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Inc. J. Psycho-Anal. (1979) 60,3

THE TWO ANALYSES OF MR Z

HEINZ KOHUT, CHICAGO

INTRODUCTION in the writing of The Analysis ofthe Self (l97 l). Although hardly more than a dozen years old, The second installment, then, coincided with the the psychoanalytic psychology of the self has time when I was beginning to test a new frame now reached a point in its development when, of references-a new viewpoint, which, to state for the benefit both of those who understand it it briefly, allowed me to perceive meanings, or thoroughly, and are used to applying the new the significance of meanings, I had formerly not concepts in their clinical work and in their consciously perceived. This case thus allows me research, and for the benefit of those who are to demonstrate that the change in my theoretical seriously trying to learn more about this new outlook that had taken place during this time step and want to form a judicious judgement influenced decisively the focus of my perception about it, we need to summarize our theoretical of Mr Z's psychopathology and enabled me, to conclusions and to demonstrate their usefulness the great benefit of the patient, to give him in our clinical work. The first-a summary of access to certain sectors of his personality that the present state of our theoretical insights- had not been reached in the first part of his was attempted in the summarizing statement treatment. which appeared recently in this Journal (Kohut & Wolf, 1978), the second-the demonstration CLINICAL DATA of the clinical usefulness of the new viewpoint- was undertaken with the publication of The When Mr Z consulted me for analysis he was Psychology of the Self, A Casebook (Goldberg, a graduate student in his mid-twenties. He was a 1978). The present case report belongs, of handsome, well-built, muscular man. His pale course, in the second realm: it aims at showing and sensitive face, the face of a dreamer and the relevance of the new psychoanalytic insights thinker, stood in noticeable contrast to his in the clinical field. athletic appearance. He was soft-spoken, his Two considerations determined my choice of speech often halting. this particular case within the context outlined The patient lived with his widowed mother in above: First, the structure of Mr Z's personality very comfortable financial circumstances be- illustrates with great clarity the explanatory cause the father, who had died about four years power of the psychology of the self. Second, this earlier, had not only been a highly successful purpose is also served, and perhaps even more business executive but had himself inherited a unambiguously, by the fact that Mr Z's analysis considerable fortune. Mr Z was an only child. took place in two installments, each conducted The disturbances for which he sought relief five times a week and lasting about four years, seemed at first quite vague. He complained of a which were separated by an interval of about number of mild somatic symptoms-extra- fiveand a half years. During the first installment systoles, sweaty palms, feelings of fullness in the I was viewinganalytic material entirely from the stomach, and periods of either constipation or point of view of classical analysis. But the diarrhoea. And he also mentioned that he felt second installment started when I was writing socially isolated because he was unable to form 'Forms and Transformations of Narcissism' any relationships with girls. Although his (1966) and ended when I was deeply immersed academic work, as measured by his grades and Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

4 HEINZ KOHUT the reaction of his teachers, was good, he that is driven on by the coachman's whip to give expressed the opinion that he was functioning its last ounce of strength, or similar to Roman below his capacities. He tried to relieve his galley slaves whipped on by their overseer loneliness by reading and by going to movies, during a sea battle. the theatre, and concerts-either alone, or with The genetic data obtained during the first an unmarried friend with whom he had been phase of the analysis can be divided into two close since high school and who also seemed to groups: material from Mr Z's childhood; and have had some trouble in his relations with material from his preadolescence and early women. Not infrequently, the two friends were adolescence. accompanied by the patient's mother, a woman There was every indication, both from with a variety of artistic interests (she painted external evidence and from the over-all flavour and she wrote poetry). It was my impression of Mr Z's personality, that the unremembered that however pathological and unsatisfactory earliest part of his life, perhaps the first year or this mode of life might have been for an year and a half, had been a happy one. However intelligent and handsome young man in his mid- severely distorted the personality of his mother twenties, the balance he had achieved in his basically might have been, as will be discussed relationship to mother and friend had spared later on, she was quite young when the patient him the full impact of a confrontation with his was born, and the intense relationship with her inhibitions, and I wondered what specific event male baby might, as long as he was still small might have prompted him to seek therapy at this and the interweaving of her with him still phase- time. As I found out later, there was indeed an appropriate, have brought out her healthiest event that had upset the balance which the attitudes. At any rate, to all appearances, he was defensively established threesome had provided: the apple of her eye, and the father, too, seems a few months before the patient consulted me, to have been pleased with him-at least as far as his friend had become attached to a much older could be judged from entries in a baby book and woman. He not only excluded the patient from snapshots and home movies that had been taken the relationship to this woman-Mr Z never met by the young couple. Whether his picture was her nor did he even know her name-he also taken as he was held by his mother or, became much less interested in seeing Mr Z. He occasionally, by the father, his facial expression no longer participated in the social and cultural and general demeanour seemed that of a happy, activities that had included Mr Z's mother, healthy baby. And, to anticipate, although in although he did retain some contact with both the second analysis we came to see the of them by telephone. significance of many of the data from childhood The revelation of the details of Mr Z's in a quite different light, our impression problems proceeded at first very slowly and concerning the earliest part of his life remained against resistance motivated by shame-it was unchanged: there was a core of vitality, playful particularly difficult for the patient to reveal not vigour, and enterprisingness in Mr Z's person- only that he masturbated frequently, but that ality that had survived from earliest times, the masturbatory fantasies were masochistic. In despite the distortions it underwent later. his fantasies-he had never tried to enact When the patient was about three and a half them-he performed menial tasks submissively years old certain events of far-reaching signifi- in the service of a domineering woman. He cance took place. Mr Z's father became seriously always reached sexual climax after spinning out ill and was hospitalized for several months. The a story of being forced into performing the father's illness by itself would undoubtedly have sexual act by a woman whom he imagined as been upsetting. What was of even greater being strong, demanding, and insatiable. At the importance, however, was that during the moment of ejaculation he typically experienced hospitalization the father fell in love with a the feeling ofdesperately straining to perform in nurse who took care of him, and after his accordance with the woman's commands, recovery he decided not to return home but to similar, as he explained, to a horse that is made live with the nurse. During the time of this to pull a load that is too heavy for its powers and relationship, which lasted about a year and a Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

THE TWO ANALYSES OF MR Z 5 half, the father seems only rarely to have visited calm manner. He said that the change had taken his family. Still, there was no divorce and, place not primarily because of a change in him when the patient was 5-years-old, the father, but because of something I had done. I had, he according to his mother's accounts, broke off said, introduced one of my interpretations with the nurse and returned home. Although the concerning his insatiable narcissistic demands family was thus externally re-established, there with the phrase' Of course, it hurts when one is can be no doubt that the parents' marriage was not given what one assumes to be one's due '. I an unhappy one thereafter. (A modicum of did not understand the significance of my affection seems to have become rekindled remark at that time-at least not consciously- between the parents during the last year of the and continued to believe that the patient was father's life when, during his final illness, Mr Z's now giving up his narcissistic demands and that mother took care of him.) his rages and depressions had diminished The theme that was most conspicuous during because of the cumulative effect of the working- the first year of the analysis was that of a through processes concerning his narcissism. regressive mother transference, particularly as it And I told myself that it was in order to save was associated with the patient's narcissism, i.e. face that the patient had attributed the change as we then saw it, with his unrealistic, deluded to the, as it seemed to me, innocuous and grandiosity and his demands that the psycho- insignificant phrase with which I had recently analytic situation should reinstate the position introduced an interpretation. I remember that I of exclusive control, of being admired and even considered pointing out to the patient that catered to by a doting mother who-a by denying the effectiveness of my interpreta- reconstruction with which I confronted the tion he was putting up a last-ditch resistance patient many times-had, in the absence of against the full acceptance of the delusional siblings who would have constituted pre-oedipal nature of his narcissistic demands. But luckily- rivals and, during a crucial period of his as I see in retrospect-I decided not to go childhood, in the absence of a father who would through with this move, since I did not want to have been the oedipal rival, devoted her total disturb the progress of the analysis, which attention to the patient. For a long time the seemed now to be making headway in new patient opposed these interpretations with directions and was moving, as I then thought, intense resistances. He blew up in rages against towards the central area of his me, time after time-indeed the picture he psychopathology. presented during the first year and a half of the The centre of the analytic stage was from then analysis was dominated by his rage. These on occupied, on the one hand, by transference attacks arose either in response to my inter- phenomena and memories concerning his, as I pretations concerning his narcissistic demands then saw it, pathogenic conflicts in the area of and his arrogant feelings of 'entitlement' infantile sexuality and aggression-his Oedipus or because of such unavoidable frustra- complex, his castration anxiety, his childhood tions as weekend interruptions, occasional masturbation, his fantasy of the phallic woman, irregularities in the schedule, or, especially, my and, especially, his preoccupation with the vacations. In the last-mentioned instances, it primal scene-and, on the other hand, by his might be added, the patient also reacted with revelation that, beginning at the age of 11, he depression accompanied by hypochondriacal had been involved in a homosexual relationship, preoccupations and fleeting suicidal thoughts. lasting about two years, with a 30-year-old high After about a year and a half, he rather abruptly school teacher, a senior counsellor and assistant became much calmer and his insistent assertion director of the summer camp to which he had that his anger was justified because I did not been sent by his parents. understand him lessened conspicuously. When I My perceptions with regard to the first- remarked approvingly on the change and said mentioned themes need little further expla- that the working through of his own narcissistic nation here, since they were fully in tune with delusions was now bearing fruit, the patient the classical outlook of psychoanalysis. As the rejected this explanation, but in a friendly and patient's main resistances, I saw his defensive Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

