Kohut and addictions
Heinz Kohut Psychology of the Self and Addictions
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Heinz Kohut Psychology of the Self and Addictions
Heinz Kohut (1913-1981) was an Austrian-American psychoanalyst, known as the father of self psychology. Born in Vienna to a Jewish family, he immigrated to the United States in 1938 following Nazi persecution. Kohut explored the importance of interpersonal relationships and the development of the self, and emphasized the need for empathetic understanding on the part of the therapist.
His major books include The Analysis of the Self (1971) and The Healing Self (1977), in which he introduced concepts such as the “grandiose self” and the “empathic mirror.” His work contributed to a deeper understanding of narcissistic pathologies and influenced modern psychoanalytic therapy. Kohut left a significant legacy in the fields of psychoanalysis and psychology.
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Key Elements of Drugs Detox:
Medical Supervision: Drugs detox must be conducted under medical supervision, as the body may experience withdrawal symptoms. These can include nausea, anxiety, muscle aches, and insomnia. A medical team will monitor and manage these symptoms to ensure the patient’s safety and comfort.
Holistic Therapies:
Holistic Therapies: Many detox programs incorporate holistic therapies such as mindfulness, yoga, and meditation to help individuals cope with stress and anxiety during the detox process. These therapies support the mind-body connection and contribute to overall recovery.
Tapering Process
Tapering Process: Drugs detox often involves a gradual tapering of the drug to reduce withdrawal severity. Doctors will slowly decrease the dosage over time to allow the body to adjust to lower levels of the substance.
Psychological Support:
Psychological Support: Like any addiction recovery process, detox from Drugs includes psychological support. This can involve counseling, therapy, or support groups to address the mental and emotional aspects of addiction.
Post-Detox Treatment:
Post-Detox Treatment: After completing detox, continuing treatment is crucial to prevent relapse. This often includes participation in ongoing therapy, group support, and the development of new coping strategies to maintain sobriety.
On Heinz Kohut's childhood:
Family and early childhood
Heinz Kohut was born into an upper-middle-class Jewish family in Vienna. His father, Felix Kohut, was a successful and respected businessman, but was a less prominent figure in Heinz’s life due to his demanding job. His mother, Elsa Kohut, was a piano teacher and very close to Heinz, but was also dominant and critical of him. This complex relationship with his mother greatly influenced his personal and professional development.
Education and hobbies
Kohut was a bright and intelligent child. His mother encouraged him to excel in his studies and in the arts, especially music. He attended a high school in Vienna that was considered one of the best in the city. During his studies, Kohut developed a deep interest in psychology and psychoanalysis, fields that were then in their infancy and were seen as revolutionary in the human sciences.
Cultural and Intellectual Influence
Kohut’s upbringing in Vienna at that time was unique, as the city was a major cultural and intellectual center in Europe. Vienna was home to many intellectuals, scientists, and artists, who influenced the shaping of European consciousness and thought. Kohut was exposed to the ideas of Sigmund Freud, who greatly influenced his professional development.
Living in the Shadow of Anti-Semitism
As a Jew in Vienna in the 1920s and 1930s, Kohut was exposed to increasing anti-Semitism. The anti-Semitic events, especially after the Nazi Party came to power in Germany and annexed Austria in 1938, greatly affected Kohut and his family. The feelings of insecurity and fear of persecution influenced his psyche and his decision to emigrate to the United States.
Immigration to the United States
In 1938, after the Anschluss (the annexation of Austria by Nazi Germany), Heinz Kohut immigrated to the United States to escape the persecution of Jews. He settled in Chicago, where he continued his studies and became a key figure in the field of psychoanalysis. The move to the United States was a crucial step in his life, allowing him to develop his ideas and make significant contributions to the field of psychology.
Heinz Kohut’s childhood was filled with events and connections that formed the basis for his future thinking and developments in the field of psychology. He grew up in a rich intellectual environment, with an emphasis on studies and the arts, and was greatly influenced by the complex relationship with his mother and the historical events of his time.
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The concept of "self" as described in Heinz Kohut's psychology of the self:
The concept of “self” is central to Kohut’s psychology of the self and refers to a person’s sense of identity and inner unity. The self is a psychological construct that consists of a person’s subjective experience of themselves, and develops from interactions with significant figures in the environment.
