Carl Rogers and Heinz Kohut - Edwin Kahn · ROGERS AND KOHUT 295 Different psychoanalysts, with...

Psychoanalytic Psychology Copyright 2000 by the Educational Publishing Foundulit

2000, Vol. 17, No. 2, 294-312 0736-9735/00/$5.(KI DOT: 10.K137//0736-9735.17.2.25

Carl Rogers and Heinz Kohut

A Historical Perspective

Edwin Kahn, PhDCity University of New York

Arnold W. Rachman, PhDAdelphi University

Earlier psychoanalytic thinkers, with their humanistic orienta-

tions, anticipated Heinz Kohut's theories and, therefore, contrib-

uted to the historical evolution of self psychology. Carl Rogers,

a founder of humanistic psychology in the United States, was a

theorist who struggled with many of the same issues as Kohut.

Rogers had new ways of looking at therapy, and especially at

the therapeutic ambience, ways that foreshadowed the discover-

ies of Kohut. This article discusses areas of compatibility of the

2 theorists, such as their focus on empathy and the self, to

encourage a rapprochement between humanistic psychotherapy

and self psychology. Kohut revolutionized psychoanalysis by

making it more humanistic. In that revolution, many of

Rogers's empirically tested ideas were incorporated into a

comprehensive psychoanalytic theory and clinical method.

Because of the areas of mutual concerns and overlap, a fuller

appreciation of Rogers's important ideas will be beneficial to

self psychology.

Edwin Kahn, PhD, Department of Social Sciences, Queensborough CommunityCollege, City University of New York; Arnold W. Rachman, PhD, Derner Institute,

Adelphi University.Correspondence concerning this article should be addressed to Edwin Kahn,

PhD, 50 West 97th Street, Apartment 6T, New York, New York 10025. Electronic mail

may be sent to [email protected].

294

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ROGERS AND KOHUT 295

Different psychoanalysts, with their humanistic orientations, such as Fer-

enczi, Rank, Alexander, Winnicott, Guntrip, and Fairbairn, anticipated the

discoveries of Heinz Kohut and therefore made an important contribution

to the evolution of self psychology (see Detrick & Detrick, 1989; Rach-

man, 1997a, 1997b). Carl Rogers, a co-founder of humanistic psychology

in the United States, was a humanistic theorist who can be seen as

struggling with some of the same issues as Kohut. Rogers, farm-raised in

the Midwest, developed a theory of psychotherapy that in many respects is

very American. Rogers's psychotherapy was optimistic, it focused on the

here and now, and it was usually short term (contemporary Rogerian

therapists report that long-term therapy is now common). Also, Rogers had

more interest in personality change than in development, and he thought

the relationship in the here and now was more important than transference

or countertransference issues. Importantly, Rogers's approach was Ameri-

can because it was influenced by the logical positivism and empirical

tradition of American philosophy. Personality change, expressed in terms

of the self, was central in Rogers's theory and was based, considerably, on

empirical data.

Rogers did, for his time, have some very new ways of looking at

therapy, and especially at the therapeutic ambience, ways foreshadowing

different discoveries of Kohut. For example, Stolorow (1976), in an early

comparison between Rogers's and Kohut's work, stated that

there appear to be striking parallels between the techniques, therapeutic

processes and ideal outcome formulated in the analytic treatment of narcissistic

disorders,... and the techniques, therapeutic processes and ideal outcome of

client-centered therapy as conceptualized by Rogers. The understanding and

treatment of the narcissistic disorders may thus provide an unexpected area of

rapproachement between psychoanalytic and client-centered therapists, (p. 28)

Other investigators, in addition to Stolorow, have made comparisons

between Rogers's and Kohut's work (see Bohart, 1991; Kahn, 1985,1989a,

1989b, 1995, 1996; Tobin, 1990, 1991). These comparisons show that a

rapproachement between humanistic psychology and psychotherapy and

psychoanalytic self psychology is meaningful and could be of benefit to

self psychology (as well as to client-centered therapy). A discussion of

Rogers's contributions as they relate to Kohut's is also important to

chronicle more thoroughly the historical evolution of self psychology.

To explore the potential contribution that Rogers's work can make to

self psychology, the following is a summary of those aspects of his work

that are relevant to a rapprochement. Rogers's basic premise was that there

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296 KAHN AND RACHMAN

is a constructive striving in each individual (as well as in all of nature) to

reach his or her potentialities, which he called an actualizing tendency.

