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Kohut deals with matters of great contemporary interest. Almost every psychoanalytic student, psychiatric resident, and psychology intern brings up continually in seminars the issues of narcissism, its relation to borderline states, and “Kernberg versus Kohut.”
I agree that Kohut's formulations are of great clinical value in
understanding and treating the narcissistic patient. His empathic-phenomenological stance, the “space” and acceptance offered the patient who needs “self-objects” in the course of striving for a sense of cohesiveness, the importance of the emerging grandiose self and the idealized parent imago and the “working through” of idealizing and mirroring transferences—all of this is undoubtedly important and is beautifully expressed by Kohut.
In this recent writing, Kohut admits that he is determined to elaborate his own concepts clearly rather than to relate them to the contributions of others. He succeeds in making his points and may have good reason to circumscribe his focus. Despite my admiration, I find it objectionable when anyone's contribution is not viewed in the perspectives of our rich heritage of psychoanalytic theory. I believe that our patients and our own efforts to advance our science and art are better served when we seek an historical context in which to evaluate and compare theory construction and practical application.
Kohut describes the type of patient he is concerned about and the rationale for his treatment method convincingly; however, despite certain unique additions to theory construction, credit for several theoretical constructs belongs to others. For example, Kohut contends that the therapist is experienced by narcissistic patients as a “self-object.” Many clinicians have appreciated this, among them Annie Reich, Balint, Eidelberg, Sechehaye, Winnicott, Jacobson, and, in a sense, Federn and the Kleinians.
Perhaps it is both Kohut's strength and weakness as a theoretician that he hypothesizes an independent developmental line