We are very pleased to present “Self Psychology: A Contemporary Relational Perspective” by Estelle Shane as the first in a series of articles by prominent members of the IAPSP community on their very individual understandings and uses of self psychology. Dr. Shane, a former president and tireless supporter of IAPSP, is the ideal person to lead off our new eForum column. She was one of the original members of a Chicago-based study group led by Heinz Kohut – a group that evolved into the present International Council for IAPSP–and is a founding member of the Institute of Contemporary Psychoanalysis (ICP) in Los Angeles. One of the co-authors of Intimate Attachments: Towards a New Self Psychology, she has published numerous journal articles, edited journal issues, and presented papers at many international conferences. Dr. Shane is in private practice in West Los Angeles.

Self Psychology: A Contemporary Relational Perspective

by Estelle Shane

As I sit down to write this essay, reflecting on my current version of the self psychology I love and practice, it surprises me to realize just how often I’ve done this same thing over the years following the late 70s when I first fell in love with Kohut, and, particularly, how much my own perspective on what it comprises has changed, grown, and expanded. I think of self psychology, or at least my take on it, as an ever evolving approach to human understanding; I see it as a basic relational and intersubjective model of the mind that lends itself well to adjustments and revisions from within, as well as to current findings from infant studies, brain research, and systems understanding, and, importantly, to changing ideas integrated from other models of psychoanalysis. It is this openness to change, growth, and revision that maintains self psychology as a theory that can transcend its origins in time and place.

My latest experience of writing about self psychology as a contemporary model was in collaboration with Barry Magid when we conducted a Webinar for IARPP earlier this year. In the paper Barry and I wrote together as an introduction to that webinar, we examined what self psychology and Relationality can learn from each other. In this short essay I will extract some of the ideas about the contemporary relational version of self psychology that emerged from our effort. Taking off from the frame of Kohut’s basic model, I will address only the ideas from Kohut’s model that have been changed and expanded by virtue of its openness to influence from related scientific fields and other contemporary psychoanalytic models.

I’ll begin first with changes in the Self as conceptualized in classic self psychology. Kohut had insisted from the beginning that self was at the center of psychoanalytic understanding, and that this self was the locus of subjectivity present at birth and developing ongoingly from interactions with attuned caregivers. While self was conceptualized by Kohut as possessing an inherent internal design, a design that unfolded over the course of the individual’s life, in contemporary self psychology, self is no longer understood as a preformed psychic structure; rather, self forms over one’s lifetime as a fluid, ever-changing set of emerging capacities for awareness, attachment, and affect, origins consistent with the nature of an emergent self developing by virtue of ongoing, bi-directional interaction with its caregiving surround. This is consistent with what Kohut himself had conceptualized (in self-contradiction with his idea of self as inherent internal design) and consistent with what infant research has since affirmed.

I’ll turn second to the term selfobject. It is the functional, or experiential, aspect of the selfobject concept that is emphasized in contemporary self psychology, underlining the fact that the term was not meant by Kohut to refer to a person per se, but, rather, to that person’s provision of an essential, stabilizing, constitutive function, experience, or relation exercised for the self’s well being. While Kohut had always maintained that the term does not refer to a person, but, rather to designate that which provides a necessary role for the development, restoration, or stabilization of the self, in Kohut’s actual usage of the term he was imprecise, creating confusion in the psychoanalytic world about his own meaning.

And in any case, Kohut’s inspired creation of selfobject as a single word rendered typographically literal the self’s embedded existence, with the infant’s growing sense of the self, sense of the other, and sense of the surround all emerging together from within the self-other intersubjective system, again consistent with contemporary infant research and a systems sensibility. The self in contemporary self psychology, then, is not an inner structure, but a recursive pattern of capacities and expectations, a pattern located, not inside the person, but arising from within the system of the self-selfobject milieu. This systems concept facilitates the deconstruction of notions of internal psychological structures or internal objects. Our capacities for affect regulation and for self- and interactive regulation exist neither inside nor outside the self; rather, they arise, are constituted by, or fail, as a part of a self-selfobject unit. Self psychology has thus been increasingly clarified as grounded in languages of process rather than structure; dynamic systems rather than either internal objects, projections, or representations; nonlinearity rather than linearity; and the intersubjective rather than the intrapsychic.