6 HEINZ KOHUT narcissism and the mechanism of denial. I on the fact that memories concerning the attempted to demonstrate to him that he had, frequent serious quarrels between his parents from way back, denied the fact that the father which the child witnessed and memories of the had indeed returned home when the patient was primal scene emerged in many of his associ- still only four-and-a-half or 5-years-old and that ations in temporal sequence, allowing the his insistence-as enacted in the transference- reconstruction that he had experienced the that he did not have an oedipal rival, that his intercourse not as lovemaking but as a fight. pre-oedipal possession of his mother had His own sexual activity, the masturbation in remained total after the father's return, was a childhood, began, as far as he could remember, delusion. In other words, I interpreted the at about the time of the father's return and persistence of defensive narcissism as it pro- continued, with increased intensity, after he was tected him against the painful awareness of the assigned his own bedroom. The content of his powerful rival who possessed his mother masturbation fantasies in childhood, as far back sexually and against the castration anxiety to as he could remember, was masochistic. We which an awareness of his own competitive and could not recover any hints of a masculine- hostile impulses towards the rival would have assertive competitive content from which these exposed him. fantasies might have been said to constitute a Two sets of memories emerged in response to defensive retreat, motivated by castration these interpretations: one cluster-first announ- anxiety. Defined in the terms of a complemen- ced in dreams-concerned his observation of tary series of regression and fixation (Freud, parental intercourse, the other revealed his 1933, p. 126), the masturbatory activity seemed childhood masturbation and the elaborate set of to be due to pre-oedipal and pregenital fixations fantasies which accompanied it. I might add at (with a mixture of oral and anal drive elements this point a fact which became intelligible only and a preponderance of passivity), but not to years later, during Mr Z's second analysis, that regression. For although according to his the childhood masturbation did not subside memories the masturbatory activity began during latency, stopped only temporarily during around the time of the father's return, its his relationship with the counsellor, and content was from the beginning rooted in the continued from then on. The fantasies that pre-oedipal, pregenital period when he had been accompanied the masturbation remained in the sole possessor of his mother. Specifically, so essence-though not in their specific content- far as he could recapture, the masturbatory unchanged from childhood to adulthood. They fantasies were always more or less extensive disappeared during the second half of the first elaborations of themes taken from Uncle Tom's analysis. Cabin, a book which Mr Z's mother had read Mr Z undoubtedly had witnessed his parents' aloud to him on numerous occasions during his sexual intercourse from the time he was about early childhood years, either at bedtime or when 5 until about the age of 8, when he was he was ill. In the fantasies which occurred assigned a separate bedroom. Up to the time of invariably from age 5 to age II he imagined the father's return he had slept next to his himself a slave, being bought and sold by mother in the father's bed. After that, a couch women and for the use of women, like cattle, was moved into the parental bedroom, placed like an object that had no initiative, no will of its crosswise at the foot end of the parents' beds in own. He was ordered about, treated with great such a way that the apparently fairly high strictness, had to take care of his mistress' footboards prevented him from seeing the excrements and urine-indeed, in one specific, parents if he did not raise himself up, yet so often repeated fantasy, the woman urinated into closely placed that the vibrations of the parental his mouth, i.e. she forced him to serve her as an bed were transmitted to the couch. inanimate vessel such as a toilet bowl. We talked a great deal about the impact In my interpretative-reconstructive attempts I which these experiences must have had on him: moved in two directions: I tried, more or less the frightening noise, the anxious sexual successfully,to address myself to the elements of stimulation. And we concentrated, in particular, pregenital fixation as they related to the infantile Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

THE TWO ANALYSES OF MR Z 7 sexual ties to his pre-oedipal mother; and, spiritual leader who infused the boys with his increasingly, but with scant success, I tried to own deep, almost religious, love for nature. discern and to interpret to him the motivations Later on, when the two continued their contact for his clinging to pregenital drive aims-or in the city, the boy's admiration continued but even regressing to them-namely, that the fear now shifted to the friend's moral and social of taking a competitive stance vis-a-vis the philosophy and his knowledge and love for father had forced him to return to the earlier literature, art, and music. All in all it was my developmental level, or, at any rate, that impression, at that time, that the relationship in castration anxiety prevented him from making its deepest layers was a reactivation of the bliss the decisive forward move. of the pre-oedipal, pregenital relation to the All in all, my approach to Mr Z's psycho- idealized mother, especially in view of the fact pathology as it was mobilized in the analysis can that, during this period, the boy was for the first be said to have been fully in tune with the time in his life to all outward appearances classical theories of psychoanalysis. His maso- emotionally completely detached from his chism, in particular, I explained as sexualization mother. The friendship with the counsellor of his guilt about the pre-oedipal possession of ended when Mr Z approached puberty, i.e. his mother and about his unconscious oedipal when his voice changed, when he began to rivalry. And I said that by creating the imagery develop a beard and body hair, and when his concerning a domineering phallic woman he genitals began to mature. The last months of fought his castration anxiety in two ways. Via their relationship were clearly the worst. The the denial in fantasy of the existence of human rapidly progressing pubertal changes apparently beings who have no penis, i.e. had lost their removed the psychological basis of their penis, and by the assertion that his mother was friendship-at least we could never discover any more powerful than the father, i.e. that the other reason for its coming to an end. The father need not be feared as a castrator, that his affectionate bond between them seemed to mother could effectively protect him against the dissolve, while simultaneously-and for the first father because she possessed a more powerful time-gross sexuality entered into the picture. penis than he, was stronger than he. On one occasion the counsellor tried to We also investigated, of course, Mr Z's penetrate the boy anally (the attempt failed), homosexual relationship during his pre- and on another occasion-it was the first and adolescent years. Although the patient had only time in the two years of their friendship- talked about it off and on from the beginning of he had an ejaculation when the boy caressed his therapy, the memories about this theme were penis. Soon after these events they ceased to especially prominent rather late in the analysis. meet. He described these years as extremely happy Mr Z felt no resentment against his friend and ones-they might well have been the happiest spoke warmly about him whenever he men- years of his life, except perhaps for his early tioned him during the analysis. He felt that their years when he possessed his mother seemingly affection had been genuine and that their without conflict. The relationship to the friendship had been mutually enriching. counsellor appeared indeed to have been a very Although they hardly saw one another after the fulfilling one. Although overt sexual contact breakup, they never lost contact altogether, between them occurred occasionally-at first even to the present. (The man, it might be mainly kissing and hugging, later also naked added, is now married in what appears to be a closeness with a degree of tenderly undertaken happy marriage. He has several children and is manual and labial mutual caressing of the successful in his career.) genitalia-he insisted that sexuality had not After this two-year enclave of comparative been prominent: it was an affectionate relation- happiness, Mr Z's existence became troubled ship. The boy idealized his friend. During the and unsatisfactory. Puberty did not bring about summer, in camp, he admired him not only in any genuine interest in girls. Instead, he his function as an expert outdoorsman who . experienced an increasing sense of social taught his charges various skills but also as a isolation, and he gradually again became more Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

8 HEINZ KOHUT

and more tied to his mother. The father, so far mobilization and the working-through of Mr as we learned in the first analysis, remained a Z's nuclear conflicts. During the early part of distant figure for him. His mother seems to have the analysis his grandiosity and narcissistic engaged in a social life of her own and, for a demands had been taken up and were worked while-preceding the time when Mr Z attached through, both in so far as they were the himself to the counsellor-was intensely in- continuation of his fixation on the pre-oedipal volved with another man, a married friend of mother and in so far as they were clung to as a the family-a liaison, it might be added, to defence against oedipal competitiveness and which the father apparently did not object. castration fear. These themes did not, ofcourse, The patient's sexual life from the time of the disappear abruptly but their frequency and termination of his homosexual friendship to the intensity abated. And what seemed to me to be present was restricted to frequent, addictively even more significant as an indicator of the pursued masturbation, always accompanied by genuineness of the termination of the analytic fantasies of masochistic relationships with process was the fact that it was preceded by a women. The fantasies contained no homosexual shift in the dominant themes with which the elements. Indeed, although I was of course alert patient was dealing. Pari passu with a gradual to the possibility of homosexual propensities, I lessening of associations concerning Mr Z's could not, with the exception of an anxiety pre-oedipal mother attachment, there was a dream toward the end of analysis, discern any gradual increase of allusions that a repressed unusual homosexual tendencies in Mr Z, or any oedipal conflict was being activated. At any rate unusual defensive attitudes concerning homo- I consistently, and with increasing firmness, sexual stimulation, either in the first or in the rejected the reactivation of his narcissistic second analysis. attitudes, expectations, and demands during the To put the symptomatic and behavioural last years of the analysis by telling the patient results of the first analysis in a nutshell: Mr Z's that they were resistances against the confronta- masochistic preoccupations disappeared gradu- tion of deeper and more intense fears connected ally during the second half of the analysis and with masculine assertiveness and competition were almost nonexistent at the end. He made, with men. The patient seemed indeed to respond furthermore, a decisive maturational step by favourably to this consistent and forcefully moving from his mother's house to an pursued attitude on my part: the narcissistic apartment of his own. And, finally, he not only features receded, the patient's demands and began to date but had also several sexually expectations became more realistic, and he active, brief relationships with girls of approxi- began to be increasingly more assertive in his mately his own age and of his own cultural career-directed activities and vis-a-vis women. background and educational level. During the In the transference, too, he reported aggressive last year of the analysis, while pursuring a thoughts towards me and expressed some research project, he became acquainted with a curiosity concerning my private life, including professional woman, about a year older than he, my sex life. with whom he consulted about certain aspects The most significant sign of his advance in of his investigations that lay outside his own facing what I then believed to be his deepest field but were in the area of her competence. He conflicts was a dream which occurred about half pursued her actively, had satisfactory sexual a year before the termination. In this dream- relations with her, and entertained thoughts of his associations pointed clearly to the time when marrying her, although at the time of the the father rejoined the family-he was in a termination of the analysis he had not yet come house, at the inner side of a door which was a to any decision concerning this step. crack open. Outside was the father, loaded with More important to me in evaluating the giftwrapped packages, wanting to enter. The effectiveness of the treatment than these patient was intensely frightened and attempted to improvements, however extensive they ob- close the door in order to keep thefather out. We viously were, was the fact that I felt that they did a good deal ofwork on this dream, to which had come about as the direct result of the he had many associations referring to present Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