When a person experiences unconditional positive regard (nonjudgmental

acceptance) and empathic understanding from a significant other who is

also experienced as genuine and human, the person develops unconditional

positive self-regard (self-esteem), and the process of actualization is

promoted. Conversely, this natural growth tendency is thwarted when the

person experiences conditional acceptance or the absence of empathy.

Thus, there are three conditions, according to Rogers, that are necessary

and sufficient to facilitate the growth of a person: unconditional positive

regard (prizing the other), empathic understanding, and a nondefensive

integrated state characterized by openness and genuineness (also called

congruence). In the therapeutic relationship, which came to be called

client-centered therapy, Rogers focused completely on the subjective

experiences of the client, seeking to be a companion to the client and to

avoid imposing an agenda on or guiding the client in any way.

Rogers, beginning in the 1950s, and even more so in the last decades

of his life, came to emphasize that the ideas he discovered in the field of

psychotherapy applied to all human relationships: that "the boundary

between psychotherapy and ordinary life is necessarily thin" (Kramer,

1995, p. xii). In this respect, Rogers's ideas are quietly permeating today's

culture in sell-help groups, the classroom, and parenting. Rogers's ideas

were very simple, yet profound. With an accepting, understanding, and

genuine attitude and the relinquishing of power and control over others,

people will grow. This application of Rogerian ideas outside of therapy

came to be called the person-centered approach (for a complete descrip-

tion of the evolution of Rogers's ideas, see Raskin & Rogers, 1995).

As can be seen in these basic tenets of Rogers's humanistic psycho-

therapy, there are similarities and compatibilities with Kohut's thinking.

Coincidentally, Kohut and Rogers were at the University of Chicago at the

same time, from 1945 to 1957. Kohut was in the Department of Neurology

and Psychiatry, and Rogers was a professor of psychology. Rogers, curious

about the parallels between his work and Kohut's (personal communica-

tion, August 27, 1986), wrote:

I certainly acknowledge there is a large and important overlap between Kohut's

views and mine. What I wish I knew, and perhaps you may have some clues toIhis, is how much uf his thinking and his "new discoveries" were based on a

knowledge of my work. It certainly is not a coincidence that while at theUniversity of Chicago he developed an interest in empathy and the self, the twomajor features which I had been formulating and writing about for quite a

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number of years. I deeply regret that I never had personal contact with him. The

Department of Psychiatry at that time was attacking my work at the Counseling

Center, declaring that we were practicing medicine without a license. They did

not like the idea of psychologists doing therapy. I don't believe that Kohut had

any part in this at all, hut the estrangement between the two departments was

very deep and I never got to know any individuals except the chairman of

psychiatry.

It is of interest that Kohut was apparently aware of Rogers's work,

which he unfortunately described with some disdain, but it is not clear

whether any of Kohut's "discoveries" were influenced by this awareness.

According to Kohut (1973/1978b):

Certain forms of psychotherapeutic counseling, for example, which enjoy at

present a not inconsiderable popularity, restrict their technique in the main to

letting the patient say everything that occurs to him. The counselor's passive

attitude seems to be similar to the analyst's attitude of expectant silence; he

listens, and either says nothing or merely repeats what the patient has just said

himself. But while the analyst employs his method for a specific purpose—he

listens in order to understand and then explain, thus enabling the patient to

enlarge his knowledge of himself—for the counselor, the method of free

association appears to have become an end in itself. But when this use of free

association is extolled as being superior to psychoanalysis, then the analyst

cannot refrain from shaking his head in amazement. He understands, of course,

how, in certain instances, temporary improvements are quickly brought about in

this way. (pp. 523-524)

Kohut went on to compare this type of psychotherapeutic counseling with

the work of a repairman who managed to fix an old alarm clock of his. This

repairman knew nothing about clocks; what he did to restore its function-

ing was just clean and oil the clock's inner parts.

