Transforming Narcissism

Reflections on Empathy, Humor, and Expectations

Frank M. Lachmann

• Publisher: Routledge
• Year: 2011
• eBook ISBN: 9781135469221
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Using Kohut's seminal paper "Forms and Transformations of Narcissism" as a springboard, Frank Lachmann updates Kohut's proposals for contemporary clinicians. Transforming Narcissism: Reflections on Empathy, Humor, and Expectations draws on a wide range of contributions from empirical infant research, psychoanalytic and psychotherapeutic practice, social psychology, and autobiographies of creative artists to expand and modify Kohut's proposition that archaic narcissism is transformed in the course of development or through treatment into empathy, humor, creativity, an acceptance of transience and wisdom.

He asserts that empathy, humor, and creativity are not the goals or end products of transformations, but are an intrinsic part of the ongoing therapist-patient dialogue throughout treatment. The transformative process is bidirectional, impacting both patient and therapist, and their affect undergoes transformation - for example from detached to intimate - and narcissism or self-states are transformed secondarily as a consequence of the affective interactions. Meeting or violating expectations of emotional responsivity provides a major pathway for transformation of affect.

For beginning therapists, Transforming Narcissism presents an engaging approach to treatment that incorporates the therapeutic action of these transformations, but also leaves room for therapists to develop styles of their own. For more experienced therapists, it fills a conceptual and clinical gap, provides a scaffold for crucial aspects of treatment that are often unacknowledged (because they are not "analytic"), or are dismissed and pejoratively labeled "countertransference." Most importantly, Lachmann offers a balance between therapeutic spontaneity and professional constraint. Focused and engaging, Transforming Narcissism provides a bridge from self psychology to a rainbow of relational approaches that beginning and seasoned therapists can profitably traverse in either direction.

Dr. Lachmann contributed to an article on empathy in the April, 2008 issue of O magazine, pp. 230.

PART 1

Transformation

1 The Process of Transforming

The year was 1953. I was a psychology intern at Bellevue Hospital in New York. As an intern I was able to attend a seminar led by a training analyst from New York Psychoanalytic Institute. The other members of the seminar were psychiatric residents and psychiatrists, a number of whom were already in psychoanalytic training. The analyst opened one meeting of the seminar by relating the following incident: “Tell me what you think about this,” he said to the group. “Last weekend I went to a restaurant with my wife and several other couples, colleagues from the institute. At a nearby table sat a patient of mine. We exchanged greetings through eye contact. When he left, the patient came over to say good-bye and that it was good to see me. When my friends and I were ready to leave and asked for our bill, the waiter told us it had already been paid, for all of us, by the gentleman who had just left.” The analyst then turned to us and asked, “What do you all think of this?”

Very privately, I thought to myself that this patient must have liked his analyst very much. Fortunately, I kept quiet. The next thing I remember is that terms were flying past me from all directions. This patient was narcissistic, grandiose, competitive, controlling, demeaning, hostile, and destructive. He was defending against castration anxiety by submitting passively to his father’s phallus, as well as expressing castrative hostility toward his father. The analyst looked very pleased with the psychoanalytic formulations of his students. They understood that narcissism and object relationships, self-centeredness, and an ability to relate to others were on a seesaw and that this patient’s unbridled grandiosity and manipulativeness—his “narcissism”—had drained his ability to be concerned about others. Therefore, they contended his aggression was given free rein and he acted it out by paying for the dinners, thereby elevating himself and demeaning his analyst.

I was glad I had said nothing because I would obviously have been all wrong. I said to myself, “So this is what psychoanalysis is all about.” One looks underneath or behind a person’s actions to find the “real” motivation. Behaviors that appear kind, generous, or perhaps even an expression of gratitude and appreciation actually conceal baser, unconscious motivations that are aggressive and narcissistic.

This was in 1953, and if it weren’t for the contributions of Heinz Kohut, we might still be understanding and treating patients from this perspective today. But in 1953 Kohut had not yet become a self psychologist, although his extraordinary ideas were already beginning to coalesce. In 1959 he would publish “Introspection, Empathy and Psychoanalysis,” breaking new ground in redefining the analytic task as one of understanding and explaining patients’ experiences from within their perspective rather than from the vantage point of an outside, “objective” observer. But in his essay on Thomas Mann’s Death in Venice, which was published in 1957, Kohut had already begun to rethink narcissistic pathology and to conceptualize destructive impulses as secondary to the disintegration of a narcissistic self-organization. This formulation would eventually move therapists to a position vastly different from the one held by the analyst at Bellevue and the participants in his seminar. Rather than viewing narcissism as a character structure to be confronted, analysts could address the person’s vulnerable sense of self and the protection, defense, and compensation that the person sought.

