Showing posts with label Heinz Kohut. Show all posts
Showing posts with label Heinz Kohut. Show all posts

Tuesday, September 03, 2013

Heinz Kohut - Reflections on Empathy


When Heinz Kohut broke with the Freudian tradition in which he had become a leader, he opened a new world for future generations. In the 1940s, Kohut had become a prominent member of the Chicago Institute for Psychoanalysis, having become such a strong proponent of the traditional psychoanalytic perspective that was then dominant that he jokingly called himself, “Mr. Psychoanalysis.”

As a bit of background, here is a generalized summary of the development of his Self Psychology model, via Wikipedia:
Though he initially tried to remain true to the traditional analytic viewpoint with which he had become associated and viewed the self as separate but coexistent to the ego, Kohut later rejected Freud's structural theory of the id, ego, and superego. He then developed his ideas around what he called the tripartite (three-part) self.[7]

According to Kohut, this three-part self can only develop when the needs of one's “self states”, including one's sense of worth and well-being, are met in relationships with others. In contrast to traditional psychoanalysis, which focuses on drives (instinctual motivations of sex and aggression), internal conflicts, and fantasies, self psychology thus placed a great deal of emphasis on the vicissitudes of relationships.

Kohut demonstrated his interest in how we develop our “sense of self” using narcissism as a model. If a person is narcissistic, it will allow him to suppress feelings of low self-esteem. By talking highly of himself, the person can eliminate his sense of worthlessness.
 
Historical Context

Kohut expanded on his theory during the 1970s, a time in which aggressive individuality, overindulgence, greed, and restlessness left many people feeling empty, fragile, and fragmented.[7]

Perhaps because of its positive, open, and empathic stance on human nature as a whole as well as the individual, self psychology is considered one of the “four psychologies” (the others being drive theory, ego psychology, and object relations); that is, one of the primary theories on which modern dynamic therapists and theorists rely. According to biographer Charles Strozier, “Kohut...may well have saved psychoanalysis from itself”.[2] Without his focus on empathic relationships, dynamic theory might well have faded in comparison to one of the other major psychology orientations (which include humanism and cognitive behavioral therapy) that were being developed around the same time.

Also according to Strozier, Kohut's book, The Analysis of the Self: A Systematic Analysis of the Treatment of the Narcissistic Personality Disorders,[3] “had a significant impact on the field by extending Freud's theory of narcissism and introducing what Kohut called the 'selfobject transferences' of mirroring and idealization”. In other words, children need to idealize and emotionally “sink into” and identify with the idealized competence of admired figures. They also need to have their self-worth reflected back (“mirrored” Note : This term isn't a synonym of "mirroring") by empathic and care-giving others. These experiences allow them to thereby learn the self-soothing and other skills that are necessary for the development of a healthy (cohesive, vigorous) sense of self. For example, therapists become the idealized parent and through transference the patient begins to get the things he has missed. The patient also has the opportunity to reflect on how early the troubling relationship led to personality problems. Narcissism arises from poor attachment at an early age. Freud also believed that narcissism hides low self-esteem, and that therapy will re-parent them through transference and they begin to get the things they missed. Later, Kohut added the third major selfobject theme (and he dropped the hyphen in selfobject) of alter-ego/twinship, the theme of being part of a larger human identification with others.

Though dynamic theory tends to place emphasis on childhood development, Kohut believed that the need for such selfobject relationships does not end at childhood but continues throughout all stages of a person's life.[8]
With that background, here is a brief video of Kohut talking about empathy in his final public speech.



Heinz Kohut - Reflections on Empathy


Uploaded on Jan 9, 2009

Kohut's final speech, "Reflections on Empathy", was given at the 1981 Self Psychology conference in Berkeley, California. He was aware he was dying, and at the conclusion of his speech he announced his final farewell. This is a Lifespan Learning Institute video.

