The self-psychologies of heinz Kohut and karen Horney: A comparative examination

THE SELF-PSYCHOLOGIES OF HEINZ KOHUT AND KAREN HORNEY: A COMPARATIVE EXAMINATION

Leland van den Daele

The theories of Homey and Kohut possess clear parallelism-so clear, in fact, that once the discrete theoretical bases are taken into account, the observations upon which these respective theories are formulated might easily be substituted. Homey and Kohut seemed to have treated the same kind of patients, experienced the same therapeutic difficulties, and, in some important ways, reached the same conclusions. But beyond this, the therapeutic approaches possess different emphasis, and this, I believe, is based on a different view of the rules of formation and regulation of intrapsychic structure. So although the purpose of this paper is a discussion of the parallelisms between Homey and Kohut, this discussion entails metatheoretical issues of general significance to theory construction. Perhaps differences in these issues, more than observation, are responsible for differences in therapeutic technique and emphasis which separate Horney's approach from Ko hut's.

PARADIGMATIC CONFLICT BETWEEN CONFIGURAL STRUCTURALIST AND DRIVE-REDUCTIONIST THEORIES

Just as Freud's drive-reductionist psychology with its forces, counterforces, energies, and chathexes was influenced, if not inspired, by the scientific explanation of the Victorian period, so Horney's descriptive structuralism was influenced, if not inspired, by the social and life sciences of the post-Ed- wardian era. ~-3 The contrast between psychological explanation of the Vic- torian and post-Edwardian period is a remarkable example of dialectical

Presented at the symposium "Narcissism: Differing Psychoanalytic Perspectives," sponsored by the American Institute for Psychoanalysis, New York, January 1980.

Leland van den Daele, Ph.D., Associate Psychoanalyst, Karen Homey Clinic; Faculty, American Institute for Psychoanalysis of the Karen Horney Institute and Center.

The American Journal of Psychoanalysis © 1981 Association for the Advancement of Psychoanalysis

VoL 41, No. 4, 1981 0002-9548/81/020327-1051.00

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thesis and antithesis in scientific inquiry. Through the conceptual innova- tions of the Wurtzberg and Gestalt schools, the reductionist program widely championed in European and American psychology aimed at the reduction of thought to its elements, ultimately "atomic sensations", was repudiated. 4 Perception and its handmaiden, sensation, appeared to conform to configural patterns that possessed properties independent of the particular elements which composed the pattern: the whole, it was asserted, determined the form and function of parts. 5

This conceptual shift from attention to molecular constituants, atomic elements, and the like, to the total configuration, the gestalt, the organized totality ramified in the personality theories of the 1930s-in particular, the psychologies of Goldstein, 6 Lewin, 7 AIIport, 8 Angyal, 9 and others. Coinci- dent with this historical proliferation of configural, holistic theories were the derivatives of the antecedent reductionist era: in psychoanalysis, Freud's libido theory, and, in academic psychology, learning theory. In dialectical terms, psychology, as well as psychoanalysis, remains, to this day, in a period of paradigmatic opposition, l°13

I believe that this paradigmatic opposition is infused with the absolutism that attends the emergence of any new paradigmJ ° As Piaget has argued, complex structures do not arise ready-made, but possess a history24 In general, any complex structure may be decomposed to more elemental configurations which reveal the course of genesis, once the rules of structure-building are knownJ 5"~6 Moreover, structures or elements thereof may possess various valences, be infused with energies, or charges, and obey lawful rules. Not all energy models of intrapsychic regulation and transformation are hydrolic models. I believe that it is incumbent upon the new generation of psychoanalysts to reconcile these dialectic antinomies into a new and more complete synthesis of energy, structure, and transformation. I hope to provide here a common ground between representatives of these positions, Homey the holistic theorist and Kohut, in a relative sense, the drive-reductionist theorist.

