Discussion of Anna Ornstein's “The Fate of Narcissistic Rage in Psychotherapy”

I will first address briefly the concept of transference from a self-psychological perspective, evident in Dr. Anna Ornstein's clinical material (and highlighted in her original presentation), and the concept of narcissistic rage that Dr. Ornstein spells out in detail. I will then focus on Dr. Ornstein's captivating case material with a close examination of the reported session shortly after the analyst's vacation.

With regard to transference, Kohut used the term in two ways: to address the repetitive object relational patterns, in keeping with the more traditional usage of the term, and to demarcate his newly formulated selfobject transferences, namely, the use of the analyst for developmental and structure building experiences. Kohut (1971) initially referred to his new finding as “transference-like” phenomena, recognizing that the patient was seeking the requisite developmental experiences rather than seeking to repeat the old. Later, he (1977) placed these phenomena under the rubric of selfobject transferences. Kohut (1984) came to view what he called object relational transferences essentially as resistances that needed to be analyzed to enable the emergence of selfobject transferences, seen as the primary change agents. In his last book Kohut's frequent use of the term transference to refer to selfobject transferences created the false impression that other aspects of transference are not addressed in a self-psychologically informed psychoanalysis.