13 Self Change and Development in the Analysis of an Adolescent Patient: The Use of a Combined Model with a Developmental Orientation and Approach

From the time that Hartman distinguished self from ego in 1950, there has been increasing interest and corresponding conflict within the psychoanalytic community concerning the concept of the self. As Richards (1982) points out in his discussion of a panel on the subject, two broad and antithetical positions can be discerned: one, elucidated by mainstream analysis, holds that no radical revision of theory is required to encompass a consideration of the self, and the other, exemplified by self psychology, maintains that indeed a “radical revision approaching replacement of psychoanalytic theory is necessary because traditional theory is deficient, inaccurate, or in some way limited” (p. 940). Each of these antithetical positions implies that one can conceptualize the psychoanalytic situation without reference to either aspects or the totality of the other, competing theory. Yet it is obvious that self psychology remains dependent upon a great many of the insights contained in classical theory, as Kohut himself maintained until the end of his life (see also Greenberg & Mitchell, 1983, in this regard). On the other hand, while classical analysis does not depend upon self psychology per se, the theory is rendered inadequate by its central assumption of a more or less well-functioning ego in the patient. In particular, it is in the area