Chapter V

From Heinz Kohut: The Chicago Institute Lectures
Edited by Marian Tolpin and Paul Tolpin

January 1975

Revised July 1991

[This lecture deals with aggression and masochism; the casebook, ed. A. Goldberg was being written during these lectures]

Kohut: Well, I have a few questions left over from last time – shame and guilt, masochism and transference. There are other topics too but I think I’ve more or less discussed them. Any others?

Candidate: My question was about shame, guilt, masochism and in a way I would like to state it even more broadly. I’m hazy in my thinking about them and about relating them to the whole question of aggression and the question of the meaning of aggression as a drive, what are its object-related and narcissistic aspects, and how does one deal with it clinically. What popped to mind as I was saying this is a recent paper on transference in which the author says that many analysts don’t allow the emergence of real negative transference, the murderous hostility that has to come up. So the whole issue about aggression as it relates to masochism and as it relates to guilt and shame are ones that are very much on my mind.

Kohut: Well, these are all excellent topics. The issue of aggression, in particular, is a very important one, especially when we look at it in its relationship to much more broadly based issues as instinct theory, narcissism, and, above all, Freud’s theory of paranoia. As long as I can remember, the issues that are involved here have almost always led to a polarization of views of analysts. In other words, there have been two groups of emphases and preferences, both on the theoretical level as well as on the clinical therapeutic level. The best known of these dichotomies has been the opposition between what is generally considered the mainstream of analysis, on the one hand, and the Kleinian school and its various off-shoots, particularly in South America, on the other. I understand, by the way, that the Kleinian influence is now fairly great in some areas of the West Coast, particularly around Los Angeles, and also that there are quite a few analysts in Europe who are more or less influenced by the theories of Melanie Klein.

When one talks about primary aggression or aggression as a drive, you immediately get into the whole issue of the definition of a drive. To begin with, I see no possible way one can doubt that aggression is a biological given. After all we are born with an apparatus for aggression: we have nails and teeth. And, Psychologically we develop angry fantasies. And sociologically there are murders, and there are wars. Aggression is a fact of life. There is no question about the ubiquity of these phenomena and no question about the inherent nature of man’s aggressive responses. In addition, from the point of view of depth-psychology, there is no question that introspective-empathic observation of the aggressive states, that are perhaps most easily observable – the phenomena that I have referred to as chronic narcissistic rage – supports the idea that aggression has a quality of drivenness, that it is experienced as a continuing urge. There may, furthermore, be an object to whom the aggression is directed; the urge can be focused on a specific human target. There may be a revenge motive, for example, and there is a set of actions you want to perform, and maybe after it’s done, after the aggressive urge has led to certain actions, there may be some kind of a relief. So we are dealing with an inner state experienced as drivenness. I have always preferred to think in psychological terms when formulating a psychological theory – this is the way I think a psychoanalytic theory ought to be. A drive in such a theory is simply a generalization of inner experiences that have a driven quality. From the biological viewpoint there is little to add to the fact that, as I said, there is a pre-formed set of physical tools (muscle, nails, teeth) which subserves this drive-like psychological state as an executive apparatus. But having acknowledged all that, we are a long way from understanding the psychological phenomenon of aggression as in fact it does occur in people. Is the baby born with a need to be aggressive – with an urge to discharge aggressive energy – in the same way that he is born with an appetite to feed himself? Should we think of man as in need of a periodic outlet for the aggression which otherwise accumulates in him, or is it more appropriate to speak of his having to respond aggressively with the aid of a congenital apparatus on the basis of specific psychological constellations which are activated by various internal and external stimuli? It is very difficult to know how other analysts think about these issues; they may not be very clear about them, or they may not be open about their opinions. Most often they do not take their thoughts to a final clear conclusion the way Freud did at least in one respect. Freud, as you know, finally assumed that aggression was parallel to libido: that an urge toward death was part and parcel of life, just as the sexual drive is. But Freud remained unclear about the position of aggressions as they actually occur in life. He gave us his beautiful theory of the two parallel, basic biological drives, of Eros and Thanatos. [Freud applied his theory of aggression clinically to the eighteen year old he called a homosexual woman, S.E., p. The case is rarely cited. Neverthelss many formulations that are part of ego psychology and object relations re. aggression derive from this case history – another of Freud’s failures with an adolescent, see J. Glenn, ed. 198] But that does not explain the fact that aggressions clearly serve the life instinct, are used in the service of the libido, and are used in order to obtain one’s libidinal goals. How does this fact jibe with Freud’s basic biological theory?

