In this article the author outlines his understanding of self-psychology as an independent psychoanalytic treatment paradigm created by the late Heinz Kohut and initially geared toward the psychoanalytic treatment of narcissistic disorders. Since then, self-psychology theory and practice have been enriched by new theoretical and clinical considerations and have been introduced into other forms of psychotherapy, counseling, and education, for example. One important conceptual contribution to developmental theory was Heinz Kohut’s differentiation of separate narcissistic and “object love” related developmental tasks. Today, new paradigms as i.e. relational analysis stress the value of human relationships and of the value of mutual recognition. This warrants a revisiting of the clinical value of the self-psychological understanding of narcissism. According to the author it lies in the nature of unattended narcissistic needs that when unattended they take primacy over relational aspects and demand adequate attention in order to open up the space for mutuality, reciprocity et cetera.