I will discuss the parallelisms between Homey and Kohut under five major categories: first, the role of the self; second, early interpersonal relations; third, narcissistic characteristics; fourth, intrapsychic structure; and fifth, major solutions and narcissistic transferences. Finally, I will turn to the issue of the therapeutic interdependence of the two viewpoints.

THE ROLE OF THE SELF

In Horney's Neurosis and Human Growth, 17 published almost 20 years before Kohut's Analysis of the Self, ~8 Homey placed the self as the central construct in psychoanalysis. All neuroses arise through character disorder,

KOHUT AND HORNEY COMPARED 329

and all character disorders involve a pathology of the self. Traumatic neuroses arise only insofar as such trauma potentiate existing conflicts within the personality organization. 19

Similarly, Kohut's recent statements on self-psychology have tended toward the assertion that all neuroses involve some weakness in the organization of the self. In his monograph The Restoration of the Self, 2° he argues that although purely structural conflicts may occur, neurotic pathologies may simply mask disorders of the self, and in those instances where drive- defense conflicts appear paramount, the self may undergo changes in self- esteem. Hence, drive-defense conflicts implicate disorders of the self.

Kohut appeals to a principle of "complementarity" to reconcile the relation of his self-psychology to classical theory. 2°,P.xv The complementarity principle taken from contemporary physics coordinates the quantum and particulate theories of light, two theoretical perspectives which yield correlative, but not contrary, predictions. In my view, whether complementarity may extend to the psychology of self and drive-defense theory is highly problematic for two reasons: First, drive-defense and self4heory are not discrete in any energetic or particulate sense as in physics, so the analogy limps. Second, contrary predictions from classical theory and self-psychology may be readily derived. This is not complementarity, but plain old incom- patibility. Elsewhere, Kohut seems to apprehend these difficulties and sub- ordinates classical drive to archaic narcissistic grandiosity where these arise as fragmentation products through the breakdown of self-cohesiveness. 2°,p-77 Such subordination provides a coherent approach to the problem of integration of instincts with narcissistic structures, and perhaps suggests a line of development for the eventual coordination of observations associated with the drive-defense theory and the theory of the self.

Kohut's problems in the coordination of his self-psychology with classical theory is highly instructive. Homey simply avoided the problem through a general disavowal of classical metatheory. 21 But, in my view, the problem did not go away. A structuralism derived from interpersonal adjustments and intrapsychic processes of equilibration is simply insufficient to account for the cross-cultural regularities in human pleasure-seeking, affective dis- play, pair-bonding, and a host of other phenomena.

EARLY INTERPERSONAL RELATIONS

As early as 1937, Horney departed from the drive-defense theory of the neurosis to a point of view which placed primary emphasis upon early interpersonal relations. 22 Neurosis arises not from any particular frustration of pleasure-seeking or sexual desire, but rather from failures in the empathic matrix of the child's early development, "A child can stand a great deal of

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what is often regarded as traumatic-such as sudden weaning, occasional beating, sex experiences-as long as inwardly he feels wanted and loved. • . . A child feels keenly whether love is genuine, and cannot be fooled by a faked demonstrations. "22,p,8° The inability to provide an optimum environ- ment is strongly linked with parental neuroses. Muriel Ivemy wrote in 1946 on the subject of basic anxiety:

[The] deeper significance [of a neurotic parent] has to do with the effect of the total personality of the parent upon the child's whole, immature, malleable self . . . . If a parent has had no inner experience of natural, strong, healthy development, and if he has not found himself and recaptured a sense of wholeness and significance, he wilt be unable to understand and appreciate the child's whole personality and his needs throughout his developmental period. 23,p.5

Moreover, the destructive and lasting jealeousies associated with the oedipal complex are not as universal or as common as Freud assumed, but con- nected with neurotic development in the child already well underway by the time of the oedipal crisis. 21,pp.7987

Kohut's position on these matters is essentially similar. He decries the over- emphasis among drive-defense adherents on trauma and the correlative superficial treatment of the whole child-parent relationship in the etiology of the neurosis. Trauma, even multiple trauma, are unlikely to have far-reach- ing significance if the total empathic matrix of the child's early development is satisfactory, that is, if the child's needs for warmth and optimum respon- siveness are met. 2°,p-187lgl As in Horney, so in Kohut, the neurotic adjust- ment of the parents possesses primary etiological significance in the envir- onmental causation of neurosis. 2°,pp,19s496 Consistent with his reexamination of the causal significance of drive frustration, Kohut reassesses the presump- tive significance of the oedipal complex.

