Paul Ornstein

When it comes to presenting and illustrating the theories of Heinz Kohut, Paul Ornstein is a “Yes, and …, ” I know because I am a “Yes, but. …” I will illustrate Paul’s skill as ambassador for self psychology through a retrospective appraisal of his 1993 article, “Chronic Rage From Underground: Reflections on its Structure and Treatment.”

Paul began with a brief but erudite summary of the central dynamic of Dostoyevsky’s (1864) seminal Notes from the Underground. Here Paul, an ardent reader and scholar of the great Russian novelist, follows Freud and Kohut in drawing linkages between the insights of great creative artists and psychoanalysis. Parenthetically, in my first analysis I used Dimitri, Ivan, and Alyosha—the Brothers Karamazov—to attempt to discover and delineate who I was—emotional, intellectual, and/or spiritual? Consequently, I am an admirer of Paul and others of our colleagues who live in and with characters in literature as prototypes of living in or with the dyadic experience of analysis—the theater of two interacting minds. Paul notes: in reading or hearing the words of the protagonist in Notes from the Underground, “A whole gamut of reactions is mobilized … as if we were listening to a patient’s free associations. And we can completely extricate ourselves neither from the ‘underground man’s’ revelations nor from our own affect-laden reactions to them” (Ornstein, 1993, p. 143).

Paul used his literary reference as prelude to his main purpose—to elucidate Kohut’s theory of narcissistic rage and illustrate the theory through Paul’s treatment of Mr. K. In Notes, the protagonist lives in a continuous altered state now regarded as a consequence of Kohut’s (1972) newly defined “narcissistic rage.” Huge investments of energy go into planning his revenge without gaining relief. “If he does act, he agonizes over having done it, and if he does not, he ends up in endless recriminations for his cowardliness. There is no escape for him from self-loathing and self-to