There is no need to spell out the analogy between the so-called watchmaker and

the practitioners of certain kinds of psychotherapy—except, T think, that my

so-called watchmaker had a higher percentage of successes and knew more

about what he was doing than most of the psychotherapists who borrow one or

the other insight or technical rule from psychoanalysis and apply it without

understanding. (Kohut, 1973/1978b, p. 525)

With these comments, Kohut obviously was not exhibiting much

appreciation of Rogers's therapeutic innovation of empathic listening, that

is, attempting to see things as completely as possible from the client's

framework. American psychoanalysts, in general, have rarely appreciated

Rogers's contributions, which have often been dismissed as shallow or

superficial. We believe that Rogers's therapeutic innovations are more

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profound than has been previously appreciated and that many of his ideas

have already been incorporated into psychoanalytic self psychology. One

possible reason for Kohut's dismissal of Rogers's therapeutic innovations

was that Kohut wanted to claim that he was the originator of the concept of

therapeutic empathy. Rachman (1989, 1997a, 1997b) has noted that Fer-

enczi introduced "the rule of empathy" into psychoanalysis in the 1920s

and that Kohut also failed to acknowledge Ferenczi's contribution. Kohut

(1959/1978a) did discuss Freud's use of empathy and introspection as

observational tools to investigate a person's inner world (p. 211), but

nowhere, to our knowledge, did he give credit to any predecessors for the

therapeutic benefits of empathy.

Interestingly, there is a link between Rogers and psychoanalysis in

his early training at Rochester, when he became familiar with the work of

Otto Rank and several of Rank's students. For example, his "reflection of

feeling" response was influenced by a Rankian-trained social worker,

Elizabeth Davis (Raskin & Rogers, 1995, p. 133).

Relevant to the rapprochement of Rogers's views with self psychol-

ogy is Robert Stolorow's (1976) article, "Psychoanalytic Reflections on

Client-Centered Therapy in the Light of Modern Conceptions of Narcis-

sism." Stolorow (1976) described how Rogers, with his empathic reflec-

tion of feeling and his acceptant attitude, encouraged the development of a

mirror transference:

Indeed, Rogers' technical recommendations (which are in many respects similar

to those of Kohut with regard to the unfolding of the grandiose self) seem ideally

suited to promote the development of a narcissistically sustaining mirror

transference. The therapist is enjoined to reflect the patient's experiences with an

attitude of unconditional positive regard and acceptance, with an eye toward

affirming the client's worth, significance and value to the therapist. The client

thus comes to experience himself as "prized" . . . by the therapist, much as does

the narcissistically disturbed patient immersed in a mirror transference, (p. 28)

Stolorow (1976) then selected abeautiful quote from Rogers's 1951 book,

Client-Centered Therapy:

The therapist endeavours to keep himself out as a separate person . .. his whole

endeavour is to understand the other so completely that he becomes almost an

alter ego of the client.... The whole relationship is composed of the self of theclient, the counselor being depersonalized for the purposes of therapy into being

"the clienl's olher self." (Rogers, 1951, pp. 42, 208)

Stolorow (1976) eloquently noted the similarity of this way of being to

Kohut's description of narcissistic patients who use the analyst imperson-

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ally to fill in missing parts of their self-structure. According to Stolorow

(1976):

The therapist who follows Rogers' recommendations thus divests himself of his

own selfhood and embraces the role of a part, extension or duplicate of the client,

a "pure mirror image" of the client, a depersonified medium in which the client'ssense of self may germinate and consolidate. As in the handling of the mirror

transference, the client-centered therapist accepts (and even promotes) his role asan impersonal function substituting for missing or defective segments in the

client's own self-structure. Tt is not surprising, then, that the recipient of

client-centered therapy would report a buttressing of his sense of self-cohesion,

self-identity and self-esteem by virtue of his immersion in the therapeutic

relationship. It is also not surprising that Rogers describes individuals in

client-centered therapy who, like patients involved in a mirror transference,

experience temporary states of self-fragmentation when there is a disruption in

the narcissistically sustaining therapeutic relationship, (p. 28)

With this comparison, Stolorow highlighted the remarkable similarity of

the therapeutic relationship for Rogers and Kohut.

In the remainder of this article, we further elaborate Rogers's ideas as

they relate to Kohut's on a variety of issues. This comparison will be useful

to self psychology, because Rogers's humanistic psychotherapy provides,

in many respects, a foundation for Kohut's thinking. In other words, self

psychology, with its more comprehensive theory and clinical methods,

may be seen as an analytic evolution of Rogers's client-centered psycho-

therapy.

