Introduction
Self-psychology is a multifaceted and broad field of contemporary psychoanalytic thought. According to Govrin and Mills (2019), it is characterized by a shift from traditional psychoanalysis to a relational perspective on psychology. The contemporary relational theory has its origin in the concept of self-psychology developed by an influential psychoanalyst Heinz Kohut (Govrin & Mills, 2019).
At the same time, the original model was expanded to include a two-person paradigm that emphasizes intersubjective processes as critical for change. In this regard, it is essential to explore the significance and efficiency of the contemporary approach to psychoanalysis, namely relational self-psychology. The improvement of mental health is one of the aspects that can indicate the positive impact of therapy and evidence of its therapeutic value. This paper aims to discuss the relevance and effectiveness, including strengths and counter-indications, of relational self-psychology.
Therapy’s Relevance and Effectiveness
Kohut’s Contribution to Relational Self Therapy
The self psychology theory comprises a wide range of ideas that can be considered a modern reevaluation of traditional psychoanalysis. In this regard, it is essential to discuss the contribution of Heinz Kohut, the author of this therapeutic and developmental model (Gök, 2021). Self psychology can be defined as a psychological tool that aims to process one’s subjective and unique experience with regard to personal growth and development. Kohut played an essential role in the development of this concept by developing open and comprehensive ideas regarding self psychology techniques and their contribution to treatment outcomes (Magid et al., 2021). In particular, narcissistic disorders were central to the model of self psychoanalysis.
The evolution of Kohut’s original theory resulted in the development of a new perspective. As stated by Magid et al. (2021), it is “characterized by a recognition of the bi-directionality of the analytic relationship and, alongside the patient’s subjectivity, the centrality of the analyst’s subjectivity” (p. 1). The combination of these aspects resulted in the transformation of self psychology from the one-person to two-person approach. This shift in the theory is associated with the adjustments of the role of the therapist, which is more expanded compared to traditional psychoanalysis. According to Magid et al. (2021), subjectivity and participation of the analyst are emphasized, which means that a mutual relationship is formed rather than a provision of functions. In other words, the therapeutic process is considered dynamic and comprehensive.
Relational self psychology is based on the ideas of an intersubjective model and enriched by contemporary considerations. Govrin and Mills (2019) note that modern psychoanalytic theory is coherent with other fields, including “attachment theory, infant research, existential epistemological philosophy, systems theory, evolutionary biology, and … neurobiological studies” (p. 153). As a result of their contributions, the principles of self psychology were introduced in counseling and education. Relational self therapy emphasizes the importance of human relationships and the role of mutual appreciation. As can be seen, these implementations redefine the clinical value of the definition of narcissism (Govrin & Mills, 2019). The unmet needs of a person with a narcissistic disorder result in one’s dependence on others’ attention and increase the importance of mutuality.
Overall, relational self theory can be considered one of the variants of self psychology. Hence, the role of Kohut’s formulations should not be undervalued since he designed an alternative theory of self in contrast to the traditional one (Gök, 2021). In particular, his suggestion regarding one’s need for self-object interactions to remain healthy is one of the central ideas of the framework. Furthermore, Kohan believed that an individual is never complete, which continues to be central to the new model. At the same time, they were modernized in accordance with contemporary perspectives, knowledge, and clinical research (Magid et al., 2021). The relationship between the patient and the counselor was redefined as self psychology continued to develop.
Effectiveness of Self-Psychology
It is essential to discuss the effectiveness and relevance of relational self-psychology. The improvement of mental health is one of the aspects that can indicate the positive impact of therapy and evidence of its therapeutic value. The overview of the literature on this subject has revealed that contemporary psychoanalytical thought can be considered an effective method with regard to the treatment of mental health disorders. Gök (2021) reviewed relevant scientific research papers “published between 2010-2020” and established a positive tendency among findings (p. 654).
The content analysis technique was applied to determine themes and interpret them. As Gök (2021) reports, case studies’ review “contributed to getting important results in this study, in which the effectiveness of the self-psychology approach was examined in the improvement of mental health disorders” (p. 663). It was concluded that relational self-psychology helped clinicians dealing with couple therapy. Gök (2021) highlights the importance of “understanding and reframing conflicts in terms of the underlying self-object needs, the impact of unconscious organizational frameworks, and the effect of learned patterns related to cooperation” (p. 664). The combination of these factors can improve the couple’s ability to meet their self-object needs.