THE TWO At-JAL YSES OF MR Z 9

experiences (including the transference) and to stark contrast to the striking contents that we the past. Our conclusion was that it referred to transacted, was, with the exception of one area, his ambivalent attitude towards the father. And, emotionally shallow and unexciting-note- in view of the overall image I had formed of the worthy because the patient was not an construction of his personality and of his obsessional personality, was not inclined to split psychopathology, I stressed in my interpreta- ideation and affectivity. On the contrary, he had tions and reconstructions especially his hostility always been able to experience and to express toward the returning father, the castration fear, strong emotions. He had always experienced vis-a-vis the strong, adult man; and, in addition, shame and rage with great intensity and often I pointed out his tendency to retreat from felt deeply upset about setbacks and wounds to competitiveness and male assertiveness either to his self-esteem; and he could also react with a the old pre-oedipal attachment to his mother or warm glow of triumphant satisfaction when to a defensively taken submissive and passive accomplishment and success enhanced his self- homosexual attitude toward the father. esteem. To draw specific comparisons: nothing The logical cohesiveness of these reconstruc- in the terminal phase-neither his experiences in tions seemed impeccable, and in view of the fact real life nor his experiences in the analytic that they were entirely in line with the precepts sessions came anywhere near equalling the about the unfolding of an analysand's conflicts emotional depth with which in earlier phases of and about the ultimate resolution of these the analysis he had talked about his idealization conflicts brought about in a well-conducted of the pre-oedipal mother and his admiration analysis-precepts that were then firmly estab- for the counsellor. Only the feelings concerning lished in me as almost unquestioned inner the parting from the analyst appeared to have guidelines in conducting my therapeutic work- real depth; and his ultimate acceptance of the I had no doubt that Mr Z's vast improvement fact of having to give up the analytic was indeed based on the kind of structural relationship seemed hard-earned and genuine. change that comes about as a result of bringing After the analysis had ended with a warm formerly unconscious conflicts into conscious- handshake and the expression of gratitude on ness. To my analytic eye, trained to perceive the his part and of good wishes for his future life on configurations described by Freud, everything mine, I had hardly any contact with Mr Z for seemed to have fallen into place. We had about five years. About three weeks after our reached the oedipal conflict, the formerly last session, a brief letter came with his last unconscious ambivalence toward the oedipal payment. In this letter he again expressed his father had come to the fore, there were the gratitude and stated that, while the termination expected attempts at regressive evasion with of our relationship was still emotionally difficult temporary exacerbations of pre-oedipal con- for him, he was handling it all right. He also flicts, and there was ultimately a period of mentioned that he had decided not to marry the anticipatory mourning for the analyst and the woman he had dated during the last year, but relationship with him, abating towards the very that he would look elsewhere. I also accidentally end, as the dissolution of the bond of trust and met the patient on two occasions: once in the co-operation was in the immediate offing. It all theatre and once at a concert. In each case he seemed right, especially in viewof the fact that it was in the company of a young woman-a was accompanied by what appeared to be the different one each time-whom he introduced unquestionable evidence of improvement in all to me, and each time we had a brief but friendly the essential areas of the patient's disturbance. social chat. From what I could glean from these What was wrong at that time is much harder conversations he was doing well enough in his to describe than what seemed to be right. Yet, I profession and, while not overly vivacious, he believe that, although both the patient and I did not appear to be depressed. must have known it preconsciously, we failed to I was surprised when, about four and a half acknowledge and confront a crucial feature of years after the termination of his analysis, Mr Z the termination phase. What was wrong was, to let me know that he was again experiencing state it bluntly, that the whole terminal phase, in difficulties. His message was contained in a Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

10 HEINZ KOHUT Christmas card which, he wrote, he was sending information we obtained in the course of the me in order to congratulate me concerning a second analysis. professional office I was currently holding. (1 He then told me that the masochistic fantasies later discovered that he had learned about this had indeed never completely disappeared, but from a newspaper notice more than half a year that he had often called them up actively during earlier, without then writing to me.) He closed intercourse with his girl friends. He did this, he by wishing me a happy holiday. It was only said, as an antidote to premature ejaculation seemingly as an afterthought that he added the and in order to experience the sexual act more crucial information that he had been doing less keenly. Finally, during the last few months, well recently and that he would probably after breaking up with his most recent girl, he contact me in the near future. In acknowledge- had become alarmed about an increasing sense ment, I told him he should get in touch with me of social isolation and especially-he reacted if he continued to feel the need to do so. Shortly like a former addict threatened by the danger of thereafter he set up an appointment. succumbing again to his addiction-about the My very first impression when he came to see temptation, so far resisted, to buy pornographic me was that he was under some strain. But he books and to masturbate with masochistic talked freely and openly as he filled me in on the fantasies. events of the intervening years and explained the Although 1misinterpreted its significance as a reasons for contacting me at this point. There factor in Mr Z's return for treatment at that was little overt change in his life. He still lived time, 1 dimly realized that the most important alone, in an apartment of his own. He was at the bit of information he gave me during the first of present time not attached to any particular girl, two interviews concerned the fact that Mr Z's but until recently he had had a succession of mother, at that time in her middle fifties, had affairs. He was always sexually potent-a mild about a year and a half ago undergone a serious tendency to ejaculatio praecox that had personality change. After Mr Z had moved developed some time ago did not appear to pose away from her (about five years ago) she had any serious difficulties-but he had progress- become increasingly isolated, leaving the house ively become aware of the fact that the more and more rarely, and, as became relationships in which he engaged were ultimately unmistakable about two years ago, emotionally shallow and, in particular, that his she had developed a set of circumscribed sex life gave him no real satisfaction. He then paranoid delusions. I wondered immediately mentioned, in quick succession-a manifest non whether the mother's serious emotional disturb- sequitur which, as I assumed, indicated a latent ance was not in some way causally related to causal relationship-that there had been no the worsening of Mr Z's condition and to his recurrence of the former addictive masturbation turning to me for help. Was he being confronted with masochistic fantasies and that, although with the loss of a still unrelinquished love object outwardly he was doing reasonably well in his from childhood or with guilt feelings about profession, he did not enjoy his work but having abandoned her and having thus caused experienced it as a necessary routine, a burden, her illness? He had, himself, considered these a chore. I remember that I immediately possibilities; and he was indeed aware of some suspected, on the basis of the juxtaposition of feelings of loss and of guilt. He did not realize, his statement concerning the non-recurrence of however-we achieved this surprising insight in his sexual masochism and the complaint about the course of the second analysis-that, the burdensomeness of his work, that, contrary paradoxically, the mother's serious emotional to my hope, the first analysis had not achieved a disturbance had not been a deleterious force cure of his masochistic propensities via struc- dragging him back into his former illness but tural change, but that they had only become rather, as will be explained later, a wholesome suppressed and had now shifted to his work and one propelling him toward health. to his life in general. This impression, 1 might Although it became immediately apparent add, was later amply corroborated by the that Mr Z required further analysis, it would Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

THE TWO ANALYSES OF MR Z II

have been very difficult for me to start with him pair ofgloves in the other. The figure ofthe man at that time. Since, as he said in the second was visually very plastic and prominent-as in interview, he felt much better after the first some photographs in which the object is sharply in contact with me-indeed, the change in focus while the background is blurred. The appearance and demeanour was striking: his associations showed that the figure was a face had been tense and pale; now it was relaxed condensation of(a) the camp counsellor (certain and his colour had returned; he held himself features ofthe landscape referred to the location more upright and was bouncier in all his of the summer camp); (b) his father (the hair); movements; his speech was more lively-he and (c) the analyst (umbrella, gloves, the accepted without hesitation my suggestion that handkerchief, the ring). The relationship to an we postpone the beginning of further analysis idealized object, the establishment of an for about half a year. He also agreed with my idealizing transference, was portrayed by the suggestion that I would see him now and then, if impressive appearance and proud bearing ofthe he should feel the need for an appointment. As a man and by the tone of admiration with which matter of fact, Mr Z did not make any further the patient described him. I did not, at the time, appointments after the initial visits, but wrote to understand the meaning of the multifaceted me once, about half-way through the waiting richness of the figure, especially as portrayed in period, confirming his expectation that we the way he was dressed. The fact, however, that would start again at the date that we had set and in his associations the patient recalled briefly the stating that, in the meantime, he was now doing dream of his father, loaded with packages, reasonably well. I might add at this point, that I trying to intrude into the house, established a suspected that his increase in well-being after link with the terminal phase of the first seeing me again was an aspect of the analysis-announcing as it were that the second transference he had established, and wondered analysis was a continuation ofthe first one, that, whether his improvement was analogous to the as I came to see later, it took off from the very well-being that he had experienced much earlier point where the first one had failed most in his life, at the time when he had turned from significantly. the mother to the camp counsellor. I began to As is characteristic for cases of the type to assume in other words-a hypothesis that I had which Mr Z belongs, the initial phase of not entertained during the first analysis-that idealization was of short duration. In harmony he was establishing an idealizing transference. with my then newly acquired insights about the When we began the second analysis as analyst's correct attitude vis-a-vis a narcissistic planned, this hypothesis was confirmed by the transference in statu nascendi (cf. Kohut, 1971, patient's first dream (dreamed during the night pp. 262-4), I did not interfere with the unfolding that preceded the first session). The meaning of of the patient's idealization of me. Still, after certain aspects of the very simple manifest about two weeks, it gradually began to subside, content were almost immediately under- in accordance with the spontaneously unrolling standable, the full depth of its meaning, sequence of transferences that is determined by however, became intelligible only much later. endopsychic factors-i.e. by the structure of the The dream contained no action or words. It was patient's personality and psychopathology-to the image of a dark-haired man in a rural be replaced by a mirror transference of the landscape with hills, mountains, and lakes. merger-type (cf. Kohut, 1971, pp. 137-42). The Although the man was standing there in quiet glow of well-being and inner security that he relaxation, he seemed to be strong and experienced in consequence of feeling himself confidence-inspiring. He was dressed in city within the milieu provided by the idealized clothes, in a complex but harmonious way-the analyst faded away, and in its stead the patient patient saw that he was wearing a ring, that a became self-centred, demanding, insisting on handkerchief protruded from his breast pocket, perfect empathy, and inclined to react with rage and that he was holding something in each hand- at the slightest out-of-tuneness with his psycho- perhaps an umbrella in one hand, and possibly a logical states, with the slightest misunder- Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

