Revolution And Its (Unwitting) Discontents: Did Kohut’s Ideas Enhance or Undermine American Psychoanalysis?

Over the last 80 years revolutionary developments in North America have sought to modify or update perceived limitations in Freud’s clinical technique. The question asked in this paper is how to know whether any suggested modifications enhance or undermine what Freud argued was the core of psychoanalysis. Deploying a new clinical theoretical framework for comparing the ways psychoanalysts work, published clinical material is examined to explore the empirical support for Kohut’s revolution as an exemplar of how to consider other changes such as the relational “turn.” Evidence is presented to suggest that Kohut’s clinical shift from the Freudian core was based on assumptions of which Kohut was not aware. The problem that concerned him may not have derived from the core components of Freud’s theory or clinical procedure, but rather from how he understood and put them into practice. The paper concludes by suggesting that we routinely review the suppositions about the analytic situation and the data we use to draw inferences that are implicit in our clinical work, particularly if we find ourselves in an impasse. This may help us to strengthen our discipline rather than propose a new “modern” clinical psychoanalysis throwing the baby out with the bathwater.