Characteristics of the self
1. Unity and integration: The self represents the sense of inner unity and coherence. This is the sense of unity that allows a person to experience themselves as a continuous and consistent entity over time and in different situations.
2. Central self-experiences: Kohut identified three central self-experiences that shape the healthy development of the self:
Mirroring: The need to receive approval and recognition from significant figures, especially parents. This is the need for parents to recognize the child’s self-worth and reflect to them their sense of worth and uniqueness.
Idealization: The child’s ability to see the parents as ideal, all-powerful figures. This is the need to see parents as a source of strength and security that can be trusted.
Twinship: The need to feel similar to others and to feel a sense of belonging. This is the need to find people who have similar experiences and who have shared values or goals.
3. Stable self-structure: A healthy self is a stable structure that allows a person to cope with life’s challenges and adapt to changes without losing their sense of identity and inner worth. When one of the components of self-experiences is damaged, narcissistic disorder or another disorder in the sense of self may develop.
Self-development
The development of the self begins in early childhood and continues throughout life. It depends largely on the quality of interactions with significant figures, especially parents. If the child experiences enough reflection, idealization, and twinning, he develops a stable and healthy sense of self. If there is a lack or damage to any of these components, this may lead to damage to the sense of self and the development of various pathologies.
Pathological Self
Kohut focused particularly on understanding narcissistic disorders, which are the result of a damaged self-development. A person with a damaged self may experience feelings of emptiness, worthlessness, excessive dependence on external approval, and difficulties in interpersonal relationships. Kohut’s treatment focuses on empathically understanding the patient and helping him restore his sense of self.
The role of empathy
Empathy is a central tool in understanding the self and in self-psychology treatment. The therapist provides a supportive and empathetic environment that allows the patient to relive damaged self-experiences and repair them. Empathy on the part of the therapist helps the patient restore his sense of self and develop a healthier and more stable sense of identity.
The concept of “self” in Kohut’s self-psychology describes a person’s sense of identity and inner unity, which develops from meaningful interpersonal interactions. Kohut emphasized the importance of reflection, idealization, and twinning in the development of the self and the role of empathy in psychoanalytic therapy.
Mirroring in Self Psychology
Mirroring is one of the central concepts in Heinz Kohut’s psychology of the self. It refers to the need for a person, especially in early childhood, to receive approval, recognition, and validation from significant figures in their lives (especially parents). Proper mirroring is critical to the healthy development of the self.
Examples of mirroring
1. A baby cries and calms down:
When a baby cries, and the parent responds quickly and empathetically, picking him up, speaking softly, and calming him down, the baby experiences positive mirroring. The parent reflects back to the baby the feeling of security and love, which contributes to the development of the baby’s stable sense of self.
2. A child shows a drawing to a parent:
A small child draws a drawing and shows it to the parent. If the parent responds with excitement and says, “Wow, that’s a great drawing! I see you drew a house and a tree here. Well done!”, the parent reflects back to the child his achievement and effort. Such a response encourages the child and strengthens his sense of self-worth.
3. Adolescent shares academic success:
Adolescent tells a parent about academic success, such as good grades on a test. If the parent responds with pride and says, “I’m so proud of you! You knew this was important to you and made a great effort,” he reflects to the adolescent the value of the effort and investment, which strengthens his self-confidence.
Effects of lack of reflection
When a child does not receive positive reflection, this may harm the healthy development of the self. For example:
A baby cries and the parent does not respond to him**: The baby may experience a feeling of insecurity and anxiety.
A child who shows a drawing and the parent ignores or criticizes**: The child may experience a lack of self-worth.
An adolescent who shares a success and the parent responds with disdain**: The adolescent may experience a feeling of incompetence and worthlessness.
Recommendations for therapists
1. Be empathetic: It is important for therapists to develop a sense of empathy for their clients. They should reflect their clients’ feelings, thoughts, and experiences in a way that reinforces their sense of worth and self-identity.
2. Recognize the client’s worth: Therapists should recognize and value their clients’ experiences, achievements, and challenges. This recognition should be honest and genuine.
3. Avoid over-criticism: Over-criticism can damage a client’s sense of self. Instead, focus on positive reinforcement and building self-confidence.