Self-Concept

Rogers and Sanford (1984) stated that

very early, it was found that clients in therapy frequently focused their problems

and their progress in terms of self. "I feel I'm not being my real self." "It feels

good to let myself go and just be myself here." Gradually, the crucial importanceof the self and its changing quality became evident, (p. 1382)

Rogers became interested in the enhancement of self-regard or self-esteem

in psychotherapy; that is, with unconditional positive regard, positive

self-regard develops. He also described the integrated, healthy self as being

able to experience nondefensively all thoughts and feelings in its organism,

a way of being that he termed congruence. Incongruence occurs when

experiences in the organism are blocked off from or distorted in self-

awareness. Rogers's description of an incongruent client experiencing

more congruence from psychotherapy appears very similar to the lifting of

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repression for Freud (Kahn, 1985). However, this lifting of repression, for

Rogers, came about not from interpretations but, rather, from a safe human

relationship that provided unconditional positive regard and empathic

understanding. Kohut, on the other hand, was more interested in self-

cohesion and various expressions of narcissistic deficit, as when the self is

either fragile or vulnerable.

Empathy and a Changed Listening Stance

Both Rogers and Kohut stressed the importance of empathy, that is,

listening to and accurately understanding the subjective experience of the

client or patient. Different writers have noted how special Rogers's

capacity for empathy was. Stolorow (1976), for example, commented that

"Rogers's discussion of the critical importance of the communication of

acceptance and empathy in client-centered therapy, and his suggestions as

to how this communication may be achieved, are probably unsurpassed in

the clinical literature" (p. 29). And Kramer (1995), in describing Rogers's

empathic stance, stated that "Rogers does what generations of psychology

students have satirized him for doing, namely, repeat clients' words. But he

also summarizes clients' feelings with precision, beauty of expression, and

generous tentativeness" (p. xiv).

Schwaber (1983, pp. 380-381) believed that Kohut's most important

contribution was his shift in listening stance, that is, his making a sustained

effort to listen from the patient's perspective. She described how that

change occurred with Kohut's well-known patient, Miss F (Kohut, 197]).

Kohut (1984) summed up this changed listening stance in the following

way:

If there is one lesson that I have learned during my life as an analyst, it is the

lesson that what my patients tell me is likely to he Irue—that many times when t

believed that I was right and my patients were wrong, it turned out, though often

only after a prolonged search, that my lightness was superficial whereas their

lightness was profound, (pp. 93-94)

Recently, Magid (1996) echoed Schwaber's sentiment: "Kohut's great

contribution was conceptualizing the centrality of the empathic stance, by

which the subjective validity of the patient's inner world was explored and

acknowledged, without any implication that this perspective be viewed as

distorted and ultimately relinquished" (p. 619).

An attitude of attempting to just listen to what the client is experienc-

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ing, without interpretation, is the attitude that Rogers was advocating as

early as the ] 940s. At that time, Rogers (1942) wrote:

This course of action imposes much self-restraint upon the counselor. The reason

is simple. As the client reveals himself more and more fully in the counseling

interviews, the counselor begins to develop insight into the client's problems....

There is the greatest temptation to most counselors, whether they are psychia-trists, psychologists, guidance counselors, or social workers, to inform the client

as to his patterns, to interpret his actions and his personality to h im. . . . The more

accurate the interpretation, the more likely it is to encounter defensive resistance.

The counselor and his interpretations become something lo be feared. To resist

this temptation to interpret too quickly, to recognize that insight is an experience

which is achieved, not an experience which can be imposed, is an important step

in progress for the counselor, (pp. 195-196)

It is important to see how early Rogers was appreciating the validity of the

subjectivity of the client. We believe that Rogers deserves historical credit

for his role in articulating the therapeutic benefits of empathy. Psychoana-

lytic thinkers of today tend to overlook Rogers's original contribution in

this area.

Of course, Rogers did not have to extricate himself from an orthodox

psychoanalytic theory that emphasized interpretations, as Kohut did.

However, in the 1920s, at his doctoral internship in New York City, Rogers

was trained in the dynamic Freudian approach (N. J. Raskin, personal

communication, January 19, 1998), and in the 1930s he used an interpreta-

tive therapy that he eventually found unhelpful and discarded (Kirschen-

baum, 1979, pp. 86-92).

Unconditional Positive Regard

According to Rogers and Sanford (1984):

The therapeutic process is enhanced when the therapist both experiences and

communicates to clients a deep and genuine caring for them as persons withmany constructive potentialities. When this caring is uncontaminated by

judgments or evaluations of the thoughts, feelings, or behaviors, it deserves the

term "unconditional positive regard." (p. 1379)

Kohut would surely agree that nonjudgmental acceptance of the person is

an important quality for therapeutic effectiveness. Rather than uncondi-

tional positive regard, Kohut emphasized mirroring, or "the gleam in the

mother's eye," as essential for the healthy development of the self. These

concepts, unconditional positive regard and mirroring, are similar but not

identical. Unconditional positive regard is an attitude of consistent accep-

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tance and nonpossessive wannth and care held by the therapist (or parent)

toward the person as a whole. Mirroring is a sharing of joy or pleasure, an

"acceptance and confirmation of the self in its grandness, goodness, and

wholeness" (Wolf, 1988, p. 184). Whereas unconditional positive regard is

ever present, mirroring seems contingent on some action or responsiveness

in the person and, therefore, may not be so unconditional.