Similarly, other researchers explored the effectiveness of relational self-therapy. Govrin and Mills (2019) highlighted the role of transference and countertransference. Furthermore, the importance and potential of conflicts were explored from the therapy perspective. According to Govrin and Mills (2019), “intra-psychic conflicts would be transformed into a profoundly sensitive therapeutic instrument” (p. 31). Therefore, the responses of patients to underlying conflicts should be examined with more attention due to their contribution to the process of transference.
Furthermore, relational self-psychology considers the therapeutic process as an individual’s opportunity to eliminate empathic failures. There are several relevant instances that support the effectiveness of relational psychoanalysis. In particular, poetry therapy was applied according to the self psychology approach, which resulted in improved empathy, trust, and ego harmony (Gök, 2021). In addition, the relational self-psychology approach allows for a reactivation of the restrained processes and needs of the client through the transference relationship with the counselor (Gök, 2021). Transference is essential for the enhancement of one’s emotional regulation skills.
Another essential aspect of relational self-psychology is the opportunity to end the process healthily. Gök (2021) claims that “even if psychotherapy ends before the therapist’s internal functions are integrated, and negative feelings towards the therapist are fully resolved,” the client maintains the process of change in self (p. 665). Therefore, relational self-psychology aims to help the client preserve the integrity of self throughout the therapy process (Magid et al., 2021). Overall, the review of the literature indicates important findings with regard to the effectiveness and relevance of relational self-psychology. The evaluation of study findings reveals that self-therapy can be considered an effective approach in relation to mental health disorders.
Strengths
The strengths of relational self-therapy must be analyzed as part of the evaluation process for the therapy’s effectiveness. As per Shane and Carr (2021), mutuality must be considered as “a sense of being in it together, a we-ness – that strengthens and restores both the patient’s and the analyst’s sense of self” (p. 139). One of the strengths of the relational model is its suggestion that the therapeutic process is a result of the interaction between the client and the counselor. As a result, there is an opportunity to develop a mutual relationship with an expanded role of the analyst and their subjectivity (Magid et al., 2021). The two-person approach makes relational self-psychology different from its predecessor and the principles of traditional psychoanalysis.
Another essential aspect is maturity which can improve the client’s ability to engage in mutually supportive self-object relationships. In this regard, early narcissistic needs do not determine the individual’s choice of self objects (Magid et al., 2021). In turn, emotional health allows for the choice based on adult development. Empathy is another strength of the self psychology approach since it enables the therapist to explore the inner world of the patient. As a result, psychological information can be collected efficiently, which can improve therapeutic outcomes (Shane & Carr, 2021). In other words, empathy can be considered a useful tool for introspection, allowing the counselor to understand the client’s fears and concerns. This process is central to establishing a working alliance with the patient.
Furthermore, relational self-psychology emphasizes the role of the therapist. For instance, the counselor becomes a new self object, which allows the client to establish more mature self-object relationships in their life (Shane & Carr, 2021). In addition, the therapists’ calming and competent manner can be detrimental to the patient’s ability to self-empathize and self-comfort. There are two essential aspects involved in this process: mirroring and idealizing (Magid et al., 2021). Overall, the conceptual uniqueness of self-psychology constitutes one of its main advantages.
It is worth noting that this characteristic of relational self psychology makes this therapy efficient for children. Lack of impulse control, depression, rage, and insufficient social skills can be a result of inadequate responses of the caregiver. In other words, important childhood wishes and needs are not met, which leads to recurring patterns of negative behavior in an attempt to gain the required response (Magid et al., 2021).
In particular, this can be done by mirroring and idealizing self-objects. Therefore, the therapist can evaluate the child’s needs and respond to them appropriately. It is essential to understand the specifics of working with young patients and not to interpret their needs. Similarly, relational self-psychology can be implemented in treating adolescents. They tend to loosen ties with self-objects and compare parental ones to those of peers with regard to values and ideals (Magid et al., 2021). Strength and flexibility are critical in the process of experiencing self.