4. Listen actively: Be attentive and active in listening to clients. This is an essential part of empathic reflection, allowing the client to feel understood and valued.
5. Use affirming language: When speaking to clients, use language that encourages and reinforces their sense of self. Emphasize their successes and strengths.
Therapeutic Example
During a therapy session, if a client successfully shares work, the therapist might respond with, “I’m really impressed with your dedication and hard work. It’s great to see how you’ve been able to take on this challenge and overcome it. You’re truly talented and have a lot to offer.”
Reflection is a key tool in self-psychology and helps develop a stable and healthy sense of self. Therapists should be empathetic, recognize the client’s worth, avoid over-criticism, actively listen, and use empowering language to help clients develop and maintain a positive and healthy sense of self.
Psychological Support:
Psychological Support: Like any addiction recovery process, detox from Subutex includes psychological support. This can involve counseling, therapy, or support groups to address the mental and emotional aspects of addiction.
Idealization in Self Psychology
Idealization is one of the central concepts in Heinz Kohut’s psychology of the self, and refers to the child’s need to see the significant figures in his life (especially parents) as ideal and all-powerful figures. This is a critical part of the healthy development of the self, as the child draws strength and security from the ideal parent.
Examples of idealization
1. A child sees his father as a hero:
A small child may see his father as an all-powerful figure, a hero who is able to solve any problem and protect him from any danger. When the father functions as a role model and truly provides support and security, the child feels safe and protected. This sense of security contributes to healthy self-development.
2. A girl admires her mother for her abilities:
A girl may see her mother as ideal, as wise, strong, and successful. She may strive to be like her and be inspired by her in difficult situations. This admiration strengthens the girl’s sense of self and provides her with a positive role model.
3. A student who admires a teacher:
A student at school may see their teacher as a smart and successful figure who teaches them important things in life. When the teacher gives support and trust to the student, the student feels valued and capable, which contributes to their sense of self-worth.
Effects of lack of idealization
When a child fails to find an ideal figure or when the significant figures in their life disappoint them, this may hinder the healthy development of the self.
For example:
A disappointing father: If the father is present in the child’s life but does not function as a positive role model (for example, behaves erratically or unsupportively), the child may experience a sense of insecurity and instability.
A critical mother: If the mother is overly critical and does not provide positive support, the child may feel a lack of self-worth and have difficulty striving for healthy ideals.
Idealization in Self Psychology
1. Serve as a supportive and trustworthy figure: The therapist should be a stable and trustworthy figure that the patient can rely on. It is important for the therapist to provide consistent support and reassurance.
2. Recognize the patient’s worth and abilities: Therapists should recognize the patient’s abilities and skills and express this openly. Genuine appreciation can strengthen the patient’s sense of self-worth.
3. Serve as a positive role model: The therapist should serve as a positive example, demonstrating qualities such as compassion, honesty, professionalism, and empathy. Patients can draw inspiration from these qualities.
4. Use the patient’s past experiences: Explore the patient’s childhood experiences and see if there were any ideal figures in their life. If there were none, try to understand the effects of the lack of idealization and help repair the vulnerabilities.
5. Encourage the patient to strive for healthy ideals: Help the patient develop positive ideals and visions for life. This can include setting personal, professional, and emotional goals and expressing support and guidance in achieving them.
Therapeutic example
During a therapy session, if a client shares that she has difficulty achieving goals due to insecurity, the therapist might respond like this: “I see your dedication and investment in what you do. It’s amazing to see how invested you are in yourself and your goals. You have impressive abilities, and I’m sure you can achieve great things. I’m here to support you and help you get there.”
Idealization is a central concept in self-psychology and refers to the child’s need to see significant figures as ideal and all-powerful. It is a critical part of self-development, giving the child a sense of security and strength. Therapists can help clients by being a supportive and trustworthy figure, acknowledging the client’s worth and abilities, and providing a positive role model.
Twinship in the Psychology of the Self
Twins is one of the central concepts in Heinz Kohut’s psychology of the self, and refers to the child’s need to feel similar to others and to experience a sense of belonging. It is a natural human need to find people who share similar experiences and with whom one can feel a sense of brotherhood. Twins contribute to a stable and healthy sense of self by strengthening the feeling that the person is not alone in the world and that there are others who understand them and identify with them.