So far as Klein and the Kleinian schools are concerned, I believe they are essentially of the opinion that aggression is primary – a drive in the psychological sense. Their opinion is that the baby is born with a primary wish to destroy. But even at the very beginning of life, they think, there are psychological complexities that cannot be accounted for simply in terms of the urges of a particular basic drive. The Kleinian school asserts, therefore, that from the very beginning there are conflicts – in particular that the baby experiences primitive guilt, and primitive despair about the wish to destroy the source of pleasure. It is the concept of a kind of original sin in the baby, and some archaic trend to expiate for it. I think such seemingly clinically oriented statements as the technical advice that the analyst must not only allow the negative transference to emerge, but that the patient’s aggressions must be allowed to unfold freely in the transference are really, overtly or covertly, connected with the theoretical conviction that aggression is a primary drive. If aggression is seen as a primary drive then there are certain logical consequences with regard to its developmental fate and to the way it is confronted in therapy. You can build up structures to contain it, you can build up structures to sublimate it, you can build up structures to inhibit it. In therapy we “say” to the analysand that your drive is there somewhere, and now you have to learn to expose it, and when it is exposed you must build up ego structures to master it. If one accepts this kind of concept of aggression, in other words, one is also led to conclude that a push towards ego development will be the appropriate analytic direction vis-a-vis that set of phenomena that we conceive of as a manifestation of an aggressive drive. As I said, in the Kleinian school and in some of its off-shoots, this is indeed what happens. As far as I can tell, there are very, very long analyses in which over and over again the patient is exposed to aggressive urges and to fantasies about the guilt he consequently experiences about them with the hope, I suppose, that finally the fully exposed aggressions will find their match in sublimatory and inhibiting ego structures which have been built up.

Now if one does not hold this opinion about the existence of a primary aggressive need, that does not mean that one does not allow aggressions to come to the fore in the psychoanalytic situation. The mode, however, in which one sees it when it comes to the fore, and the attitude one has towards its emergence, will of necessity be very different from the way in which these phenomena are seen and from the way in which they are handled by those who feel that the emergence of the aggression itself is the ultimate step. Obviously – regardless of whether one believes that there is a primal need to be aggressive and a deep drive to be destructive, or whether one doesn’t hold this view – one will recognize not only that there are aggressive impulses, aggressive attitudes, and aggressive fantasies, but also that some of them are hidden away and need to be brought to light – that they must be brought into consciousness so that they can be dealt with. Yet the way in which the analyst will look on the aggressions when they do emerge – how they will be basically understood, the way the analyst will urge the patient to display them, to be open about them, all of these essential attitudes which are part of the analyst’s total response and part of the feeling tone in which the revealed aggression will be discussed and investigated by him – all this will be very different when he, as in the case with me, has the conviction that aggression is not the expression of a primary need to destroy but a specific reactive response to specific experiences. In other words if left alone I do not believe that people would develop great urges to destroy, even though they have the capacity to respond aggressively. I think that the aggressive urge, with its quality of drivenness, that this drive toward destructiveness, that these aggressive fantasies are always mobilized for specific reasons. The aggressive urge always arises under very specific psychological circumstances.

