Early Career Essentials:
A Self Psychology Canon for Early Career Professionals
A column by Flora Lazar, Ph.D., L.S.W.
When I was contemplating a clinical career after a long period in and around academia, I often worried about the "salvage value" of my former life. As it has turned out, the study of history is pretty good training for psychotherapy and psychoanalysis. But there are two things I really miss from my former life. One is admittedly pretty nerdy, the precision of footnotes in Modern Language Association (MLA) style, which require details not included in APA style. (All the better to challenge you!)
The other, with perhaps broader relevance in the clinical world, is the annotated bibliography. This common component of serious historical scholarship is an indispensable tool of the historical trade, helping to mark out the essential intellectual domain of various areas of history and the significant interpretive and methodological issues that arose in advancing new ideas. As an early career clinician, I miss jumping enthusiastically to the "Note on Sources" at the back of a work as I try to figure out how all the dimensions of clinical theory fit together. I amassed my share of class syllabi in graduate school and subsequent training. But almost none has had the evaluative power of annotated bibliographies I had grown accustomed to reading in many works of history.
I did not fully appreciate how indispensable these annotated bibliographies were to me until one was presented via voce quite to my surprise at the conclusion of a self psychology workshop I took last year as part of the professional development program at the University of Chicago. There, in a swift ten-minute tour de force, as some people were packing up their belongings, the instructor, Denise Davis, treated us to one of the most useful "orienting" exercises I have ever had on the self psychological literature.
In the spirit of recapturing that experience in writing, I asked several long-standing members of the self psychological community to identify a work or several works that were most influential to them in their early career and to explain why. Here's what I gathered:
Elizabeth Carr, APRN, MSN, BC
Given that I have been practicing for over forty years, going back to my first ten years and naming a publication that transformed my clinical work takes me directly to Heinz Kohut. In 1979, I attended a conference at UCLA featuring Kohut and I bought both The Analysis of the Self and The Restoration of the Self. Kohut is with me in every session -- his appreciation of developmental processes and his clinical wisdom. For a relative newcomer, I recommend Charles Strozier's Kohut biography, The Making of a Psychoanalyst alongside Kohut. Strozier's book can provide a kind of translation of some of the jargon Kohut used. A bit later in my career, Jospeh Lichtenberg, Frank Lachmann, and James Fosshage's book Self and Motivation Systems became important to my development as did Daphne Socarides and Robert Stolorow's paper, Affects and Selfobjects.
Denise Davis, L.C.S.W.
In "Affects and Selfobjects" Robert Stolorow and Daphne Socarides offer a very clear explanation of the self as an organizer of experience and underscore that it is affect that organizes experience. The authors emphasize the central function of the selfoboject in responding to affect states since affect integration is critical for the consolidation of self experience; affects that have not been properly responded to cannot be integrated, leading to disavowal of experience and vulnerability to self fragmentation. Their article includes an illuminating clinical vignette that describes a patient whose developmental experience with an emotionally unavailable mother left him feeling that negative affect was a dangerous sign of imperfection. In the treatment he fears expressing feelings that might cause the therapist to feel inadequate. The therapist's capacity to articulate, participate in, and organize the patient's affective world results in greater self-cohesion and a capacity to experience a wider range of affects.
By putting side by side a narrative of a classical analysis and a self psychologically informed analysis of the same person, Heinz Kohut in The Two Analyses of Mr. Z reveals how different theories simultaneously release and close off ways we tell about our lives. Ironically, the persistent detection of unconscious repression through interpretation seems to repress more than it reveals, while a more reflective approach adds complexity to the portrait and puts a landscape behind it. The paper leaves me with a certain awe and suspicion of the way theory, including self psychology, generates the stories we hold to be true. It has been a good talisman to keep in my pocket as I talk and listen.
Andrea Harms, Ph.D.
Reading Heinz Kohut's How does Analysis Cure? in1987 made it possible for me to leave classical analytic thinking for a self psychological approach. It was a true change of paradigm in theory and clinical work for us here in Vienna. Judith Guss Teicholz's Kohut, Loewald and the Postmoderns. A Comparative Study of Self and Relationship offers a great textbook for teaching and includes a very interesting history of self psychology, especially references to Hans Loewald whom we did not yet know very well. Although we did not read Robert Stolorow, Bernard Brandshaft and George Atwood's Psychoanalytic Treatment: An Intersubjective Approach until 1996 (in the German translation), we thought that the intersubjective perspective was a very powerful and most interesting new level of self psychological understanding.
Annette Richard, M.Ps.
