Self Psychology: A Relational Psychodynamic Model

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Self Psychology A Relational Psychodynamic Model
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Self Psychology as a Theoretical Framework

• Heinz Kohut (1971, 1977) evolved self psychology
  concepts
• Self-esteem and sense of self dependent on
  quality or relationships with parental figures
• Self-object person who is experienced
  intrapsychically
• Self-object must be availability to the infant
  for its development of Self

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Three Self Object Relationships

• Mirroring self-object recognizes a childs
  capabilities and talents
• Idealizing self-object links a child with
  admired caregivers
• Twinship self-object provides a sense of being
  the same

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Internalization of Self-objects

• Self-objects perform adaptive functions of
  soothing and tension regulation
• Transmuting internalization child is gradually
  able to perform soothing and tension regulation
  functions in absence of original self-object

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Impairments with Internalization of Self Objects

• Without positive self-object experiences
  internalization of a healthy self cannot occur
• Shame, humiliation, helplessness the result of
  self-object failure
• True Self development hindered when child
  sacrifices expressing needs because self-object
  support is perceived as unavailable
• Person complies with needs of other at expense of
  her/his True Self development (merger bond)
• Failure to bond with caregiver leaves individual
  feeling isolated and depressed

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Impairments with Internalization of Self Objects
(cont.)

• When early narcissistic needs unmet, child
  (adult) is continually searching for nurturing
  and validating self-object experiences
• If self becomes strengthened through self-object
  responsiveness (i.e. through treatment) person
  will feel less shameful about needs for
  vulnerability and nurturing
• Will be able to give to others, emotionally,
  without feeling anxiety about anothers needs

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Maturity Self Psychology Perspective

• Maturity 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

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Empathy

• Kohut (1959) Psychological development evolves
  from attunement between self and self-objects
• 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
• Defense and resistance viewed as normal ways to
  protect oneself from pain or injury
• Therapist seeks to understand what client fears
  in life and in the worker client relationship
• Empathy frames the working alliance

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Role of the Therapist in Self Psychology

• Experience of therapist by client NOT solely
  based on past representations
• Client's feelings about worker based on her past
  experiences, current behaviors with others and
  with therapist
• Therapist needs to share her experience of client
  with that person
• 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

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Role of the Therapist in Self Psychology

• Empathic failure when the client does not feel
  the worker has been attuned to his self-object
  needs
• Perfect empathic attunement is not always
  possible
• Not problematic as long as therapist communicated
  to client the impact of empathic failure on the
  person
• 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

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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 to be affirmed
• Idealizing self-objects to merge with strength
  and wisdom
• Therapists needs are to understand the
  self-object needs presented by the child
• With children, dont interpret their behavior,
  just respond to their needs

Self Psychology Treating Children
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Self Psychology Treating Adolescents

• Adolescent brings turmoil through loosening of
  ties to primary self-objects
• Parental self-objects compared to peers in values
  and ideals
• Ongoing process of the experience of the self
  and other in parents and children
• Requires strength and flexibility

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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
• Childs 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

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Self Psychology and Learning Disorders in
Children and Adolescents (cont.)

• Ideal self-object relationships for learning
  disabled 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

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Self Psychology and the Elderly

• Integrity vs. despair ( developmental ask 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 psychical 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

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Self Psychology and Brief Treatment

• Self-psychology is applicable to brief treatment
• Clients seek treatment because of a loss of
  meaningful self-object experiences
• Causes loss of sense of self
• Goal enhance clients self esteem and restore
  her to pre-crisis functioning
• Therapeutic process of empathic investigation,"
  through mirroring, idealizing and twinship
  functions
• Understanding clients 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

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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 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

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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
  nontraumatically frustrated in a way that
  promotes self-identity and self-esteem
• Kohut the internal world should only be
  studies through the therapists empathy

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Self Psychology and Practice Evaluation (cont.)

• Qualitative research designs focusing on validity
  of meaning (comparing therapist and client
  responses)
• Quantitative assessment of change in self esteem
  could be assessed by measures addressing that
  concept ( i.e. Rosenberg Self Esteem scale)

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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

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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
• Empathy is means by which psychological observer
  gathers information about the inner world of the
  human experience
• Empathy is active listening through
• Hearing the clients story
• Communicating understanding of that story and its
  impact on the clients life
• Being understood by the therapist gives the
  client an affirming experience vital for
  establishing other meaningful relationships