•.. our observations of a joyfully entered quasi-oedipal phase should prompt us to reexamine our traditional conceptions in the light of the question whether the Oedipus complex of classical analysis that we take to be a ubiquitous human experience is not in fact already the manifestation of a pathological development? Could it not be, we should ask, that the normal oedipus complex is less violent, less anxious, less deeply narcissistically wounding than we have come to believe?20,p.246

CHARACTERISTICS OF NARCISSISTIC DISTURBANCE

What Horney describes as characteristics of neurotic disturbance, Kohut describes as characteristics of narcissistic disorders. Horney characterizes the neurotic as "divided" and in need of "a firmer and more comprehensive


integration, 17,p.2° desperately in need of "self-confidence or a substitute for it, lz,p.21 "something that will give him a hold, a .eeling of identity, 'qz,p32 Horney's stress on the neurotic need for integration is the complement to Kohut's stress on the narcissistic fear of fragmentation.

Homey asserts the neurotic is driven by the "search for glory," a prosaic term for a motive structure that includes as elements, "a need for perfection, neurotic ambition, and need for vindictive triumph. "17,p.24 These motive forces infuse the idealized image, and the idealized image circularly augments these motives. Furthermore, the neurotic lacks peace of mind, inner security, or joy of living: "Reactions of panic, depression, despair, rage at self and other to what is conceived as 'failure' are frequent, and entirely out of proportion to the actual importance of the occasion. "lz,p.31 In this quotation and others, Homey describes the general characteristics of narcissistic disorders in terms that are essentially identical to the descriptions of narcissistic disorders in Kohut's casebook, The Psychology of the Self. 24

[NTRAPSYCHIC STRUCTURE

I now turn to the relation of Horney's structural framework to Kohut's. In this comparison, when allowances are made for language, the structural correspondences between theories is virtually isomorphic. Important differences, however, occur in the conception of dynamics. Nevertheless, in my view, these differences are reconcilable, and as I will endeavor to show in a later section of this paper, enrich psychoanalytic theory and therapy.

In her theory of neurosis, Homey postulates the existence of various structures which coexist and account for the commonplace symptomatic and dynamic observations in disorders of the self. The neurotic structure consists of an idealized image, a despised image, and a split-off sector of the psyche, the real self. 17 The idealized image is an elaborate intrapsychic structure which arise through successive equilibrations of neurotic trends which have their origin in early childhood. The idealized image is invested with pr ide- in Kohut's terms, narcissistic grandiosity. The idealized image possesses a corrolary structure in the despised image, an intrapsychic struc~ ture which coordinates trends which are incompatible with the idealized image or which derive by negation of the characteristics associated with this idealization. 25

The idealized image and/or despised image may or may not be conscious, and when conscious, the person may identify with one or the other polarity or alternate between them. The relation between the idealized image and the despised image is characterized by a vertical split in the personality and, typically, is associated with a repression barrier. Each of these structures

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Figure 1. Structural Representation of Self-Pathology: Topographic organization of neurotic configurations in Horney's theory of neurosis.

Idealized image: Driven by grandiose and unrealistic self- concept with suffuses intrapsychic and interpersonal reality. Perfec- tionistic and vindictive.

Despised image: Hopeless, depressed, self-hating sector of the personality. Brooding, reproach- ful, self-critical.