In 1985, having just left a therapeutic cult and struggling to come to terms with my traumatic involvement in it, I came across Heinz Kohut's first book, The Analysis of the Self. Even though I did not understand half of it, it had a profound effect on me personally, giving meaning to my search for idealizing healing experiences which had driven me into such traumatic submission. Professionally, it opened for me a whole world of new understandings, which turned out to be boundless, of human development. And I am still learning.
Janna Sandmeyer, Ph.D.
Jule Miller's paper "How Kohut Actually Worked" illuminates Heinz Kohut's thinking toward the end of his life and juxtaposes self psychology with a classical analytic stance, in addition to providing a window into Kohut's personality and way-of-being with patients and supervisees. Because of its narrative style and structure, the paper is accessible, jargon-free, and rich with clinical gems that are unique to Kohut's way of thinking. Unfortunately, the clinical material has some aspects that are dated in a way that show psychoanalysis' heterosexist and homophobic history. I believe this paper is increasingly important in that regard because it mandates us to confront psychoanalysis' past and challenges us to offer correctives that value inclusivity and diversity.
Allen Siegel, M.D.
Of course there was never a sole work that was influential in my development, but if pushed to make the statement, I would have to say that Heinz Kohut's first published self psychological paper, "Forms and Transformations of Narcissism" would be the one. Published in 1966 during my psychiatric residency, where I was fully indoctrinated in the drive, defense, ego psychology that was the word of the day but which seemed two- dimensional and unknowable in my gut, I could not understand then what Kohut was saying. Even if I could not articulate it then, the work captured my attention and put me on the years-long path of requiring myself to learn and master what it was that Kohut had given us. It has been a sometimes difficult but wonderful journey that has brought me an understanding of the human condition that has affected both my clinical work in particular and my attitude toward life more generally.
Steven Stern, PsyD
The book that was most transformative for me in my early career was Christopher Bollas' 1987 The Shadow of the Object: Psychoanalysis of the Unthought Known. I found Bollas to be synergistic with self psychology. As I recall, it was self psychologist Ernest Wolf who first brought him to speak at the Chicago Institute for Psychoanalysis. In Bollas' first book, he was at his most brilliant, bursting with ideas, not least of which was re-envisioning the unconscious in relational terms with his concept of "the unthought known," which anticipated Robert Stolorow et al's "pre-reflective unconscious" a few years later. I found a kind of secular psychoanalytic spirituality in his early writing, and his ideas have continued to profoundly influence my own thinking and writing throughout my career.
The most important book that I read when I was a candidate in the early 1970s was Heinz Kohut's The Analysis of the Self. To appreciate its significance, I had to get beneath all the meta-psychological jargon to the groundbreaking illuminations of the phenomenology of narcissism and self-experience hidden therein. In particular, Kohut showed that the experience of selfhood and its disruptions are always embedded in a context of emotional interrelatedness. I regard this contribution to clinical phenomenology as much more important than the proposals for a psychology of the self in Kohut's two later books.
Judith Guss Teicholz, Ed.D.
The transformative power of Heinz Kohut's three books -- The Analysis of the Self, The Restoration of the Self, and How Does Analysis Cure? -- was amplified for me by a number of what at the time were additionally eye-opening books and articles. These included Robert Stolorow and Frank Lachmann's book Psychoanalysis of Developmental Arrests and Paul and Anna Ornstein's article "Clinical Understanding and Explaining." Equally enlightening for me, because of its affirmation, from another viewpoint, of all Kohut's ideas, was Daniel Stern's The Interpersonal World of the Infant and more recent version of this experience coming for me in the form of Karlen Lyons-Ruth's 1999 "Two-Person Unconscious: Intersubjective Dialogue, Enactive Relational Representation, and the Emergence of New Forms of Relational Organization." All of these readings together supported certain ways that I had been thinking and working, but until that point in psychoanalytic history had been unable to find external recognition or validating supervision.
Flora Lazar, Ph.D., L.S.W. has spent most of her professional life at the intersection of human services, research, and public policy. She is a graduate of the University of Chicago's School of Social Service Administration and works at Live Oak, a multi-disciplinary group of psychotherapists from all theoretical orientations, all engaged in trauma-informed, LGBTQ affirmative, multi-systemic, and multicultural practice. She is a student-at-large at the Chicago Institute for Psychoanalysis. An historian by training, Dr. Lazar is currently working on a revision of her doctoral dissertation on the development of the empirical tradition and the role of the university in American psychoanalytic education. She contributed to the writing and editing of Infant and Childhood Depression: Developmental Factors (John Wiley & Sons) and Infant and Childhood Depression: Developmental Factors (John Wiley & Sons) and Infant Depression: Paradigms and Paradoxes (Springer Science & Business Media).
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