Self Psychology in Depth - Amy Feld, PsyD

Amy Feld, PsyD

Using Self Psychology with Children ©1996-2001 Amy S. Feld, PsyD

Self Psychology Terms
Attachment Theory
Self Psychology History
The Therapeutic Process
Criticism of Self Psychology
References

Self Psychology in Terms

Self psychology refers to a particular group of developmental theories. This body of theory is characterized by emphasis on changes in the structure of the self and the associated experiences of selfhood, both conscious and unconscious (E.S. Wolf, 1988). The essence of a person's psychological needs is seen as the individual's need to organize personal experience into a cohesive structure, of self, and to establish relationships that evoke, maintain and strengthen the self.
Self psychology defines the self as the core of personality. A number of self states, or types of self concept can be present, depending on the level of development of one's self. The virtual self is an infant's self as seen through the parents, which determines how the parent treats the child. The cohesive self describes a stable structure and the "normal" and "healthy" functioning of the self. The grandiose self describes the early infantile presentation of the self viewed as omnipotent and the center of all existence. The fragmented self refers to a less cohesive self, resulting from faulty selfobject experiences. This can be seen on a spectrum from anxiety to panic at the total loss of self structure. The empty self is one that has lost vigor and is depressed, a result of depletion of energy for lack of joyful selfobject responses. The overburdened self is unable to self soothe, because it has not experienced merger with an idealized selfobject. The overstimulated self is predisposed to recurrent states of excessive emotion or excitement as a result of unempathically excessive or phase-inappropriate responses from the selfobjects of childhood (E.S. Wolf, 1988).
Objects, meaning others, are needed to induce the emergence and maintenance of the self, termed selfobject experiences or selfobjects. Infantile selfobjects are what upholds the self during infancy. When these selfobjects are evoked during adulthood, they are referred to as archaic selfobjects. Mirroring selfobjects sustain the self by providing acceptance and confirmation. Idealized selfobjects support the self through a merger with the calmness, power and goodness of an idealized person. Alter-ego selfobjects provide the self an experience of similarity to another's self. Adversarial selfobjects sustain the self by providing experiences of nondestructive conflict.
Selfobject disorders, many of which are more commonly known as personality disorders, develop when a child has encountered severe or chronic selfobject failures. Psychosis occurs when serious damage to the self is permanent and there are no defense structures to cover the defect. A biological predisposition is usually seen in conjunction with the environmental factors. Borderline states occur when the self has experienced serious damage and experiential manifestations are masked by complex defenses (E.S. Wolf, 1988). Narcissistic behavior disorders are temporary and restorable through therapy. The individuals are seen as attempting to control the environment through their behavior, to meet selfobject needs. Narcissistic personality disorders can also be restored through therapy. Symptoms express tensions associated with damage to the self and the autoplastic attempts to restore selfobject functioning (e.g., addiction, delinquency) (E.S. Wolf, 1988). Depression is conceptualized into three types. Preverbal depression is described as "apathy, a sense of deadness, and the diffuse rage related to primordial trauma" (E.S. Wolf, 1988). Empty depression is depletion of self esteem and vitality that occurs as a result of inadequate selfobject responses. Guilt is depression characterized by self-rejection and self-blame, resulting from a lack of idealized selfobject experiences.
Empathy or an empathic stance, defined as affective attunement to the client (Ornstein & Ornstein, 1990), is a central tool used in self psychology. This refers to the therapist's ability to recognize complex emotional states that may be inarticulately or incompletely expressed (Kohut, 1971; B. Wolf, 1992). Empathic failures occur when the selfobject is experienced by the child as unattuned to his or her feelings. Affective attunement, the first step in the empathic process, is the ability of the therapist to shift the focus of attention from a behavior to the motive behind that behavior.
Selfobject transference is the client's displacement on the therapist of archaic selfobject characteristics or needs. There are five types of such transfers. Merger transference occurs when the client seeks to reestablish an identity of an archaic selfobject through the relationship with the therapist. Alter-ego transference occurs when the clients attempt to reestablish latency needs of being seen and understood by someone like themselves. The term mirroring transfer is interchangeable with merger transference, alter-ego transference and mirror transference. It is used to describe validation clients seek for whom they are. Idealizing transfer occurs when the client derives temporary strengths from feeling merged with what he or she sees as the therapist's greatness and power (Orienstein & Orienstein, 1990). Transference of creativity is the need of creative people to merge with a selfobject while engaged in strenuous creative tasks.
Mirroring refers to interactions characterizing a healthy mother-child relationship, including reflections of grandiosity, consistency, nurturance, a general empathy and respect (Kohut, 1977). A person's need to experience sameness or likeness with another person is known as twinship, while alterego is the experience of sameness or likeness within a group (Detrick, 1986). The twinship merger occurs in childhood as a child receives mirroring experiences with other children. Parents and other adults are also able to provide this in part, but peer relationships, which begin during the toddler phase of development are necessary for this process. This function, through support, mirroring and acceptance, serves a reparative function for the self system (Kriegman & Solomon, 1985).
Transmuting internalization is the process by which the self structure is formed. Selfobjects are internalized under the pressure generated by optimal frustration. The integration of self object relations, known as transmuting internalization, can be observed on a continuum with the state of well being on one end of the pole and anxious depression at the other end (Greenberg & Mitchell, 1983; E.S. Wolf, 1988). Personality is determined by the content of these poles and their relationship to each other. Kohut also conceptualized the bipolar self, with ambitions and goals representing the two poles (Kohut, 1971). He later added a third pole to include talents and skills. This became known as the tripolar self (Kohut, 1984). The imbalanced self is loosely cohesive with one of the poles overshadowing the others.
Efficacy need is one's need to experience the self as capable of evoking a selfobject response. Efficacy pleasure is the feeling a person has knowing the self has been strengthened through the experience of efficiency and effectiveness.
Narcissistic rage is anger directed toward a selfobject failure, which is experienced as threatening to the cohesion of the self. Narcissistic rage does not disappear when the threat to the self disappears. It recurs when the self is threatened again, even when the threat is minor to the self. Narcissistic rage can be seen as unresolved anger that dissipates when another selfobject's empathic understanding can be trusted again (E.S. Wolf, 1988).
The self can split horizontally or vertically. A horizontal split occurs when painful or unacceptable thoughts are originated from the psyche and kept out of consciousness. A grandiose fantasy about the self may be kept repressed by an individual who believes that it is "wrong" or "bad" to have such thoughts. A vertical split occurs when the precepts of external reality are disavowed or denied (E.S. Wolf, 1988). For instance, a man may consciously know that his dog has died, but say that his dog is alive to protect himself from the painful impact of the loss. The term curative fantasy is defined as an organized set of hopes for recovery and optimism in the therapeutic process that has to be recognized by psychotherapists as essential aspects of the treatment process (A. Ornstein, 1992). Transference can be viewed as the client's experience of the therapeutic relationship (Gill, 1982) and countertransference is seen as the therapist's experience of that relationship.
Defense mechanisms are automatic, unconscious psychological activities that people use to exclude unacceptable thoughts, threats or impulses from awareness due to the fear of negative outcomes. Reaction formation occurs when a person adopts feelings or behaviors opposite of negative ones. An example of this is a person who acts unnaturally kind to mask feelings of anger. Denial is a primitive defense used when a person is unable to acknowledge negative thoughts or situations which are perceived as intolerable. Displacement is seen when a person directs an impulse or thought from one object to a less threatening object. A man who is angry with his boss, but yells at his children is an example of this defense mechanism. Projection, another primitive defense, is when a person disowns his or her attitudes, ideas or feelings by seeing those attributes in another person.