Sunday, August 18, 2013

Robert D. Stolorow, Ph.D. - Emotional Dwelling Is More than Empathic Understanding

Robert Stolorow is one of the co-founders of the intersubjective systems theory model of relational psychoanalysis, along with Donna Orange, George Atwood, and Bernard Brandchaft. Among the foundational books written by Stolorow and others in this group are Working Intersubjectively: Contextualism in Psychoanalytic Practice (2001, with Orange and Atwood), Contexts of Being: The Intersubjective Foundations of Psychological Life (2002, with Atwood), and Psychoanalytic Treatment: An Intersubjective Approach (2000, with Atwood and Brandchaft).

Stolorow's blog at Psychology Today, from which this post is shared, is Feeling, Relating, Existing: On Emotion and the Human Dimension. This is the bio given at PT:
Robert D. Stolorow, Ph.D., Ph.D. is a Founding Faculty Member at the Institute of Contemporary Psychoanalysis, Los Angeles, and at the Institute for the Psychoanalytic Study of Subjectivity, New York City. He is the author of World, Affectivity, Trauma: Heidegger and Post-Cartesian Psychoanalysis (Routledge, 2011) and Trauma and Human Existence: Autobiographical, Psychoanalytic, and Philosophical Reflections (Routledge, 2007) and coauthor of eight other books. He received the Distinguished Scientific Award from the Division of Psychoanalysis of the American Psychological Association in 1995, the Haskell Norman Prize for Excellence in Psychoanalysis from the San Francisco Center for Psychoanalysis in 2011, and the Hans W. Loewald Memorial Award from the International Forum for Psychoanalytic Education in 2012.
In this post, Stolorow clarifies the differences between empathy, as first proposed by Heinz Kohut in his Self Psychology model, and the "phenomenological contextualism" proposed in the intersubjective systems model.

Undergoing the Situation

Emotional dwelling is more than empathic understanding

Published on August 10, 2013 by Robert D. Stolorow, Ph.D. in Feeling, Relating, Existing
“The person with understanding does not know and judge as one who stands apart and unaffected; but rather, as one united by a specific bond with the other, he thinks with the other and undergoes the situation with him.”—Hans-Georg Gadamer
Traditional notions of therapeutic empathy have been pervaded by the Cartesian doctrine of the isolated mind. This doctrine bifurcates the subjective world of the person into outer and inner regions, reifies and absolutizes the resulting separation between the two, and pictures the mind as an objective entity that takes its place among other objects, a “thinking thing” that has an inside with contents and looks out on an external world from which it is essentially estranged. Within this metaphysical vision, human beings can encounter each other only as thinking subjects, and something like empathic immersion—what psychoanalytic innovator Heinz Kohut famously called vicarious introspection—is required to bridge the ontological gap separating their isolated minds from one another. In a post-Cartesian philosophical world, no such bridging is required, as we are all always already connected with one another in virtue of our common humanity (including our common finitude and existential vulnerability) and our co-disclosive relation to a common world.

Kohut’s and others’ contention that a therapist’s empathic immersions can be neutral and objective is especially saturated with Cartesian assumptions. One isolated mind, the therapist, enters the subjective world of another isolated mind, the patient. With his or her own psychological world virtually left outside, the therapist gazes directly upon the patient’s inner experience with pure and preconceptionless eyes. From my vantage point, this doctrine of immaculate perception (Nietzsche) entails a denial of the inherently intersubjective nature of analytic understanding, to which the therapist’s subjectivity makes an ongoing, unavertable, and indispensable contribution.

The framework of phenomenological contextualism developed by my collaborators and me embraces the hermeneutical axiom that all human thought involves interpretation and that therefore our understanding of anything is always from a perspective shaped and limited by the historicity of our own organizing principles—by the fabric of preconceptions that the philosopher Gadamer called prejudice. The claim that all analytic understanding is interpretive means that there are no decontextualized absolutes and universals, no neutral or objective analysts, no immaculate perceptions, no God’s-eye views of anything or anyone—and thus no empathic immersions in another’s experiences. This contextualist sensibility keeps our horizons open to multiple, relationally expanded possibilities of meaning. Analytic understanding is thus seen as forming and evolving within a dialogical context.