Another feature of contemporary self psychology as opposed to classic self psychology is that unlike in Kohut’s original presentation of the self-selfobject unit, which was conceptualized in uni-directional rather than bi-directional terms, self-selfobject relations are more likely now to be conceptualized as bi-directional and intersubjective, although the self-selfobject relationship itself remains hierarchical in the provision of selfobject function.

Moving beyond these more current concepts of self and selfobject in self psychology, I’ll turn to empathy as another hallmark of Kohut’s self psychology, how empathy has been understood, misunderstood, and finally reconceptualized in contemporary self psychology.

It seems that Kohut’s original meaning of the term continues to be misunderstood, even in the contemporary psychoanalytic world. Remember that Kohut delivered his final talk in Berkeley in 1981, three days before he died. There, for one last time, he tried to clarify what it seemed that so many of his colleagues and critics continued to misunderstand: Empathy, he declared, is not compassion; it is not a positive or sympathetic feeling the analyst cultivates within herself; it is not merely feeling what the patient is feeling. Once again, from that podium in Berkeley, Kohut insisted that empathy describes a tool for data-gathering, a particular observational stance, one characterized by entering into and experiencing the world from within the patient’s perspective. Kohut was attempting to distinguish the empathic listening stance from an observational stance positioned outside the dyad, a stance that presumes to represent an objective, scientific view. From that external vantage point the classical analyst imagines himself to be interpreting to the patient what is objectively true, correcting the patient’s own inevitably flawed perspective, thus an entirely different perspective from an empathic one in Kohut’s terms.

That said, contemporary self psychologists do not only or exclusively listen and respond from an empathic perspective; rather, an empathic stance on the part of the analyst serves as a guide for selecting from among the wide variety of ways we may engage with our patients, listening and responding according to the patient’s different and differing needs as these needs are perceived in the moment. That is, the use of empathy does not preclude the analyst from observing and responding to the patient from alternative perspectives, as in Shane, et al’s (1997) terms, either listening and responding from a self regulating other perspective, or listening and responding from an intimacy sharing other perspective; or, in Fosshage’s (2003) terms, either listening and responding from an Other-centered position, or listening and responding from a Self- centered position. For example, the analyst may listen and respond from a self-centered position when he is assessing a patient’s potential for suicide. Or the analyst may listen and respond from an other-centered position when he is reflecting back to the patient what the patient’s partner may have experienced. But, and this is the significant point, listening empathically from within the patient’s perspective always and inevitably contextualizes our understanding of how we might best respond to our patient as we choose from among responses derived from an empathic mode, from an intimacy sharing mode, from a self-centered mode, or from an other centered-mode.

To repeat, It seems unfortunate that despite Kohut’s (1971, 1977, 1979, 1984) contentions to the contrary, many clinicians persist in misunderstanding what Kohut meant by using empathy as a neutral tool, continuing to believe that the self psychologist’s stance towards the patient is limited to kindness and compassion. Or some may continue to believe that empathy is the only analytic stance in Self Psychology. Or, finally, they may continue to believe that the empathic stance can only engage the patient’s conscious, but not his unconscious, experience. This seems paradoxical because, reading Philip Bromberg’s (2012) writings that have won wide and well deserved praise, describing how he, Bromberg, enters with neutrality into the varying points of view of his patients’ different and dissociated self states, we see the employment of empathy par excellence. Bromberg appreciates the legitimate perspectives of each of his patient’s self states, not presuming to preside over, or to choose among, competing positions. One such perspective may privilege, say, security from re-injury on the one hand vs. the potential for new intimacy on the other, and Bromberg remains neutral to each. Thus for Bromberg, just as for Kohut, the patient’s “unconscious” in this scenario consists of the patient’s hitherto unrecognized and unarticulated hopes and dreads when faced with new experience. How a person comes by their particular hopes and dreads is the work of analytic exploration, with the analyst proceeding in an inquiring, non-judgmental manner in self psychology, just as in Bromberg’s Relationality – or in any theory, for that matter that does not presume to know or to pre-judge the results of its exploration before it gets started, not knowing which of the choices that a patient may face is the “right” one for the patient to make. In this approach the clinician recognizes that taking an empathic perspective is addressing the patient’s experience from within the particular self state present in the moment, and preserving an analytic stance of self state neutrality, rather than choosing any correct way to feel, think, or perceive the world. It is from this empathic stance that the analyst understands (and sometimes interpretatively communicates) the needs and defenses of each self state. Whether the analyst adopts an attitude of non-intrusive reserve, attuned listening, or passionate engagement is determined only by the analyst’s assessment of the apparent needs and requirements of each (often shifting) self state of the patient as perceived empathically (not sympathetically, not kindly, but as extracted from the patient’s perspective) by the analyst at that moment in time. Theory does not dictate the response. Empathy thus offers the analyst the means for assessing what, for a particular patient in a particular self state, “counts” to that patient as feeling held, heard, or responded to. This recognition of empathy as a mode of self-state neutrality builds an important conceptual bridge between Kohut’s cohesive self, and Bromberg’s and other Relationalists’ models of multiple self states.