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Attachment Theory

A child's sense of self begins and grows in the attachment relationship (James, 1994). Attachment to the mother or primary care giver, referred to as archaic heritage (Greenberg & Mitchell, 1988), is the basis by which a child is able to develop other relationships and how he or she will interact in those relationships (Bowlby, 1976, 1971, 1988). A child's self state, one of security, anxiety, or distress is largely determined by the accessibility and responsiveness of a primary attachment figure (Bowlby, 1973).
Emotional stability is built upon confidence in the availability of attachment figures, which develops slowly throughout childhood and adolescence. As children begin to realize that they are separate from their mothers, they are able to transfer the dependent attachment onto a transitional object, which serves to help maintain the bond with the mother. A child needs to feel trust and closeness to the parents, which gradually promotes autonomy (Baker & Baker, 1987). The value a parent places on the quality of attachment transfers to the child. Parents who value autonomy have autonomous children. Those parents who value dependency will have dependent children (Karen, 1990). Allowing the child to have some privacy and autonomy is important to the development of the self. Parents need to balance stimulating their children's needs while allowing them to have their own experiences and make their own mistakes, which are necessary for growth and development.
When the primary care giver is inconsistently unresponsive or unavailable to a child, anxious attachment occurs. Anxiously attached children often exhibit behaviors that alienate their peers and adults with whom they are in contact, which can reinforce their feelings of insecurity (Karen, 1990). The more predictable and stable a child's environment is, the more likely the child's attachment will be secure. Securely attached children are able to show appropriate anger and other negative feelings toward others without fearing abandonment. An insecure child does not have the confidence in the permanence of relationships.
When the environment is particularly chaotic, boys often exhibit aggressive attachment, becoming belligerent, defiant and exhibiting poor impulse control, whereas girls are more likely to show anxious attachment (Moore, 1971). When the primary care giver threatens to withdraw love or abandon a child if he or she does not behave, anxious attachment occurs in a deeper, more pathological manner. Threats of abandonment can be direct or indirect and are seen to have an extremely frightening effect on children (Bowlby, 1971), even when these threats are communicated as teasing.
Children who are physically, emotionally or sexually abused have complicated and confused attachment behaviors. Children who are molested by a primary caretaker, while being told that they are loved and special, will likely view attachment with mixed emotions. Similarly, a child who is beaten, later receiving affection or gifts from the guilt-ridden parent, is likely to misinterpret the actions of others they meet outside the home (Karen, 1990).
A child's reaction to the loss of a parent through abandonment is complicated by the surviving parent's reaction to that loss (Bowlby, 1980; Rosen, 1991), and can cause the child to tremendously yearn for the nurturance of the remaining parent (Rosen, 1991). This can be emotionally draining for the surviving parent, who is also struggling with the loss. Empirical studies of social development in children with and without a permanent mother figure have found that those without a consistent mother figure were significantly more anxious in their attachments and significantly more afraid of strangers (Schnurmann, 1949; Tizzard & Tizzard, 1991).
As children grow, they begin to direct their attachment toward subsidiary attachment figures, while maintaining the importance of their attachment with their mother. This depends primarily on the composition of the household and who cares for the child (Bowlby, 1969). Attachment figures are sought out when the child is in need of nurturing, tired, hungry, sick or afraid. The child will look to friends for social interaction when confident of the proximity of the attachment figure. When children have a healthy attachment to their primary caregiver, they are able to seek out secondary attachment figures and social companions.
Erikson (1971) conceptualized child development as occurring in stages. The first stage is basic trust vs. mistrust, which begins in infancy. This central developmental task, is not only the first task of the ego, but is also a developmental task of the mother. Attachment is a learned trait, developed during the first years of a child's life. Attachment behaviors that develop incompletely or less than optimally can change as arrested developmental needs are met. When a child has had an inconsistent history of attachment with a primary care giver, the therapist often functions as the attachment figure, which allows the child to reexperience the developmental stages not experienced during infancy and toddlerhood (Farber, Lippert & Nevas, 1995).
Psychopathology is understood by self psychologists to be reflective of disturbances and interference in relationships with others (Greenberg & Mitchell, 1988). The ego is defined as a set of functions, similar to what other theorists have referred to as self (Greenberg & Mitchell, 1988). The process of psychotherapy is an attempt to restore the ability of the patient to make direct and full contact with others. Fairbairn (Greenberg & Mitchell, 1988) theorizes that the psychological state of the child stems from a merger with the mother during the earliest months and attributes interference with the mother-infant bond as a major source of problematic relationships later in life. For children to mature and become comfortable in relationships with others, they must feel loved and believe that their own love is welcomed and valued.
Children seen in therapy have various levels of attachment to their primary caregivers. The "good enough" attachment meets the needs of both the parent and the child. Problems can arise when there is a disruption in the relationship, but the basis of the attachment is strong enough to withstand that break (Winnicott, 1960). When the parent and child have a maladaptive attachment relationship with a potential for change, working with both the child and caregiver to strengthen the attachment bond is usually the recommended course of treatment. When the relationship is maladaptive without potential for change, individual therapy focusing on helping the child develop positive attachments is necessary (James, 1994).

