Self-psychology

Self psychology is a school of psychoanalytic theory and therapy created by Heinz Kohut and developed in the United States. Self psychology explains psychopathology as being the result of disrupted or unmet developmental needs. Essential to understanding Self psychology are the concepts of empathy, self-object, mirroring, idealising, alter ego/twinship and the tripolar self. Though self psychology also recognizes certain drives, conflicts and complexes present in Freudian psychodynamic theory, these are understood within a different framework.

Heinz Kohut started out with an idealizing image of Freud and his theories, but with self-psychology, he ended up going back to the roots of psychology, viewing therapy as a "talking cure" rather than an analytical process. After almost a century of conflicting, but working, theories of the mind, Kohut argued that what made therapy work, was more about the patient, than the analytical theories. To make therapy work, one needed to address the patient's self.

Self
Kohut's concept of self, and "defects" in it, is the core variable of self-psychology, where for instance superego/ego/id and oedipal conflicts could be considered to be the core of Freudian theory. The self is thought to be an adaptable structure, with a static core, defined in early life.

Psychopathology is observed with regards to how the self adapts and reacts to other objects. For the therapist, the patient's self will also be examined with regards to how to approach the patient.

Empathy
Kohut maintained that parents' failures to empathize with their children and the responses of their children to these failures were 'at the root of almost all psychopathology' [1]. Correspondingly, he emphasized the use of empathy as a tool in therapy.

The use of the word "empathy" in self-psychology, should not be confused with a softer, more cushioning and friendly approach to therapy. In stead, Kohut describes human empathy as a therapeutic skill. When a patient acts in a certain way, "put yourself in his/her shoes" - and find out how it feels for the patient to act in this manner.

Using the skill of empathy, the therapist could be able to reach conclusions sooner (with less dialogue and interpretation), and there would also be a stronger bond between patient and therapist, making the patient feel more fundamentally understood. The implicit bond of empathy would have a curing effect in itself.

The conceptual introduction of empathy wasn't intended as a "discovery". There had been empathic moments in psychology long before Kohut. Instead, Kohut pointed out that empathy in psychology should be acknowledged as a powerful scientific tool - extending beyond "hunches" and vague "assumptions" - enabling empathy to be described, taught, and more actively used in psychology.

Selfobject
Selfobjects are external objects which function as part of the "self machinery". In other words, persons, objects or activities that "complete" the self, and which are necessary for normal functioning. Observing the patient's selfobject connections is a fundamental part of self-psychology. For instance, a person's particular habits, choice of education and work, taste in life partners, may fill a selfobject-function for that particular individual.

Selfobjects are addressed throughout Kohut's theory, and include everything from the transference phenomenon in therapy, relatives, and items (for instance Linus van Pelt's security blanket). If psychopathology is explained as an "incomplete" or "defect" self, then the self-objects can be described as a self-prescribed "cure".

As described by Kohut, the selfobject-function (ie. what the selfobject does for the self), is taken for granted, and seems to take place in a "blindzone". The function thus usually doesn't become "visible" until the relation with the selfobject is somehow broken.

When a relationship is established with a new selfobject, the relationship connection can "lock in place" quite powerfully, and the pull of the connection may affect both self and selfobject. Powerful transference, for instance, is an example of this phenomenon.

Optimal Frustration
When a selfobject is needed, but not accessible, this will create a potential problem for the self, referred to as a "frustration". This is solved, optimally, by imagining the object's presence, thus creating a "surrogate" selfobject until the selfobject is available.

If the frustration is solved too eagerly, this means that the imagined presence may not develop it's "surrogate" function. On the other hand, if the frustration response is suboptimal, the "surrogate" image may become too important.

Suboptimal frustrations and maladaptations following them, may be compared to, for instance, Freud's trauma concept, the concept could also be considered reminiscent of problem solution in the oedipal phase. However, the scope of optimal frustration describes shaping of every "nook and cranny" of the self, rather than a few dramatic conflicts.

Idealizing
The need to establish a mutual selfobject connection with an object of idealization.

Alter ego/Twinship
Alter ego/Twinship needs concern the need to feel alikeness to other human beings[1,2]. This need relaxes as development continues allowing a greater degree of difference from others to be accepted [1,2].

The Tripolar Self
The tripolar self is not associated with bipolar disorder, but is the sum of the three "poles" of the body. The first pole is the pole "grandiose-exhibitionistic needs," the second pole is of "the need for an omnipotent idealized figure," and the third pole is pole of "alter-ego needs." The tripolar self forms as a result of the needs of an individual binding with the interactions of other significant persons within the life of  that individual.