In general, I believe, that psychologically speaking, drives do not originally occur in pure culture – this is an important point to keep in mind – and this holds true especially with regard to the aggressive drive. I think that the experiences of the baby are compounds right from the beginning – albeit relatively simple ones; they are not isolated drives. I think that to believe that the drive is the primary psychologic constellation is a conceptual error. It is as erroneous as would be the assumption that the basic units of biological development are inorganic elements. The primary units may indeed be comparatively simple biochemical molecules but even the smallest child’s body is not composed of inorganic elements. I think that the same holds true for the basic chemistry of our psychology. Even the simplest psychological units are complex constellations in which one might conceptualize the drives as having an integrated position – like the atoms in the structure of a more or less complex molecular group. Although drives, therefore, do not by themselves constitute the primary psychological units (just as atoms do not constitute primary biochemical units), their participation in the compound that does form the primary unit will influence the nature (e.g., the specific action propensity) of the unit.

The phenomena that we have tended to identify as drives in adults are generally disintegration products. And even the “drives” we see in children and infants are disintegration products; they appear as the result of the breakup of more or less complex psychological constellations. To return now to our starting point: aggression, in particular, is from the beginning but one factor in an already complex psychological structure in which it is imbedded.

From the very beginning aggression serves an important function in the delimitation of the self [see, for example, Spitz, 195 on psychic organizers, particularly being able to say “no”]. But that is not its only function. It also functions from the beginning as a tool which helps the infant get responses from the self-object. As I see it, the early psychological attitudes of a baby are misunderstood when seen within a theoretical framework which suggests that one separate, individual unit is interacting with another separate, individual unit. [Kohut’s statement here can only be understood in connection with parental selfobject functions, otherwise he appears to be talking about the self and object merger into a state of oneness that is part of object relations theory] At the beginning of psychological life we are dealing with a world in which a “you” and an “I” are not differentiated. It is a world in which an empathic environment fits into the child’s needs and supplies what the child needs: nourishment, warmth, dryness, rhythmical stimulation – whatever happens to be required by the child. No doubt that the functions of an inherent biological apparatus enter into these early, simple, primitive constellations and help to maintain the empathic fit with the self-object who, in turn, must maintain the child’s psychologic equilibrium. The baby cries – and then the baby cries angrily when whatever needs to be done is not done immediately. But there is no original need to destroy; the original need is to establish an equilibrium. Now under normal circumstances the environment responds empathically to the child, and a satisfactory equilibrium is established, the tensions subside. With each delay of gratification there is an intensification in the child’s needs and an increase in the assertiveness of his demands as the urge to re-establish the previous equilibrium mounts. At the same time each delay promotes the differentiation between self and other. If there is no delay, if the self-object is 100% empathic as it were, there is no reason to differentiate it from the self [it is imposible to have a real-life situation without delay, unless the infant is held constantly, never allowed to cry, etc. This pathological situation was described by Greenson, R., 19 in connection with his treatment of a boy with a serious gender disturbance]. Only when there is delay does the baby begin to ask questions – if you forgive me this “adultomorphic” expression [developmental psychologists, including analysts like Daniel Stern made tremendous advances in understanding the infant’s “independent self” by designing experiments that put the “right questions” to babies.[see Stern, 19 THE FIRST RELATIONSHIP] I got what I needed yesterday, but I don’t today. So it cannot be all me, so I am not both the giver and the receiver. The baby begins to perceive that there is a part of the self that makes demands and there is another part of the self that doesn’t necessarily respond to the demands. Some differentiating border is gradually set up between these two parts of the self: the ultimately established self and the recalcitrant self that becomes not-self, that becomes “you”. Aggression, I would think, plays an important role in this differentiating process, in establishing the periphery, the borders, of the self. The self becomes established as a center of aggressively assertive demands. Aggressive assertiveness then contributes to the delimitation of the self. But as I said, under normal circumstances, given a reasonably responsive and empathic environment, these processes do not involve the fragmentation of the complex psychological constellation to a serious degree – there is no chronic dedifferentiation of an aggressive drive in the psychological sense. From what I can extrapolate on the basis of the reactivation of early self-self-object states in the analytic transference, no pure destructive urge arises so long as the environment is reasonably empathic and responsive. The pure culture of a destructive urge arises as a disintegration product when the environment is traumatically non-responsive, i.e., when the non-responsiveness transcends the limits one should expect for a parent vis-a-vis his or her child. When the environment becomes traumatically non-responsive, then the original, broader psychological configurations disintegrate and then you may indeed see isolated rage, the isolated indiscriminate wish to destroy and to kill and to tear apart because no empathic response is forthcoming. In other words, the way I see the issue is this: if empathy failures of the self-object environment are with non-traumatizing limits – optimal frustration of the child’s need for empathic responses – then there are minor swings in the psychic equilibrium of the child, manifested by an increase of the child’s aggressive assertiveness and healthy demandingness. If the empathy failures are of traumatic degree, then the complex psychological constellation breakup, fragment, and behavioral manifestations appear that can be referred to as motivated by an aggressive drive. The drive, in other words, is not a primary psychological given [hunger, for example, is a primary biological given; the ideation, emotion, content associated with it is part of psychology].

