Self Psychology:
A Relational Psychodynamic
Model
SOW6425 Assessment and Planning
Professor Nan Van Den Bergh, PhD, LCSW
Self Psychology as a Theoretical
Framework
• Heinz Kohut (1971, 1977) evolved self
psychology concepts
• Self-esteem: sense of Self dependent on quality
of relationships with parental figures
• Self-object: person who is experienced intrapsychically
– Self-object must be available to the infant for its
development of Self
Three Self Object Relationships
• Mirroring self-object: recognizes a child’s
capabilities, talents and responds to the child’s
needs/feelings
• Idealizing self-object: offers the child someone
to admire, idealize and from whom the child
gains strength “ to bask in the glow of …….”
– Pride and strength by association.
• Twinship self-object: provides a sense of being
the same.
– “Being in the same boat…”
Internalization of Self-objects
• Self-objects perform adaptive functions of soothing and
tension regulation
• Transmuting internalization: person develops the
capacity to perform self-soothing and tension selfregulation functions in absence of original self-object
Impairments with Internalization of Self
Objects
• Without positive self-object experiences internalization of
a “healthy self” cannot occur
– Shame, humiliation, helplessness the result of
ongoing self-object failure
– Conflicts arise when individual fears her own
expression of needs will diminish whatever self-object
experiences are available
– Failure to bond with caregiver leaves individual
feeling isolated and depressed
– Individual, anxious for support of the self-object, may
falsely comply with the needs of the other at the
expense of the development of a “true self”
Impairments with Internalization of Self
Objects (cont.)
• When early narcissistic needs unmet, child (then adult) is
continually searching for nurturing and validating selfobject experiences
• If SELF becomes strengthened through self-object
responsiveness (i.e. through treatment) person will feel
less shame about their need and desire to be vulnerable
and to be nurtured
– Outcome will be ability to give to others, emotionally,
without feeling anxiety about responding to another’s
needs
Maturity: Self Psychology Perspective
• Maturity is the ability to evoke and engage in
mutually enriching self-object relationships
• Emotionally healthy individual has ability to
choose self-objects based on adult development
levels, not early narcissistic needs
– Early narcissistic needs are “feed me, see me, praise
me….” etc.
Empathy
• Kohut (1959): Psychological development
evolves from attunement between self and selfobjects
– Experiencing attunement allows self to evolve from
early, narcissistic needs to capacity for empathic
attunement to others
• Empathy as “vicarious introspection: ability of
therapist to investigate inner world of client
• Empathy as tool through which therapist gathers
psychological information
• Empathy frames the working alliance
Empathy (cont.)
• Defense and resistance viewed as normal
ways to protect oneself from pain or injury
– Therapist seeks to understand what the client fears in
life and in the worker/client relationship
– Worker reflects back, empathically, client’s efforts to
“defend” against focusing on anxiety-related topics
• “ It is painful to talk about the circumstances that led to your
separation and divorce from your wife…..”
Role of the Therapist in Self Psychology
• Client’s transference response to the therapist is not only
based on past “representations or others”
• Client's feelings about worker could be based on past
experiences, BUT ALSO current behaviors with others
and with therapist (totalistic transference)
• Therapist needs to share her experience of the client
with the client
• Through “transmuting internalization” of the therapist as
calming (mirroring) and competent (idealizing) client can
learn to self-soothe, self-comfort and self-empathize
• Therapist becomes a new “self-object”
• This process enables client to find more mature
self-object relationships in her life
Role of the Therapist in Self Psychology
(cont.)
• Empathic failure: when the client does not feel the
worker has been attuned to his or her self-object needs
– Perfect empathic attunement is not always possible
– Empathic failure not problematic as long as therapist offers an
interpretation, to the client, of the failure’s’ impact on the client
– Client learns to tolerate frustration in the same way a young child
is helped by parents who do not gratify every need
• Learning to deal with frustration, through an empathic
relationship with therapist, allows client to choose more
emotionally sustaining self-objects and to experience
empathy for others
Self Psychology: Treating Children
• Rage, depression, clinging, lack of impulse control,
inhibition in social skills and learning can result from lack
of caregiver responses to appropriate childhood needs
and wishes
• Driven, repetitious behaviors seen as desperate
attempts to achieve recognition and response to vital
needs
– Mirroring self-objects: being affirmed by another
– Idealizing self-objects: merging with strength and wisdom of
another
• Therapist’s needs to understand the self-object needs
presented by the child
• With children, don’t interpret their behavior, just respond
to their needs (typically through play)
Self Psychology: Treating Adolescents
• Adolescent brings “turmoil” through loosening of
ties to primary self-objects
• Parental self-objects are compared to peers in
terms of values and ideals
• Ongoing process of “the experience of the self
through parents and other youth”
– Requires strength and flexibility
– This ongoing “re-experiencing of selves” between
parents and children occurs throughout the life cycle
Self Psychology and Learning Disorders
in Children and Adolescents
• Palombo (1995): Disorders of the self do not
cause learning disorders since they are
neurologically based
– However, neurological weaknesses can give rise to
disorders of the self
– Child’s thoughts and behaviors are neurologically
based and not motivated by psychological factors
• When child cannot make sense of her
experiences and she receives negative
feedback from family or educators, child can
have problems with self esteem and self concept
Self Psychology and Learning Disorders
in Children and Adolescents (cont.)
