Nearly a century of diverse currents of psychoanalytic thinking have given rise to two predominant paradigms of both theory and treatment today: conflict and deficit. In encapsulated form, the conflict model posits an intrapsychic struggle between incompatible forces of the mind, especially repressed sexual or aggressive urges and the ego defenses that guard against them (Freud, 1933; Kernberg, 1984). Alternatively, the deficit model postulates that early environmental events of interpersonal insufficiency, especially lack of empathic attunement between caregiver and infant, results in defects of the self (Kohut, 1971). These pivotal positions of contemporary conceptual controversy in the complex understanding of the