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Self Psychology: History

Self psychology is a theoretical framework for understanding the psychological development of a child (Pessein & Young, 1993). The theory evolved from Freud's psychoanalysis, which examined mental processes, a body of psychological knowledge and a method of treatment for psychological illnesses. Post-Freudian analysts further developed and modified psychoanalytic theory, but stayed within Freud's theoretical framework. Heinz Kohut, the so-called "father" of self psychology, revised the basic tenets of psychoanalysis by focusing on empathy and introspection (Kohut, 1959). This shifted the focus of understanding the individual from the psychobiological foundations of the id, and the drives central to psychoanalysis to the psychological considerations of the self, it's development and tribulations. He developed self psychology as a study of the self and its relationship to selfobjects.
In contrast with earlier theories, the self is seen, not as a representation or product of activity of the ego, but in itself an active agent (Greenberg & Mitchell, 1983). Freudian psychoanalysis focused on examination of the inner life of a person, examining psychic structures such as the super ego as a response to unexpected changes of drive discharge patterns. Neo-Freudians, including Klein, Fairbairn, Guntrip, Winnicott, Horney, Fromm, Sullivan and Fromm-Reichmann modified the classic theory to include the influence of the environment and external objects.
Kohut viewed self psychology, not as an interpersonal or object relations framework, but intrapsychically dynamic, placing selfobject theory at the center of self psychology. "The most fundamental finding of self psychology is that the emergence of the self requires more than the inborn tendency to organize experience." (E.S. Wolf, 1988, p. 11). The primary psychological task, for self psychology, is the maintenance of the self, and the relationships between the self and selfobject are at the center of development from birth to death (Tolpin, 1986). At the base of self structure is self esteem (Peoples, 1991).
Kohut believed that the rudimentary development of the self begins at about eighteen months, when the child's needs are narcissistically based. In order for normal development to occur, these powerful needs must be met in certain ways, or psychopathology can develop (Lynch, 1994).
The self psychology framework identifies nine phases of human development. The archaic infantile phase occurs during early infancy, when the child experiences himself and the world as one and the same. Needs for mirroring, idealizing, twinship and efficacy begin and continue throughout the course of life. The Oedipal phase utilizes the infantile needs to develop gender identification and self structure. During the latency phase twinship and alter-ego needs are important to the development of social skills. Selfobjects are expanded during the prepubertal phase, shifting away from the primary care givers toward peers, teachers, and symbolic substitutes for the selfobject person. Self psychology combines the adolescent and young adult phase. During this period cognitive development allows the recognition of parental deficits and thus; the continued development of peers as selfbojects. During the marital phase, spouses use each other to meet a variety of selfobject needs. If adults have a cohesive and solid self, the parenting phase is a time when children are included as selfobjects. This is also a time when a fragile self structure can become more evident and lead to increased fragmentation. The middle-age phase is usually a time of introspection and self evaluation. This is when a person needs selfobjects who are accepting of the self's readjustment of goals. An absence of this can create a "mid-life crisis". During the old-age phase, individuals need to be idealized by their selfobjects to confirm that their life has been purposeful.
Empathic failures are an inevitable occurrence in both child development and the therapeutic relationship. The individual's negative response to these lapses in empathy is seen as the basis of psychopathology. Interventions in treatment are made while accepting, rather than challenging the client's feelings. The feeling of being understood often has a powerful effect on the client and "can be compared to the calmness an agitated child may experience upon being firmly held in the arms of a care giver" (Ornstein & Ornstein, 1990, p. 333). The interactive experience between therapist and client, of understanding and being understood, increases trust in the therapeutic relationship and encourages the client's increase of self-cohesion. Ornstein and Ornstein (1990), compare affective attunement to the "key that opens the door to the inner world of an other" and empathy to "the light that illuminates the content of the room that is behind the door" (p. 328). The bond of empathy that occurs between the therapist and client functions as a curative agent. The essential therapeutic task is "reentering into the course of the line of development of self-selfobject relationships at the point where it had been traumatically interrupted in early life" (Kohut, 1980, p. 453).
Empathic selfobject experiences are necessary for the gradual development of the self and encourage structural cohesion and the energetic vigor of the self (Greenberg & Mitchell, 1983, p. 353, E.S. Wolf, 1988). The concept and function of the selfobject differ in definition. Young children conceive their primary selfobjects, usually the mother, as an extension of themselves and relate to her as if she has no feelings or preoccupations other than their own. Her function is to accept and participate in this interaction, which is a necessary part of the development of the ego. As a child grows and this function changes (Meares, 1988). The "self" begins to take over the archaic selfobject functions, "becoming self-soothing, self-knowing and accepting, self-confident or admiring, and able to regulate tension." (Cooper, 1992, p. 148). Selfobject failures are a natural and necessary part of child development and become pathological or pathogenic when the development of the self is impeded (Baker & Baker, 1987, P.H. Ornstein, 1993). Some children are intrinsically more able to handle empathic failures, although chronic selfobject disappointments often have a cumulative effect on the self structure.
