A Self Psychology Perspective: The Protesting Patient

I am very glad to have the opportunity to discuss the analysis of Dr. Dewald's patient from the viewpoint of self psychology. But before I do, I would like to state formally how gracious it is of Dr. Dewald to be willing to discuss a case of his that lies so far behind him now. I am sure I am not alone in believing that most of us would be hard put to do the same. But Dr. Dewald has for years set an admirable example of openness in the face of traditional psychoanalytic secrecy. His participation in this symposium affords us a rare chance to follow some of the ways that an experienced analyst's thought develops over the course of his career, to learn how he thinks about his past work now, and perhaps to hear something about the way he experiences his own development as a psychoanalyst over the 25 or more years since his contact with this patient. Revisionism abounds in the psychoanalytic literature, but the opportunity to go back in time to discuss, with its original author, an important case that received widespread attention at its time of publication, is rare, and Dr. Dewald certainly deserves our thanks for it.

Let me look first at the wider context in which my discussion is embedded. A study of this case is particularly evocative because its location in the landscape and history of psychoanalysis leads one to think also about how the spirit of psychoanalytic inquiry is handed down. It was published in 1972, 1 year after Kohut's (1971) seminal monograph, The Analysis of the Self, appeared. The authors were men of an age, and although Kohut's early education and medical training were in Vienna and Dewald's in this country, both matured as psychiatrists and psychoanalysts in the heartland of America. They both devoted much of their professional lives to teaching psychoanalysis, were deeply engaged with students, and as training analysts must have gained much of their clinical experience with very similar groups of analysands. Yet they came to very different end poi