Speaking in biological terms, we will, of course, acknowledge the presence of a pre-formed apparatus (teeth and nails and muscles) that determines the specific patterns in which the continuum, assertiveness-aggression-destructiveness manifests itself. But the human baby is, psychologically speaking, not analogous to an adult beast of prey and the formulation that the baby is born with isolated drives and that he gradually learns to tame these drives, that this is the essence of acculturation, is erroneous.

Our theoretical conceptualization in this area – i.e., whether we believe that the baby is, or is not, born in essence as a bundle of drives – will decisively influence our attitude in the analytic treatment situation. Certainly, even if we don’t subscribe to the theory that the drive is the basic and primary psychological formation, if we are confronted with unconscious or preconscious anger our first step is to make conscious the emotional and the ideational context in which it is embedded. Certainly, furthermore, I am by no means denying the practical necessity of not just naming the experience but, in addition, of allowing the experience to emerge fully and to be consciously appreciated in all its ramifications. But then comes the decisive difference: once the experience has emerged, it is not dealt with in terms of how it must be contained, or educated, or sublimated. Rather, one responds first by analyzing the feelings of guilt that accompany the rage, and then by analyzing the origin, the given of the rage. First the guilt must be analyzed – it is explained as understandable because after all, the patient is destructive. But the analysis of the interplay between destructiveness and guilt must be understood by the analyst (and, in consequence, by the analysand) as a transitional task. The guilt must be lessened so that the patient can allow himself to grasp the deepest area of experience that becomes accessible: the genesis of the rage. The patient works through this aspect of the dynamics of his problems by learning to recognize the current causes of his anger as well as the genetic matrix from which it arose. This crucially important genetic matrix for later rage propensity consists of early failures in empathy from the side of the self-objects of childhood. These led to rage reactions in the past, and they continue to provoke the same rages in the present.

There is another point that affects the analyst’s attitude. It concerns a specific form of guilt in the analysand. This, often very severe guilt is derived from attitudes of the adults – usually, of course, the parents – by whom the child is most decisively affected. These parents become angry with and blame the child who overtaxes their ability to respond empathically to him. I have observed this dynamic sequence in the transference and have been able to reconstruct it many times from the remembered data of childhood. These patients had parents who for reasons of their own – one must not blame them for it, one should rather feel sorry for them – could not respond maternally or paternally to them. And they begin to hate their children, for their mere presence constitutes a demand they cannot fulfill. It is this hatred – this hatred which arises secondarily in the parents as a result of the narcissistic injury to which their children’s demands expose them that is the recognition of their severely restricted responsiveness – that then becomes part and parcel of the severe self-rejection and guilt that the children internalize. I believe you can see how the understanding of this fact will influence the attitude of the analyst towards the guilt of such analysands.

