How Does Analysis Cure?

by Heinz Kohut

How Does Analysis Cure? by Kohut

Genres: Psychology, Psychoanalysis, Nonfiction, Psychiatry

Unknown Binding

First published June 15, 1984

About the author

Heinz Kohut was an Austrian-born American psychoanalyst best known for his development of Self psychology, an influential school of thought within psychodynamic /psychoanalytic theory which helped transform the modern practice of analytic and dynamic treatment approaches.

Reviews

[Warren Fournier]

Sheer brilliance, if you can unlock Kohut's language. The main complaint that most people have about Kohut has nothing to do with his ideas--it's his writing. So this review will tackle the elephantine question: is it worth reading Kohut's original works?

The short answer is absolutely! This answer holds true even if you are not a therapist, psychologist, or psychiatrist. I will detail who could benefit from this book and why. I will also explain how to navigate the difficulty of Kohut's writing.

Incomplete at the time of Kohut's untimely death, this classic of psychology was given the finishing touches by Arnold Goldberg, but you can tell that the language is almost 100 percent Kohut. The book has the distinctive Kohutian loquacity and circumstantial logic, as well as his pet phrases. Yep, this is Kohut all right.

But I think this is one of the easiest books to start with to understand where Kohut was coming from. This might seem an odd thing to say, but hear me out. The whole point of the book was for Kohut to explain himself. It is a response to years of criticism by the psychoanalytic community. By this point, he had gathered enough data from this criticism to grasp what people were misunderstanding about his previous writing. Also by this point, he had been practicing psychoanalysis for enough years that he had a much firmer grasp on what was working for patients and what wasn't. As a result, this book is the clearest and most complete compilation of his thought before he died.

For example, if you begin your Kohut journey with his first book, "The Analysis of the Self" from 1971, you will be missing some key features of self-psychology theory, because he was still working things out for himself. A glaring example that will be noticed by seasoned analysts is that he talks about idealizing and mirroring self-object functions, but not the twinship. He hadn't yet formulated that idea yet. Six years later, "The Restoration of the Self" was a more complete formulation of his theories and practice, but it only served to open the door for more questions by his peers.

One such question came from his implication that the therapist does not need to jump into tackling traumatic self-object failures that may have happened during a patient's early development. His colleagues thought that Kohut was saying that it was okay to leave an analysis "incomplete". And if it is okay to end an analysis unfinished, then what is the therapist even doing to help patients? How do we know when a patient is well enough to terminate therapy? In other words, "how does analysis cure?"

Kohut takes each criticism, whether it be an objection or a friendly question, and answers in kind. And though he still tends to be verbose, he does signal when to pay particular attention. He will summarize his points, usually in numbered order, with plenty of warning. So even if your eyes were crossing in the middle of the chapter, he gives you opportunity to regroup, observe his summarized points, and go back to his earlier paragraphs to follow his logic.

I've criticized authors for this kind of thing, from works of fiction to other psychoanalytic and philosophic literature, but this happens when I detect insincerity behind the prose. Some authors really do not have a fully fleshed story or thesis, only a single pitch which they obfuscate, hoping both critics and friendly readers will confuse a failure with a work of surreal genius that only the privileged few will "get." Other authors do actually have something to say, but their genius is a product of their neurospiciness, so the result is literature that truly takes an analyst to unlock. But then there's just the fact that sometimes the ideas are too grand (or even too simple) to explain within the limitations of language. That's Kohut. He's the genuine article. He isn't trying to confuse you, nor is he confused. So, just settle in your chair and trust him to take you where he needs to take you.

You may be surprised at how much of a sense of humor bleeds through his professional veneer. Sometimes, it's obvious. In one clinical vignette, he tells a medical student who he is treating that he's about to give him the most profound interpretation of his whole analysis. "You are a complete idiot." This made the patient laugh and loosened him up a bit to verbalize an inner experience that he had hitherto been acting out in reckless behaviors while driving. Kohut wasn't trying to attack his patient. In fact, he liked the boy but was concerned about his choices that could lead him to seriously hurt himself or someone else, and the patient knew it. It's funny because it seems to come out of nowhere and be completely out of character, but it is perfectly timed, because Kohut was trying to emphasize a few important points about the flat, cold approach of most analysts. Under the right circumstances, if you know your patients well enough, you can cut loose and do things outside of the box to help your patients progress.

Readers will often verbalize that Kohut's writing is very technical. It is. But it isn't. What I mean is that Kohut really only uses a handful of technical psychological terminology which gets repeated throughout the book. So if you are a novice to Kohut, I suggest you get on Wikipedia or find a primer on self-psychology and familiarize yourself with the basic terminology first. That will make things SO MUCH easier. The other thing that makes this book challenging is that he compares the theories and techniques of self-psychology, Kleinian object-relations, and Freudian classical analysis. I find this incredibly interesting and clarifying, because he highlights how the different approaches are similar, how they all benefit different disorders, and where he thinks self-psychology is superior. So, you will have to be familiar with Freud and Klein as well.

"But wait a second, Warren," I hear you asking, "why would anyone be reading this book if they don't know much about psychoanalysis?"