This understanding attributed to the contemporary self psychologist depends, of course, upon an acceptance of the usefulness of the concept of multiple self states, a concept necessary to the self psychologist’s clinical work with trauma where dissociated self states are clearly present in the traumatized or abused patient (Shane, et al, 1997, Shane, E 2006),. And parenthetically, this begs the question, how close is Kohut’s language of “fragmentation” to Bromberg’s (2012) and D. B. Stern’s (2004) concepts of “dissociation?” When Bromberg speaks of the goal of analysis as being to replace dissociation with the ability to hold conflict, he can be understood, in self psychological terms, as describing a self with sufficient cohesion to withstand the tensions of conflict without fragmenting. And so when Bromberg talks about normality in terms of feeling like one self while actually being many, can that not be seen as akin to the experience of self cohesion in self psychology? Kohut writes that conflict is not pathogenic in itself; it is only when the degree of conflict is so severe that a state of fragmentation ensues that conflict is considered pathogenic. Can these, then, not be understood as virtually parallel concepts?

Circling back to the concept of empathy, I will take up the conceptual complication engendered by Kohut when he spoke of empathy as being both a mode of observation and an agent of healing. That is, in that same final talk in Berkeley, along with the protest he made about not being understood, Kohut (1981) also confronted, more or less directly, these contradictions in his writings and his own ambivalence about them. While contending, on the one hand, that empathy is fundamentally an observational stance, he at the same time acknowledged that empathy carries, in and of itself, a healing function. Contemporary self psychology still struggles to balance these two visions of empathy embedded in Kohut’s (1959) writings: that is, the vision of empathy as the analytic stance of “vicarious introspection” (p. 459), and the vision of empathy as imparting an invaluable and reparative feeling of being understood. Perhaps the confusion is reduced when we, as contemporary self psychologists, conceptualize feeling understood as a selfobject function in itself, one that serves to stabilize, organize, and regulate self experience. From this standpoint, we might say that empathic interpretations function by helping a patient to map his experience onto an organizing, meaningful, narrative grid. Rather than functioning to uncover what has been hidden, such interpretations enable the patient to make sense of something the potential for which, or the essence of which, had always been there, but had remained unknowable, perhaps, in D. B. Stern’s (2004) terms, heretofore unformulated, or in C. Bollas'(1982) terms, heretofore the unthought known . What had been quite literally unspeakable might then be put into words by this healing selfobject function of empathy, not directly recognized by Kohut.

To continue, respecting the developmental legitimacy of the patient’s emergent grandiose self experience, and maintaining a respectful, helpful, non-intrusive presence, might, consistent with Kohut’s teachings about the classical selfobject transferences, indeed be sufficient. But the evolutionary perspective of Slavin and Kriegman (1998) as they consider “why the analyst needs to change” (p. 247), reveals that many patients require a far more actively engaged level of responsiveness than is conveyed by mirroring or idealizing alone.

As Slavin and Kriegman (1998) have written, deep analysis of the patient, particularly the traumatized patient, often forces Into the analyst’s awareness pathogenic issues that the analyst believed had been resolved heretofore in his own analysis. Or perhaps issues that had always remained dissociated in the analyst’s mind are catapulted into his consciousness as they emerge from within the mutually interactive system he is engaged in with his patient. These unwanted thoughts and feelings may, and too often do, interfere with the satisfactory resolution of the patient’s pathology. The analyst must change, then, in order that the patient may be helped, Slavin and Kriegman aver; the analyst must explore areas of trauma within himself, integrate dissociated areas into his full consciousness, fully expand his awareness, and successfully address his conflicts so that both patient and analyst can move forward and achieve resolution. Analytic work that demands from the analyst his own engagement in the change process obviously goes beyond and requires more for cure than what Kohut had foreseen in his theory of Self Psychology, requiring the expansion of Self Psychology into its more current contemporary form.

