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CHAPTER SIX

The Psychology of the Self and the Psychoanalytic Situation

The theoretical framework that defines our understanding of psychopathology and normal psychology will influence not only our specific technical activities (especially with regard to the content of our interpretations), but also, via subtle innuendos and gross moves, our general attitude vis-à-vis analytic process and patient. The point of view, for example, taken with regard to such seemingly esoteric questions as whether it is correct to say that man is born helpless because he is not born with a significantly functioning ego apparatus—rather than that he is born powerful because a milieu of empathic self-objects indeed his self—or whether man’s untamed drives are the primary units in theis world of complex mental states with which introspective-empathic depth psychology deals—rather than that the primary units are the complex experiences and action patterns of a self/self-objectab initio unit—is closely connected with the attitude (manifested in concrete behavior) that the depth-psychologist chooses to adopt as the most appropriate one for the therapeutic setting.

All psychoanalysts subscribe in principle to the tenet that the structure of the patient’s personality (particularly his nuclear psychopathology and the genetically decisive experiences of his early life) will emerge optimally in a neutral analytic atmosphere. I fully agree with this tenet—indeed, I believe that it was only by a strict adherence to it that I was able to discern the specific form of psychopathology of the narcissistic personality disorders and that I could recognize the dynamic essence of this disturbance and delineate its genetic determinants. When I try to conduct myself in accordance with the principle of analytic neutrality, however, i.e., of being the neutral screen upon which the personality of the analysand, with its needs, wishes, and desires, can delineate itself, I do not attempt to approach a zero-line of activity.

I have wondered how psychoanalysts who in general are endowed with far-above-average ability to be empathic, could ever commit the error, as I think they sometimes do, of equating neutrality with minimal response. Could the analyst’s training in the nonpsychological sciences be responsible for this misinterpretation of a sound psychological principle? Someone who was first trained in the physical sciences might well be inclined to compare the analytic situation with an experiment in chemistry or physics or with a surgical operation. And he might define the analyst’s attempt to create a neutral psychoanalytic atmosphere in analogy to, let us say, the attempt to keep a sensitive scale insulated from any vibrations produced by noise or other uncontrolled sources. But appealing as such an analogy might be on first sight, it is misleading.

During the analytic process the analyst’s psyche is engaged in depth. The essence of his evenly hovering attention is not to be defined in the negative, as a suspension of his conscious, goal-directed, logical thought processes, but positively, as the counterpart of the analysand’s free associations, i.e., as the emergence and use of the analyst’s prelogical modes of perceiving and thinking. Evenly hovering attention, in other words, is the analyst’s active empathic response to the analysand’s free associations, a response in which the deepest layers of the analyst’s unconscious from the area of progressive neutralization (Kohut, 1961; Kohut and Seitz, 1963) participate. The concept of the analyst’s passivity,1

as Freud occasionally called the analyst’s basic therapeutic attitude, is therefore in need of elucidation. The analyst’s human warmth, for example, is not just an adventitious accompaniment of his essential activity—to give interpretations and constructions—which is performed by his cognitive processes. It is an expression of the fact that the continuous participation of the depth of the analyst’s psyche is a sine

for the maintenance of the analytic process. Expressed in metapsychological terms, thequa non analyst’s responses to the analysand—his interpretations and constructions—are the activities of a

of his psyche, not of a and what is called for in the analyst’s work is not butsector layer; ego autonomy (see Kohut, 1972, pp. 365–366). Ego autonomy, I should add, is requiredego dominance

occasionally—transitionally—at moments when the analyst is trying to surmount an endopsychic obstacle that blocks his empathic understanding.

But if analytic neutrality or passivity is not to be defined in analogy to the attempt to protect the

C o p y r i g h t 2 0 0 9 . U n i v e r s i t y o f C h i c a g o P r e s s .

A l l r i g h t s r e s e r v e d . M a y n o t b e r e p r o d u c e d i n a n y f o r m w i t h o u t p e r m i s s i o n f r o m t h e p u b l i s h e r , e x c e p t f a i r u s e s p e r m i t t e d u n d e r U . S . o r a p p l i c a b l e c o p y r i g h t l a w .