12 HEINZ KOHUT

standing of his communications. This phase in aspects of the change is the fact that between Mr the second analysis was quite similar to the Z's first and second analysis my theoretical corresponding one in the first. What was outlook had shifted so that I was now able to different, however, was my evaluation of the perceive meanings, or the significance of psychological significance of his behaviour. meanings, that I had formerly not consciously While in the first analysis I had looked upon it perceived. More important, however, than my in essence as defensive, and had at first tolerated broadened perception was the subtle effect it as unavoidable and later increasingly taken a which the change in my theoretical outlook stand against it, I now focused on it with the exerted on my attitude vis-a-vis Mr Z. However analyst's respectful seriousness vis-a-vis import- mitigated by considerations that in everyday ant analytic material. I looked upon it as an parlance one might refer to as patience or analytically valuable replica of a childhood human kindness or tact, and that, to speak in condition that was being revived in the analysis. theoretical terms, had been an outgrowth of my This altered stance had two favourable con- respectful attention to the fact that structural sequences. It rid the analysis of a burdensome changes come about only as the result of a great iatrogenic artifact-his unproductive rage reac- deal of working-through, I had in the first tions against me and the ensuing clashes with analysis looked upon the patient in essence as a me-that I had formerly held to be the centre of independent initiative and had unavoidable accompaniment of the analysis of therefore expected that he would, with the aid of his resistances. And-a reliable indication that analytic insights that would enable him to see we were now moving in the right direction-the his path clearly, relinquish his narcissistic analysis began to penetrate into the depths of a demands and grow up. In the second analysis, certain formerly unexplored sector of the however, my emphasis had shifted. I had patient's personality and to illuminate it. acquired a more dispassionate attitude vis-a-vis Formulated in the traditional terms of early the goal of maturation, and, assuming that object relations, we would say that this phase of growth would take care of itself, I was now able, the analysis revived the conditions of the period more genuinely than before, to set aside any when, in early childhood, he had been alone goal-directed therapeutic ambitions. Put dif- with his mother, who was ready to provide him ferently, I relinquished the health- and maturity- with the bliss of narcissistic fulfillment at all morality that had formerly motivated me, and times. We would, in other words, look upon this restricted myself to the task of reconstructing stage of the transference as a revival of an early the early stages of his experiences, particularly situation when he was spoiled by his mother, as they concerned his enmeshment with the when a condition of overgratification had pathological personality of the mother. And prevailed which, in turn, led to the fixation that when we now contemplated the patient's self in hampered further development. But this tradi-l the rudimentary state in which it came to viewin tiona I pattern of explanations fails to do justice the transference, we no longer saw it as resisting to two significant features of Mr Z's personality change or as opposing maturation because it did that I could discern, even during this phase of not want to relinquish its childish gratifications, the analysis: an underlying chronic despair but, on the contrary, as desperately-and often which could often be felt side by side with the hopelessly-struggling to disentangle itself from arrogance of his demandingness; and, par the noxious selfobject, to delimit itself, to grow, excellence, the sexual masochism that had to become independent. reappeared and stood in stark contrast to his It was in the context of our focus on the self-righteous claims for attention. struggles of his feeble self to define itself that we It is not easy to describe the subtle but came to understand the significance and effect decisive differences between this phase in the of Mr Z's mother's recent psychosis. In the first second analysis in which the reactivation of Mr analysis I had seen the patient's persistent Z's early relationship to the mother dominated attachment to the mother as a libidinal tie that the picture and the corresponding phase in the he was unwilling to break. His idealization of first analysis. Fundamental to all the other the mother, which was still much in evidence Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

THE TWO ANALYSES OF MR Z 13

during the first analysis, I had understood as the determined the nature of their relationship, was conscious manifestation and accompaniment of accompanied by great anxiety, often leading to his unconscious incestuous love for her. But serious resistances. The flow of his revelations now we saw the personality of Mr Z's mother would then be interrupted and he retreated from and the nature of his relation to her in quite a the pursuit of the analytic task, voicing instead different light. The picture of the mother that serious doubts whether his memories were Mr Z had painted for me in the first analysis was correct, whether he was not slanting his that of the image which she portrayed presentation to me. As we discovered-a successfully to people outside the family. Those dynamically extremely important insight with- intimately involved with her, however, espec- out which progress would surely have ulti- ially, of course, the patient and the patient's mately been halted-his fears concerned the loss father, knew better, even though they were not of the mother as an archaic selfobject, a loss able to raise this knowledge to a level of that, during this phase of remembering and awareness which would have allowed them to working through the archaic merger with the share it with each other. They knew that the mother, threatened him with dissolution, with mother held intense, unshakable convictions the loss of a self that at these moments-and that were translated into attitudes and actions they were more than moments-he considered which emotionally enslaved those around her to be his only one. His doubts, his tendency to and stifled their independent existence. True, take back what he had already recognized and when Mr Z reported in the first analysis that the revealed, were due to a temporary repression of mother had responded to him with gratifying his memories, or rather, in most instances, to the enjoyment, he had not misrepresented her. fact that his intense disintegration anxiety re- What had been missing from his reports was the established the dominance of the disavowal that crucial fact that the mother's emotional gifts had already in childhood prevented him from were bestowed on him under the unalterable fully acknowledging what he in fact experienced and uncompromising condition that he submit and knew. to total domination by her, that he must not I would like here to draw attention to a allow himself any independence, particularly as feature of this phase of Mr Z's analysis that I concerned lmtnlft'cant rn1.il.tionsblps with others. have found in all similar cases: the remobiliza- M1' mother was mtensely and pathologically tion of childhood experiences in the analytic jealous; and, it may be added, not only father situation did not lead to sustained transference and son but the servants, too, were under her distortions of the image of the analyst. strict domination. Transference distortions did, ofcourse, occur- His father's attachment to the nurse and his almost always as the elaboration of a nucleus of decision to live away from home, constituted, as a real perception concerning the analyst, i.e. Mr Z came ultimately to realize, a flight from concerning some attitude or action of the the mother. It was also an abandonment of his analyst which he correctly but oversensitively son, as the patient must have preconsciously perceived as being similar to those of the experienced the behaviour of his father in pathological mother. But they usually disap- childhood-the conscious acknowledgement of peared quickly, to be replaced by childhood this feeling was reached only during his second memories concerning the mother. It is my analysis. As the patient saw it: the father had impression that the comparative underemphasis tried to save himself, and in doing so he had of transference distortions in such cases is not a sacrificed the son. defensive manoeuvre but that it is in the service The description of Mr Z's relation to the of progress. In order to be able to proceed with mother filled many hours of his second analysis. the task of perceiving the serious pathology of The emergence of his memories, however, and, the selfobject of childhood, the patient has to especially his acquisition ofgradually deepening be certain that the current selfobject, the insights into the essence of his relation with the analyst, is not again exposing him to the mother, above all his recognition of the serious pathological milieu of early life. distortion of the mother's personality which Let me now turn to certain concrete details of Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

14 HEINZ KOHUT the mother's behaviour, to provide the data that and unmodifiable need to retain her son as a will allow us to understand the pathological permanent selfobject. nature of their relationship. Mr Z's memories No direct memories emerged during Mr Z's here did not emerge directly. They were recalled analysis that referred to his toilet training. It only after he had first re-examined certain seemed to have taken place fairly early during features of their relationship such as the the second year of his life, apparently created no mother's reading to him, playing with him, serious problems, and resulted in reliable talking with him, and spinning out fantasies sphincter control. There was no encopresis and with him about what his future would be like, only a single unusual incident of enuresis, that he had already described during his first shortly after he was moved from the parental analysis. At that time these aspects of the bedroom to another room. Despite the fact that mother's attitude towards him were seen by us his development in this area appeared to have in the light of his then prevailing idealization of been in itself uneventful, Mr Z's associations the mother, and we had both taken them as and memories led us, in the context of his manifestations of the mother's love for him. overall struggle to reassess the mother's Now, however, feeling supported by the analyst, personality, to a specificabnormal feature of her he began to question the formerly unques- behaviour. He recalled now (this topic was tionable. And as he gradually became able to rid especially active during the early part of his himself of the sense of the sacrosanctity of the second analysis) the mother's intense interest in outlook on their relationship with which the his faeces. She insisted on inspecting them after mother had indoctrinated him, he began to each of his bowel movements until he was about recognize a certain bizarreness of even these six. At that point she abruptly ceased the seemingly so normal and wholesome activities inspections and almost simultaneously began to of the mother. He began to recognize, for be preoccupied with his skin, particularly the example, that she had by no means been in skin on his face. empathic contact with the needs of his self for It is remarkable that this striking feature of an anticipatory resonance to its future power the patient's childhood had never become a and independent initiative when, in her imagery prominent topic during the first analysis. It had about him as a grown man, she had always emerged briefly on a number of occasions, but taken totally for granted that, however great his was never recognized by us as the important successes in life, their relationship would never indicator of the mother's serious personality be altered, he would never leave her. disorder that in fact it was. We had looked at it After the slow and painful process of freeing only in the context of what we had then himself from the idealized outlook on his considered to be the patient's defensively clung- relation with the mother had gone on for some to narcissism. The mother's behaviour, in other time, enabling him for the first time to recognize words, had served us as an explanation of his that the sector of his self that had remained tendency to overvalue his' productions '-his merged with her since childhood was neither all statements in social conversations and to the of his self nor even its central part, he began analyst, his written work in school, etc.-and I haltingly, and against surges of severe resistance can still remember the slightly ironical tone of motivated by disintegration anxiety, to talk my voice, meant to assist him in overcoming his about some of the mother's more overtly ehildish grandiosity, when I pointed out to him abnormal activities when he was a child and how his mother's interest in every detail of his adolescent. Three examples of Mr Z's mother's physical and mental ' excretions ' had brought behaviour during the patient's early life, namely Mout a fixation on an infantile pride in them, her interest in his faeces, her involvement with leading to his current oversensitivity to short- his possessions, and her preoccupation with comings in himself and in what he produced, small blemishes in his skin, constitute rep- and ultimately to his propensity to react to resentative aspects of her attitude towards criticism, and even the mere absence of praise, him-an attitude which, as we came to see more with depression or rage. and more clearly, manifested her uneradicable In contrast to the first analysis, the second Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

THE TWO ANALYSES OF MR Z 15

one focused on the depression and hopelessness memories that emerged during the early part of that the mother's attitude evoked in him. She the second analysis concerned the mother's was not interested in him. Only his faeces and intense involvement with her furniture and the her inspection of them, only his bowel functions art objects and bric-a-brac that she collected and her control over them fascinated her-with and displayed in their home. One would be an intensity, a self-righteous certainty, and inclined to call her concern with these adamant commitment that allowed no protest possessions an obsessional character trait, to be and created almost total submission. explained as due to anal fixations, just as one As I mentioned earlier, her preoccupation would, of course, be inclined to explain the with his faeces stopped, apparently abruptly, ritual of the blackhead-removal sessions under when he was about 6 years old; she then became the same diagnostic heading as a displacement as obsessed with his skin as she had been with of anal-sadistic drive aims. I have little doubt, his bowels before. Every Saturday afternoon- however-and not only because she had the procedure became an unalterable ritual, just developed a paranoid psychosis after the patient as the faeces-inspections had been-she ex- moved away from her-that a diagnosis of amined his face in minutest detail, in obsessional neurosis, i.e. a diagnosis based on particular-and increasingly as he moved drive-criteria, would, even if not wrong, be toward adolescence-with regard to any irrelevant. She was, in essence, a 'borderline developing blackheads she could detect. case'. (See Kohut, 1977, p. 192, for the Mr Z began to talk about the skin-inspection definition of this diagnostic category.) The ritual after telling me about the faeces psychotic core, the central pre-psychological inspections; but, even though he was now chaos of her personality, the central hollowness dealing with events of later childhood and of her self was covered over by a rigidly adolescence, it was harder for him to give me a maintained hold on and control over her self- clear picture of what had happened during one objects whom she needed in order to shore up period of his life and what during another. The her self. Although to superficial acquaintances events had become telescoped and the chrono- she presented a picture of normal emotionality, logy blurred. As I would judge now in even outsiders soon felt the lifelessness that lay retrospect, this blurring of time relationships underneath the appearance of normality. Thus was to some extent defensive. It might well have none of Mr Z's classmates and acquaintances, been that it was especially hard for him to either from primary school or later, liked to visit acknowledge how strong a hold his mother's his house, which contributed to his social pathological influence had had on him, even as isolation. Even though a room was finally comparatively recently as his late teens. assigned to the boy, he enjoyed no privacy. The Be that as it may, the complete ritual mother insisted that his door be kept open at all consisted of two phases. During the first times and often entered suddenly and un- phase-the emotionally most trying one for Mr expectedly, disturbing whatever conversation or Z-she described disapprovingly in great detail other activity might have developed between the what she saw. The second phase closed with the, patient and a visiting friend by a chilling look of often quite painful, removal of the ripest of the disapproval (cf. the description of the similar blackheads. The mother, who frequently ex- behaviour ofMr B's mother in Kohut, 1971, pp. pressed her pride in her long and hard 81-2.) fingernails, described to her son its extrusion We are again confronted by the puzzling and showed him the extracted plug ofsebum-a question why this crucial material had not faecal mass in miniature-with satisfaction, appeared during Mr Z's first analysis. To be after which she seemed gratified, and Mr Z, too, sure, it had indeed appeared, but-what is even experienced some temporary relief. The worst more incomprehensible-it had failed to claim occasions were those when either no ripe our attention. I believe that we come closest to blackhead was found or when an attempted the solution of this puzzle when we say that a removal failed. crucial aspect of the transference had remained Another cluster of Mr Z's associations and unrecognized in the first analysis. Put most Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

