Transcription
Welcome to psychoanalytic talk. And today, we're going to be talking about the differences in the transference of narcissistic people according to Kohut and Kernberg. So, before we begin, I need to explain that both of those authors have worked with narcissistic patients, but both of them have come to very different understandings on how the transference, how the relationship, and the development of the relationship works. So, basically, my aim with this video is to present both cases and to explain the differences and why they're so different.
The first phase I'm going to focus on, because both authors have three phases for each, so kind of parallels each other. So, the first phase for Kohut is the merger transference. So, the merger transference is a phase in which the narcissist feels completely merged with the therapist. So, basically, the therapist is the basically the manifestation of their ideal. Therefore, the therapist is expected to be perfect in this phase. Perfect, how so? Well, basically, they are meant to basically correspond to the image in the mind of the narcissist of what a therapist is supposed to be, be it through the interpretations, through the setting, through what is expected of them.
In this phase, is basically, um, if the therapist ever has any flaws, for example, coming late, giving the wrong interpretations, not quite understanding, the narcissistic individual might react with rage because this does not correspond to what they feel the therapist should be doing. Therefore, the therapist is disentangling themselves with the ideal, which is something that they're very afraid of. Because for Kohut, the narcissistic individual is stuck between a grandiose sense of self, i.e., they feel perfect, and an internalized idealized parental imago, i.e., their mother, father are perfect, and that mother, father perfect is basically they feel merged with them.
So, by basically being in that merger transference, the narcissist is giving the therapist all of the narcissistic, um, power. But when the therapist fails, they're going back to a position of a grandiose self, in which basically they feel that they have to re-internalize everything. Therefore, there's a lot of hatred for the therapist because they're not ideal. So, the whole point of that phase is for the therapist to try and basically disentangle themselves slowly but surely of the ideal, because in that phase, the patient basically wants to control the therapist, wants the therapist to fit exactly precisely the image that they have of what the therapist is supposed to be. So, this is the first stage for Kohut, sort of disentanglement from a primitive, archaic, idealized parental imago, and the therapist, how the therapist is trying to become a separate person.
For Kernberg, the first phase is very different. He coins the term psychopathic transference. What happens during that phase, according to Kernberg, is that the narcissist is going to resist creating a relationship with a therapist. They're not going to project anything. They're not going to even engage in anything. What they are doing fundamentally is basically protecting themselves. And how do they do so? Well, they manifest a form of psychopathic, um, presentation in which they're not going to show any emotions, any psychic life, any conflict, anything. They're basically going to go for a form of "circule," which in French means "go on, move on." There's nothing to be seen here, there's nothing interesting, there's nothing important, just move away, right?
And often, they will tend to use that, uh, through manipulative processes. They will, for example, lie, cheat, obfuscate what has been happening or what they're feeling. The aim here is not to create a relationship, quite the opposite. The aim is to distance oneself from a potential relationship. The aim is basically to be a blank screen in which the therapist will see what he wants to see and therefore leave them alone and not engage with them or not see through that. So, we can see that here it's very different because Kohut directly assumes that the patient, the narcissistic patient, will merge with the therapist, will try and become one with the therapist, and basically create a dyad. Whereas Kernberg, he, on the contrary, feels that the first movement is a movement of defense against and a movement of rejection of the therapeutic process.
Moving on to the second stage for Kohut, that second stage is a twinship transference. So, what's going to happen now is that once the therapist has been disentangled from the, uh, ideal, he starts to become a sort of twin. That twinship gives the therapist a bit of separation from the patient, but not that much, because the patient is at this phase not going to try and control, but they're going to assume that the therapist acts alike or acts alike, that they are basically mirror versions of each other. That, for example, the patient might say, "Oh, you get me, you understand me. I'm sure you would have done the same as me. I'm quite positive that we are both of like mind on this issue." They're going to directly assume that you are basically, um, completely like them. You're not them, but you're like them. And basically, it's going to be there because they're starting to see you as someone different, but not, we're not quite there yet, we're not separate yet, but it, it's there, it's time to occur, it's a process that's on its way, so to speak.
In this phase, um, basically, um, the therapist is going to be start to be someone of their own, but not exactly, right? So, it's a kind of a hybrid between the two phases. But what's important here is that the patient is able to start growing out of that merger, that's what's the most important. So, so basically, this is the twinship transference.
In the case of Kernberg, the second phase is called psychopathic transference. In this phase, for Kernberg, what's going to happen is that once you've peeled off the psychopathic transference, the patient's going to project onto the therapist all the negativity that's within them, all the hatred, all the feelings of suffering, all the fears, all that is going to come in, in an exploding fashion into the relationship. So, how does this going to manifest? It's going to manifest through, um, basically a lot of, uh, suspicion on the behalf of the patient. The patient is going to say, "I don't trust you, I don't believe you. I think you're basically just wanting my money. All you want is basically to get worthy through me," they might say, or "You're only using me to write your case studies to gain fame, glory, and so on and so forth."
So, basically, the patient is going to react very vividly because they feel that all the negativity that they would have done, that they basically hide through, uh, a psychopathic, uh, persona, that the therapist is going to do it to them. Basically, they're projecting all their negativity. But by doing so, and this is what's important in this phase for Kernberg, is that they are basically entering a relationship, whereas before they were resistant and reluctant to do so. Here, they're engaging with something real of themselves. They're engaging with this massive aggression, an aggression that is essential because basically, it's still a relationship with the object. And that aggression is very important because basically, the fact that there's going to be no retaliation is going to help them basically see that they're not going to be destroyed by the object, i.e., by the relationship, by the other. That they can risk being real with a therapist.