That being said, Kohut had always understood that analysis was a developmental process. What is added here in the repertoire of the contemporary self psychologist is that analysis is a developmental process for the analyst as well as for the patient (Shane, et al, 1997; Shane, E. 2006).

Moreover, within the framework of contemporary self psychology we can comprehend an additional formulation: the patient’s urgent need is not just to have his feeling understood; it is also often to make the analyst feel, along with him, what he himself is feeling, to render the analyst just as frustrated, angry, confused, or aroused as he is. And it is vitally important that the analyst can tolerate, and show that he can tolerate, those same feelings. The analyst can do this in part because he can imagine a different outcome, not a repetition of the disruption of vital selfobject ties by unacceptable or unbearable affect, as the patient himself is prone to dread, but instead, the analyst can imagine a positive new experience for the patient (Shane, 1997, 2006). The analyst thus both models, and, in serving a selfobject function, enables, the patient’s capacity for containment of affect. Envisioned in this way, that the patient’s experience of having a visible impact on the other constitutes for the patient an added dimension of feeling understood, permitting the Psychologist to perceive and accept such transference phenomena.

Another significant expansion of self psychology comes with the integration of a systems sensibility, particularly the many contributions of Intersubjective Systems Theory of Stolorow and others (e.g., Stolorow, 1995; Stolorow, Atwood, & Brandchaft, 1994; Stolorow, Atwood, & Orange, 2008). They offer, to begin with, correctives for Self Psychology. For just one example, Stolorow argues that Kohut’s concept of empathy is pervaded by an isolated mind doctrine that bifurcates the subjective view of the person into inner and outer, so that the mind becomes pictured as an objective entity looking out at the world from which it is separated or estranged. For Kohut, vicarious introspection is required to bridge the gap between the two isolated minds in the analytic situation, but in Stolorow’s world, such bridging is not required as the two minds are not isolated from one another to begin with; they are always already connected to one another in the system the share.

Further, Brandchaft and Stolorow (1984) have expanded the range of self-psychological empathy and clinical effectiveness by suggesting that the so-called borderline personality disorder may be more helpfully understood as an iatrogenic byproduct of the analyst’s failure to provide necessary empathic attunement in the clinical setting. Chronic misattunement, in their view, leads to characteristic fragmentation and negative transference configurations. Thus the so-called intrapsychic pathology of the borderline may be perceived more accurately as a pathogenic consequence of the analyst’s malattuned treatment of the patient, a disruption in the dyadic system. This conceptualization of the “borderline personality” as a byproduct of the breakdown of a stable selfobject milieu is a landmark in systems and relational theory and important to contemporary self psychology. The consequences for treatment are clear: individuals who had been perceived previously as treatment resistant might emerge from an apparently unmovable negative transference once they were provided an empathic treatment milieu wherein an idealizing transference is allowed to emerge.

A further new perspective offered by Intersubjective systems theory to contemporary self psychology is the concept that the theory embodies two distinct levels of discourse, the theoretical/explanatory level and the phenomenological/subjective level, making it possible to accommodate clinical concepts perceived as useful that are derived from any psychoanalytic perspective within its reach. On the theoretical level of Intersubjective Systems Theory, a systems understanding is unvaryingly maintained, with the focal point of interest always the dyad, not the individual, and with the self conceptualized as always already inseparable from the other in a system of mutual influence. At this level, one cannot say who does what to whom, or where a particular thought, feeling, or emotion has originated: Self and other are unified.

On the phenomenological/subjective level, on the other hand, the individual’s subjective world of experience is the focal point of interest. In addition to the particular self psychological assumptions and concepts introduced by Kohut (1971, 1977, 1979, 1984) and elaborated by others following him, the clinician can also integrate formative ideas from alternative theories when these ideas are seen to enhance one’s clinical perspective in the moment. Thus a systems model offers a wide range of options for the psychoanalyst, allowing him to individualize the treatment to suit the needs of a particular patient at a particular moment in time.

I’m afraid that in writing about contemporary self psychology I could expound without end, but space requires that I leave a good deal of importance both unsaid and unreflected on. Suffice to say now, first, that what I have written emerges from the far longer paper that Barry Magid and I had written for the IARPP plenary earlier this year; and second, to summarize: Self psychology, informed by dynamic systems theory, attachment theory, and infant research, and expanded and revised by current ideas stemming from intersubjective systems theory and Relationality, offers a fully relational, contemporary theory and model of mind, of transference phenomena, and of therapeutic action, that admirably serves the needs of the clinician in the pluralistic world of today.