While separation anxiety is common during early childhood, the chronic failure of a child's selfobject experiences results in prolonged separation anxiety and an immature awareness of self-boundary (Meares, 1988). During the earlier years of childhood, a child's ability to think is concrete, things are viewed as good or bad and right or wrong. At this age a child is not yet able to reason abstractly the many shades of gray that separate the colors (Brothers, 1992). Persistent selfobject failures during childhood can leave an individual in a chronic state of evaluating trust versus mistrust (Erikson, 1973). This can be the foundation for characterological disturbance. If "the child does not acquire the needed internal structure, his psyche remains fixated on an archaic self object, and the personality will throughout life be dependent on certain objects in what seems to be an intense form of object hunger (Kohut, 1971, p. 45). The therapeutic process allows the client to express narcissistic rage, which during childhood would have "destroyed the tenuous emotional contact with the most important people in his life." (A. Ornstein, 1992, p. 24).
Fragmentation and emptiness of the self occur when faulty selfobjects are prominent in a child's life. Repeated failures of selfobjects to meet the needs of a child affect vigor, assertiveness, playfulness and affectionateness (Tolpin, 1986). Kohut believed that psychopathology in both children and adults stemmed from multiple selfobject failures early in life which created structural deficits leaving the individual "depleted, deflated, disillusioned and prone to fragmentation" (Tolpin, 1986, p. 125). Some children, whose mirroring, idealizing and selfobject needs are not met by parents, are able to find those selfobject needs from others (Tolpin, 1986).
Psychological and affective development of a parent begins with the pregnancy. It continues to develop through the birth and ongoing growth of the child in the context of the relationship with the child. Parenting is viewed as a developmental stage where the parent first experiences double identification. The new mother's identification with her own mother is reactivated when her child is born. As the new mother identifies with the baby's needs, she relates to both her child and her mother at the same time. New mothers who are overwhelmed with past conflicts can regress to negative identification, becoming the "bad mother" to her child and the "bad child" to her mother (Wagner, 1994).
Parenting is more than the sum of behaviors (Eldridge & Schmidt, 1990). "Children are a burden, and if they bring joy, it is because they are wanted, and two people have decided to take that kind of burden; in fact, have agreed that it is not a burden, but a baby" (Winnicott, 1976, p. 131). Parents who have had deficits in their selfobject relationships as children, often find fulfilling their parenting roles to be difficult.
Parents who are unable to provide adequate selfobject experience for their children, often have had failures with their selfobject relationships during childhood. Parents with disorders of the self, including personality disorders and compulsions with food, sex, or substances, are unable to serve as empathic selfobjects and cannot provide the necessary stimulation for the development of a child's healthy self. A healthy self is able to regulate self esteem and self soothe, while the unhealthy self has not developed the necessary internal structures to accomplish this. To an extent, all children meet some narcissistic needs of their parents. This becomes pathological when the parent uses the child to meet archaic selfobject needs and the parents place his or her narcissistic needs above the child's (Miller, personal communication, July 15, 1996). "When self objects are too needy, depressed or anxious to give the self what it needs the power and structural integrity of the self and selfobject alike will suffer" (Tolpin, p. 125). In response to this, children often develop problems, as they struggle to make use of whatever selfobject responsiveness they can find.
When there is no adequate selfobject, children sometimes retreat into a fantasy world, creating their own fictional versions of competency and structure ( Slade & Moskowitz,1988; Miller, 1996). While creativity and fantasy are normal processes in child development, psychopathology occurs when the child is not able or does not wish to distinguish fantasy from reality. The child who is abandoned has fantasies of self blame, needing to find other ways of stimulating the memories and fantasies that form self structure. If this does not happen, psychosis can occur. (Miller, 1996). If the child is in psychotherapy, the therapist can often become that selfobject, with the goal being to "resume the thwarted developmental process, forming internal structures that assume the functions provided by selfobjects" (Baker & Baker, 1987, p. 7).
Most children grow up in an environment that is usually responsive to their selfobject needs. Empathic failures are present in all relationships and "good enough" parents are able to balance this with empathic responses, leaving the self diminished, but not destroyed (Baker & Baker, 1987). It is important to remember that the empathic failure is not the root of psychopathology, rather the child's response to that emapthic failure. Children seen in therapy are generally not those of "good enough" parents, but individuals for whom the parent-child interaction seriously failed to meet the child's selfobject needs.
Children who have not been able to bond with their primary care giver due to chronic empathic failures usually emerge from that experience with one of three personality types. Merger hungry individuals long to attach themselves to an appropriate selfobject. These are often the adults who remain in abusive relationships or are labeled codependent, as they are unable to differentiate between their own needs and the needs of the selfobject. A therapist is often the first healthy merger that the client encounters. Contact shunning personalities avoid social interactions, fearing further empathic failures. These individuals are typically difficult to engage in the therapeutic process. Mirror hungry people are the least pathological of the three personality types. They continually seek confirming and admiring responses and are often quite needy. These individuals often alternate between states of depression and acting out rage.
While Kohut's theories of development may at times seem to hold the parents responsible for not providing the child with adequate selfobject experience, he was "unambiguously clear that parents should not be blamed for their child's emotional experiences" (Young, 1994 p. 84). He believed that all parents want and do the best they can for their child. Kohut viewed parents who were unable to adequately meet their child's needs as limited by their own selfobject disorders or lack of knowledge of child development and not responsible in a "moral sense" (Young, 1994, pp. 84-86).