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accuracy of a sensitive scale, how it to be defined? I believe that, psychologically speaking, it shouldis be defined as the responsiveness to be expected, on an average, from persons who have devoted their life to helping others with the aid of insights obtained via the empathic immersion into their inner life. Although this average empathic responsiveness lies within a broad band in the spectrum of possibilities and allows many individual variations, it is not— —an approximation of the functions of ain principle psychologically programmed computer that restricts its activities to giving correct and accurate interpretations. The conclusion that it is “in principle” true that the analyst must not try to function like a well-programmed computer rests on two premises: that the analyst’s responses require the participation of the deep layers of his personality and, as I shall elaborate shortly, that the responses of a computer would not constitute an average expectable environment for the analysand.

These statements are, it seems to me, in full harmony with the basic principles of analysis; and the attitude they advocate is one that furthers the analyst’s recognition of the emerging unconscious material. If, for example, a patient’s insistent questions are the transference manifestations of infantile sexual curiosity, this mobilized childhood reaction will not be short-circuited, but, on the contrary, will delineate itself with greater clarity if the analyst, by first replying to the questions and only later pointing out that his replies did not satisfy the patient, does not create artificial rejections of the analysand’s need for empathic responsiveness. These considerations hold true especially in the analyses of narcissistic personality disorders, where such seeming derivatives from infantile drives as the manifestations of sexual curiosity are merely the channel through which a more deeply lying striving for the responses of the self-object finds expression. And they also apply to some extent in the classical transference neuroses because the transference nature of the analysand’s object-instinctual demands will become illuminated more sharply if the normal average needs of the patient are not rejected out of hand as defensive disguises or as derivatives of infantile drive-wishes, but are first taken at face value and responded to.

As I said earlier (see ), man can no more survive psychologically in a psychological milieu thatp. 85 does not respond empathically to him, than he can survive physically in an atmosphere that contains no oxygen. Lack of emotional responsiveness, silence, the pretense of being an inhuman computer-like machine which gathers data and emits interpretations, do no more supply the psychological milieu for the most undistorted delineation of the normal and abnormal features of a person’s psychological makeup than do an oxygen-free atmosphere and a temperature close to the zero-point supply the physical milieu for the most accurate measurement of his physiological responses. Appropriate neutrality in the analytic situation is provided by average conditions. The analyst’s behavior vis-à-vis his patient should be the expected average one—i.e., the behavior of a psychologically perceptive person vis-à-vis someone who is suffering and has entrusted himself to him for help.

An objection might be raised here that I am carrying coals to Newcastle, that it goes without saying that the analyst must behave humanly, warmly, and with appropriate empathic responsiveness, and that analysts do indeed behave warmly and humanly vis-à-vis their patients. I am inclined to believe that,2

to a certain extent, this criticism is accurate, for the simple reason that it would be an almost impossible feat, in the long run, to behave otherwise in this so deeply human constellation we refer to as the analytic situation. But I also know that a theoretical bias exists that makes it hard for the analyst to behave in a natural, relaxed way, and that, in the obverse, analysts tend to feel vaguely uneasy or guilty when they behave thus with their patients. In consequence, a certain stiffness, artificiality, and strait-laced reserve are not uncommon ingredients of that attitude of expectant “neutrality” analysts bring to the analytic situation. And when the analysand reacts with anger to what is by no means a neutral but in reality a grossly depriving atmosphere, the analyst will assume that he is confronted with the emergence of resistances against the analytic procedure—resistances he interprets as manifestations of underlying drives (aggressions)—when he is in fact dealing with artifacts. If the analyst does indeed feel so much as a trace of guilt whenever he does not behave according to Freud’s (1912, p. 115) famous dictum that analysts should “model themselves during psycho-analytic treatment on the surgeon, who puts aside all his feelings, even his human sympathy,” then his emotional spontaneity will be restricted.

Freud’s expressed views, it should be added here, were clearly at variance with theinformally injunction cited above. In a letter (October 22, 1927) to Pfister, for example, he expressed himself in a

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way that is in harmony with the attitude I am delineating as the appropriate one in the context of the psychology of the self: “You know the human propensity to take precepts literally or exaggerate them. I know very well that in the matter of analytic passivity that is what some of my pupils do. Of H. in particular I am willing to believe that he spoils the effect of analysis by a certain listless indifference, and then neglects to lay bare the resistances which he thereby awakens in his patients. It should not be concluded from this instance that analysis should be followed by a synthesis, but rather that a thorough analysis of the transference situation is of special importance. What then remains of the transference may, indeed should, have the character of a cordial human relationship” (E. L. Freud and Meng, 1963, p. 113).