I will again stress then in order to prevent a caricaturing distortion of my work that the patient must first experience his aggressions as such in treatment, if he has not experienced them earlier. And when the aggressions first emerge we must not immediately focus on the genetic narcissistic matrix, i.e., the early unempathic injuries to his developing self, or of which they arose – that would be a short circuiting technique and it would be quite opposed to the working-through processes and to the correct analytic principle that we must permit the gradual flowering of psychological contents in the treatment situation. Still, once the patient has become aware of his aggressions and of his guilt about them, the essential goal is not that he must now learn to contain them. It’s true that for tactical reasons, sometimes one may have to tell the patient, “Come on now, we don’t know yet why you are so angry but first of all calm down a bit” – just openly and directly. If on rare occasions, this is necessary to do, we should do so without pussyfooting. We should state our admonishment directly. We will say: “Contain yourself, for your sake and for our sake. We want to continue the analysis. I don’t want to have to visit you in the penitentiary after you have committed murder.” I am speaking here in a light vein about something that can at times be a very serious matter which has to be handled in an earnest fashion. But these episodes are not the essence of analysis. The essence of the analysis is to show that broad assertive configurations have disintegrated and have become foci of hatred and destructiveness because the environment has seemed hopelessly unempathic. It is much more difficult for the patient to become aware of this essential cause of his present rage or guilt (or reactive masochism) than to accept the idea – already held up to him by the unempathic self-objects of early life – that he manifests a primary evilness, i.e., a primary destructive urge (which must be curbed), or sadistic (“oral,” “anal” or “oedipal”) impulses which he must control. From way back the patient responded to his parents’ unempathic attitudes towards him with destructive rage, and he has taken over the hatred of the parent towards him and now hates himself. The true recognition of the origins of his variously manifested, destructive attitudes evokes great resistances. True, in a vertical, split-off part of his personality, the patient may make insistent rageful demands that are obviously unreasonable. But at bottom this is a helpless rage – the helpless rage of a self, that because of early empathic failures, considers itself as incapable of obtaining what it has a right to expect. The patient rages and acts sadistically because he feels helpless vis-a-vis an environment that he experiences as unresponsive, because he is incapable of obtaining what he rightfully should obtain. This is not easy for the patient to see. It is hard for him to recognize what it was that triggered his furious rage – often some apparently trivial event in the present which repeated the broadly unempathic childhood environment. He arrives at the suburban station and his wife arrives a few seconds late to pick him up. He becomes violently enraged, destructive; he embarks on a chain of actions that lead to a whole evening, weekend, week to be messed up between him and his wife. Yet, at the same time, he is also totally unwilling to look at the event with a self-tolerant, understanding attitude. He blames himself – how can I become so crazy, so furious, how can I become so destructive? Isn’t it entirely wrong? And then the analyst has to be able to show him that, while these few seconds appear to be absolutely meaningless when evaluated as elapsed time, they have a deep emotional significance. And not only because of events in childhood, e.g., that the mother’s face did not light up when she looked at him. The wife is the same kind of a wife who instead of being there ten minutes ahead of time and looking forward to seeing her husband, regularly comes a few seconds late as an expression of her deeply frustrating emotional flatness. The patient’s rage, then, is to be explained on the basis of two sets of factors: (1) the fact that the wife-mother really frustrates the adult-child’s need for mirroring responses; and (2) the helplessness which he feels – the rage is a reaction to his impotence, to his incapacity to tell his wife calmly and firmly what he wants of her. These insights can be obtained only against great resistances. It is hard for the patient to acknowledge that there are psychologically valid reasons why he is so angry. It is only after that has been worked through innumerable times that he will begin to be able to tolerate the normal vicissitudes or the frustrations of adult life.

Well it’s an endless topic obviously and I could only give you the broadest outlines of my views on that matter. But I think I’ve described its essentials. Is there any more about this issue that you would like to discuss?

Candidate: Could you develop this whole question of self hatred and masochism further?

Kohut: Well, let’s see. Anyone else?

Candidate: The situation of the wife being a few seconds late triggers the patient’s anger. In the transference the analyst is always somewhat unempathic and the fury is unleashed at the analyst who is a few seconds late. Of course, you have been unempathic and you are like the bad mother or the mother who could not light up. Could you say something about dealing with and distinguishing between you and the mother at that moment in the analysis when you have been somewhat like the mother to the patient? Could you say anything about handling the transference at that moment, or handling the situation?