Whereas Rogers, from the 1940s onward (see Rogers, 1951, pp.

159-172), advocated the consistent acceptance or prizing of a client, Kohut

and other self psychologists, at least through the 1970s and 1980s, were

more hesitant to "prize" or "mirror" a patient in analytic therapy. For

example, Stolorow (personal communication, June 1983) wrote:

For Kohut, mirroring is nvl something that the analyst actually tries to provide.

Rather it is something that the patient is permitted to experience subjectively as

an aspect of the transference revival of an early selfobject tie. The patient's need

for mirroring is accepted, understood, empathically interpreted, and ultimately

worked through in the transference according to Kohut.

Kohut (1983) also denied the criticism "that we gratify our patients by

'mirroring' them" (p. 402), and Basch (1981) stated that "a patient's need

to be mirrored . . . can be met with an analytic response . . . no . . .

indulgence of the patient is called for" (p. 343).

One does find, however, examples in Kohut's writings in which he

advocated providing positive experiences for patients. For instance, in his

seminal paper on introspection, empathy, and psychoanalysis, Kohut

(1959/1978a) wrote, when describing addicts:

Their addiction must not, however, be confused with transference: the therapist

is not a screen for the projection of existing psychological structure; he is a

substitute for i t . . . The patient now really needs the support, the soothing of the

therapist. His dependence cannot be analyzed or reduced by insight; it must be

recognized and acknowledged, (p. 225)

And, in his final book, when discussing the overevaluation of patients by

their analysts, Kohut (1984) stated that, "this overevaluating attitude too is

'normal' .. . and that an analyst who consciously eradicates this attitude

and replaces it by cold objectivity... is as misguided as the Watson-guided

'objective' mother of half a century ago" (p. 190). Kohut (1984, pp. 78,

153) and other self psychologists (e.g., Miller, 1990; Wolf, 1990) also

emphasized the importance of providing a "corrective emotional experi-

ence," as described by Alexander (1956). And Orange (1995), echoing

Rogers's humanistic beliefs, has commented that "psychoanalytic under-

standing is, among other things, a form of loving, and it can be experienced

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in that way by the patient. It differs from empathy, which is value-neutral

and can be used to hurt people" (p. 171).

At this point, it may be useful to briefly discuss the relationship

between unconditional positive regard and empathy. As noted, with uncon-

ditional positive regard the person as a whole is prized, whereas empathy is

the ability "to perceive the internal frame of reference of another with

accuracy" (Rogers, 1980, p. 140). Empathy, as pointed out by Kohut

(1981) and others (e.g., Shlien, 1997; Orange, 1995), in addition to having

a therapeutic function, can also be used to harm or manipulate people. In

his final address, Kohut (1981) said, "If you want to hurt somebody, and

you want to know where his vulnerable spot is, you have to know him

before you can put in the right dig." Appreciating this negative use of

empathy, Orange (1995) distinguished, in psychoanalytic epistemology,

between empathy and empathic understanding: "Empathy defines the way

of knowing—vicarious introspection—and the nature of the known—

complex psychological configurations—that we seek to understand in

depth" (p. 23). In contrast, empathic understanding includes a helpful

response, such as a therapist adjusting the heat and light for a patient's

comfort or a parent protecting a child from mistreatment (Orange, 1995,

pp. 22-23). It seems that, for Orange, empathic understanding (in contrast

to empathy by itself) includes caring responsivity (i.e., unconditional

positive regard).