Examples of twins
1. Children who play together:
– A group of children who play together and discover that they have common interests, such as ball games or drawing. Through playing together, they experience a sense of belonging and brotherhood, which strengthens their sense of value and self-confidence.
2. Adolescents in a youth group:
– Adolescents who join a youth group and make friends with their peers who feel and experience the same problems and struggles, such as peer pressure or difficulties in school. The sense of belonging to a group strengthens their sense of self and provides them with emotional support.
3. Adults in a support group:
– Adults who join a support group for people who are dealing with similar problems, such as addictions or loss. The shared experience with people who understand and identify with the difficulties strengthens their sense of belonging and self-worth.
Effects of twinship
When a child does not experience a sense of twinship, this may harm the healthy development of the self. For example:
A child who feels isolated: A child who does not find friends who share his interests or who has difficulty integrating socially may feel lonely and disconnected, which may lead to lack of self-confidence and a low sense of self-worth.
An adolescent who feels like he does not belong: An adolescent who does not find his place in a social group may experience a sense of alienation and loneliness, which can affect his emotional and social development.
Recommendations for therapists
1. Recognize the patient’s need for companionship: Recognizing that patients need a sense of belonging and camaraderie with others is important. They should be helped to find and create social connections that provide this feeling.
2. Encourage participation in social groups: Help patients find groups, activities, or communities that match their interests and that can provide them with a sense of belonging. This could be support groups, clubs, or community activities.
3. Be a role model: As therapists, it is important to serve as a role model by creating a personal connection and empathy with patients. This can help them feel understood and valued.
4. Encourage positive family relationships: Help patients cultivate positive relationships within their family. A sense of belonging and camaraderie within the family is an important foundation for a stable sense of self.
5. Use group therapy: Group therapy can be a particularly effective tool for creating a sense of companionship. Participating in a group with people who are experiencing similar issues can provide emotional support and positive identification.
Therapeutic example
During a therapy session, if a client shares feelings of loneliness and lack of belonging, the therapist might respond like this:
“It’s very important to feel like you belong and that there are people who understand you. I recommend trying to join a group or activity where you can meet people who share similar interests. I’m here to support and help you find a place where you can feel part of something meaningful.”
Twinhood is a central concept in self-psychology and refers to the human need to feel similar to others and to experience a sense of belonging. Twinhood experiences strengthen the sense of self and provide a sense of security and belonging. Therapists can help by recognizing this need, encouraging participation in social groups, acting as role models, fostering positive relationships within the family, and utilizing group therapy.
Stable self-structure in self-psychology
A stable self-structure refers to a person’s sense of identity and internal unity, which allows them to function consistently and confidently over time and in different situations. A stable self gives a person the ability to cope with challenges, maintain a positive sense of self-worth, and conduct themselves in a balanced manner in their personal and social lives.
Meaning of a stable self-structure
1. Internal unity: A stable and unified sense of identity, which allows a person to experience themselves as a consistent and continuous entity.
2. Positive self-worth: A positive and ongoing sense of self-worth, which does not depend solely on external recognition.
3. Coping ability: The ability to deal with challenges and pressures in a healthy and balanced way.
4. Healthy interpersonal relationships: The ability to maintain social and personal connections based on trust and mutual appreciation.
Therapeutic recommendations for developing a stable self-structure
1. Cultivating empathy and self-understanding
Therapeutic example:
During a therapeutic session, the therapist can use techniques of empathetic listening and deep understanding of the client’s feelings. The therapist reflects the client’s feelings, validates their experiences, and helps them understand themselves better.
Recommendation:
Develop empathy for the client by actively listening and reflecting on their experiences. Help them to recognize and understand their feelings, thoughts, and reactions in a deep way.
2. Strengthening a sense of self-worth
Therapeutic example:
The therapist identifies and reinforces the client’s successes and strengths. He uses genuine and focused compliments to strengthen the client’s sense of self-worth.
Recommendation:
Strengthen the client’s sense of self-worth by identifying and acknowledging their successes and strengths. Use sincere and focused compliments to encourage the client to feel valued and valuable.
