6 Summary of Kohut's “The Self Psychological Approach to Defense and Resistance”

In this chapter of Kohut's How Does Analysis Cure?, he considers three interrelated questions: first, in general, the place of defense in self psychological theory; second, in particular, whether the analysis of defense, that is, resistance analysis, is still indispensable to analytic technique as conceived by self psychology; and third, and more particularly, how self psychology evaluates the traditional treatment process as an overcoming of resistance in order to make the unconscious conscious.

Kohut ties these three questions related to defense and resistance to a distinction he made previously between 19th-century scientific objectivity, which he sees as defining traditional psychoanalysis, and 20th-century scientific objectivity, which he sees as defining self psychological psychoanalysis. The traditional analyst sees his patient objectively, and seeks to discover discrete mechanisms of a mental apparatus; the self psychologist acknowledges his own impact on the field he is observing, and, using empathic contact with the patient, is able to broaden his perspective beyond this mechanistic view. Traditional psychoanalytic beginnings in hypnosis introduced a mode of thinking ill-adapted to the requirements of complex mental states. It encouraged a metaphor of surgical detachment, viewing the unconscious as an abscess to be penetrated and drained. By and large, according to Kohut, the traditional analyst imitates and models the surgeon who puts aside all feelings, even his human sympathy, as he proceeds to drain the pathogenic abscess in the unconscious. While the introduction of ego psychology influenced the theory of mental illness, it did not influence the technique. There were exceptions, however, to this overall approach of traditional psychoanalysis; Loewald and Stone, for example, introduced a new attitude of understanding and explaining so that stunted psychological development might resume. However, the old conceptualizations persist and remain strong, espe