Not only did Kohut’s perspective offer a radically new slant on narcissism, but it also changed our understanding of aggression. In the self psychology tradition, following Kohut (1972), aggression was thought of and treated as a reaction to narcissistic injuries. I elaborated this view of aggression in Transforming Aggression (Lachmann, 2000), where I distinguished between reactive and eruptive aggression. Both types of aggression are responses to narcissistic injuries in the broadest sense. Their manifestations differ and they reflect injuries to the sense of self over different time frames. Reactive aggression is comparatively a more short-range phenomenon (though obviously it has its own history), while eruptive aggression is a long-term phenomenon. Reactive aggression comes about in response to narcissistic injuries, experiences of deprivation, rejection, and frustration. However, aggression becomes “eruptive” like a volcano lying in wait quietly, ready to erupt at some slight atmospheric change, and functions as though it is innate, as a consequence of early persistent emotional and physical abuse and neglect. Aggression then appears for “no apparent reason” (A. Freud, 1972). Expressions of anger, rage, or hostility and other variations of aggression then become a prominent and dominant mode of affect expression. Under these circumstances aggression can become a way of expressing anxiety, shame, despair, sexual excitement, and any number of other affects and combinations of affects. Furthermore, eruptive aggression can become self-perpetuating and acquire a life of its own. A habitual link between narcissistic vulnerability and aggressive reactions is thereby established and maintained.

In his theoretical contributions, Kohut ultimately linked aggression and narcissism by considering aggression a “breakdown product” of the self, a form of self-pathology. In his clinical contributions, Kohut (Lachmann, 2000; Miller, 1985) spelled out these theoretical contributions by formulating “leading edge” and “trailing edge” interpretations. Kohut never wrote directly about these edge interpretations, but his then-supervisee, Jule Miller, did. In the case material in the chapters that follow, leading edge interpretations are implicitly and explicitly presented. However, sequences of trailing edge interpretations, when relevant, are neither avoided nor omitted. However, since they are the more familiar psychoanalytic interventions, in these chapters I pay more attention to the therapeutic action of leading edge interpretations. A more detailed description of these interventions now follows.

When Jule Miller (1985) was supervised by Heinz Kohut, Miller discussed the interventions suggested by Kohut that were in contrast to the ones he had been offering to his patient. Coming from a traditional psychoanalytic perspective, Miller had been addressing his patient’s competitive and regressive behaviors based on the patient’s childhood experiences. In the course of these supervisory sessions Kohut distinguished between leading and training edge interpretations. The leading edge interpretations address the “evolving and developing aspects of the transference relationship, as well as other factors of the patient’s progress—how he handles conflict, what new or different tactics he uses to manage it” (p. 19). In the spirit of leading edge interpretations Kohut also advised that “one should always take analytic material first in a ‘straight’ manner, as if it means what it seems to mean” (p. 15).

Kohut referred to Miller’s interventions as “trailing edge” interpretations. These included the genetic basis for a particular associative or behavioral sequence as well as what the patient might be afraid or ashamed to reveal—for example, his competitiveness, hostility, or envy—as well as what was subject to repression, negation, rationalization, denial, or other forms of defensiveness and resistance. These interventions were not to be excluded, but rather offered along with the leading edge interpretations, when appropriate.

In an example Miller described a sequence in which the patient had come an hour early to his analytic session and, upon seeing an unfamiliar person in the waiting room, felt dislocated and anxious. Miller focused on the patient having “set up” this situation by coming an hour early. In contrast Kohut proposed a leading edge formulation—namely, that the patient, like a young child eager to see his father (of particular importance in this instance), came early to the session. Kohut suggested that “the patient’s motivation should be regarded first as one of an intense childlike wish rather than as an attempt to ‘set up’ a situation of disappointment” (Miller, pp. 15–16).

Leading edge interpretations take into account patients’ heightened sensitivity to shame and criticism, attempts at mastering painful situations on their own, and attempts at restoring self-cohesion. Furthermore, they attempt to recognize the naturalness of the patient’s response from within the patient’s subjective framework.

Previously (Lachmann, 2000), I have suggested that leading edge interpretations are framed to recognize the extent to which a patient’s thoughts, fantasies, and behaviors are necessary for and strive toward self-protection, self-restoration, self-righting, or self-regulation. These interpretations are particularly powerful in recognizing and validating aspects of a patient’s communications that may be contained within self-defeating behaviors but yet are in the service of attempting to achieve self-cohesion.