• Ideal self-object relationships for learningdisabled youth:
– Direct verbal explanations to clarify confusion
– Soothing guidance on how to deal with problems
– Emotionally calm presence to reduce anxiety
• Therapist must be a self-object for both
child and the caregiver
Self Psychology and the Elderly
• Integrity vs. despair ( developmental task of last life cycle):
maintaining self esteem in the wake of biological, psychological and
social stressors
• Symptoms of disorders of self in seniors:
– Sensitivity to slights and insults
– Reactive anger and withdrawal in response to rejection or
disappointment
– Hypochondriasis
– Overdependence on others for approval
– Viewing others not as separate but as extensions of self
– Over-emphasis on physical appearance, possessions and past
accomplishments to cope with diminished self esteem
• Major goal of therapy with elderly is restoration of self esteem
– Reminiscence about past
– Mourning loss of self-object relationships
– Listening to past narcissistic injuries
Self Psychology and Brief Treatment
• Self-psychology is applicable to brief treatment
• Clients seek treatment because of a loss of meaningful selfobject
experiences (source of most adjustment disorders, DSM IV)
– Causes loss of sense of self
• Goal:
– Enhance client’s self esteem and restore her to pre-crisis functioning
• Therapeutic process of “empathic investigation," through mirroring,
idealizing and twinship functions
• Understanding client’s subjective experiences, providing “self-object
responsiveness” restores self-cohesion and decreases symptom
logy
• Tasks of therapist:
– Helps patient appreciate the legitimacy of her needs and feelings
– Promotes self awareness, understanding and acceptance
Self Psychology and Group Treatment
• Self psychology has been effective in group treatment
with clients having self-esteem problems
• The group can provide affirming self-object relationships
• 12 Step meetings:
– Mirroring transference through sharing and listening to others
with same experiences
– Idealizing transference through “sponsors” and subscribing to
the “Steps”
– Twinship transference through the “we” experience of mutual aid
and peer support
Self Psychology and Practice Evaluation
• “Success” would be client's ability to identify and
seek out positive self-objects within her
surroundings
• Treatment provides a “reparative emotional
experience” of being empathically understood
and non-traumatically frustrated in a way that
promotes self-identity and self-esteem
• Kohut: the “internal world” should only be
studied through the therapist’s empathy
Self Psychology and Practice Evaluation
(cont.)
• Qualitative research designs focusing on validity
of meaning (comparing therapist and client
responses)
• Quantitative assessment of change in selfesteem could be assessed by measures
addressing that concept ( i.e. Rosenberg Self
Esteem scale)
Ending in Self Psychology: the Therapist
Experience
• At end of treatment, therapist may experience:
– “ loss of the therapy as a self-object experience” that
may have provided mastery, growth and professional
stability”
Self Psychology: Summary
• Kohut pioneered the term empathy as a clinical concept
plus an important component of the healing process
• Empathy more than “feeling for the client”
– Empathy as the “scientific tool” of psychotherapy
– Practitioner has only one tool; that tool is herself/himself
– “Empathy is means by which psychological observer gathers
information about the inner world of the human experience”
• Empathy is active listening through:
– Hearing the client’s story
– Communicating understanding of that story and its impact
on the client’s life
• Being understood by the therapist gives the client an
affirming experience vital for establishing other
meaningful relationships
Self Psychology: Summary (cont.)
• Assessment:
– What is level of self-esteem?
– Self-absorption?
• “piece of furniture counter-transference”
– Capacity to be available to others?
– Narcissistic personality characteristics:
•
•
•
•
•
•
•
•
•
Grandiose sense of self-importance
Preoccupied with fantasies of unlimited success, brilliance, beauty, etc.
Believes s/he is ‘special,’ unique, understood only by other ‘special” people
Requires excessive admiration
Sense of entitlement and expects especially favorable treatment
Interpersonally exploitative
Lacks empathy
Arrogant, haughty behaviors or attitudes
Envious of others or believes others are envious of her/him
Self Psychology: Summary (cont.)
• Interventions:
– Monitor transference responses and provide empathically for
needs demonstrated through transference:
• Mirroring
• Idealizing
• Twinship
– Offer person-situation and developmental reflections plus
interpretations as to relational dynamics in therapeutic
relationship and with others