3. Developing stress coping skills
Treatment example:
The therapist teaches the patient stress coping techniques, such as relaxation techniques, meditation, and time management. The patient learns to apply these tools in daily life.
Recommendation:
Help the patient develop and apply stress coping skills, such as relaxation techniques, meditation, time management, and problem-solving. Encourage the patient to apply these tools in daily life.
4. Creating healthy interpersonal relationships
Treatment example:
The therapist helps the patient identify unhealthy relationship patterns and learn how to create and maintain positive, trusting interpersonal relationships.
Recommendation:
Help the patient identify and change unhealthy relationship patterns. Support him in developing positive, trusting interpersonal relationships. Work on communication and assertiveness skills.
5. Working on past traumatic experiences
Treatment example:
The therapist works with the patient to process past traumatic experiences, such as traumas or losses, in order to free the patient from their negative effects on their sense of self.
Recommendation:
Work with the patient to process past traumatic experiences and traumas. Use techniques such as controlled exposure, narrative therapy, and other therapeutic approaches to process trauma.
Developing a stable self-structure is an important and significant process in psychological therapy. By cultivating empathy and self-understanding, strengthening a sense of self-worth, developing stress coping skills, creating healthy interpersonal relationships, and working on past traumatic experiences, therapists can help patients develop a stable and healthy sense of identity.
Heinz Kohut and Sigmund Freud
Heinz Kohut and Sigmund Freud are two central figures in psychoanalysis, but their approaches and focus differ significantly. Here are some key differences between Kohut and Freud:
1. Focus on personality theory
Freud
Psychosexual theory: Freud developed psychosexual theory, which consists of five stages of development: oral, anal, phallic, latency, and genital. He believed that the conflicts and experiences in these stages influence personality.
Personality structure: Freud proposed a personality structure consisting of the id, ego, and superego. The id contains the primitive drives, the ego acts as a reality mediator, and the superego represents the moral conscience.
Kohut
Self psychology: Kohut developed self psychology, which focuses on the development of the self and the interpersonal relationships that shape the self.
Central self-experiences: Kohut focused on mirroring, idealization, and twin experiences as keys to healthy self-development.
2. The role of interpersonal relationships
Freud
Early relationships: Freud emphasized the role of early relationships with parents, but mainly through conflicts and sexual drives.
Intrapsychic conflicts: Freud focused on internal conflicts within the person and how they are expressed in interpersonal relationships.
Kohut
The importance of interpersonal relationships: Kohut saw interpersonal relationships as central to the healthy development of the self.
Empathy: Kohut emphasized the importance of empathy on the part of parents and therapists in understanding and developing the self.
3. Treatment approach
Freud
Classical therapy: Freud developed classical psychoanalytic therapy, which focused on dream interpretation, oppositional analysis, and transference.
Interpretive approach: Freudian therapy focuses on interpreting unconscious content and internal conflicts.
Kohut
Empathic therapy: Kohut emphasized the need for empathic therapy, in which the therapist understands and identifies with the patient’s experiences.
Repairing vulnerabilities in the self: Kohut’s therapy focuses on repairing vulnerabilities in the development of the self and strengthening the sense of self.
4. Understanding narcissistic disorders
Freud
Narcissism as a developmental stage: Freud viewed narcissism as an early developmental stage, in which sexual energy (libido) is directed toward the self.
Pathology: Freud viewed pathological narcissism as a result of abnormal development at this stage.
Kohut
Narcissism as a self-disorder: Kohut viewed pathological narcissism as a disorder resulting from vulnerabilities in the development of the self. He argued that narcissistic disorders stem from a lack of empathy and appropriate reflection during childhood.
5. The goal of therapy
Freud
Insight and integration: The goal of Freudian therapy is to bring unconscious content to the conscious, provide insight, and integrate internal conflicts.
Kohut
Self-reinforcement: The goal of Kohut therapy is to strengthen the sense of self, restore vulnerability, and provide the patient with experiences of empathy and positive reflection.
While Freud focused on internal conflicts, sexual drives, and the intrapsychic structure of personality, Kohut focused on the development of the self, interpersonal relationships, and the importance of empathy. Freud’s therapy aimed to bring insight and integration of unconscious conflicts, while Kohut’s therapy aimed to strengthen the sense of self and repair past vulnerabilities.
