Kohut (1984) contrasted self psychology with traditional psychoanalytic theory partly on the basis that the latter understands transference behavior (as well as pathology) in terms of infantile wishes that ultimately need to be renounced, while the former understands transference behavior (and pathology in general) in terms of needs that are to be understood and partially met in the treatment.

The main purpose of this article is to try to show that Kohut's explicit position notwithstanding, a careful examination of the self psychology conception of pathology and of treatment suggests that it is characterized by an implicit reference to wishes rather than simply to needs. I also try to show that an adequate conception of pathology as well as of treatment will involve an understanding of the patient's behavior in terms of the active pursuit of wishes and aims, rather than simply in terms of needs that are the automatic consequences of defective structures.