REPRESSION BARRIER

Real self: Weakened self is not integrated with the total personality. The source of joy, enthusiasm, commitment. Otherwise, genetic infrastructure not spelled-out by Homey.

may be decomposed into neurotic constellations which, like the atoms of a larger molecule, possess a developmental history. 26

At a deeper level of analysis and in horizontal relation to the idealized and despised image is the real self. The real self "leads to genuine integration and a sound sense of wholeness, oneness. Not merely are body and mind, deed and thought or feeling, consonant and harmonious, but they function with- out serious inner conflict. "t7,p.1~7 So defined, the real self corresponds to Kohut's nuclear self, which coordinates ambition and ideals and healthy self- esteem with firm and joyfully pursued goals. In Figure 1, I depict the relations of these structures. I have chosen the format to facilitate comparisons with Kohut's schematic representation of self-pathology presented in the Restoration of the Self. 2°,~.2~3

Kohut's anatomy of his case "Mr. X" is directly analogous to Horney's typi- cal structure of self-pathology. 2°,p.~9219 The patient's overt grandiosity corresponds to the idealized image; the depressed empty self, to the despised image; and his incompletely organized nuclear self to the real self. Lest the relation between the incomplete nuclear self and the split-off real self seem far-fetched, let me quote from Kohut on this sector of the personality:

The nuclear self was, however, not only fragmented and weak, it was also out of touch with the functioning surface of the personality; it had gone into hiding. It had no access to the conscious self-structure, but was separated from them by a horizontal split in the personality-it was repressed. 2°,p2°6

In her discussion of self-idealization, Horney argues that the energies which otherwise might be in the service of the real self are put into the ser-


vice of the idealized image. This conceptualization suggests not only an energic model, but the weakening of the real self suggested by Kohut. Within the framework of both theories, the psychoanalytic interpretation and working through of the idealized/grandiose self and its corrolary despised/hopeless self prepares the way for the reintegration of the real/nuclear self with other sectors of the personality.

MAJOR SOLUTIONS A N D NARCISSISTIC TRANSFERENCE

In Our Inner Conflicts, published in 1945, Homey postulated three major types of self-pathology. 2~ In later work, these types were further differen- tiated into various subtypes. The types were organized into these three groups on the basis of the predominant interpersonal mode of relationship: Expansive, effacing, or resigned.

Like Kohut's Mr. X, the expansive individual identifies with his grandiose, idealized self. The despised, empty, dependent sector of his personality is separated from the idealized sector by a vertical split. The purpose of life and its appeal "lies in its mastery. "17,p.192 He exists in relation to self and others only as a "superior being. "lz,p.lsl Yet he is extremely sensitive to criticism and failure, "or to the mere possibility of his 'bluff' being called by criticism.'~7,P.~93

The effacing type tends "to subordinate himself to others, to be dependent upon them, to appease them. "~7,p.215 He identifies with his despised image. In this case, the grandiose, idealized sector of the personality is repressed. He must shun any thought, feeling, or gesture that is presumptuous: ~7,p.2~z "His salvation lies with others. "~7,p.22~

These discrete configurations appear to conform to the two lines of development described by Kohut as primary narcissistic dispositions. These dispositions have the paradigmatic form: "1 am perfect" and/or "You are perfect. "le,p.27 The first of these dispositions, I am perfect, invests the self with narcissistic libido and provides the foundation when "untamed," for persis- tent greatness fantasies. The configuration implicates the mirror transference and corresponds to the "claims" which typify the expansive type. The second of these dispositions, You are perfect, invests another with narcissistic libido and implicates an idealizing transference with claims that typify Horney's effacing type.

The correspondence of Kohut's major lines of narcissistic development and transference with Horney's expansive and effacing types is a correspondence which enriches both theoretical perspectives. On the one hand, Kohut's lines of development are integrated with a general theory of self- structure, and, on the other hand, Horney's solutions are related to a developmental theory of disorders of the self which lends far greater precision

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and sensitivity to genetic reconstructions than those based on general nostrums.