16 HEINZ KOHUT

concisely: my theoretical convictions, the tances in the form of doubts motivated by the convictions of a classical analyst who saw the nameless fear, to which (Kohut, 1977, p. 104) I material that the patient presented in terms of have referred as 'disintegration anxiety'. infantile drives and of conflicts about them, and Which reality was real? His mother's reality? of agencies of a mental apparatus either clashing The reality for which the first analysis had or co-operating with each other, had become for stood? Or the present one? Over and over, he the patient a replica of the mother's hidden struggled with these questions. And many times, psychosis, of a distorted outlook on the world to particularly in the beginning of this phase of the which he had adjusted in childhood, which he analysis, he turned in his search for certainty to had accepted as reality-an attitude of com- the fact that the mother had now developed a set pliance and acceptance that he had now of delusions which demonstrated without reinstated with regard to me and to the question that her outlook was distorted. And seemingly unshakable convictions that I held. over and over, he remembered his reaction when The improvement which resulted from the he had first fully realized that the mother was first analysis must therefore be considered in mentally ill, that she harboured a set of essence as a transference success. Within the delusions. His immediate reaction-deeply analytic setting, the patient complied with my puzzling to him at that time but now becoming convictions by presenting me with oedipal intelligible-had been one of a quietly ex- issues. Outside the analytic setting, he acceded perienced, intense inner joy. It was the to my expectations by suppressing his symptoms expression of his sense of utter relief about the (the masochistic fantasies) and by changing his fact that he now, potentially at least, had behaviour, which now took on the appearance witnesses; 1 that he was not alone in knowing of normality as defined by the maturity morality that the way the mother saw the world, to which I then subscribed (he moved from particularly, of course, the way she had behaved narcissism to object love, i.e. he began to date toward him during his childhood, was girls). pathological. Was the success of the second analysis based It was after overcoming surges of resistances on a similar mechanism, it may be asked. Did of this type that the most significant progress he, in other words, simply shift to a new was always made, i.e. that he was able to take compliance with the new convictions to which I another step towards freedom, away from the now adhered? I do not think so. Not only was enmeshment with the mother. Although this his need to comply-particularly the fears that process came to full fruition only much later in src;;)(; in the way of non-compliance-exten- the analysis, the lessening hold of the merger- sively investigated and worked through; the enmeshment with the mother allowed us to take intense emotions which accompanied his strug- a fresh look at two important sets of childhood gles with the issues that were activated now and experiences which, during the first analysis, I the zest with which he ultimately turned towards had interpreted as manifestations of a fixation life had a depth and genuineness that had been on and/or regression to infantile modes of absent during the first treatment. pleasure gain through the gratification of But let me be specific. Mr Z's increasing pregenital drives. We now saw the significance awareness of the mother's psychopathology and of his childhood masturbation, with the his understanding of its pathogenic influence on fantasies of being the slave of a woman who him could not be maintained without a great unconditionally imposed her will on him and deal of emotional toil. The emergence and treated him like an inanimate object that had no analytic illumination of this material was will of its own, and the significance of his interrupted time and again by serious resis- involvement with the primal scene-ofmaterial,

I I am here focusing only on the all-important inner when the mother, at one time, on the basis of her delusional experiences of Mr Z. It is of lesser importance in the present convictions, wanted to take a step that could have had very context that he also had actual witnesses: a relative who troublesome practical ccnsequences. worked in the mental health field whose help he enlisted Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

THE TWO ANALYSES OF MR Z 17

in other words, around which the working- delimitation, as the accompanying masochistic through processes of the first analysis had taken fantasies demonstrate. In the second memory- place (which we thought had led to a cure)-in a it belonged to the deepest layer of the totally different light. Where we had formerly unconscious uncovered during this period-he seen pleasure gain, the sequence of drive recalled not only that, before the construction of demand and drive gratification, we now his masochistic fantasy system, he had for a recognized the depression ofa self that, wanting brief time engaged in anal masturbation but to delimit and assert itself, found itself also-this aspect of his recall was initially hopelessly caught within the psychic organiza- accompanied by the most intense shame-that tion of the selfobject. We realized not only that he had smelled and even tasted his faeces. As I neither his masturbation nor his involvement in said, the recall of these memories was at first the primal scene had ever been enjoyable, but extremely painful and the reactivation of his that a depressive, black mood had pervaded childhood sadness or shame seemed at times of most of his childhood. Since he could not overwhelming intensity. Still, in the context in joyfully experience, even in fantasy, the which the recall took place, Mr Z's experiences exhilarating bliss of growing self-delimitation were well within tolerable limits because he had and independence, he tried to obtain a come to understand for the first time, in minimum of pleasure-the joyless pleasure of a empathic consonance with another human defeated self-via self-stimulation. The mastur- being, that these childhood activities were bation, in other words, was not drive- neither wicked nor disgusting, but that they had motivated; was not the vigorous action of the been feeble attempts to provide for himself a pleasure-seeking firm self of a healthy child. It feeling of aliveness, manifestations of that was his attempt, through the stimulation of the surviving remnant of the vitality of a rudimen- most sensitive zones of his body, to obtain tary self which was now finally in the process of temporarily the reassurance of being alive, of firm delimitation. He understood, in other existing." words, that to be separate from the mother was I remember in particular the time during this neither evil nor dangerous but the appropriate phase of the analysis when Mr Z recovered the assertion of health. following two interconnected memories. In the We also re-evaluated the primal-scene ex- first, he recalled how during childhood and periences and ultimately grasped their essential latency he would often drag himself through a significance only when we saw them as joyless day by telling himself that night would belonging to the depression that had pervaded come and he would be in bed and could his childhood. His involvement with the primal masturbate. I shall not attempt to describe the scene, in other words, was not a manifestation emotionality that surrounded this memory, of the healthy sexual curiosity of a firmly poignantly presenting the utter dreariness of a consolidated, investigative self-a healthy child's existence whose only solace in the face of curiosity that may come to grief if the the almost total lack of the joyful sense of prohibitions from and fears of the loved-hated growth and independence open to healthy incestuous objects create conflicts that the child children, is the thought that he could stimulate is unable to solve and therefore represses. For his lonesome body in endlessly prolonged Mr Z, the primal scene was ab initio an masturbatory activities-yet even then unable unempathically overstimulating experience, to rid himself ofthe awareness ofhis lack of self- understood by him as a demand to be absorbed

2 It should be mentioned here that Mr Z's secondary my view. The absence of guilt, I believe, is in tune with the conflicts about his masturbatory activity were never very fact that the pathogenic parent, the father or mother who great. This relative absence of conflict is commonly found in enslaves the child because of his or her own need for a self- individuals with personality structures similar to that of Mr object, completely disregards the child's sexual activity as Z. I used to think that the comparative absence of guilt was long as it is part of the child's depression about the more apparent than real, that analysis should remove unbreakable merger. It is only when the child's sexual resistances in order to allow the analysand to confront his activities become associated with the assertion of indepen- conflicts and to deal with them. But after many unsuccessful dence that the parent begins to exert guilt pressure on him. attempts to penetrate to conflicts and guilt, I have changed Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

18 HEINZ KOHUT by the activtties of the mother. And he point remained unclear.' It was replaced by a submitted to this demand via the masochis- period of strong transference involvement, in tically sexualized relinquishment of his the specific form of the need to know more independence. about me. Side by side, in other words, with The second phase of the second analysis continuing references to the primal scene and cannot, of course, be neatly separated from the complaints about the weakness of his father and first, but, taken as a whole, it differed from the of his father's lack of interest in him, he began first in its feeling tone. The depressive elements to express intense curiosity about me. He receded, and active yearnings, intensely felt and wanted to learn about my past, in particular vigorously expressed demands, an increasingly about my early life, my interests, my education; prominent vitality, buoyancy, and hopefulness he wanted to know about my family, the nature were now in evidence. And simultaneously, the of my relationship to my wife and whether I had content of his communications shifted; he children. Whenever I treated his inquiries as a turned from the previous almost exclusive revival of infantile curiosity and pointed out the preoccupation with the mother to thoughts associative connections with the sex life of his concerning his father. parents, he became depressed and told me I He still talked about his parents' sexual misunderstood him. No serious analytic im- relations, for example. But whereas in the passe developed, however. Although I did not preceding phase he had hardly considered his accede to his demands for specific information father's participation-and my attempts to about me, but told him that his wish to get to emphasize that mother and father had been know me was surely rooted in an old wish or engaged in intercourse had evoked no signifi- need, I did concede that, after listening to him cant response from him-his associations further and watching his reactions, I had to (direct memories and, occasionally, transference agree with him that the term ' curiosity' that I fantasies about the analyst's sex life) now began had been using had not been right-that what to turn spontaneously more and more to his he was experiencing now was not a revival of father's role. At first the affect that accom- sexual voyeurism of childhood but some panied the analytic work in this area was, again, different need. And I finally ventured the guess one of depression and hopelessness-the mood, that it was his need for a strong father that lay in other words, that had been prevalent during behind his questions, that he wanted to know the first phase was still the same. But his whether I, too, was weak-subdued in inter- hopelessness was now not as diffuse as it had course by my wife, unable to be the idealizable been before-it related increasingly to a distinct emotional support of a son. The result of this preoccupation: that his father was weak, that shift in my interpretative approach was a the mother dominated and subdued him. At this dramatic lessening of his depression and time he also reminisced briefly about the old hopelessness. He dropped his demands that I schoolfriend who, by turning from him and his supply him with information about me-as a mother (see p. 4), seemed to have brought about matter of fact he ultimately saw the friendly the psychic imbalance that had prompted him to firmness with which I had refused to accede to seek analytic help in the first place. Despite the his demands as an asset of my personality, a sign importance which the support he had obtained of my strength-and he made do with certain from the relationship with this friend had had bits ofinformation which he had obtained either for him, and despite the fact that we could accidentally or via inference-my interest in art understand its nature without much difficulty- and literature, for example-and talked about it was in essence a mutually supportive his impression that, in my case at least, the love twinship-this theme did not remain active for of the world of the mind was not a retreat long and the significance of its emergence at this motivated by inability to compete in the real