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The Therapeutic Process

Psychotherapy is the process of, first establishing a curative self-selfobject transference, then working through the client's issues, using that selfobject transference (Muslin, 1986). Psychotherapy is concerned with restoring a sense of vitality, cohesion or harmony to a self that has been injured through narcissistic assault or fears the disruption of a selfobject tie (Baker & Baker, 1987).
Heinz Kohut conceptualized a framework that views individuals as "struggling to establish and maintain an all encompassing cohesive self throughout life" (Jackson, 1994, p. 1-2). This begins, first, with teaching the client that there is such a thing as a sense of self, that it is safe to have a sense of self and that he has a right to have that (James, 1994). Change occurs in an empathic environment, "fostered by the use of therapeutic interventions of acceptance, understanding and explanation. Empathy is seen as an important intervention in the self psychological therapeutic process (Donner, 1994).
Understanding, acceptance, and explanation are also important therapeutic tools and interventions. Acceptance refers to clients as they are, with the symptomology they present, which can be conveyed through active listening, reflective responses, tone of voice, facial expression and body language (Donner, 1994). The therapist must strike a balance between accepting the client, while recognizing the cognitive or behavioral changes that need to be addressed. Understanding is expressed through the therapeutic dialogue as the therapist speaks in an interpretive mode, choosing words that convey understanding and explain and interpret the client's subjective experience (A. Ornstein, 1986b; Ornstein & Ornstein, 1990; Donner, 1994), through empathic responsiveness (P.H. Ornstein, 1980) or optimal responsiveness (Bacal, 1985). The process of understanding is not to determine what the client is leaving out of the conversation, but an attempt to join with the client to understand what he or she is experiencing. Empathic explanation of the client's symptoms and interactions increases self awareness and insight and is an important part of the treatment process (A. Ornstein, 1986; Donner, 1994). The ability of the therapist to accurately attune himself to the client's subjective experience is central to the process (Schwaber, 1981). Psychic structure is acquired in the context of the therapeutic self-selfobject relationship (Jackson, 1994, p. 2).
Certain principles are used in psychotherapy with a self psychological framework. A weakened self is seen as the center of psychopathology and the treatment process should center around strengthening the self. The depleted self results from faulty selfobject relationships during important developmental stages. The empathic failure of a fragile self force it to use defenses, which is often maladaptive and which interfere with present relationships. While no therapeutic experience can undo events of the past, a self psychology perspective aims to diminish the emotional scars that resulted from those unaffirming selfobject experiences. This is the disruption-restoration process (E.S. Wolf, 1988). If a client is to improve, the therapist must be friendly and responsive, which allows the client to feel comfortable enough to re-experience archaic self needs through the transferential relationship. Finally, a focus on the client's experience and not the content of the information shared by the client, is essential for the therapeutic process to be successful (E.S. Wolf, 1988).
The goal of treatment can be described in structural terms "as increasing the cohesion and wholeness of the self through transmuting internalization" (Wolf, 1988, p.103) For some clients, just being in the presence of an empathic therapist is healing. Wolf (1988) argues that this approach is not a corrective experience, as described by Alexander (1958) and others, because the therapist is not perfect in his responses. Through the empathic handling of inevitable selfobject failures that occur between clinician and client, the therapist can provide a more understanding forum for the client to experience these failures. Restoration of the self occurs through mirroring, and the affective regulating of affective functions that the therapist promotes (Peoples, 1991). A motivation to change is necessary for success in any form of therapy, including self psychology. Failure in therapy can result from an incompatible match between therapist and client, the therapist's inability to provide enough empathy, and clients who are so psychologically damaged that the self is too fragile for the rigors of an introspective process.
The concepts of mirroring, idealizing and twinship transferences, self, selfobject functions, transmuting internalization, and self-selfobject relationships, are central to the understanding of the therapeutic process (Donner, 1994; Lynch, 1994; Nicholson, 1994). Mirroring must be developmentally appropriate to the child. While it is an accomplishment for a toddler to remain dry at night for the first time, praising a seven-year-old child, who has been dry at night for four years, is inappropriate and destructive.
Defense mechanisms are understood as a person's attempt to protect his or her "self" from harm (Ornstein & Ornstein, 1990). Using a self psychology framework, defenses are " appreciated as the glue that holds a vulnerable or fragmentation-prone self together" (p. 334). Defenses are not conceptualized as having to be removed for the therapist to understand the client's core issues. Defense mechanisms naturally diminish as the client experiences a greater level of self cohesion, creating a sense of safety that reduces the need for defensive behavior. "Defense activities are undertaken in the service of psychological survival....The patient's attempt to save at least that sector of his nuclear self, however small and precariously established it may be, that he has been able to construct and maintain despite serious insufficiencies in the development-enhancing matrix of the selfobjects of his childhood" (Kohut, 1984 p. 19). By viewing the client's defense mechanisms as positive strengths that have become painful, the therapist is able to enhance the therapeutic relationship.