Well, I will finish my review by discussing who would benefit from this book. Obviously, Kohut was writing to his professional peers in psychoanalysis. But what about the rest of us?

Everyone has interests, and deep dives have to begin somewhere. A person may be psychologically minded, but not be aware of it until they are exposed to basic concepts in a high school or college course, and they want to know more. Maybe they have their own struggles and developed a healing relationship with their counselor and want to know more about how and why it helped. Or maybe they are just curious about the human mind from genuine academic curiosity or some personal motivating factors. Whatever the case may be, you don't need to be an analyst to learn something valuable from Kohut, just like you don't need to be a philosopher to enjoy Schopenhauer or Nietzsche. I encourage any self-motivated reader to discover self-psychology for themselves, as I think the insights it provides are transformative, and if the ideas move you, your journey will inevitably take you to Kohut. There is just no better place to learn about any revolutionary movement than from the mouth of its leader.

Make no mistake--this book is a revolution. Self Psychology has progressed and refined its techniques and has had influences both within and outside psychoanalysis since Kohut's death, but I find that the seeds of those advancements all sprout from the soil laid here. And I truly think that if more people across the world read and understood Kohut's revolution, our world could be truly wonderful. Kohut's revolution was in redirecting the self away from the Western concept of ego. To Kohut, the self is a developmental experience that persists throughout one's lifetime that requires the presence and nourishment of OTHERS. But Western society is largely unaware of Kohut and more rooted in other philosophies, philosophies that promote the idea of the individual who forges their own path. Our embrace of postmodernism is also to our detriment, reducing the self to "the subject" in its endless quest to deconstruct and dehumanize. As a result, we are a society of egos and not selves. We desperately try to keep pace with life's demands on our own with little regard for others and our need for others. We behave selfishly, and we elect selfish leaders and build mega corporations who look out only for their own interests without playing the tape forward to see how their decisions impact others. For over a century, many people have looked to socialism as an answer to all this capitalist rat race selfishness, but this philosophy also has no cohesive sense of self, which is why socialism continues to sink into the very corruption it claims to fight. If we could truly think like Kohut, if we recognized the need for each other and acted on that need by taking care of each other, then corruption and destruction would naturally and truly be anathema to our culture.

So, if you have the inclination, do not be intimidated or put off by rumblings from some readers about "psychobabble" or that Kohut is too hard to read. Whether you are an analyst, a psychotherapist, a psychologist, a psychiatrist, a student, a mental health advocate, an anthropologist, a sociologist, a political activist, a patient, a historian, a philosopher, or just a curious reader, I encourage anyone to give Kohut a try. This may be his "last" book, but I think it may be a good place to start.

SCORE: 5 transmuting internalizations out of 5

[Ghenadie Virtos]

A rather difficult and rewarding read. This book is not for the large public, it is closer to the academic style. I had to approach it in small bites as it assumed a lot of background knowledge and understanding. The writing is convoluted and at times difficult to follow, with many digressions and intertwining of various ideas, the reader if often left alone in identifying what the main tenets are, without much help from the author or the editing of the book (as it was put together post-humously from Kohut's various manuscripts).

The main idea of the book was to explore a different approach to therapy, one that focuses on the importance of self-objects (people that played a major role in one's emotional development, usually, but not necessarily, the parents) their role in establishing a nuclear self. The reactions and responses that we receive from self-objects help us build a coherent self which is becomes autonomous in a healthy way. The failure of self-objects to provide not only the necessary support but also the necessary frustrations leaves the self without a coherent structure and without the proper mechanisms to relate to life in adulthood. Seems like most of the ideas are well accepted in modern psychoanalysis, but at the time of the book it flewed in the face of the traditional Freudian theory of drives and the three-partite structure of the self (id-ego-superego).

A worthy and difficult read to which I shall return for further research and inspiration.

[A YOGAM]

Kohut rehabilitiert den Narzissmus und zeigt, dass wir nicht von dunklen Trieben gesteuert werden, sondern vor allem auf der Suche nach einem Spiegel sind, der uns wohlwollend zurücklächelt. Er verschiebt den Fokus weg von der strafenden Vater-Couch der klassischen Psychoanalyse hin zur Empathie für das fragile Selbst. Dieses Buch vermittelt die tröstliche Einsicht, dass Heilung nicht darin besteht, seine Impulse zu zähmen, sondern endlich jemanden zu finden, der einen wirklich versteht.

[Honey's Literary Adventures]

I actually give it 3 and a half stars. I think it is important to read original authors of a theory. While this book gives a good sense of Kohut's theory and thinking, he is loquacious which required some patience on my part. If you are in the field, I think it is worth reading. If you are not, maybe consider a primer on Kohut.

[Trevor]

Interesting theory about the role of empathy and selfobject transference in self psychology, but this unedited version endorsed by his wife is clumsy. I'm sure Kohut's editors cleaned up his meandering writing style.

[John]

nonfiction,psychology

[Julia Fronduti]

Self psychology is such an important and useful theory and approach to psychotherapy but the way Kohut articulates himself is confusing and convoluted!