3 My knowledge of the further course of the analysis tells father. His associations here say in essence: I am thinking me now that this theme emerged as an allusion to the about a man who abandoned me by turning from my forthcoming central complex of memories about Mr Z's mother to another woman. Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

THE TWO ANALYSES OF MR Z 19 world, but compatible with masculinity, with which he may be said to have taken the road courage. toward emotional health. But the road was not And when he talked again about the camp an easy one. As the analysis moved towards the counsellor, he spoke as in the first analysis, of next waystation, the unfolding of the principal his friend with affection and respect, expressed theme-the recovery of the strong father-was no regrets about the homosexual activities in interrupted by recurrent attacks of severe which they had engaged, but saw his relation- anxiety, including a number of frightening, ship to him as an enriching friendship with a quasi-psychotic experiences in which he felt strong and admired man. On the whole, I himself disintegrating and was beset by intense tended to concur with Mr Z's assessment. hypochondriacal concerns. At such times he' Different, in other words, from the under- dreamed of desolate landscapes, burned-out standing of the friendship that I communicated cities, and, most deeply upsetting, of heaps of to the patient during the first analysis-namely, piled-up human bodies, like those in pictures of that it had represented a regression to the concentration camps he had seen on T.V. The phallic mother-I now agreed that his friend last image was especially horrible because, as he had been the yearned-for figure of a strong reported, he was not sure whether the bodies fatherly man, perhaps the admired older brother were those of dead people or of people still he had never had. I disagreed with him, however barely alive. It should be added here that during (I did not expand on this view, mentioned it this phase of the analysis neither the patient nor only once, briefly) about the innocuousness of the analyst was as concerned about a possible the sexual aspect of the relationship. I thought, irreversible or protracted disintegration as one in other words-and I continue to incline might perhaps expect in view of the alarming toward this view4-that Mr Z would have content of many of the sessions. There is no obtained more lasting benefits from the question that our tolerance for the upsetting friendship with this man who, as far as I can material was in essence connected with our judge, was indeed a remarkable person, if their always present and continuously deepening closeness had remained free of sexual contacts. understanding of its meaning and significance: (The fact, it may be added, that no homosexual that Mr Z was now relinquishing the archaic self conflict became activated during the trans- (connected with the selfobject mother) that he ference revival of the relationship could well be had always considered his only one, in taken as evidence that I am wrong and that the preparation for the reactivation of a hitherto patient was right.) unknown independent nuclear self (crystallized Be that as it may, the analysis took a new turn around an up-to-now unrecognized relationship at this point: it fastened for the first time to his selfobject father). directly on Mr Z's father, who had remained a Only once did the mother appear in any of shadowy figure up to now, despite my these dreams. Although the visual content of interpretative efforts during the first analysis to this dream was simple and in itself innocuous- penetrate resistances which, as I then believed, a starkly outlined image ofthe mother, standing shielded his narcissistic delusions from the with her back turned toward him-it was filled awareness of a powerful oedipal rival. For the with the deepest anxiety he had ever ex- first time now-and with a glow ofhappiness, of perienced. Our subsequent work, pursued for satisfaction-Mr Z began to talk about positive several sessions, illuminated the dream in features in his father's personality. considerable depth. On the most accessible level This was, as can be judged in retrospect, the there was this simJ?le meaning: the mother was crucial moment in the treatment-the point at turning her back to him; she would now

4 I am by no means certain whether this viewis correct or The most important structure building occurs, after all, in whether I am here still unduly influenced by the classical childhood, and it is not only not prevented by vigorous and theory of drive sublimation. The question we are sensually stimulating contact with the selfobjects, contacts confronting here, in other words, whether sexual activities that might wellcorrespond to the lovemaking of adults, but between self and selfobject preclude structure formation, seems rather to be enhanced by it. should be considered still in need of empirical investigation. Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

20 HEINZ KOHUT abandon him because he was moving closer to personality in intermeshment with her-was his father. Without going into the details of his itself a delusion. associations, I should add that, in connection For the sake of clarity and in order to avoid with this interpretation of the dream, which was unnecessary complexity I shall now describe the suggested by the patient without any prompting process of the reinstatement of Mr Z's from me, Mr Z gave several examples- childhood relationship to his father during the memories from childhood and later-of the analysis as if it had had a clearly defined mother's icy withdrawal from him when he beginning at a point when the working through attempted to step towards independence, in of the aforementioned anxiety and of the particular toward independent maleness. In resistances that were mobilized by it had come former times the patient had always responded to a clearly defined completion. In reality, of to this signal by an emotional return to the course, Mr Z's move toward his father and the mother. recovery of memories about him took place step The deeper meaning of the dream was by step, each step being preceded and followed contained in its invisible part: it concerned the by renewed and intensified fears and resistances. unseen, the unseeable frontal view of the In view of the fact that the relation between mother. When he tried to think about it, to transference analysis and the recall of genetic imagine what it would show, he experienced data is well known, there is also no need to intense anxiety; and he was never able to find describe the details of the transference pheno- words for what he might see. When I suggested mena in the restricted meaning of this term that the horror of castration, of the sight of the were in evidence during this period. Suffice it to missing external genital, of fantasies of blood say that the emergence of the decisive, positively and mutilation which children form by combin- toned childhood memories about the patient's ing the sight of the menstrual blood and of the father was preceded and accompanied by his vulva, the patient brushed these suggestions idealization of me-including, as one would aside. While he agreed that the imagery of expect, the idealization of my professional mutilation, castration, and blood was related to proficiency. And, also unsurprising in this the unnamed horror, he was sure that this was context, Mr Z expressed at that time the wish to not the essential source of the fear. Although he become an analyst-a wish, it may be added, himself was never able to formulate his fear in a that soon faded spontaneously. concrete way, when I suggested that the mother In the memories which now emerged, he may not have lost her penis but her face, he did dwelt particularly on a two-week skiing not object but responded with prolonged silence vacation he had taken with his father in a from which he emerged in a noticeably more Colorado resort at the age of 9 (probably relaxed mood. Thus although I believe that the because, at the time, the mother was involved archaic fear to which he was exposed defies with her own mother's terminal illness). These verbalization, I think that my attempt to define memories are of decisive significance because it came sufficiently close to the psychic reality of they concern two crucially important topics: his his experience to allow him a degree of mastery. discovery that his seemingly weak and shadowy All in all, expressed in more objective terms, the father possessed indeed certain rather impress- conclusion which we ultimately reached was ive assets embedded in a well-defined person- that the unseen side of the mother in this dream ality, and his increasing realization that he stood for her distorted personality and her harboured an intense need from childhood to pathological outlook on the world and on find out something about his father, to clear up him-of features, in other words, that he was a specific, mystifying secret. not only forbidden to see but whose recognition With regard to his father's positive features would in fact endanger the structure of his self about which he spoke now with an increasing as he knew it. The dream expressed his anxiety glow ofjoy, it must be said that, as far as I could at the realization that his conviction of the judge, Mr Z did not describe any outstanding mother's strength and power-a conviction on qualities and there was clearly some discrepancy which he had based a sector of his own between Mr Z's emerging enthusiasm and Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

THE TWO ANALYSES OF MR Z 21 objective fact. But Mr Z's father seems indeed to suspicion was justified, I believe, and Mr Z have been a good skier and also something of a agreed, that the evidence does indeed speak for man of the world. He had a way with the waiters it. The patient had, with a single exception, no and chambermaids, and was soon surrounded direct memory of any particular woman to by a circle of followers who were fascinated by whom his father might have been attached. The his stories and appeared to look up to him. exception concerned a small but notable event. From listening to his telephone conversations There were no manifest indications that the and hearing his comments when he read the emergence of this memory was opposed by papers, the patient also got a glimpse of his resistances; it is, however, surely significant that father's business activities; and he came to it appeared only after all the other memories admire his resoluteness, perceptiveness, and skill about the stay in Colorado had been communi- in this area. The psychological essence, how- cated. As the patient remembered it, it was on ever, of this phase of the analysis lay not in the the last day of their stay at the hotel that his patient's discovery of any surprising qualities of father, for the first and only time, took the boy his father, either at the time in his early life of along to the bar in the evening. Although his which he spoke, or in his retrospective father was in general not a heavy drinker, he evaluation, but in his recovery of the intensely seemed to have become somewhat high on this experienced awareness that his father was an occasion and-the son, despite some embarrass- independent man who had a life independent ment, reacting to his father's capers with from the life of the mother-that his father's pride-at one point joined the small orchestra personality, whatever its shortcomings, was by and took over for their regular male singer. no means as distorted as that of the much more There was applause from the other guests, and powerful mother. I will add here that my his father received many congratulations, interpretations during this phase, both as they especially from one particular woman who came concerned the idealizing transference and the to their table and had a brief chat with the boy. recovery of his father's positive features, were Mr Z thought now that this woman might well focused on the meaning that these two sets of have had a special relationship with his father; experiences had for the patient. I did not and he even speculated whether she could have confront him with the reality of either my own been the nurse who had taken his father away or of his father's shortcomings, but restricted from the family when the patient was a small myself to giving expression to my understanding child. for his need-in childhood and as now revived Be that as it may, the patient never mentioned in the transference-for an idealized man to the episode to the mother when, after their whom he could look up, of whom he could be return, he responded to her inquiries about the proud. vacation. Although his father had never The content of this phase of the analysis (Mr explicitly asked him to refrain from mentioning Z's detaching himself from the mother and the episode, he felt that there was a silent turning toward his father) and, especially, the understanding between them that he would be intensity of anxiety and resistance that we quiet about it. Most suggestive, and perhaps the encountered, had been unexpected. I was, only piece of positive evidence with regard to however, even more surprised by what followed. Mr Z's suspicion that the significance which the After speaking again briefly, mainly in associa- woman at the bar had for him was not simply tions to dreams, about the primal-scene due to endopsychic falsifications but that she experiences when he was 5 or 6, he began to was in fact the ' other woman' in his father's complain of how little he knew about his father. life, was that he now recalled a specific image Following a brief period of transference which had appeared fleetingly in several dreams fantasies, he suddenly expressed the suspicion of his first analysis, dreams that now took on a that his father had had a woman friend and that new significance and became understandable. this woman had been present during the The only thing these dreams had in common Colorado vacation. Although we were never was that they contained the image of an able to ascertain beyond doubt whether this unknown woman. When Mr Z reported these Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