Horney's third type of self-pathology is resignation. The resigned type is an onlooker at life and himself. He possesses no "serious striving for achieve- ment," and he has "an aversion to effort. "I~,p,2°I Wishes are restricted and goal direction is absent. Interpersonally he is hypersensitive to "influence, pressure, or coercion or ties of any kind. "17,p266

This type appears to represent a line of development in Kohut's sense in which both narcissistic and idealizing libido are contained. The primordium of the nuclear self appears walled off with no evidence of libidinal ties, moti- vating goals, or the vaguest use of imagination oriented to pleasure-seeking. The patient evidences neither the mirror nor idealizing transferences; so complete is the containment of his narcissistic drives. Yet, for all this, the patient is not psychotic. The self exists in hibernation, and emerges, in my experience, like Athene, fully mature.

OVERVIEW OF THEORIES AND THEIR THERAPEUTIC INTEGRATION

In this paper my interest has been the examination of parallelisms between Horney and Kohut. I wish now to briefly summarize and characterize the differences between the theories and how they might complement one another.

Horney's theory enriches the theory of self-pathology through her careful description of the complex relations between intrapsychic and interpersonal behavior. Her theory of types provides an important contribution to the clinical diagnostic and dynamic literature (See, for example, Kohn's recent monograph on hysteria with its many parallels to Horney's effacing type)Y Her emphasis on the total character structure as a determinative of neurotic pathology augments the more restrictive interpretive approach identified with developmental reconstruction. Her conception of reciprocal deter- mination and augmentation of corrolary neurotic complexes, the functional autonomy of complexes, and their constant elaboration and reworking provide a powerful theoretical and interpretative approach to self-pathology.

Kohut's contribution to the psychology of the self is thoroughly complementary to these conceptions. Horney's descriptive excellence and theoretical eloquence encompass the fully equilibrated neurotic structures which arise through disturbances in early interpersonal relations. Kohut's strengths concern genesis and development, and a profoundly sympathetic compre- hension of those deprivations which prepare the way for self-pathology. I have found his conceptions of the role of narcissistic and idealizing libido and their place in self-structuration invaluable aides in reconstructive, developmental interpretations. His orientation to self-pathology is remarkably


free from the often moralistic tenor which, in my view, mars Horney's char- acterization of narcissistic disturbances.

Additionally, Kohut's theory coordinates the pathology of the self to those more serious disorders which fall outside the spectrum of the narcissistic disorders. Moreover, his work consistently addresses issues and formula- tions of classical theory to relate and coordinate prior psychoanalytic observation to the theory of the self. By this he has accomplished what Homey failed to d o - t o relate the psychology of the self to broader domain of psychoanalytic theory. And by this effort, insofar as Horney's theory stands in intimate observational and conceptual relation to his theory, he has pro- vided a foundation for the reintegration of Horney's theory to the main- stream of psychoanalysis.

In my view, this reintegration can proceed rapidly. The clinical application of a combined self-theory derived from these complementary perspectives of Homey and Kohut poses few technical difficulties. In my work, the first phase of treatment involves the analysis of character structure along the lines described by Homey. The genetic analysis of trends and interpretation of transference follows Kohut's approach. Horney's theory provides a powerful tool for analysis of resistences and defense associated with mature narcissistic self-structures, and Kohut's theory provides an equally powerful approach to developmental reconstructions, the viscissitudes of archaic grandiosity, transference, and the nuclear self. The ease of clinical integration suggest the work of the future is neither a justification for Horney's theory nor a justification for Kohut's theory, but the formulation of a general psychology of the self which integrates self-psychology with the cultural, interpersonal, and biological determinants of individuality.

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12. Overton, W. F., and Reese, H. W. Models of development. In J. R. Nesseiroade and H. W. Reese (eds.), Life-span Developmental Psychology: Methodological Issues. New York: Academic Press, 1970.

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The self-psychologies of heinz Kohut and karen Horney: A comparative examination

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