I know that the weight of a statement made in a carefully formulated basic contribution to the technique of analysis is quite different from that of an informal, relaxedly chatty remark made in a letter to a friend. But I would venture the guess that the points in Freud’s life at which the two views were given are not without significance. We must first of all take into account that, between the first and second of the two contrasting views, Freud had added fifteen years to his clinical experience. And there may yet be another explanation for the change, namely, that Freud was in the main exposed to analysands suffering from structural neuroses during the early years of his analytic career, while, later, a shift in the dominant psychopathology may increasing have taken place—a shift to the form of pathology to which we are now referring as narcissistic personality disorders—and that Freud’s second statement was a preconsciously determined response to this change.

In general, I have come to hold the view that an attitude of emotional reserve and muted responsiveness from the side of the analyst is often in tune with the needs of analysands who suffer from the classical transference neuroses. This view is based on the conclusion that these patients had been overstimulated as children, that they had been involved in the emotional life of their parents to a degree that overtaxed the capacity of their immature personality organization. Indeed, I believe that having been overstimulated as children by the adult environment is a genetic determinant of the type of their later psychopathology, namely, structural neurosis.3

An analyst’s inclination to react with muted responsiveness vis-à-vis an analysand who had been traumatized as a child by an unempathically overstimulating adult environment could hence be indicative of his understanding of his patient’s personality. And it could even be argued that, in view of the prevalence of such patients, the classical position was correct at that earlier period. But the fact that muted responsiveness was held to be the correct attitude with all cases argues against this conclusion. Because the classical analyst lacked conscious comprehension of the reasons for the validity of his position, his muted responsiveness cannot be evaluated as an appropriately empathic response—even in those instances where the patient experienced it as providing him with a wholesome therapeutic atmosphere. Whereas the correct empathic response is an intrinsic aspect of the first phase of the two-phase essential activity of the psychoanalyst in the therapeutic situation (cf. ), it mustpp. 85–93 eventually be followed by verbal interpretations (in this case concerning the dynamics of the patient’s sensitivity to overstimulation and concerning the reconstruction of the genesis of this sensitivity, i.e., concerning the unempathically overstimulating self-objects of the patient’s childhood). But, so far as I can tell, the interpretive focus of the classical analyst lay elsewhere. I am thus inclined to hold the view that even with regard to structural neuroses the classical attitude of emotional reserve and muted response cannot be unequivocally regarded as creating the average expectable analytic milieu that constitutes true neutrality, even though it happens to be in harmony with the needs of the analysand’s overstimulated childhood self. The analyst’s muted response is not adopted in consequence of the specific need of his analysand, is not adopted in consequence of his deep comprehension of the genetic core of the analysand’s disturbed personality, it is adopted in obedience to the tenet that contamination of the transference has to be avoided. The analyst’s mutedness and reserve would therefore be experienced as unempathic even by the analysand who suffers from a structural neurosis—were it not for the fact that it is frequently softened decisively by emotional undertones and overtones, which, arising from the depths of the analyst’s psyche, make themselves heard despite the analyst’s conscious theoretical convictions.

The conceptual changes brought about by the viewpoints of the psychology of the self thus lead to conclusions that lend theoretical support to the way analysts—some analysts at least—really act in their

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clinical pursuits, even though theory and theory-bound technical prescription are in their way, and even though they therefore feel obliged to play down the significance of the attitude they adopt in dealing with the manifestations of some of the most central sectors of their analysand’s psychopathology by relegating it to a peripheral position and by referring to it cautiously as analytic tact.

The analyst’s tactful behavior may thus be taken as the manifestation of his awareness of the vulnerability of the analysand who suffers from a disorder of the self, of his awareness of the analysand’s tendency to retreat or to respond with rage. But even the most sensitively responsive behavior from the side of the analyst, based on the analyst’s correct but only preconsciously achieved assessment of the psychopathology of analysands who suffer from disorders of the self, cannot replace the reconstructive-interpretive approach based on the analyst’s conscious grasp of the patient’s structural defects in the self, and of the self-object transferences that establish themselves on the basis of these defects. And if, in addition to the analyst’s failure to grasp the essence of the analysand’s psychopathology and to interpret it appropriately, he insists on behaving with an attitude of cautious reserve and overly muted responsiveness vis-à-vis his analysands with narcissistic personality disorders, there will be further deleterious consequences. The analysand will feel that the germinally displayed exhibitionism of his self or the cautiously offered tendrils of his idealization have been rejected; these delicately constituted configurations, which have just barely begun to be remobilized, will again break down; the analysand’s behavior will be characterized by a mixture of disappointed lethargy (enfeeblement of the self) and rage (regressive transformation of the self’s assertiveness); and, in further elaboration, the analyst’s interpretations will begin to focus on a supposedly reactivated interplay of infantile aggression and guilt —the lethargy of the rejected self is often mistakenly4

