The Use and Abuse of Theory in Psychoanalysis

In his well-known paper, “The Two Analyses of Mr. Z” (7), Kohut writes that in the first analysis he confronted the patient many times with interpretations about his grandiosity, which the patient opposed with intense resistances. In fact, the patient “blew up in rages time after time.” Kohut explains his perceptions and interpretations with the idea that they were fully in tune with the theories of classical psychoanalysis. When similar material appeared in the second analysis, Kohut tells us that “My theoretical outlook had shifted, so that I was now able to perceive meanings, or the significance of meanings, that I had not formerly consciously perceived.” Later he writes that he was able “to set aside any goal-directed therapeutic ambitions.” Interestingly, in the second analysis, he appears to be doing his analytic work according to Freud's (4) dictum of “evenly suspended attention” or Bion's (3) idea of the “absence of memory and desire” and a very “classical” approach indeed. It seems to me that Kohut is aware of, but has not distinguished clearly, between two groups of theories. The first group has to do with the technique we use when we do psychoanalysis and would include the technique of “giving up goal-directed therapeutic ambitions.” Other theories that would fit into this group would be Klein's (5) implied theory of the analyst being available for the patient's use of projective identification, Bion's (1) modification of Klein's idea to include the analyst as a container to contain and detoxify what the patient cannot contain, and Kohut's (6) theory of the analyst as a “selfobject” for the patient.

The other group of theories has to do with the content of what we find when we practice psychoanalysis and includes such ideas as envy, jealousy, the oedipus complex, narcissism, paranoia, etc. This latter group of theories is extensive, and each analyst must have his own armamentarium of such theories for use when he finds examples of those theories in his