Being Human

In a conference commemorating the 100th anniversary of psychotherapy,

Rogers (1985) was asked by a participant what the profession of psycho-

therapy had learned over the past 100 years. Rogers thought about the

answer for several moments and then said, "I don't know what the

profession has learned, 1 really don't. I've learned to be more human in the

relationship, but I am not sure that that's the direction the profession is

going." For Rogers, what is most healing is being openly oneself in a

relationship. In a lovely passage, Rogers and Sanford (1984) wrote:

The kind of caring that the client-centered therapist desires to achieve is a

gullible caring, in which clients are accepted as they say they are, not with a

lurking suspicion in the therapist's mind that they may, in fact, be otherwise. Thisattitude is not stupidity on the therapist's part; it is the kind of attitude that is most

likely to lead to trust, to further self-exploration, and to the correction of falsestatements as trust deepens, (p. 1379)

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Kohut (1984), although probably more reserved than Rogers, did

write that, because of self psychology, "I have come to feel freer and,

without guilt and misgivings, to show analysands my deep involvement

and concern via the warmth of my voice, the words that I choose, and other

similarly subtle means" (p. 221). And Wolf (1987), in a speech discussing

whether or not interpretation should be used, stated, "It really doesn't

matter what you do, what matters is who you are," which surely relates to

the human qualities of the therapist.

But for Rogers, Kohut did not go far enough in emphasizing the

human qualities of the therapeutic relationship. For example, Rogers

(1986) had interesting comments to make after viewing Kohut's (1981) last

lecture, "On Empathy," given 4 days before Kohut's death. We present

what Kohut said, followed by Rogers's reply. Kohut's (1981) remarks

came at the end of his talk, as he described his work with a strongly suicidal

I suddenly had the feeling . . . "how would you feel if I let you hold my fingers

for a little while, now while you are talking, maybe that would help you";

doubtful maneuver, I am not recommending it, but I was desperate, I was deeply

worried. So I gave her two fingers. Moved up a little bit in my chair, gave her two

fingers, now I'll tell you what is so nice about that story, because an analyst

always remains an analyst—I gave her my two fingers, she took a hold of them

and I immediately made a genetic interpretation to myself, "it was the toothless

gums of a very young child clamping down on an empty nipple." That's the way

it felt. I didn't say anything. I don't know whether it was right, but I reacted to it

even there as an analyst to myself. [It] was never necessary any more. 1 wouldn't

say that it turned the tide. But it overcame a very, very difficult impasse, at a

given dangerous moment, and gaining time that way, we went on for many, many

more years, with reasonably substantial success.

Rogers's (1986) reaction to Kohut's remarks was as follows:

It seems clear that in this interaction Dr. Kohut is experiencing desperation,

caring, and compassion. He found a beautifully symbolic gesture that enabled

him to express something of what he was feeling. Yet he is apologetic about this,

about giving her his fingers to hold. Even more astonishing—and sad—is his

interpretation to himself that he is giving her a dry nipple. He appears unaware

that by giving something of himself—of his own deep and persistent feel-

ings—he is giving her the nourishing human caring and compassion that she so

desperately needs. Being thus openly feeling with her is most therapeutic. Yet he

seems dubious and apologetic about his action. He appears to be unaware that

being openly himself in the relationship was the most healing thing he could

have done. It is obvious that I differ deeply from Dr. Kohut in the value I give to

being one's own whole person in the relationship, (pp. 132-133)

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Rogers, we imagine, was unable to fully appreciate the orthodox tradition

that Kohut, with considerable conflict, was seeking to separate from.

Toward More Equality

Rogers called for a greater equality in the therapist-client relationship. He

was critical of the psychoanalytic approach of his era, in which inter-

pretations were often imposed on patients. There is no "expert" in the

client-centered approach: The client's power in the relationship is pro-

tected as much as possible, and power is not invested in the therapist or

specialist. Kramer (1995) stated that, "for Rogers, the cardinal sin in

therapy, or in teaching or family life, is the imposition of authority" (p.

xiii). The very labels he chose for his form of therapy (at first he called it

nondirective therapy) illustrate this wish to relinquish any influence or

control over another. In a speech, Wolf (1987) agreed with Rogers's

sentiments:

One can think of the analytic situation as being sort of tilted, with the analyst

up here and the patient down there, and a really consistent application of

selfobject theory would bring that tilt up to a more equal kind of level, and

it's our defensiveness, our narcissistic defensiveness, that tries to keep us up

there.

Also important is that Kohut, with his changed listening stance, corrected

some of the more obvious power inequities of traditional psychoanalysis.

