8 Discussion: The Primacy of the Preservation of Self

There are so many complex details that make up and support the overall argument of Kohut's chapter that I have decided to discuss it in relation to some experiences with a patient of my own, which I shall link to Kohut's discussion of his lawyer-patient.

I once had a patient whose childhood was, for the most part, as lacking in health-promoting experiences and as injurious to her as were the childhood experiences of Kohut's lawyer-patient whose dreams are used to illustrate his ideas on defense and resistance. Without going into the details of her history, I shall relate a brief exchange—a question I asked her one day and her answer to that question—that focuses on Kohut's concerns in this chapter.

After the patient, Mrs. A, had been in psychotherapy for several weeks, I gradually began to realize how massively unavailable her parents had been for her throughout her childhood, and consequently how much more terrible the unannounced, sudden desertion at age 3 by her beloved nurse was for her. One day when the full horror of the abandonment and isolation of her childhood became clear to me, I asked in amazement: “But what saved you?!” She thought for a moment and then replied, “I was intelligent and I was beautiful.” I was taken aback by her answer. What she said was certainly objectively true, but I hadn't expected that kind of response and although I didn't know what to make of it at the time, I felt that she was on to something. Only later in the course of a 5-year analysis did I come to understand and believe, despite the necessary oversimplification of such a brief reply, that what she said so ingenuously was essentially correct. Her intelligence had enabled her both to escape from her emotional deprivation and to grow through the use of, among other talents, precocious reading abilities that transfused her with a kind of life and excitement, and a world of ideas to which she had little access otherwise. In part her reading substituted for experiences of her own. I