To formulate a leading edge interpretation for the man who paid for the dinners of his analyst and colleagues, the treating analyst would investigate the man’s experience as he observed him with his colleagues at the other table. Not having access to the man’s experience, we might speculate here that he may have felt hurt and humiliated in that his tie to his analyst—his idealizing “selfobject” transference in Kohut’s later (1971, 1977) terminology—was ruptured. A leading edge formulation would recognize the necessity for the patient to restore this connection, to feel anew his inclusion in his analyst’s world, by paying the bill for his analyst and his fellow diners. Yet, Kohut also recognized the traditional psychoanalytic trailing edge meanings of narcissism—what the patient tried to ward off and avoid through repetition of self-defeating patterns and defense. In this instance, we might speculate that he may have been warding off feelings of humiliation at being excluded by “competitors.”

Kohut’s work shifted psychoanalysis by reconfiguring surface behaviors and their underlying motivations. He uprooted narcissism from its moorings in pathology and moralistic judgments based on “the altruistic value system of Western civilization” (Kohut, 1966, p. 427) and gave narcissism respectability as a metapsychological construct.

Until its rehabilitation in the works of Kohut, the term “narcissism” had a sad history in psychoanalysis. It had been, and to some extent still is, applied pejoratively to patients who behaved in a conceited, self-centered, insufferably entitled manner, unaware of or unconcerned about their effect on relationships with others and yet demanding recognition or some form of tribute from them. This was the view that the seminar participants seemed to have held about the man who paid for all the dinners. The prevailing wisdom was all too clear: Narcissism and object relations stood in an inverse relation to one another. In contrast Kohut proposed that the antithesis of narcissism is not object relations but object love. Making this distinction allowed him to clarify that we use objects for the contribution they make to our sense of self, a legitimate psychological need that had its own history and was open to analytic investigation. Recognizing the vicissitudes of these needs, how they were met and thwarted, and when and by whom led to a new definition of transference to include this “narcissistic” tie to objects that functioned to regulate self-esteem. Kohut’s revolution consisted of the recognition that it was no longer tenable to suppose that narcissistic patients failed to form transferences; rather, the issue was to understand and investigate the kinds of transferences they did form.

I emphasize this way of thinking about Kohut’s contribution because it shifts our thinking about the analytic dyad and the processes whereby it evolves. That’s the subject matter of this book. To recapitulate, in contrast to the prevailing wisdom that the antithesis of narcissism was object relatedness, Kohut proposed that the antithesis of narcissism was object love, not the object relations with which, traditionally, it had been linked in a seesaw relationship. Object relations, according to Kohut at that time, referred across the board to the whole range of a person’s interpersonal relationships—not to how other people were subjectively experienced. Pursuing this idea further, Kohut (1971) went on to develop the concept of the “selfobject,” to highlight the self-affirming way in which the analyst or another person was subjectively experienced. Various selfobject transferences referred to needed relational experiences that fulfilled vital self-sustaining, self-vitalizing, and self-organizing needs. In his later writings, however, Kohut focused less on object love than on articulating the lifelong need for selfobjects. He subsumed what he had earlier proposed about object love and narcissism in the selfobject concept.

It’s not Kohut’s overall theory that I consider here, but rather a specific aspect of it: his view of what might be achievable with respect to transforming archaic narcissism. In 1966 Kohut published “Forms and Transformations of Narcissism” and it is this paper that provides the overarching theme for this book. It’s my favorite paper by Kohut. The chapters of this book are elaborations and variations on the “transformations of narcissism” he proposed. What I like so much about this paper is Kohut’s application of insights derived from psychoanalysis and psychoanalytic treatment to communication with oneself and with others. In a sense it is a philosophical paper. It speaks of and to the human condition on a grand scale. Through maturation we can come to view ourselves and our world with empathy, humor, creativity, wisdom, and an acceptance of transience.

Clinically, the paper envisioned a novel fate for archaic narcissism. Kohut defined archaic narcissism as referring to the child’s narcissism when it had not been met with favorable parental responses and had therefore been retained, in its archaic form, into adulthood. It had remained in a childlike grandiose and peremptory form, unavailable for tension regulation and self-esteem maintenance. Life experiences had not muted or transformed it into mature forms of narcissism, so now it was up to psychoanalysis to do so. Kohut proposed that archaic narcissism could be transformed into mature forms of narcissism: the traits that Kohut expected a patient to develop through analytic treatment. More generally, these can be thought of as the hallmarks of successful maturation and development over the course of life.

