Kohut's Concept of Cure

Kohut's last book, How Does Analysis Cure?, should be understood within the context of his entire work. It is a reexamination and a summarizing commentary on his own thinking, describing in broad brushstrokes his central ideas. With a body of innovative work behind him, he was in a position to dispense with the scientific rigors of originality and to allow himself the luxury of being opinionated. Some analysts have been disappointed by the lack of entirely new ideas. However, its value and originality lie in the introspective perspective Kohut himself offers of his work. Specifically, it lies in the systematic linking of Kohut's understanding of key clinical constructs to the curative process. In this paper, I will therefore examine the relationship between cure and the transformation of the self-selfobject matrix—including the roles of defense and resistance, cure and the purpose of interpretations, and finally, structure formation in the curative process.

To put the relationship between cure and the transformation of the self-selfobject matrix into perspective, a brief statement of Kohut's (1984) view of the human condition will be helpful:

Man of our time is the man of the precariously cohesive self, the man who craves the presence, the interest, the availability of the self-cohesion-maintaining selfobject. It is the very intensity of this need that via a wall of secondary prideful disavowal accounts for the fact that he may experience our theory that the self's autonomy is only relative, that, in principle, a self can never exist outside a matrix of selfobjects, as a serious narcissistic blow. (p. 61)

It is not surprising, therefore, that Kohut believes that the essence of psychopathology is the damaged self, that the self is damaged by disturbances in the early self-selfobject relationships and that cure lies in the transformation of the self-selfobject relationships.