Curative fantasy is important to the success of therapy. One such fantasy of cure is that one's feelings and actions, whether positive or negative, will be accepted and understood. The curative fantasy is often uncovered during therapy when the client experiences empathic failures with the therapist. Examples of curative fantasies outside the therapeutic context include; a woman's who believes that if she wins the lottery, all of her problems will go away or a couple that believes having a baby will save their marriage.
Children who are brought into therapy for such issues as hyperactivity, behavior problems, poor social skills or affective disorders, have crucial selfobject needs that have been unmet (Elson, 1986). Elson (1986) discounts the notion of unruly drives as the root of these problems. She focuses on the failure of the child's selfobject needs being met, noting that the caretakers of these children have often experienced inadequacy of the selfobjects in their childhoods. Children presenting with such issues as dependency, anxiety, depression and other states of depletion often have disturbances in the cohesion of their self structure (M. Tolpin, 1971). Injured cohesion can also present symbolically in the form of phobias or sexually precocious behavior (Elson, 1986). The decision of whether to work with the parent and child together or focus on individual treatment involves "the nature and depth of the parental deficit, and the degree of cohesiveness in the self of the parent and the self of the child" (Elson, 1986, p. 79).
The understanding of the significance the child places on of therapist and other people in the child's environment as self objects "guide the therapist's use of himself in the treatment relationship with the child and also leads to interventions designed to correct or alleviate specific forms of empathic failure within the child's current self object milieu" (Young, 1988, p. 245). Young (1994), discusses using self psychology with children, both with and without parental involvement to provide understanding and self object functions, as well as to modify the child's self object milieu. He described the child's relationship with the therapist is "an opportunity to reactivate arrested developmental needs for mirroring, merger with an idealized source of strength, and twinship" (pp. 79-80). The therapist is seen, not as an anxious, unreliable selfobject, but as a selfobject that mirrors the need of the client to desire and work toward his or her own goals (C. Goldberg, 1993).
Therapeutic regressions can be seen when the client is overcome by feelings and is unable to access the defenses he or she normally utilizes. During such regression the client will say everything that comes to mind, relinquishing some control over speech. The regression interferes with "learned logico-cognitive thought processes and lessens the firmness of the self's boundaries, making them more permeable to empathic communications" (E.S. Wolf, 1988, p. 118). In particularly vulnerable people, severe regressions may become uncontrollable and progress to a psychotic-like state. A therapist who is aware of clients with extremely fragile self structures can take steps to slow the regressive process until the client has built enough defenses to access during periods of fragmentation.
Kaplan (1990), describes her work with an adolescent girl who did not have the support of her parents during treatment. The role of the therapist was to serve as a stable adult that provided necessary selfobject functions, consistency, reliability, and the provision unconditional acceptance. These functions were different from those provided by the girl's parents. The therapist allowed her warm feelings for the client emerge and the interactive process of sharing feelings had a positive effect on the client. It allowed for the experience of healthy interpersonal communication from which to use as a model for the client's outside relationships.
Anger in the therapeutic relationship is not viewed as the client's displacement of past feelings, but as a vehicle for exploration of his or her subjective experiences of feeling angry. The issue is the client's ability to "contain and regulate the affect of anger", not the ability to differentiate past from present (A. Ornstein, 1986b, p. 28). Kohut saw intense narcissistic rage, or intense anger in the therapeutic process, as serving the client's purposes of "communicating selfobject needs, narcissistic repair, revenge against negative selfobject experiences, restitution of selfobject bonds, the creation of a more responsive selfobject and working through a reevoked experience of loss or deprivation" (Patrick, 1994, p. 183). This is often expressed by the client's criticism or intimidation of the therapist.
Depression is approached from a self psychological perspective introspectively, focusing on the meaning of the experiences or thoughts that produced the feelings. Depression can be described "as reflective of an experience of something felt to be missing" (Palombo, 1985, p. 35). It is seen, not as a reaction to the loss of an external object, but from the emotional meaning of a sustaining relationship (Lewis & Lewis, 1979). Depression is understood as a "depletion of the self, associated with a deficit in the self or as resulting from an irreconcilable yearning within the self for a missing selfobject function" (Palombo, 1985, p. 33). The goals in the treatment of depression are correcting the state of depletion, when possible, depending on the specific dynamics of the individual and the illness.