The transformations are discussed in greater detail in the chapters devoted to them. For now, in the order in which I will be discussing them in this book, the transformations of narcissism are

Empathy: “The mode by which one gathers psychological data about other people and, when they say what they think or feel, imagines their inner experience even though it is not open to direct observation” (Kohut, 1966, p. 261). Kohut considered the groundwork for accessing another person’s mind to be laid in the early inclusion of the mother’s feelings, actions, and behaviors in oneself. He considered these assertions about empathy to be “speculative in essence and, for their verification, a psychoanalytically oriented experimental approach” (p. 260, footnote 13) to be needed.

A sense of humor: Especially when combined with “cosmic narcissism, [humor] aids man in achieving ultimate mastery over the demands of the narcissistic self, i.e., to tolerate the recognition of his finiteness in principle and even of his impending end” (p. 267). Like Dickens, who considered a sense of humor to be a sense of proportion, Kohut also considered humor and especially irony to provide an invaluable perspective about the vicissitudes of life.

Creativity: Kohut distinguished between two sides of the narcissism of the creative person, whether artist or scientist. On the one side is the hunger for acclaim of some artists. On the other side is the narcissism that is transformed into the creative act. Kohut links this latter side of narcissism with the blurring of a barrier between oneself and one’s surroundings, leading to a heightened awareness of those aspects of the artist’s surroundings that are relevant to creativity.

Transience: Transience is a capacity to contemplate one’s own impermanence, one’s mortality as one ages. Transience entails a capacity to acknowledge one’s mortality or, as Kohut put it, the finiteness of existence, and to act in accordance with this painful discovery. He held this to constitute a great “psychological achievement despite the fact that it can often be demonstrated that a manifest acceptance of transience may go hand in hand with covert denials” (p. 264). Woody Allen (2006) expressed this tension between acceptance and denial of one’s transience when he quipped: “I was born to the Hebrews but as I got older I converted to narcissism.”

Wisdom: Achieved during the later phases of life, wisdom is preceded by the acquisition of information and knowledge during the earlier phases. Wisdom rests on an “acceptance of the limitations of [one’s] physical, intellectual, and emotional powers” (p. 268). Kohut defined wisdom as a stable attitude toward life and the world, formed through the integration of humor and acceptance of transience and firmly held values and ideals. He held that wise people are able to contrast the “utter seriousness and unrelieved solemnity of approaching the end of life by transforming the humor of their years of maturity into a sense of proportion, a touch of irony toward the achievements of individual existence, including even their own wisdom” (p. 269).

Intuitively, we can feel the aptness and the relevance of Kohut’s contrast of the limitations imposed by archaic narcissism with the expanded and enriched world of relationships with oneself and others depicted in these transformations. Empathy, humor, creativity, an acceptance of transience, and achieving wisdom, Kohut argued, all required overcoming the demands of the narcissistic self. He thereby placed the transformation of archaic narcissism at the center of becoming a mature human being.

Yet, Kohut did not spell out how these transformations were to be brought about in development generally. Nor did he say how they would be brought about through psychoanalysis in particular. He posits that transformations result in these traits or qualities but he does not spell out how this process happens. That is what I address in this book.

Much has happened in psychoanalysis since Kohut published this paper. For me, the contributions of empirical infant research (with special attention paid to the bidirectionality of interactive processes) are especially pertinent. They allow us to consider interactive processes, including therapeutic processes, with new precision. We can fill in some of the details in the picture that, in 1966, Kohut could only have painted in broad strokes.

Kohut’s conceptualization of archaic narcissism and its transformations came from an era of theorizing in which one-way influence models predominated. That is, in development as well as in treatment, effects were predominantly studied in one direction: from parent to child and analyst to patient. Concepts like “co-creation” or “co-construction” were circling in the air but had not yet landed in the field of psychoanalysis. Co-creation means that each partner has made some contribution to what emerges through the partners’ interaction, but their contributions are not necessarily similar, equal, or symmetrical.

Using Kohut’s paper as a template, here is what I propose. First, extrapolating from recent empirical infant research, transformation is presented as a process that is bidirectional and co-created by therapist and patient. The transformed or mature forms of narcissism are thus not end-points or goals of analysis, but rather are embedded within the ongoing therapeutic process and are more or less present as part of the process throughout the treatment. Using empathy as an illustration, the analyst is more often the one who contributes empathic understanding, while the patient contributes a readiness to be empathically understood. This co-creation of empathy directly shapes the affective ambience of the treatment and can gradually transform the analytic experience for both partners.

Note again that “co-create” does not mean that each partner contributes similarly, equally, or sym...

Table of contents

• Cover
• Halftitle
• Title
• Copyright
• Dedication
• Contents
• Preface
• Acknowledgments
• Part 1
• Part 2
• Part 3
• References
• Index