22 HEINZ KOHUT dreams during the first analysis he had never of the child's feeling defeated by the adult male, been able to produce any illuminating associa- but a glow of joy and the invigorating sense of tions to this figure, except that the woman was having finally found an image of masculine thin-similar in appearance to the woman in strength-to merge with temporarily as a means Colorado-and-dissimilar to the woman in of firming the structure of his self, of becoming Colorado-, being dressed like a working-class himself an independent centre of strength and girl, that she was not of their own social group. initiative. As is usual in such instances, no early My own conclusion during the first analysis had oedipal material from Mr Z's childhood been that the woman represented the debased emerged in the analysis, and the competitive image of the patient's mother, that the patient, fantasies that arose related to the analyst, not to when he came closest to incestuous sexual his father. And they were not accompanied by fantasies, produced a degraded image of her- hopelessness and anxiety but by a sense of approximately corresponding to the splitting of optimism and vitality. The analyst-father was the man's love aspirations that Freud (1912) experienced as strong and masculine, and so did described. the analysand-son now experience himself. There is little more that needs to be said about The actual onset of the terminal phase was this period of the analysis-a period whose end marked by the patient's returning to the marked the beginning of the termination phase. analogous moment of his previous analysis, It might not be amiss, however, to emphasize namely, to the dream that had set in motion the my view that, in spite of the fact that at the time processes that ultimately led to the termination of the episode at the resort Mr Z was already 9 of the first analysis, the dream of his father's years old-i.e. drive-psychologicallyclassifiedin return, loaded with packages containing gifts a period of latency-this material represents, in for the patient, in which the patient had terms of the structure of Mr Z's personality, the desperately struggled to shut the door against deepest layer of the repressed. I am basing my the father's pressure. To my great surprise the opinion on the fact that, as I mentioned before, patient now presented associations that threw a this cluster of memories was the last one in the totally different light on the meaning of this course of the analysis to which Mr Z gained dream. In the previous analysis, as will be access, that it was reached after overcoming the recalled, it had seemed to us that we had here most formidable resistances we encountered, the unambiguous manifestations of the ambiva- and that the end of the processes of recall and lence of the child towards the oedipal rival who, working-through concerning it signalled the he feared, would-Timeo Danaos et dona beginning of the termination phase of the ferentes--end his near-exclusive possession of analysis. No doubt it might be maintained by the mother, and destroy him. Now the memory some that these memories were no more than of this old dream emerged, not in order to start derivatives: a cover for even more deeply us on a period of working through, but as a unconscious material from the oedipal period- result of successfully carried out working- that the triangle at the age of 9 was nothing but through processes. Its emergence constituted a a relatively harmless replica of the triangle bonus, so to speak: confirmatory evidence that experienced four years earlier. I considered this the material with which we had been dealing in possibility, of course. But I came to the the preceding year had indeed been of crucial conclusion, as I have indeed in several significance. It is in harmony with this view that analogous instances in other, similar cases, that the unrolling of the process by which the re- no pathogenic oedipal conflicts still lay in analysis of this dream took place was hardly -hiding. And, unlike the feeling-tone that we based on associations or slowed down by recover in the reactivation of the oedipal resistances. True, there were associations pre- experiences in structural neuroses, Mr Z's sented in the session in the second analysis in memories were not accompanied by a sense of which he returned to this dream. And there were hopeless rivalry with his father, but by a feeling also, in subsequent sessions, interspersed with of pride in him. Further, there was no additional reflections about this dream, associa- depression and sense of inferiority, outgrowths tions-including currently dreamed fragmen- Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

THE TWO ANALYSES OF MR Z 23 tary dreams-that dealt with fleeting trans- he had secretly yearned, gifts which indeed he ference-fears with regard to me, i.e., to be exact, needed to get. The father, loaded with packages, with regard to the image of the analyst. But trying to enter, the son defending himself otherwise the emergence of all this material was desperately against his father's entry-despite virtually unopposed. It was as if all the decisive the fact that some of Mr Z's associations work leading up to the present significant touched briefly on intermediate systems of insights had already been done, and that the psychological material relating to homosexual associations were therefore not stepping stones themes, particularly with regard to his homo- on the way to the new insight but supportive sexual attachment in preadolescence, this dream evidence for an already preconsciously estab- deals in its essence with the psycho-economic lished new explanation. imbalance of major proportions to which the The new meaning of the dream as elucidated boy's psyche was exposed by the deeply wished- by the patient via his associations, to put his for return of his father, not with homosexuality, message into my words, was not a portrayal ofa especially not with an oedipally based reactive child's aggressive impulse against the adult male passive homosexuality. accompanied by castration fear, but of the Since 1 am familiar with the propensity of the] mental state of a boy who had been all-too-Iong psyche to respond to traumatic states by various without a father; of a boy deprived of the forms of sexualization-by sexualizing the over- psychological substance from which, via in- burdening psychological task (see Kohut, 1971, pp numerable observations of the father's assets 69-73, esp. p. 72n. and p. 168)-1 was alert to the and defects, he would build up, little by little, possibilitythat Mr Z might have developed wishes or fantasies of anal penetration by his father, i.e. of the core ofan independent masculine self. When obtaining male psychological substance by passive the father suddenly returned to take his position means. 1could obtain no evidence for the existence of in the family, the patient was indeed exposed to such fantasies, however, either in the transference or a frightening situation. The danger to which he via the recall of memories from his childhood or was exposed was not however to his body but adolescence. The manifest content of his dream-the t hi . d At' ti t t' f h· h] multiplicity and spatial distribution of the gifts with o IS mill. IC saearose 0 .w IC whichhis father wasloaded, a feature which,as 1said the constitutes only a tame rephca-a earlier, invitescomparison with the richly elaborated traumatic state that had threatened not the description of the appurtenances of the father figure boy's physical but his psychological survival. in the first dream of the analysis Having been without his father during the p. I I)-and the actual mode of bodily contact WIth . d h I If . h . I the counsellor-holding and being held, kissing, w en a ma e se IS p .ase-appropnate y smelling-indicate that his need for the firming of an acquired and strengthened via the male self- independent self had become focused mainly on the object, the boy's need for his father, for male absorption of the selfobject via the skin and, to a psychological substance, was enormous. No lesser extent, via the respiratory apparatus and the independent self had gradually formed: what mouth. (I might add here, in passing, that in the .. 'analysis of homosexualsthe nature of the relationship .he had managed to to the selfobject and thus the type of transference- bUIld was rooted III his attachment to the mirror, twinship, or idealizing-is usually easily mother. In his enslavement he managed to gain deduced from the patient's description of the some drive-pleasure-but not the exhilarating homosexual practices he engages in or wishes for.) joy of the experience of an active independent sexual self. It is not difficult to see in retrospect what turn His father's return had exposed him suddenly Mr Z's psychic development took at this point. to the potential satisfaction of a central Unwilling to resign himself to giving up an psychological need. Just as a correct but independent self for good, yet finding himself unempathically overburdening interpretation confronted by the impossible task ofperforming may expose the analysand to a traumatic state the work of years in a moment, he began to (see Kohut, 1971, pp. 232-5), so he had been experience himself in two different, separate exposed-but a thousandfold-to a traumatic ways-his personality established a vertical state by being offered, with overwhelming split. Ostensibly he remained attached to the suddenness, all the psychological gifts for which mother, presented a personality that remained Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

24 HEINZ KOHUT

enmeshed with hers, and-to express a host of only twice: during preadolescence in Mr Z's fantasies with the aid of a single representative relationship to the counsellor which-as I am specimen, possibly the replica of a fantasy held inclined to believe, because of its sexualiza- by the mother-submitted to the role of being tion-did not lead to truly structure-building, her phallus. And next to this sector of his wholesome results; and during his second personality that was part of the mother and of analysis when transmuting internalizations, her pathology-the sector which openly dis- gradually achieved via the extensive working- played a grandiosity that was bestowed upon through of his idealizing transference, led to the, him by the mother so long as he did not separate it is hoped, permanent and reliable completion himself from her-was another one, separated of a process that had remained unfinished in by a wall of disavowal. In this quiet but all- childhood. important sector he had preserved the idealiza- The terminal phase of the analysis was tions that maintained a bond to his father, had comparatively brief and uneventful. While we hidden away the memories of his father's had a year earlier tentatively agreed that this strength on which they were based. These might well be the last year of the analysis, the idealizations, in other words, acquired in later definite decision to end our work with the childhood as the result of his not totally beginning of the summer vacation was made unsuccessful attempt to detach himself from the only three months earlier. The substantial mother and to build, belatedly, an independent regressions that we have come to expect at the male self, had, on the whole, gone into end of long analyses did not come about in Mr repression. Z's case: neither did Mr Z's old symptoms (in particular his sexual masochism) return, nor did It is of theoretical importance to emphasize at this point that the relatively successful encounter with his he experience serious anxiety concerning the father when Mr Z was 9 was, of course, not the first loss of my supportive presence. There was a relationship with a selfobject that led to the laying brief period, perhaps three weeks, when he felt down of self structure in this sector of his personality. some sadness about losing me, side by side with While there are all indications that it was indeed the the regret, never before fully expressed, concern- most important one of his early life, that it was, in other words, not just a screen for or derivative of a ing the fact that his father was dead and that the more important earlier one, the outlines of an chance for developing a friendly relationship independent self had been drawn much earlier in life. with him, to make him proud of him and his The vicissitudes of the rudimentary self that was achievements, was gone. And for a few sessions tentatively formed during the first years of life played he also expressed considerable anger towards no significant role in Mr Z's analysis. Still, we can deduce from the information we obtained about his me for having originally failed him, like his earlier childhood that not only his father and father in childhood; that his analysis had maternal grandfather but that even the mother, therefore taken longer than it should, that he especially when he was quite young, had contributed was now older than he should be at the stage of to the formation of the nuclear self that lay inactive in development he had finally reached. The last repression in this split-off sector of his personality. The event when he was 9 was important because his months of the analysis were, however, not independent self obtained at that time sufficient entirely filled by retrospective themes; there strengthening to permit its psychoanalytic liberation were also thoughts about the future-plans and activation. It may be added here that in most about his work and about the possibility of instances of telescoping (see Kohut, 1971, p. 53) the getting married and of having children. Imagery event that becomes the representative of earlier and later events of analogous significance is the one about a relationship to a son dominated in this through which a structure is almost successfully context-he did not talk much about the kind of established, yet still not firm enough to assert itself wife that he hoped to find and about the life that through actions. he might lead with her. During the last few weeks of his analysis I was The needs which were active in his horizon- very impressed by his expanded empathy with tally split-off, i.e. repressed, layer of the psyche, and tolerant attitude towards the shortcomings and the memories of experiences that were of his parents. Even with regard to the associated with these needs, came to the fore distortions of the personality of his mother, Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