Transference as a Distortion

Rogers did not elaborate a developmental theory and was not especially

interested in the phenomenon of transference. He was interested in the real

existential encounter in the here and now. A student of Rogers's, John

Shlien (1987), in an interesting article that emphasized Anna O's erotic

attachment to Josef Breuer, criticized the transference concept. Shlien

argued that transference was a fiction or, rather, a defense mechanism used

by therapists "to protect themselves from the consequences of their own

behavior" (p. 15). According to Shlien, when a client falls in love with or

gets angry at a therapist, therapists, starting with Breuer, have used the

concept of transference to deny their culpability in eliciting these feelings.

However, with the elaboration of a two-person paradigm in self psychol-

ogy, the idea of transference as a distortion disappears. Shlien's criticism

becomes moot, because in contemporary self psychology it is acknowl-

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edged that, in their mutual interaction, the different qualities of the

therapist are influencing the patient, and vice versa.

Interpretations

Kohut (1981, 1982, 1984) distinguished between two kinds of empathy—

understanding, a lower form, and interpretation, a higher form—and he

believed that an interpretative phase was necessary for a psychoanalytic

cure. Rogers came to oppose interpretations; he believed that they were a

manifestation of the medical model, having an expert cure an illness. For

Rogers, the client has the capacity to discover his or her own answers and,

as a result, will become self-empowered. After viewing Kohut's (1981)

lecture, Rogers commented:

Our purposes in being empathic are nol Ihe same. Kohut planned to use his

perception of the inner world of the patient to make interpretations of the

patient's behavior. My purpose was, through a sensitive empathy, to be a

companion to my client, giving him the courage to go on in his voyage of

self-discovery. . . . Kohut's patient, receiving an interpretation, is illuminated by

the insight when he is ready to accept it. It is also very likely, judging from the

analyst-patient relationship portrayed in the film, that he perceives Dr. Kohut as a

wise and gifted person who can provide him with these understandings of self.My client, sensing that I am a companion to him in his search, discovers Ihe

same insight and feels equally illuminated. But he also gains confidence inhimself as he realizes that he has the capacity and the power to discover and learn

the meanings of his own behavior. Thus, it appears to me that Kohut's patient

learns and profits from the insight and becomes a bit more dependent on the

analyst. My client learns and profits from the insight, perhaps a trifle later, andbecomes a bit more independent and self-empowered. (Rogers & Sanford, 1984,

p. 1379)

The questions raised in Rogers's remarks are interesting: whether a patient

becomes more dependent on an analyst as a result of an empathic

interpretation and, furthermore, whether such dependency feelings, if they

occur, are necessarily detrimental. Tt is noteworthy that some contemporary

self psychologists have deemphasized the use of interpretations. For

example, according to Miller's (1985) speech:

The stressing of interpretation is an ancient tradition in analysis, a tradition that

has been perpetuated through the passing of analytic generations, without, in myopinion, open-minded reexamination based upon empirical data. Tt is possible

that if one attempted to maintain an empathic resonance with one's patient, in sofar as possible continuously to maintain the mutual efforts at understanding thepatient's inner state, that this might be the most productive way to promoteincreasing self-awareness and maximum therapeutic effectiveness.

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And Wolf (1986) stated that "crucial is the proper attunement of affect,

guided by empathy, and not the verbal message that is being conveyed, or

what explanations the therapist gives or does not give to the patient."

Offering a slightly different position, Merton Gill (personal commu-

nication, August 28, 1991) wrote, "Rogers certainly performed an impor-

tant service by pointing to the authoritarian way in which many analysts

employ interpretation, but a misuse of a technique does not mean the

technique is to be abandoned." Finally, Orange (1995) stated, "I think

much of the therapeutic effect of analytic interpretation may lie, not so

much in the insights provided or even jointly found, but instead in the

patient's experiencing for the first time being important enough to a

parent-substitute to be thoughtfully considered" (pp. 30-31). One may add

that important selfobject needs of the therapist are also satisfied when, as a

result of a constructive interpretation, a patient expresses appreciation.

Free Will and Determinism

For Kohut (1980), a self with ambitions, skills, and talents, as well as ideal

goals, is poised to the future and "has a significance all of its own,

independent of the genetic factors that—in the area of cause-and-effect

determinism—had originally laid down its contents and had given it its

shape" (p. 540). This view of the self, making choices and exercising free

will, is central to Rogers's humanistic philosophy as well. Rogers echoed

Kohut's ideas when he stated, just as in physics,

where you can prove that the wave theory of light is supported by evidence; so is

the corpuscular theory. . . . I think one would be narrowing his perception ofphysics to deny one of these and accept only the other. And it is in this same

sense... that I regard these two dimensions [free will and determinism] as bothreal, although they exist in a paradoxical relationship, (cited in Kirschenbaum,1979, p. 269)

Freudian Instinct Theory

Both Kohut and Rogers opposed the Freudian model of human nature: that

sex and aggressive instincts need to be tamed by the influences of

civilization. With humor, Gill (personal communication, December 17,

1990) wrote, "You may be amused to know by the way that once I was on a

platform with Rogers and he criticized psychoanalysis for believing in

original sin. I told him I felt the criticism was justified but that he

apparently believed in original virtue."

