The psychology of the self and the termination of treatment

The understanding of the process of termination is contingent upon a clarification of two sets of issues: those related to the metapsychology of separation and loss, and those related to the goals set by the patient and the therapist in the treatment relationship. This article attempts to reformulate the issue of separation and loss from the point of view of the psychology of the self, and to discuss a framework through which goals may be set for treatment. The implications for termination are then considered.     

Severe borderlines and self psychology

This paper will discuss work with a woman diagnosed as having borderline personality disorder because of classic symptoms of intense unstable affect, recurrent suicidality, self-mutilation, and primitive defensive organization. Once a selfobject transference tie was established, the borderline symptoms remitted. Discussion of this case will focus on the clinical application of concepts from the field of psychoanalytic self psychology, particularly the concepts of self-object functions and intersubjectivity, in work with patients diagnosed as borderline.     

Dance therapy and self psychology

In this paper I will introduce the basic concepts of dance therapy and show how dance therapy could be viewed self psychologically. A clinical example will be presented, discussed and critiqued utilizing self psychological concepts. A brief discussion will follow that appraises the potential of blending self psychology and dance therapy together. This is a speculative paper but it may provide a basis to further develop self psychology within dance therapy.     

The treatment of borderline neurocognitively impaired children: A perspective from self psychology

The applicability of the definition of the borderline syndrome to children is questioned, as is the traditional view that its etiology lies in the type of interaction the child had with its parents. The redefinition of the syndrome of borderline proposed in prior publications using the conceptual framework of self psychology opens the door to new treatment approaches. This article addresses some of the issues related to these treatment approaches.     

Borderline conditions: A perspective from self psychology

This article begins with a distinction between the extrospective and the introspective points of view as they apply to understanding borderline conditions. The literature is reviewd using this distinction to organize the contributions that have been made to date. Two definitions of borderline conditions are given. The introspective point of view is used to further define the experience of patients with that condition and the dynamics as understood through self psychology.     

Applications of self psychology to the problem of child abuse

This article examines the application of self psychology to the problem of child abuse. The understanding of child abuse has evolved and, through the application of psychoanalytic principles, has come to be viewed as a breakdown in the parent-child relationship. Self psychology provides a furthering of this understanding and suggests treatment modalities. The case illustration demonstrates the usefullness of self psychology in both understanding and treating abusive parents.     

Adolescent development: A view from self psychology

Self psychology does not have a distinctive developmental theory. This paper discusses some of the methodological problems related to the articulation of such a theory, and goes on to outline a theory of adolescent development that is consistent with the tenets of self psychology. The major points made are: Adolescence does not represent a recapitulation of prior phase of development, the sense of self cohesion is fundamental to a healthy sense of self, and the culmination of the adolescent process is the formation of a nuclear sense of self.private practice     

Orthodoxy and heresy in self psychology: A Heretic's perspective

This paper discusses a trend in self psychology toward the establishment of a somewhat rigid orthodoxy. The conceptual problems that such a stance raises, such as the role of empathy in the treatment process and the incompatibility that this presents with the current self psychological view of the etiology of psychopathology, are discussed. The relationship of self psychology to existential theory is highlighted and a more open stance is advocated regarding divergent theorizing within the model.     

The evolution of the self through optimal gratification

In an attempt to more accurately grasp how the psychotherapeutic process heals self pathology, this paper explores the Self Psychological construct of transmuting internalization which has always assumed a climate of attunement, but has emphasized the frustration inherent in the therapeutic process. An alternative way of conceptualizing the process is offered in an attempt to refine theory to better reflect current research, clinical observations, and therapeutic experience. Specifically, the primacy of optimal frustration as the curative factor is challenged. Gratification of basic needs through an attuned environment is proposed as the fundamental foundation for the process of self structuralization. It is argued that first one must be able to express, identify and interpret affect, and that these abilities are acquired through the activation and gratification of the fundamental needs as delineated by Kohut's concepts of mirroring, idealizing, and twinship. One must have sufficient experiences in feeling valued, confirmed, comforted, affiliated, etc. by a selfobject milieu before she or he can develop self-regulating behaviors.     

