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Review of How Does Analysis Cure by Heinz Kohut - short answer: Empathy
on July 1, 2013
Strengths: The short answer to the question is "empathy." The longer answer is "transmuting internalization," a clumsy phrase necessitated by James Strachey (Freud's translator) using variations of "transformation" and "internalization" in his own essay of the therapeutic effect of psychoanalysis. From a psychoanalytic perspective, Dr. Kohut put empathy on the map. This particular work was assembled by Arnold Goldberg, M.D. and Paul Stephansky (editors), working from an advanced draft by Dr. Kohut, after the latter's untimely death in 1981. The work establishes the connection between phase-appropriate failures of empathy in the analyst and the establishment of psychic structure of the self that enables the person to transform his anxieties, etc. Empathy becomes a tool for the reestablishment of emotional equilibrium on an occurrent as well as dispositional basis. On my reading, it is the non-traumatic breakdown's in empathy and their interpretation and working through that become the basis for structural change (and expansion and "improvement") in the self. Kohut's work in The Restoration of the Self puts empathy at the center of self psychology and includes the claim (only partially justified) that data gathered empathically through vicarious introspection provide a scientific (or at least rigorous) basis for psychoanalysis as a verifiable intellectual discipline.
Weaknesses: Not really a weakness but ... The work is most accessible to those familiar with the self psychology, which itself is accessible as a conversation and (partial) disagreement with Freud. If you are turned off by the amount of sexual dynamics of to be found in Freud's drive theory [a statement that makes almost no sense in our hyper-sexual times], then you will likely find Self Psychology a welcoming option. For Freud (and his colleague Ernest Jones) sex was always the signified, never the signifier. Now sex is just another symbol - when the patient acts out sexually, he is attempting to regain his emotional equilibrium in the face of narcissistic injuries or set backs in the course of life. It is an oversimplification, but a useful one to say: Bad behavior becomes a method - admittedly mal-adapative - of regaining emotional composure when it has been lost for whatever reason. Of course, sex is also just sex in the classic Freudian way too. It is not really fair to either Kohut or Rogers to say the following, but for purposes of an Amazon-reader review, Kohut is Carl Rogers on steroids plus you are allowed to talk about dreams, the past, and even the future! This complex thicket of concepts around empathy, self-object, and narcissism, provides a challenge from the perspective of motivating Kohut's contribution to empathy (which is substantial). Not an easy read, given that Kohut knew he was dying and was unapologetic in expressing his complex thoughts in a complex syntax that borders on "run on" such as this sentence, but a worthwhile one. You get the idea. Newton is supposed to have said, If I have seen further than others, it is because I have stood on the shoulders of giants who came before me. Never was that truer than in the case of the relationship between Freud and Kohut.