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Transcripts and Empirical Testing

A significant contribution of Rogers is that he was the first to attempt to

demystify the nature of psychotherapy by making sessions open to public

scrutiny. In the 1940s, he published verbatim transcripts of therapeutic

encounters. For more than 50 years, investigators such as Porter (1943),

Snyder (1945), and, more recently, Bradley (1994), using these transcripts,

have measured how therapists actually behave with clients. Regarding this

issue, Gill (personal communication, August 28,1991) wrote, "I also think

Rogers deserves a great deal of credit for being the first person to present

verbatim sessions. Since him, a number of people have plucked up the

courage to do so but he was the first." These transcripts, along with

Rogers's persistent effort to construct a theory of the self with postulates

testable through empirical means, stimulated considerable research on

client-centered therapy.1 Raskin summarized Rogers's contributions in the

1940s:

In a very short time, an entirely new approach to psychotherapy was born, as was

the field of psychotherapy research. This approach and its accompanying

research led to the eventual acceptance of psychotherapy as a primary

professional function of clinical psychologists. (Raskin & Rogers, 1995, p. 135)

Conclusion

Magid (1996) wrote:

I think it is ironic that much of what has come to be thought of as progress inpsychoanalysis has in fact been the result of subtraction from, rather than

addition to, our theories. As analysts we have increasingly learned to get out of

our patients' way. (p. 626)

' There has been some controversy about the empirical status of Rogers'stheoretical propositions. For example, a number of reviews in the 1970s concluded thatresearch evidence supporting Rogers's postulates was weak (Mitchell, Bozarth, &Krauft, 1977; Rappaport & Chinsky, 1972). However, the studies cited as evidence forthis conclusion had serious methodological flaws (Patterson, 1984). More recentreviews of the literature indicate that the critical variables for therapeutic effectivenessare (a) the client—therapist relationship and (b) extratherapeutic variables (factors thatare part of the inner resources of the client and his or her environment that aid inrecovery; Bohart & Tallman, 1996; Bozarth, 1998; Duncan & Moynihan, 1994;Patterson, 1984). Bozarth (1998), after reviewing the last three decades of psycho-therapy research, concluded that the evidence for the importance of the person-to-person relationship of therapist and client lends support to Rogers's attitudinal qualitiesas the foundation for effective psychotherapy (p. 173).

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Magid's observation would please Rogers, because he, too, wanted to

avoid burdensome, unverifiable theory and "learned to get out of his

clients' way."

This article has discussed different areas where Rogers's contribu-

tions are a precursor to some of the discoveries in self psychology. In fact,

there may be more similarities between Kohut and Rogers than between

Kohut and some of his psychoanalytic predecessors. For example, as noted

by Stolorow (1976), Rogers's descriptions of empathy in the therapeutic

relationship ("being the client's other self") anticipate Kohut's understand-

ing of the archaic needs of narcissistic patients. Rogers's theory that

unconditional positive regard and empathy encourage positive self-regard

and congruence anticipates Kohut's ideas about self-cohesion and the

importance of mirroring for the maturation of the self. Both Kohut and

Rogers were able to free themselves from the early overemphasis on

interpretation in psychoanalysis and learn to listen with empathic under-

standing to what the patient or client was saying. Rogers, with more

freedom (but also Kohut), emphasized the human quality of the therapeutic

relationship. Rogers sought to make the therapeutic relationship more

equal, and Kohut, with his changed listening stance, highlighted this value

as well. Each acknowledged that one can observe human existence through

deterministic lenses, but to have a complete view of human psychology it is

necessary to include the concept of a self that makes choices and exercises

free will. Kohut revolutionized psychoanalysis by making it more

humanistic. In that revolution, many of the empirically tested ideas that

Rogers arrived at independently were incorporated into a comprehensive

psychoanalytic theory and clinical method. For all of these reasons, a fuller

understanding of Rogers's profound ideas will be beneficial to self

psychology.

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