Nuclear Conflict and the Nuclear Self

How does analysis cure?, Kohut's last book prior to his death, provides us with a view of its author as a concerned clinician. This book leaves no doubt that Kohut's primary interest and emphasis during his later years was in the appropriate management of special clinical situations. This focus led him to recommendations for treatment that he insisted required revisions in clinical theory — even as Freud rewrote clinical theory during the evolution of his ideas. But in Kohut's revisions the theoretical adjustments that were recommended have come into sharp conflict with the classical psychoanalytic model, which was and is in common use. Some of Freud's various revisions we know so well: his theory of narcissism (1914), the structural theory (1923), the dual instinct theory (1920), and the theory of anxiety (1926), all blossomed in settings of controversy with colleagues. However, Freud was not only a respondent but the Urquell of our science. Moreover, he never quite gave up some of the principles and ideas that were the essentials of his early models. Thus, even late in life, Freud (1926) spoke of the possibility of real trauma, the importance of topography as a complement to structural theory in depth psychology, and actual anxiety — all despite the growing interest in ego psychology.

As noted, Kohut's innovativeness has put him and his followers into a new and distinctive camp in relation to what has become the