Kohut: This is where the concept of working through comes in. An analysis is kept in motion by keeping pathogenic conflicts optimally activated. That’s really all you need to do. You don’t cure the patient. The patient cures himself. All you need to do is to point out again the sequence of events that have happened. He expected something. He came in yesterday reporting something about a success. He reported it in such a way that you didn’t even hear that he reported it because he protects himself so much against frustration that he only implied it, and you were obtuse enough not to realize that. You talked about other things. The next day he is hurt, furious, aggressive; he has killed you during the night. Then comes the point when you say, “What happened yesterday that created this set-back?” Then in the course of the session you realize it. Yes, this is what happened. This repeats what happened in childhood. You need say no more [sometimes you do need to say a great deal more]. You don’t have to say you’re sorry, you don’t have to say next time you won’t do it anymore, you don’t have to say this was beyond your limitations and that naturally you can’t fulfill them. None of that is necessary. The patient can figure all that out just as well without you. Such moralizing on issues fills so many analytic hours because one doesn’t know how to do the real thing. It doesn’t do so much harm probably so long as there is enough of the other more essential things there, too. The really important thing is only to repeat the essential conflicts over and over again – to make them conscious, and to explain them in their broader context. And in working them through, over and over again, in the dynamic transference situation, in making the genetic content connections with the past, new structure is developed. An increased, expanded mastery is achieved. It goes in a particular direction depending on each individual. It may go in the direction of enabling the patient to influence his environment to give him more. It may go in the direction of the patient’s being satisfied with less. It may go in the direction of finding substitutive satisfactions of all kinds. But the patient makes all these moves – education, admonishment, etc. from the side of the analyst is only rarely needed. The analyst’s work is to keep the conflict active [Kohut’s HOW DOES ANALYSIS CURE, 1984 elaborates extensively on these issues].

Now, when we speak about the issue of masochism and the issue of masochistically elaborated guilt, the question arises first of all whether you are talking about sexual perversion or about non-sexual masochistic attitudes (such as seeking punishment, defeating oneself, self punitive actions). What did you have in mind when you spoke about masochism? It’s a broad topic, since masochism is everything that aggression and destructiveness are – but with a negative twist. What did you have in mind?

Candidate: I personally was thinking about the question of self destructive attitudes and not the masochistic sexual perversion. Although I think in asking my question I want to understand why the former are so labeled. I take it that it isn’t by chance that both have been called masochism and that there is some relationship between the two.

Kohut: Yes, well, you see when you speak of masochism, or of self-defeating attitudes, generally you are already speaking about them on the basis of a certain dynamic theory. That is the theory which says that there are aggressions of a destructive nature about which the person is guilty and on the basis of that guilt he defeats himself. He cannot succeed. Now I believe that such instances do occur. How frequently they occur is hard for me to evaluate. Those are instances that most likely do occur as a outgrowth, as a reverberation of comparatively late psychological stages of development in childhood, of intense competitiveness, for instance, in the oedipal situation. There is an inhibition of the steps to success in order not to harm, or hurt a beloved rival – that is, the also beloved rival, the ambivalently loved and hated rival. I think such instances do occur. But I think they are much less frequent than has been assumed.

You know it is very, very difficult in psychoanalysis – just as in other branches of sciences and, as a matter of fact, in life in general – to escape from one’s theoretical biases. If in the treatment of a patient with a work-inhibition, you assume from the beginning that the patient cannot work because he (or she) is afraid of beating out his father, or her mother, or whatever the case may be, and that, therefore, out of guilt vis-a-vis success he cannot allow himself to work and therefore doesn’t mobilize himself to work, then you will see a lot of instances of masochism and self defeat in everyday life and in your patients.