THE TWO ANALYSES OF MR Z 25 which had exerted such a deleterious influence and talents nor the content of his ambitions and on his development, he could now express a ideals were thus primarily influenced by his modicum of understanding and even compas- father's personality. Yet all three constituents of sion. And he was also able to see, without a his self were decisively changed during the trace of the idealizations with which he had analysis. The working through of his trans- begun his first analysis, the positive features of ference relationship to me enabled him to re- her personality. Without any merger propensity, establish a link with his father's maleness and but on the firm basis of his separateness and independence, and thus the emotional core of maleness, he could acknowledge that, despite his ambitions, ideals, and basic skills and talents her serious psychopathology, she had given him was decisively altered, even though their content a great deal. Not only did he conjecture that remained unchanged. But now he experienced during his early infancy she might have been a these assets of his personality as his own, and he good mother whose mirroring acceptance of pursued his life goals not in masochistic him had provided him with the core of vitality compliance-as had been the case following his that, much later, had allowed him to persist in first analysis-but joyfully, as the activities of the pursuit of emotional health despite the an independent self. serious obstacles that stood in his way, he also When the analysis came to its end, the patient acknowledged that many of his greatest assets, was in a calm and friendly mood. He was not implanted into his personality much later in his involved in any significant relationship at that childhood, including those that enabled him to time; indeed, throughout the second analysis be competent, indeed creative, in his work, had there had been no strong or significant come from her. We both came to assume in this involvements with people, even though he had context that his mother had undergone a silent engaged in a number of relationships with but malignant personality change-perhaps in women and his sexual experiences were satisfy- response to a beginning deterioration in her ing. But he spoke little about that; the analytic relationship to Mr Z's father-but that, despite work which led to the crystallization of his the serious distortions of her personality we autonomous self absorbed him fully. I learned, discovered during Mr Z's second analysis, she of course, a good deal about his everyday life had preserved throughout her life, even after she during the years of his analysis, but much more developed an encapsulated paranoid psychosis, about his professional work than about his not only a healthy and lively mind with regard contacts with people. During the last year of his to areas outside of her distorted interpersonal analysis he talked from time to time about his perceptions, but also a modicum of firmness, plans for a major work that he wanted to truthfulness, and realism. undertake, plans which, I learned later, came to On the whole I believe that I now understood fruition and established him as a promising how the structure of Mr Z's self as it became contributor in his field. Thus, even though I clearly outlined during the last weeks of the thought when the analysis was over that the analysis was genetically related to the per- area of interpersonal relationships would never sonalities of his parents. His most significant play the dominant role in his life that it does for psychological achievement in analysis was the majority of people and that it would not breaking the deep merger ties with his mother. provide him with his most fulfilling experiences, But despite this break he not only retained his I felt that the narcissistic-creative sector of his most significant talents and skills, which now personality, with its rich endowment, was enabled him to be proficient in his profession, sufficiently freed and securely enough estab- but also the specific content of his ambitions lished to justify the confident hope that he and ideals which had determined the choice of would be able to lead a satisfying and joyful life. his work and made it emotionally meaningful to A number of years have now passed since the him-even though these talents, skills, ambi- end of the analysis and, except for friendly tions, and ideals had arisen in the matrix of Christmas cards (one, about a year and a half the now abandoned merger relationship with after termination, saying he had recently the mother. Neither his most important skills married; another, several years later, announc- Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

26 HEINZ KOHUT

ing the birth of a daughter), I have heard SUMMARY nothing from Mr Z directly. I did obtain some As I stated initially, the preceding report was indirect information about him from a patient presented in order to buttress the claim that the currently in analysis with me who works with new psychology of the self is helpful in the Mr Z in a subordinate position. This young clinical area, that it allows us to perceive man, who, it should be added, does not know of meanings, or the significance of meanings, that my having been Mr Z's analyst, admires Mr Z were formerly not perceived by us, at least not greatly. But since his relationship to Mr Z consciously. This is not a theoretical presenta- constitutes at times a collateral idealizing tion of the psychology of the self-the transference, his reports cannot be taken at face theoretical knowledge needed will have to be value. I do know from this source however, that obtained elsewhere (see, in particular, Kohut, Mr Z's work is recognized as outstanding in his 1971, 1972, 1977 and Kohut & Wolf, 1978). In field and that he is an inspiring teacher. Via order to assist the reader I append a another informant I have learned a good deal diagrammatic summary ofthe psychopathology about the personality of the woman whom Mr Z of Mr Z as it was perceived by me in his two married. She appears to be a well-balanced, analyses. For the rest I hope that this case report warm-hearted, socially outgoing person, with- will speak for itself. out a trace of the paranoid certainty and need to control that had characterized Mr Z's mother. Even though she works in Mr Z's field, TRANSLATIONS OF SUMMARY she is more what one might call an out-of-doors Cet expose a pour but de donner poids ala notion que la type than an intellectual. I concluded that Mr Z nouvelle psychologie du self est utile pour la pratique had chosen a partner who possessed his father's clinique et que cette psychologie pennet de percevoir des best features embedded in a matrix of significations ou I'importance de celles-ci, alors qu'elles n'etaient pas percues auparavant, tout au moins consciem- femininity. And I concluded that he had made a ment. Ce n'est pas un expose theorique de la psychologie du good choice. self; un tel expose peut etre obtenu ailleurs (en particulier,

THE CASE OF MR Z-HIS PSYCHOPATHOLOGY AND THE COURSE OF HIS ANALYSIS

As Seen in Classical As Seen in Terms of the Psychology ofthe Self Dynamic-Structural Terms in the Narrow Sense in the Second Analysis in the First Analysis r-- - - Overt grandiosity and arrogance Overt arrogance, ' superior' (j)V Low self-esteem, depression, due to imaginary oedipal victory. isolation on the basis of persisting E masochism, (defensive) idealization merger with the (nondefensively) (0R of mother. idealized mother. Mother confirms T patient's superiority over father (01 (0 (j) (0 provided patient remains an C G) G) G) REPRESSION BARRIER appendage of her. A REPRESSION BARRIER LI------i Castration anxiety and depression (Non defensive) idealization of his due to actual oedipal defeat. S father; rage against the mother; P self-assertive male sexuality and L exhibitionism. I T - - The analytic work done on the basis The analytic work done on the basis of the self-psychological concept is carried of the classical dynamic-structural out in two stages. The first stage is done at the line indicated by (0 G) G): Mr Z concept takes place throughout the confronts fears of losing the merger with the mother and thus losing his self as he analysis at the line indicated by (0 (0 knew it. The second stage is done at the line indicated by G) G) G): Mr Z (0. confronts traumatic overstimulation and disintegration fear as he becomes conscious of the rage, assertiveness, sexuality, and exhibitionism of his independent self. Copyrighted Material. For use only by UPENN. Reproduction prohibited. Usage subject to PEP terms & conditions (see terms.pep-web.org).

THE TWO ANALYSES OF MR Z 27

Kohut, 1971, 1972, 1977 et Kohut et Wolf, 1978). Pour Psychopathologie des Mr Z bei, so, wie ich sie im Laufe faciliter la lecture j'appose un resume graphique de la zweier Analysen sah. Im iibrigen hoffe ich, daf der psychopathologie de Mr Z ainsi que je I'ai percue dans ses Krankheitsbericht fur sich selbst sprechen wird. deux analyses. A part cela, j'espere que ce rapport en dira assez par lui-rneme. La informacion precedente ha sido presentada con el fin de apoyar la idea de que la nueva psicologia del yo-rnismo Der vorhergehende Bericht sollte der Unterstiitzung der (' self') es util en el campo c1inico, que nos permite percibir Behauptung dienen, daf die neue Psychologie des Selbst auf significados, 0 darle sentido a significados que, al menos klinischem Gebiet von Nutzen ist, daf sie uns gestattet conscientemente, no percibimos antes. Esta no es una Bedeutungen zu erfassen oder den Stellenwert von exposicion teorica de la psicologia del yo-mismo ; ese Bedeutungen, die wir vorher nicht sehen konnten, conocimiento teorico debera ser obtenido en otra parte wenigstens nicht bewuBt. Dies ist keine theoretische (Kohut: 1971, 1972, 1977; Kohut y Wolf: 1978). Para Darlegung der Psychologie des Selbst-das theoretische ayudar al lector, afiado un resumen-diagrama de la Wissen, das man braucht, muf wo anders erworben werden psicopatologia del senor Z tal como la percibi yo en sus dos (siehe vor allem Kohut 1971, 1972, 1977 und Kohut & Wolf analisis. Por 10demas, espero que la informacion presentada 1978). Urn dem Leser zu helfen, lege ich Diagramme der sobre este caso hable por si misma.

REFERENCES

FREUD, S. (1912). On the universal tendency to KOHUT, H. (1972). Thoughts on narcissism and debasement in the sphere of love. S.E. 11. narcissistic rage. Psychoanal. Study Child 27. FREUD, S. (1933). New introductory lectures on KOHUT, H. (1977). The Restoration of the Self. New psycho-analysis. S.E. 22. York: Int. Univ, Press. GoLDBERG, A. (ed.) (1978). The Psychology of the KOHUT, H. & WOLF, E. S. (1978). The disorders ofthe Self-A Casebook. New York: Int. Univ, Press. selfand their treatment-an outline. Int. J. Psycho- KOHUT, H. (1966). Forms and transformations of Anal. 59, 413-425. narcissism. J. Am. psychoanal. Ass. 14, 243-272. KOHUT, H. (1971). The Analysis of the Self. New York: Int. Univ, Press.

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