The conceptualization of the inner life of patients is another strength of the theory. Kohut’s hypothesis regarding narcissism allows for evaluating whether a healthy course of development takes place (Magid et al., 2021). In addition, self issues are considered a lifetime concern, which emphasizes the importance of growth for human beings (Govrin & Mills, 2019). The universal need of people for empathic responses is another strength of relational self-psychology that provides a new perspective of treatment. Empathy and mirroring are two central concepts that enable the formation of identity.
Counter-Indications
At the same time, it is essential to discuss the limitations and counter-indications of relational self psychology. According to Magid et al. (2021), Kohut’s conceptualizations challenged the original principles of psychoanalysis, questioning the main aspects of its theory and practice. For instance, the concepts of narcissism, transference, and the self-object dimension are considered reductive and neglected with regard to other important dimensions (Magid et al., 2021).
Another limitation of the theory is based on the stylistic differences in the original writings by Kohut. In particular, his early works are difficult to comprehend, which results in significant criticism of his formulations (Govrin & Mills, 2019). Another difficulty is related to the methodological issues and the fields of introspection and empathy, characterized by exclusivism. Kohut’s focus was on specific narcissistic or self-object transferences, which differed from the object transfers that classical analysts dealt with. Kohut identified three types of self-object transferences: mirror, idealizing, and twin.
Another counter-indication of relational self-psychology can be related to the lack of specificity. Namely, this approach to treatment is not disorder-specific due to the belief that a self-empowering system can help any patient, which in turn would be tantamount to homogenizing mental disorders (Govrin & Mills, 2019). In addition, one-sided responsibility is considered another limitation of the method.
According to Magid et al. (2021), it is excessively one-sided to blame the empathy of the therapist or the parents for aggression that occurs in the patient. Such an approach is differentiated and can be considered naïve environmentalism (Magid et al., 2021). Finally, confusing conceptualizations comprise another disadvantage of the self-psychology theory. The concept of the self-object is so vaguely conceptualized that the explanatory power is lost as a result. In particular, everything can become a self-object, not only people but at the same time activities, hobbies (Magid et al., 2021). As a result, there are additional difficulties in the implementation of the theory in clinical practice.
Unanswered questions can be considered another limitation of the theory based on Kohut’s framework. It would leave central questions unanswered, including what motivates the self, how idealizations and self-objects develop, and what the role of object relations is (Govrin & Mills, 2019). Furthermore, confusion of words and inner experience is part of a larger problem: confusing a patient’s statements about their experience with the real nature and severity of their regression. For example, if a patient says they feel confused or like they’re falling to pieces, that doesn’t necessarily mean they’re experiencing fragmentation.
Conclusion
Overall, self-psychology refers to a psychoanalytic theory established by Heinz Kohut and deals with the organization and maintenance of the self depending on the objects in the environment. The contemporary relational theory originates from the concept of self psychology, expanded to include a two-person paradigm. In this regard, it is essential to explore the significance and efficiency of the contemporary approach to psychoanalysis, namely relational self-psychology. The improvement of mental health is one of the aspects that can indicate the positive impact of therapy and evidence of its therapeutic value. It can be concluded that the overview of the literature shows the relevance and effectiveness of relational self-psychology. In particular, the role of the therapist, conceptualization of the inner life of patients, and the universal need of people for empathic responses can be listed as the strengths of the theory.
References
Gök, A. (2021). Systematic investigation of the effectiveness of self-psychology approach in treatment of mental health disorders. Current Approaches in Psychiatry, 13(3), 654-667. Web.
Govrin, A., & Mills, J. (Eds.). (2019). Innovations in psychoanalysis: Originality, development, progress. Routledge.
Magid, B., Fosshage, J., & Shane, E. (2021). The emerging paradigm of relational self psychology: An historical perspective. Psychoanalysis, Self and Context, 16(1), 1-23. Web.
Shane, E., & Carr, E. M. (2021). Prologue: The many faces of self psychology.Psychoanalytic Inquiry, 41(3), 139-140. Web.