unique about Kohut’s writings and his approach that leaves a lasting impression when carefully studied. Strozier is right when he emphasizes again and again that Kohut’s influence loosened the shackles that bound traditional psychoanalysts of the mid-20th-century and allowed them to become more humane and empathic with their patients without guilt and without feeling they were violating technique or introducing "parameters."

Strozier mentions several issues that are certain to offend some readers. For example, there is no clear explanation of how Kohut evaded the draft in World War II. Also, Kohut’s attitude toward his Judaism can only be described as insulting to any person of Jewish faith. Strozier says that "Kohut began presenting himself ethnically as half-Jewish at most (and not Jewish at all if he thought he could get away with it)" (p. 75). His loud and arrogant demand for a ham sandwich in a kosher delicatessen as reported by Ornstein (p. 188) ought to offend everybody. This is an issue Kohut never resolved. We are told that "Kohut could be mean and insulting, but even at best he was exceedingly arrogant" (p. 86). His behavior with his first serious girlfriend, and his habit of never apologizing "for his rage, for his arrogance, or for hurting his friend" (p. 86), help to explain why he was such a controversial figure. His wife and his son implored him repeatedly not to be so narcissistic, but he replied that he could not help it.

Nobody could deny that Kohut had an extraordinary mind, "arrogant and peculiar" (p. 139) as he was, but some of his disciples carried matters to an extreme in their idealization of him. He was an elitist (p. 114) who had no patience with those who had less education or culture than himself, and he aroused a great deal of envy among his colleagues. It did not help that "he was never open about himself, and was generally remote" (p. 128) and that "he was very impressed with himself" (p. 177). In summary, he manifested poor interpersonal relationships, especially in matters of intimacy, and one senses that he had difficulties with his only son.

The greatest strength of Strozier’s book is in his description of Kohut’s publications, and it serves as a nice ancillary text for those who are interested in the study of self psychology. The book is divided into five sections, titled Vienna, In the Footsteps of Freud, Breaking Free, A Theory and a Movement, and The Birth of a Hero. Strozier’s cogent and relatively lucid analysis of Kohut’s publications also repeatedly announces that Kohut rejected "drive theory" and "demonstrated how ridiculous" (p. 222) it was. This is one of the areas where the reader will have to decide whether Strozier is right, especially by examining Kohut’s published comments on this matter directly.

Kohut’s final years were characterized by advancing cancer, which, if we are to believe the reports in this book, resulted in an exacerbation of his worst qualities. He stopped reading the psychoanalytic publications of others. As his theories developed, Kohut, who was at one time the president of the American Psychoanalytic Association and regarded himself as "Mr. Psychoanalysis," was subjected to ostracism and the loss of the friendliness of a number of his colleagues. The conditions for yet another split in the psychoanalytic movement were ripe, and some of his disciples urged him to form an institute separate from the Chicago Psychoanalytic Institute. He refused to do so, even though, according to Strozier, some of his power and prestigious positions at the Chicago Institute were taken away from him. Strozier tells us that, in his final years, Kohut’s "bragging and self-centeredness in social situations was nearly out of control, driving his son at times to distraction" (p. 323).

Kohut was a refugee from Austria; he left at essentially the same time Freud escaped. He started out in the United States as a resident in neurology and a disciple of Richard Richter, the chairman of the Department of Neurology at the University of Chicago. Richter was an outstanding neurologist, and he was very disappointed when Kohut moved into the field of psychoanalysis, in a career somewhat parallel to that of Freud. In his final years, self psychology became Kohut’s total preoccupation, and he seemed to relegate almost all psychogenic difficulties to pathology of the self. His final work (4) was posthumously published, so Kohut was not able to have the work edited and to make final corrections and emendations. "Empathy" gained an increasing significance for Kohut, and he became convinced that empathy by itself had a curative effect (p. 347), stirring up a storm of controversy among psychodynamic psychiatrists and traditional psychoanalysts.

These controversies continue (3), but self psychology has certainly become one of the most important channels available to us for understanding patients (5). Regardless of whether one is convinced of the validity of self psychology, the importance of Kohut’s work cannot be overestimated because of the powerful personal impact that it has on anyone who takes the trouble to study it. Although I have raised some questions about the historical accuracy of this biography and I suspect that professional historians will have some complaints about it, I strongly recommend it to anyone who is interested in the practice of psychodynamic psychotherapy. It is an important contribution to the literature.

Kohut H: The two analyses of Mr Z. Int J Psychoanal  1979; 60:3-27
[PubMed]
 
Collingwood C: The Principles of History. Oxford, UK, Oxford University Press, 1999
 
Chessick RD: Self Psychology and the Treatment of Narcissism. Northvale, NJ, Jason Aronson, 1985
 
Kohut H: How Does Analysis Cure? Chicago, University of Chicago Press, 1984
 
Chessick RD: Psychoanalytic Clinical Practice. London, Free Association Books, 2000
 
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References

Kohut H: The two analyses of Mr Z. Int J Psychoanal  1979; 60:3-27
[PubMed]
 
Collingwood C: The Principles of History. Oxford, UK, Oxford University Press, 1999
 
Chessick RD: Self Psychology and the Treatment of Narcissism. Northvale, NJ, Jason Aronson, 1985
 
Kohut H: How Does Analysis Cure? Chicago, University of Chicago Press, 1984
 
Chessick RD: Psychoanalytic Clinical Practice. London, Free Association Books, 2000
 
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