considered to be the result of a structural conflict (guilt over destructive impulses)—and they will disregard the more profoundly significant repetition of the analysand’s childhood experience: his reaction to the faulty responses of his self-objects. The analyst’s reassessment of the significance of his analysand’s rage and destructiveness in the light of the psychology of the self—a reassessment, I would like to stress once more, that is fully compatible with the analyst’s complete intellectual and emotional acknowledgment of the ubiquity and importance of aggression and hostility inside and outside the clinical situation—tends not only to prevent the creation of an artificial adversary position between analyst and analysand, but, by changing the emphasis of the interpretations, it leads gradually to an analytic dissolution of the total pathogenic configuration that is the matrix of the analysand’s propensity toward rage. The analysand, in brief, is not “confronted” with a bedrock of hostility which he now has to learn first to recognize in himself and then to tame, but with the task of realizing that, while he has the right to expect a modicum of empathic responses from the self-objects of adult life, he must ultimately realize that they cannot make up for the traumatic failures of the self-objects in his childhood. It is the revival in the transference of the pathogenic self-objects of the analysand’s childhood—the reconstruction of the noxious childhood environment—and the working through of the traumatic states of early life that were the result of their failures, which, with the layingpari passu down of new psychological structures, will reduce the analysand’s propensity for rage.

To summarize my views on the analyst’s attitude in the analytic situation, I will say first that it must never become the goal of the analyst to provide an measure of love and kindness to hisextra patients—he will provide substantial help to his patients only through the employment of his special skills and through the application of his specialized knowledge. The nature of his specialized knowledge, however—his specific theoretical outlook—is an important factor in determining the way in which he conducts himself vis-à-vis his patients. It influences not only to some extent the kind of phenomena he will observe, but also the way in which he evaluates and interprets them. If the analyst is of the opinion that it is the level of drives (whether libidinal or aggressive) that constitutes the greatest depth to which analytic observation can penetrate, that, after overcoming resistances, analysis uncovers drive-wishes so that they can be suppressed or tamed or sublimated, he will be in tune with those of the problems of his analysands who suffer from structural neuroses, and he will be able to help them solve their unconscious conflicts in a satisfactory manner. Although I would maintain that his theory is incomplete if he disregards the psychology of the self in the narrow sense of the term, this incompleteness does not decisively interfere with therapeutic efficacy because, as I said earlier, a cohesive self is present on both sides of the conflict and can therefore be left out of the psychological

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equation without great loss. If the analyst, however, is dealing with patients who suffer from defects in the structure of the self, the incompleteness of the theory—I am speaking here not only of the absence of the psychology of the self in the narrow but also in the broad sense of the term—becomes a serious obstacle. Instead of recognizing that, on the deepest levels, the analysand tries to establish a transference to a self-object by moving from certain disintegration products (libidinal experiences concerning erogenous zones, rage concerning the lack of control over the self-object) to the basic psychological configurations that preceded them (the reactivated attempt to build a cohesive self by means of the empathic response of the self-object), the analyst will focus on conflicts regarding drives—the analysand’s erotic and destructive aims and his guilt about them—and become either educational (urging self-control) or—often accompanied by a display of prideful realism—unnecessarily pessimistic, on the basis of the conviction that the analysis has now reached the “biological bedrock” beyond which it cannot penetrate.