From my vantage point, therapeutic inquiry is a dialogical process in which each participant, in varying degrees and at different times, engages in reflection upon three interrelated domains—the meanings organizing one’s own experience, the meanings organizing the other’s experience, and the dynamic intersubjective system constituted by these interacting worlds of meaning. Furthermore, in this dialogical process each participant (far from entering the other’s subjective world and leaving his or her own outside) continually draws on his or her own experiential world in search of analogues for the possible meanings governing the other’s experiences. Empathic (-introspective) understanding is thus grasped as an emergent property of a dialogical system, rather than as a privileged possession of an isolated mind.

But now I want to push the relational envelope even further and radicalize what I have said so far. There is something disengaged in the traditional conceptions of therapeutic empathy. Kohut was aware of this, and in his last lecture before he died, he characterized empathy as a value-neutral investigative activity that could even be used for malevolent purposes. He suggested that the Nazis’ practice of putting sirens on the bombs they dropped on London demonstrated an exquisite empathic understanding of the terror that would be evoked in those on the ground who heard them.

Recently, I have been moving toward a more active, relationally engaged form of therapeutic comportment that I call emotional dwelling. In dwelling, one does not merely seek to understand the other’s emotional pain from the other’s perspective. One does that, but much more. In dwelling, one leans into the other’s emotional pain and participates in it, perhaps with aid of one’s own analogous experiences of pain. I have found that this active, engaged, participatory comportment is especially important in the therapeutic approach to emotional trauma. The language that one uses to address another’s experience of emotional trauma meets the trauma head-on, articulating the unbearable and the unendurable, saying the unsayable, unmitigated by any efforts to soothe, comfort, encourage, or reassure—such efforts invariably being experienced by the other as a shunning or turning away from his or her traumatized state. Let me give a couple of examples of emotional dwelling and the sort of language it employs from my own personal life.

In the immediate aftermath of my late wife Dede’s death in February 1991, my soul brother and collaborator of 4 decades, George Atwood, was the only person among my friends and family members who was capable of dwelling with me in the magnitude of my emotional devastation. He said, in his inimitable way, “You are a destroyed human being. You are on a train to nowhere.” George lost his mother when he was 8 years old, and I think his dwelling in and integrating his own experience of traumatic loss enabled him to be an understanding home for mine. He knew that offering me encouraging platitudes would be a form of emotional distancing that would just create a wall between us.

My father suffered a terrible trauma when he was 10 years old. He was sitting in class, the kid sitting in front of him was horsing around, the teacher threw a book at the kid, the kid ducked, and the book took my dad’s eye out on the spot. For the rest of his life, he lived in terror of blindness—a terror that I remember pervaded our household when I was growing up. Sixty years after that terrible trauma, he was to have cataract surgery on his remaining eye, and his optic nerve was vulnerable to being knocked out in virtue of the glaucoma medication he had been using for decades. When I went to see him just prior to the surgery, I found him in a massively (re)traumatized state—terrified, fragmented, disorganized, and deeply ashamed of the state he was in. Family members tried to offer him reassurance: “I’m sure it will be fine.” Really? Such platitudes only demonstrated to him that no one wanted to be close to him in his traumatized state. Having gone through my own experience of devastating trauma, I knew what he needed instead. I said, “Dad, you have been terrified of blindness for nearly your entire life, and there’s a good chance that this surgery will blind you! You are going to be a fucking maniac until you find out whether the surgery blinds you! You’re going to be psychotic; you’re going to be climbing the walls!” In response to my dwelling with his terror, my dad came together right before my eyes and, as was our custom, we had a couple of martinis together. The surgery was successful and did not blind him.

If we are to be an understanding relational home for a traumatized person, we must tolerate, even draw upon, our own existential vulnerabilities so that we can dwell unflinchingly with his or her unbearable and recurring emotional pain. When we dwell with others’ unendurable pain, their shattered emotional worlds are enabled to shine with a kind of sacredness that calls forth an understanding and caring engagement within which traumatized states can be gradually transformed into bearable painful feelings. Emotional pain and existential vulnerability that find a hospitable relational home can be seamlessly and constitutively integrated into whom one experiences oneself as being.

Copyright Robert Stolorow