Now you can say that if I think that most work-inhibitions are not based on this particular kind of internal conflict, and that all I am doing is shifting from one bias to another, from your bias to mine, but let me explain how I would here see another possibility. It is true, of course, that I believe that most instances of work inhibition (now I am using work inhibition as one of a number of possibilities in a broad, masochistic, self-defeating attitude toward life), are not due to the masochistic dynamics that I described but that they are of another type. These work inhibitions, I believe, are not due to an unsolved conflict about a deep wish to win out against a rival. They are the result of some deep-going, broad, diffusely insufficient cathexis of the self. The individual, therefore, feels unresponded to, he lacks self confidence, he does not have an ebullient initiative, he lacks that sense of the right for success that comes from self acceptance which in turn comes from the acceptance which in turn comes from the acceptance of him by an empathic environment that from the beginning was pleased with his maturation, with his beginning independence, with his successes. I am sure that most of you are familiar with the self consolidating environmental factors that I am referring to here. I am talking about a mother who is pleased about her child’s phase-appropriate development though it means that the child is moving away from her. I am talking about a mother who responded not to isolated fragments of the child (to his “drives”) but was able to respond to the whole child, was pleased with her child’s independent development.

So what does all this lead us to? If many instances of lethargy, working difficulties, chronic depression, self-defeating masochistic attitudes and so on are indeed due to self-pathology, then formulations interpreting these symptoms as being inhibitions due to oedipal rivalry will be in error. Such interpretations will not help the patient expand either his grasp of himself or his self-empathy, and they will not increase his ability to renew his abandoned childhood search for the response of others – self-objects – who can supply him with self esteem until he can ultimately supply it for himself. An interpretive approach based on these erroneous conceptions will, in other words, not mobilize the development of the patient’s self-confidence.

Now you ask, as I have asked myself many times, whether this is not simply another bias. Am I not seeing everything my patients tell me in my way – as self-pathology while other people are seeing everything their way, Freud’s way – as oedipal pathology? How is one to get out of this impasse?

Well, there is a way of getting out of it. The principle for all of you – as it is always for me – must remain the following: do not be swept away by an aha-closure when you have an insight, when you suddenly come to the conviction that you have understood something. Instead try to achieve other empathic closures – collect as many alternative explanations for a clinical situation as will possibly fit. Then, with the background of the various alternatives in mind, observe the clinical material afresh – over and over again. Observe the responses to trial interpretations, for example, or simply sit back and observe the further unrolling of associations in relation to the various interpretive comments you have made. Finally, in the long run you will make up your mind as to which interpretations are confirmed, which are the correct ones. There are no short cuts. There is no other way. If people claim that I’m biased, that I close myself up to other views and see everything only in light of my own theories – I’m afraid I have no defense against that except to say that I know it isn’t so. Over and over again, and for long stretches of time, I tried to interpret what I saw with the aid of the structural model of the mind – and I still do try that when I treat a case of narcissistic personality disorder, to be sure that I am not overlooking oedipal conflicts.

Let me share an interesting experience with you. A group of colleagues and I are working on a casebook [THE PSYCHOLOGY OF THE SELF: A CASEBOOK, Ed., A. Goldberg. NY:IUP] a volume describing the analyses of various cases of narcissistic personality disorders. Among the cases that will be in this book are several that I supervised six, seven, eight or more years ago. And I am now dictating those supervisory notes from that particular period. At the same time the person who treated the case is writing up the case, basing himself on his notes. We each work independently. We have a whole technique of how we go about that. But what is pertinent here and what is fascinating for me to see about myself is how I then struggled to see things in terms of the oedipus complex, how I tried over and over again to see things in terms of a structural conflict, and how I finally came to the conclusion that in case after case it didn’t work. When a patient says no to our interpretations, to our total approach of him, let us listen to him. Maybe he is right and we are wrong. But we will be able to discover the truth only if we have an open mind. Many a time, even now, I see the material one way, in oedipal terms, and it turns out to be the other. Or it is the other way around. And then there are undoubtedly still further possibilities that no one has thought of yet. There is no short-cut, there is no easy answer – but we must always attempt to be honest with ourselves. We must all learn to play the devil’s advocate with ourselves and our explanatory convictions. We must attempt to see a variety of explanatory possibilities – not one way, but two – we must see three ways, four ways, etc. The more the better. And then we must listen to the material. But we must not forget that patients tend to comply. If you overwhelm a patient with an overwhelming sense of conviction then he will agree with you. But if you are wrong without conveying the conviction of being unassailably right then the patient will complain and tell you that you are wrong – not because he is resisting but because he was in fact misunderstood by you. If one sticks to the conviction that what one is seeing is organized in a certain way, that certain established concepts must be used to order the data of observation, and if one then formulates explanations of the patient’s thoughts, feeling or behavior and communicates them to the patient and if then the patient says no, then what else can one’s conclusion be but that the analysand is resisting, that he doesn’t want to see something about himself that is “really” there. But, in fact it is like the old joke: heads I win, tails you lose. We have loaded the dice; it doesn’t work.