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Transference and Countertransference

Kohut (1984) viewed the transferential relation between therapist and client as an interactive process where both therapist and client impact and influence each other. As they examine the failure of selfobject experiences and the effort at restoration, the therapist interprets the selfobject relationship between them. What is transferred is the expectation that the therapist, functioning as the "perfect" selfobject, will provide the client what was missed in his or her emotional development. (A. Ornstein, 1992). This two-dimensional view of transference is a central element of self psychology.
Idealizing transfer is a process conceptualized by Kohut (1971) as:
"the state, after being exposed to the disturbance of the psychological equilibrium of primary narcissism, the psyche saves a part of the lost experience of global narcissistic perfection by assigning it to an archaic, rudimentary (transitional) object, the idealized parent imago. Since all bliss and power reside in the idealized object, the child feels empty and powerless when he is separated from it and he attempts, therefore, to maintain a continuous union with it." (p. 37).
More simply put, this is the need to merge with someone who the individual believes will make him feel safe, calm and comfortable (Baker & Baker, 1987). Children attach themselves to the idealized parental imago, thus becoming able to cope with negative experiences and disappointments. As they experience success with this, they gradually integrate the idealized object with their own personalities and build up the necessary internal structures to combat conflict. This developmental sequence occurs in three stages; "a merger with the parent ideal, a deidealization of the idealized omnipotent selfobject, and a gradual building of internal structures which carry on the function with the archaic selfobject relationship with the idealized parent" (Kriegman & Solomon, 1985, p. 242). This process is seen in the therapeutic context as the corrective emotional experience of repairing the developmental task that was uncompleted in childhood.
Clients express a number of needs through the transferential relationship with the therapist, including wishes to be comforted, stimulated, admired, preferred and forgiven (Basch 1980, 1984). These needs are to be understood in both their present and archaic contexts. Self psychology stresses that transferences are not the client's confusion of the therapist as a parent, but the client's legitimate need for a new selfobject in the present to his needs for structure building (Elson, 1986).
Transference is the phenomenon that both causes and allows healing through the disruption-restoration process. The first stage in this course is resistance analysis in which the therapist must try to understand the client's archaic selfobject needs, how they are manifested as defenses, and what, if any, parts of the defense mechanisms are resisting using the therapist as a selfobject. The second step is the "spontaneous mobilization of the patient's selfobject transferences" (Wolf, 1988, p. 112). The client is still conflicted between the need for positive selfobject responses and the fear of the self being injured. The third stage is the disruption of the transferential relationship. The therapist inevitably causes a narcissistic injury to the client's self, which can cause anger, disappointment and other feelings that trigger archaic injuries to the self. Temporary transference regressions result from this as the client struggles again with needs for positive selfobject experiences and fears of being hurt. In order for the most positive out come to be achieved from the disruption-restoration process, the regression must be deep enough to loosen the self's structure without endangering it's cohesiveness. Transference is restored as the therapist explains and interprets the events that caused the disruptions and empathically responds to the client's feelings caused by that disruption.
When doing psychotherapy with children, the therapist needs to be perceptive of the parents' transference toward him or her. A parent may feel threatened by the relationship between the child and the therapist. Therapy is an hour of undivided, focused, positive attention that the child may not receive outside that hour. Many a child in therapy comes home saying, "I want to go live with my therapist", which can cause the parent to have a negative reaction to the therapist and the treatment (Miller, personal communication, July, 15, 1996).
Both transference and countertransference are important to the therapeutic process. Countertransference occurs when the therapist is fearful of narcissistic injury and emotionally defends himself against that injury (Kriegman & Solomon, 1985; Shane, 1992; E.S. Wolf, 1988). This can become problematic when therapists have their own needs for excessive mirroring, possible due to archaic needs. If the therapeutic content is frustrating, the clinician may regress to the point where he or she is unable to access empathy. This can occur when clients are so absorbed in their own needs that they fail to remember to interact with the therapist as a person.
Another possibility of the therapist's inability to be empathic is as a defense against the client's idealizing of him or her. Additionally, the therapist's personal life may be so stressful and frustrating that the overburdened self cannot function adequately in the session. A client who excessively needs selfobject experiences can evoke countertransferential feelings, as well. The phenomenon of countertransference can serve as a reminder to the therapist that he is just as vulnerable to the feelings the client has with the transferential relationship. Another self psychological view of countertransference views the phenomenon as a reaction by the therapist to the client's transference of expectations to the therapist. These expectations exert pressure on the therapist, which results in the countertransference reaction (Elson, 1986).