Reviving the Undead Book

The aftermath of the 1959 Cuban Revolution produced not only a transformation of the political landscape, but also a painful and problematic bifurcation of Cuban identity and nationhood. It is against this backdrop that I review Bridges to Cuba/Puentes a Cuba, a literary anthology whose unifying axis is found in the ‘Cuban’ experience of its contributors. Rather than investing one experience of ‘Cubanness’ with authenticity at the expense of the rest, the richness of this collection lies in the complexities and hybridities of Cuban identity and nationhood which the contributors to this volume explore. Edited by Ruth Behar, their diverse voices and literary genres are testimony to the existence of ‘border subjects’ that inhabit various worlds, cultures and languages simultaneously, albeit unequally. While pointing to the inadequacy of essentialist notions of identity, the objective of this anthology is far from academic. As its title suggests, it hopes to bridge the ideological chasm (and heal the wounds) by forging a more inclusive, complex and heterogeneous vision of what it means to be and to belong to the Cuban nation.     

The treatment of bulimia from a self psychological perspective

This paper examines concepts from self psychology which contribute to the understanding of bulimia. A case example from the author's work illustrates the significance of the sense of self both in the development of bulimic symptoms and also in the therapeutic process. Painful feelings of shame and humiliation over who and what one is are often part of the bulimic experience. The author suggests that therapist's role is not so much to change the bulimic person, but to accept and understand who the person is and how he or she came to be that way. Change often follows such understanding.     

Structurally based theories and self psychology: Questions of compatibility and the integration of theory

This paper addresses the question of compatibility between two branches of psychoanalytic theory. Currently the emphasis upon differences, both clinical and metapsychological, has impeded integrative efforts. Self psychology and structurally based theories are compared in terms of how each understands and explains central elements of a psychodynamic theory. The same case is discussed from these two points of view. The author draws the preliminary conclusion that the theories generate sufficiently different understandings of personality that two parallel theories, including inherent clinical and metapsychological approaches, have developed. However, the overall conclusion is that both self psychology and structurally based theories have diagnosis near qualities which limit their overall usefulness.     

Self psychology and countertransference in the treatment of children

The issues of countertransference in the treatment of children have received far less attention than those arising in the treatment of adults. This paper attempts to begin to redress this imbalance. Some of the major countertransferences in work with children are addressed, and the perspective of self psychology is presented. In the conclusion some thoughts are offered regarding some of the narcissistic injuries therapists must confront in dealing with issues of countertransference.     

Strengthening communities through women's self help groups in South India

This article reports on an evaluation of women's Self Help Groups(SHGs) in an area in south India. Groups were evaluated, notin terms of their success as microcredit schemes, from a financialperspective, but in relation to their contribution to genderdevelopment. Evidence emerged that women perceived changes intheir identity towards working collectively to influence forchange at the village and panchyat levels. They engaged in communityand social action programmes, both at the local level and byjoining with issues beyond the local. When considered withinconstructs of empowerment, capability poverty, citizenship,and participation in democratic processes, such SHG outcomes,and the community development processes that accompany theirwork, can be seen to make a modest but significant contributionto broader transformations of oppressive structures.     

The development and disturbance of emotions: An application of self psychology to clinical work with children

This article applies self psychology, as developed by Heinz Kohut, to clinical work with children. It begins with a brief summary of self psychology as a theoretical framework, focusing on the role of selfobjects in the development of the self. Then, the role of selfobjects in the development and disturbance of emotions is discussed. The paper concludes by describing the treatment implications of the self psychological perspective for clinical work with children, illustrating them through three case vignettes, and identifying certain questions for further inquiry.     

Toward a cultural conception of the self.

The dominant mental health models rely excessively on a modern Western ideal of the self. Health services in a pluralistic society require interventional approaches that recognize the significance of culture in shaping a person's conception of self as well as mental health and illness.     

A self psychological approach to the treatment of gay men with AIDS

This paper applies the concepts and techniques of the self psychological approach to the treatment of gay men with AIDS. The psychosocial impact of AIDS on the maintenance of self and identity for gay men is explored with an emphasis on the implications for selfobject needs being met. The author illustrates through four case vignettes attempts at satisfying the mirroring, idealizing, and alterego selfobject needs of such clients. Individual, relational, and family-focused clinical concerns are addressed.