Now of course there are resistances. But I believe that the skilled ear can differentiate them from an analysand’s legitimate complaining that he has been misunderstood. I think that we can learn to hear the genuineness in a patient’s complaints when he tells you that what you have said wasn’t right, that it didn’t fit. And we can learn to differentiate these disagreements from the fights a patient will put up because something you said was just too painful to hear.

But now let me come back to something that I mentioned a little while ago as a kind of footnote. When we speak of lack of empathy in the child’s environment – whether it is from the side of the mother or father or of a variety of individuals who take care of the child – we do not mean the absence of gratification. Gratifying a child’s wishes is not equivalent to being empathic with the child. The erroneous idea that empathy leads to gratification is based on the mistaken conceptualization of the child as a bundle of drives. Under normal conditions there are no pure drives even in the infant. From the very beginning of life, drives should be seen as constituents of broader psychological constellations. From very early on what a child needs is empathic responses to him as a self (or at least as an anticipated self). Not to his drives. Every time mother gives milk to the baby, she is feeding her hungry child – she is not feeding a drive. A mother, an empathic mother, an empathic, mothering environment never responds to a drive, it responds to a child.

When we analyze adults who suffer from narcissistic disturbances – individuals who make incessant demands for gratification – we may get the impression that they had been spoiled as children. We reason: there was continuous drive-gratification, so these people became fixated on their drives and that is why they became sick. But that’s not so. They didn’t become fixated on the drive because they were spoiled, because of drive-gratification. They became fixated on drives because their budding selves were overlooked, were not responded to. They turned to drive-gratification (and later remained fixated on it) because they tried to relieve their depression – they tried to escape the horrible feeling that nobody was responding to them. Such individuals may have had mothers who satisfied their drives continuously, yet failed to respond to the whole child who expected mirroring responses – they failed to respond with pride and pleasure to the child’s increasing independent self.

I saw this clearly in the case of a fetishist who as a child had become fixated on certain tissues – soft, silky tissues with a nylon sheen [see Kohut, in Search]. Already as a young child he had used these materials while masturbating’ and he, himself, felt that his endless masturbation was an outgrowth of maternal indulgence. “I was always spoiled. My mother, and my grandmother doted over me. They gave me everything. Until finally I had to have an enclave in my life which continued my early childhood paradise. And this enclave is my fetish.” That was his own initial explanation for his fetishism early during the analysis. It was against the greatest resistance that we began to recognize late on that this marvelous mother and this marvelous grandmother were seriously disturbed people who had no idea what a child was all about. They never responded to him as a whole, active, vigorous, assertive child, but at the first sign of any assertiveness on his part they put a pacifier in his mouth or gave him something soft to touch so that he would leave them alone. And when he later turned to his father, he failed him too – that is another story that I cannot elaborate on here, even though, in the pathogenesis of narcissistic disorders the failure of the other patient is of crucial importance.

But our time is up for today. It seems that I see some puzzled faces. And I am interested, of course, in knowing what the puzzled expressions mean. But we shall leave it at that and let the puzzlers puzzle for a couple weeks and then in two weeks will try to answer the questions that have yet remained unanswered.