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Criticism

Critics of self psychology often cite the framework as attempting to "cure through love" and to "provide a corrective emotional experience", finding fault with "indulging in the patient's transference wish" by providing an "emotional echo or approval" (Wolfe, 1992). Greenberg and Mitchell (1987) found several problems with Kohut's model of self psychology. The authors note that while his theoretical model is similar to other relational theories, Kohut does not address these similarities and presents himself as if he were working in a vacuum. Kohut's description of the relationship between an infant and his primary caregiver resemble Sullivan's concepts. His emphasis of the effect of characterological disorders in parents on their children was previously noted by Fairbairn, Winnicott, Guntrip, Mahler, and Jacobson. Greenberg and Mitchell (1987) also note that Kohut's vision of emotional health is unattainable because it hinges on having perfect selfobject experiences in childhood. Kohut visioned the possibility of a world without conflict. Similarly, his views of healthy child development are unrealistic, as no person is able to provide perfect selfobject experiences. Another weakness of his theory is it's narrow interpretive focus, basing development solely on "narcissistic" issues in terms of idealization and mirroring (Greenberg & Mitchell, 1987).
Miller (1996) also found problems with some of Kohut's model of development and suggested changes to address the inconsistencies. Miller (1996) believes that infants are unable to have a grandiose self or idealized parental imago, because they are not yet capable of cognitively formed thoughts of attributes, which occur during the second year of life. While Kohut defined mirroring as admiration, Miller (1996) expands on this definition to combine admiration, understanding, and validation. Miller (1996) envisioned two types of admiration; elicited and unelicited. When a child is spontaneously praised for being cute or smart, this is unelicited. When a child says, "Look at me run.", this is elicited. Both types of mirroring are important for the child's development.
Miller identified the concept of an ambivalent selfobject, in addition to positive and negative selfobjects. An ambivalent selfobject is one that serves to maintain an individual's self structure by providing neither positive nor negative experiences to the self. A selfobject may be perceived by others to be nurturing and positive, but the individual's perception of the selfobject experience determines it's classification as positive, negative or ambivalent (Miller, 1996; personal communication, July 15, 1996).
Greenberg and Mitchell (1987), also criticized Kohut's theory of development, which is seen as a linear progression. The authors interpret the process of transmuting internalization as a move from "addictive dependence to resilience and independence" (p. 369). Kohut's view of an infant's anxiety is seen as a secondary process resulting from disturbances in the primary self-selfobject relationship.
Kohut refers to the mother as performing the mirroring functions and the father as functioning as the idealized parent. He did not mention the child's need to be mirrored by the idealized parent as well. His theory seems paternalistic, assuming that the father is the stronger, more protecting parent. While Kohut addressed parental abandonment and parental death, he did not speak of the many children who are born to single mothers without contact with the father of or infants without maternal contact. The abandonment of a child implies more than empathic failure, because a parent who is not present cannot "make things better".
Kohut also did not address the concept of negative selfobject functions. Children who are victims of the trauma of physical, sexual or extreme emotional abuse experience more than empathic failure, they experience assaults on their development. Miller's (1996) definition of selfobject, "the selfobject may either enhance the self attributes of esteem, continuity, power, image, and cohesion or diminish them", differentiates positive from negative selfobjects (p. 54-66). Children who experience a parent as a negative selfobject may also view that parent as a positive selfobject, as parts of the relationship may not be abusive or neglectful. A negative selfobject effect can result from transference or displacement, when current relationships or interactions trigger traumatic memories from another relationship, leading to fragmentation. This contrasts with Kohut's views of transference, which tend to focus on the relationship between client and therapist that is triggering unmet developmental needs.

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