Listening with A Different Theory: Commentary on Skorczewski

In his first book on the narcissistic personality, Kohut (1971) said that the determining event that caused him to rethink his classical position was a shrillness in his patient Miss F.'s voice. Repeatedly she objected to his interpretations, which focused mainly on his belief that her central conflict was oedipal and that her transference to him was an eroticized paternal one. But what she seemed most distressed by was his insistence on recasting her associations into the language of drive and defense, with Kohut the principal target of her fantasies. She loudly proclaimed that when he altered her presentations to fit his theory he was undermining the analysis. Something about her tone led him to listen in a different way—that is, in accordance with her insistence that he be more of a mirror. What he would learn from Miss F. would serve as an antidote for her weakly cathected and injured self. Kohut was able to hear in Miss F.'s communications that the tendrils of a narcissistic transference need not be a resistance, thus ushering in a major change in how we might understand many patients' symptoms, compromised object relations, and character pathology.

Viewing a patient's presenting psychopathology as revealing disturbances that could be traced back to early environmental failures meant that major traumas were linked to failures by caretakers who had been necessary for building psychic structure. The narcissistic transferences communicating the weakness of the self expressed and carried forward these unmet needs for objects (selfobjects) that would be vital in rehabilitation. These narcissistic transferences (mirror, twinship, alter ego, or idealizing) are not then pressing for the fulfillment of infantile wishes, nor are they indicative of the ego's defense against drive-centered conflicts; rather, they represent the emergence of heretofore repressed or walled-off needs. Most important, when these transferences become mobilized in treatment and the patient acknowl