Psycho Pathology Week 12 11-08

Scott Rower Psychopathology

11/8/2006

Self Psychology - Developed by Heinz Kohut in 70’s-80’s - Disorders of the self (narcissism) is the typical type of pathology for this theory - Concept of self is diff among cultures - Self is the entire person of an individual - Focus: understanding the self as a cohesive whole o How one experiences the self from the inside – out - When needs of the self are met, there is a desire & capacity to grow o Innate motivating push toward health - Empathy is large portion of theory o Self if best understood by others through empathy  The primary clinical tool o The projection of one’s own personality into the personality of another in order to understand her/him better o A way of knowing the other person - A healthy self can come from experiencing: o manageable empathic failures  misunderstood o optimal empathic gratification - The point is not the make the subject feel good, but to make them feel understood o Divorced parent trying to constantly do fun stuff w/ kids, not letting them deal with it - The more one has love for oneself, the more they can have it for others - Complete independence is not goal, everyone is dependent throughout life - Selfobject – care-giving others (or objects such as music, the ocean, art) o Experienced intra psychically o Functions: helping add to or maintain the cohesive self  Tension regulation, soothing, restoration of temp. fragmented self o Needed throughout life cycle  Give what self needs to remain energetic & cohesive o Can be mal-adaptive  boozing - Mirroring o Necessary for self objects (people) to do o Caretakers who tell people characteristics about themselves, tendencies or feelings - Psychopathology based on flaws of the self o Flaws are based on self – selfobject issues - Narcissists o Hide a sense of neediness

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o Have a lot of hidden shame & a fragile sense of self Tripartite Self o Driven my ambition, pulled by ideals & need to recognize ourselves in similar others  Poles – aspect or pathway of development w/in the self that has its own energy & needs • Each pole needs empathic responses from selfobjects to grow • Each pole is nec. for development as a cohesive whole • Flexible and every changing st  1 – Grandiose self • Predominate until age 4 • Needs others to mirror, identify unique characteristics • Wants to feel special and well being • Driven by ambition • There is healthy amount of narcissism/exhibitionism • Dealing with the specifics of characteristics which form identity & individuality • Mature needs are met then become  confident, ambitious, hopeful, productive o Don’t believe they can do anything, have courage to try • Similar to Winicot’s true self • Damaged pole  helplessness is experienced & it is humiliating o Can be good listeners but lose themselves in paying attention to others at time • Over grandiose – can start to feel anxious, their own narcissistic power can become frightening  2nd – The Idealized Parent Imago • Most intense in ages 4-6 • Need to have someone strong and calm that the child can idealize and merge with in order to feel safe and complete within the self • The self takes in the other’s growth enhancing qualities into itself • Driven by ideals • Calmness, competence of the selfobject are taken in and merged with the self • Too strong of a parent  anxiety about losing oneself • Wants to be protected and strengthened by the power of another • If others are idealized too much  self is left devalued

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When met  ability to delight in and grow from qualities of others o Can experience pleasure and pride in one’s own qualities rd  3 – Twinship • The need to feel one is like others • Age  adolescence • Too much time in twinship  person feels like they are losing touch with themselves • Mature qualities that develop  mature identity, belonging, legitimacy, nuclear self & its endeavors enhanced • Driven by the need to not be different or isolated • Goal: transmuting internalizations o Function that was formed by another (a selfobject) is taken into the self through optimal mirroring, interaction & frustration Psychological illness – how does it occur? o Self Psych  a type of deficit model – people are vulnerable to hurt, neglect & depravation o Pathology occurs when development needs from the 3 poles are not met by optimal empathy & optimal frustration  Cohesive self becomes threatened and becomes fragmented (if it was whole to begin with) Main primary disorders o Structurally damaged self  Psychosis, borderline states, narcissistic PD, narcissistic behavioral disorders Secondary disorders o More transiet, not from structural damage in self, doesn’t take away from core integrated being  i.e. SAD