Commentary on Trop and Stolorow's “Defense Analysis in Self Psychology”

Trop and Stolorow's “Defense Analysis and Self Psychology: A Developmental View” allows us to discuss the relation of psychoanalytic theory to psychoanalytic technique and the way in which theories determine and organize the data available in the analytic situation. Although the authors, in their approach, claim to enter and limit themselves to the patient's perspective, what they in fact present is the patient's perspective from a theoretical point of view. My focus here will be on the way in which their theoretical commitments seem to skew the treatment and move both patient and analyst away from themes it might have been useful to explore. In so doing, I am not proposing that Trop and Stolorow's self-psychological/intersubjective frame of reference is wrong and that an alternative theoretical approach is to be preferred. My point is only that, in the data presented, the authors do not seem to have fully exploited psychoanalysis as an investigative tool providing access to the patient's mental organization and relational configurations in their multidimensional richness.

The patient came to treatment after an experience that robbed him of self-esteem. A woman he was seeing “remarked that his muscles were flabby and told him that he needed to shape up.” For the therapist this report seems to provide a degree of closure, at least initially. The reported experience fits well with self-psychological formulations regarding the role of loss of self-esteem in precipitating difficulty for narcissistic personalities. It is also an example of trauma induced by an unempathic significant other, which again, for the self psychologist, can easily be viewed as a repetition of similarly unempathic treatment at the hands of parents. The patient certainly had an extreme reaction to what might