There is a problem—I have already discussed its theoretical significance ( above)—topp. 209–219 which I must now return, even though I consider it of much greater theoretical than clinical importance. Although I claim that the analyst’s participation in the analytic process as defined and described in the preceding pages provides the analysand with a matrix of true neutrality for the development of a—purely endopsychically determined—undistorted transference, even though I claim, in other words, that the analyst’s participation as defined will do away with artifacts—i.e., with experiences and modes of behavior that are not endopsychically determined—that do indeed distort the transference, I will, paradoxical as it may seem, admit to the possible occurrence of rare instances in which the analyst’s personality contributes to influencing the choice between two (or several) equally available and equally valid patterns of structural rehabilitation of a defective self. Although it should be obvious, it may need to be said that I am not speaking about gross identifications with the analyst’s personality. Whereas these do occur and have a legitimate place as a temporary phase of the working through that ultimately leads to internalizations (cf. Kohut, 1971, pp. 166–167), their persistence clearly indicatestransmuting that the analysis is not complete, that the patient’s self has been supplanted by a foreign self and has not been rehabilitated. Nevertheless, even if these pseudocures are carefully taken into account and weeded out, there may yet be rare instances where the selective responsiveness of the analyst will indeed influence the target of the working-through processes and thus the specific form of the ultimately rehabilitated self.

I have not been able to find indubitable evidence of the influence my own personality may have had on an analysand’s available choices. As a matter of fact, I have naturally taken pride in the fact that my analysands find solutions to the problems of their disturbance of mental health that are unequivocally their own and that—however the intrinsically predetermined patterns of their selves may be temporarily distorted by transitionally occurring gross identifications with me—they will ultimately emerge with the knowledge that they have found themselves.

But while I am unable to adduce persuasive evidence from my own practice in support of my conjecture—the objectivity required for this task is very difficult to attain—I have as a supervisor and consultant occasionally observed analyses in which the sequence and the comparative intensity of the analyst’s reactions to the emerging transference material appeared to influence the analysand’s choice of direction in working through.

I recently had the opportunity, for example, to study an extensive and expertly presented report of the analysis of a case of narcissistic personality disorder which led to a favorable result. The analysand, Mrs. Y., a woman whose psychopathology included a fairly severe diminution of the liveliness and buoyancy of her exhibitionism and a moderate disturbance of the cohesion of her body-self, reached an acceptable degree of firmness of her body-mind self and experienced a modicum of enjoyment from the display of its functions. This allowed her to feel much more accepting of herself and, as an outgrowth of this improvement, to establish much better relations with her husband and, especially, with her children. The new balance was in essence achieved via working through the transference toward the maternal mirroring self-object.

At the beginning of the analysis, however, an interchange had taken place between the patient and her analyst (a woman) that I believe to be relevant in the present context. Mrs. Y. mentioned that she had been suffering from a bowel disorder which had been diagnosed as ulcerative colitis, and she was

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emphatic about wanting to get at “the psychological cause” of this disorder. The analyst expressed caution regarding this goal, suggesting that psychological insights might well be ineffective here. The patient immediately complied with the analyst’s realism by saying that she did not expect the analysis to make “a new person” of her. And she added—a non sequitur, the significance of which, it should be noted, escaped the attention of the otherwise very perceptive analyst—that she did not expect “the analysis to make an author” out of her.

Is it possible that another analyst, unconsciously in tune from the beginning with the patient’s aspirations to express the exhibitionism of her grandiose self through creative pursuits, would have reacted differently to her hope that the analysis would be able to deal with her bowel disease? That another analyst, even if prompted by defensive realism to caution the patient about the limits of the efficacy of analysis, would still have become alerted by the analysand’s subsequent remark, which despite its expression in the negative (see Freud, 1925), indicated a connection between the bowel disturbance and her wish to become an author? And, therefore, the working through would have been channeled not only toward the faulty mirroring to which her body-self had been exposed in childhood, but also toward the insufficiently offered opportunities for a merger with an idealized omnipotent self-object who stood for goals that were the precursors of achievements in the realm of literary creativity? And is it not possible that such a shift of focus of the analysis would have led to a different analytic result? A result, it should be added, that would have been equally solid and equally valid psychoanalytically as the one in fact achieved. Such an analysis might have brought about a narcissistic equilibrium of a different sort—it might have led to the analysand’s increasing awareness of her self-expressing exhibitionistic needs, to her increasingly firm idealization of the task of shaping beautiful and/or significant replicas of her grandiose-exhibitionistic self instead of the replicas of the feeble, ill-defined, nonmirrored self extruded by her diseased bowels. The ultimate result of such an analysis would also be the analysand’s increased ability to achieve narcissistic homeostasis—not, however, on the basis of the sense of peaceful perfection that resulted from the analysis that was actually carried out, but on the basis of her sense of proud and triumphant achievements, accompanied by the joy that comes from having lived up to idealized goals.

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