And this is very important because that is going to help them reunite part of themselves with the object, i.e., part of themselves in the relationship. Part of themselves, they're also going to be able to make more conscious, i.e., that destructive side of themselves that basically exists in a form of split way. They're going to be able to rekindle with it and basically they're going to be able to project the phase of all-powerfulness, of all might onto the therapist, thus in themselves also reactivating that very schizoid paranoid schizo. I always mix them up because in inverted commas, that paranoid schizoid position is going to reactivate, meaning that basically anxieties of being destroyed by the other or destroying the other are present and very important for the final and third phase that you will come back to later on.
So, the third and final phase of transference for Kohut is the mirror transference. So, in this phase, it's very important for the patient to basically, um, seek approval from the therapist. The basically for the therapist to be a positive mirror that is shown upon the patient that the patient can basically rebuild their narcissism in a more positive way through the relationship with the therapist. They might basically feel that the fragmented parts of themselves are bit rekindled because what is happening is the therapist is seeing them for who they are in their totality and they can basically, um, put a positive regard on them and tolerate the badness of them. Therefore, what is happening is that the fragmented pieces are starting to re-emerge. They're re-emerging through the fact that they are, the therapist is the first mirror of the patient, the first positive mirror that accepts both good and bad elements, that basically is there for them. And that fragmented parts of self re-emerge together and basically lead to what Kohut calls transmutation.
Because for him, what's going to happen at that very moment where mirror transference ends is we're going to, the patient is going to go to basically, um, transmute their minds and psyches and going to enter the classical frame of ego, superego, and id mentality. I.e., we're going to, they're going to leave the narcissistic phase, that bipolar self that he uses, i.e., grandiose self and basically, um, internalized ideal parental imago, that we're going to leave that to enter the, the classic Freudian framework. So, this is a very important phase in which the therapist has to basically, um, be there for the patient, offer guidance, reunite fragments of themselves, and allow the patient to grow into the, basically, Freudian framework.
Now, moving onto Kernberg's final stage, the depressive transference. So, here, basically, when the patient has expelled all the projective negative traits, they realize that the, that the object is different, that the other one is separate, that separateness allows them to basically be able to enter the, um, depressive position. So, this is not depression per se. It is this realization that the other is different, that the other is another person, that fundamentally actions have consequences, that the object, um, is not necessarily going to be destroyed, but it's there, it's separate. And through that separateness, the individual reunites parts of themselves. They can tolerate aggression, they can understand that aggression has consequences, they can also tolerate a certain form of introspection. And it is very essential because through that, the individual basically grows back together.
For Kernberg, they grow in effect in the sense they are reuniting parts of themselves. And in this phase, we can see that for both clinicians, the major position is reuniting, reuniting parts of themselves. But the understanding is quite different. For Kohut, that unification is there to go back to a phase of life in which the patient basically could not go for the Freudian, let's say, development of mankind. I.e., what is happening for the patient is that they are blocked at a certain phase of development in their minds because of trauma, because of separation that's too early, because of a multitude of events. But the idea for Kohut is that the, the line of progression was there and it was cut. Meaning that they were left into a narcissistic position, which is normal for children, but should be grown out of with adults. And that's what he's saying is that when we work with narcissistic patients, we go back to that regressed narcissism and we allow it to grow through the good therapeutic relationship.
Whereas for Kernberg, that it's not how it works. There's infantile narcissism, yes, but what the narcissists have done is that they have entered another field completely. It's the field of pathological narcissism. I.e., it's not about going back to childhood and basically re-advancing. As for Kohut, for him, what is basically happening here is that they have to recreate something. It's not going back. It's never, never has been going back for Kernberg. What it is, is recreating. It's yes, going back into the past, but it's not to a certain event or to a fragmented event that has to be rekindled. It's about fundamentally recreating something that was never there to begin with.
So, very, very fundamentally, for Kernberg, what is going to happen with the narcissist is that they're going to be able to create a relationship with the object and a better sense of themselves by renouncing all of that schizoid paranoid schizoid elements, by basically being able to reunite parts of themselves which were split. And for Kernberg, that split is mainly the main point. Also, there's a very important divergence on the regressive aspect, which for because K, for Kernberg, what happens is it's humiliation and belittlement with the child, but also the fact that the child was both humiliated and praised, and the fact that there was a quick inversion of both. For example, a child could be praised on their looks and belittled on their intellect, or vice versa, or on something completely different. For Kohut, it's not about that. It's about a traumatic event.
So, both of them feel that basically what you have to understand is narcissism for Kohut is blocked, whereas for Kernberg, it's been, it's grown into something else. And it's not about going back to the roots. For, for Kernberg, it's very basically about creating something else. A new plan has to grow, if we were to use that metaphor of plants.
So, very fundamentally, what do I believe? Well, it might seem like a cop-out, but I believe that both authors are right. And I've read both and I've basically used both, but I don't think they're right at the same time. So, why do I feel that? I think that for Kohut and his form of narcissism are very true, but I think it's for less pathological states, are states where something has gone wrong. And basically, it's very fundamental because they're not as extreme as, like, attackful as, basically not even seen in the same setting. Like, I think that Kohut would be, and his types of narcissistic patients would be much more prevalent in practices. Whereas I think Kernberg's patients are more pathological in the narcissism, are more extreme, and perhaps are better seen in institutions because of that extreme nature of the pathological narcissism.
I'm not saying that you can't have, um, Kohut's narcissists in institutions and Kernberg's, um, patients in a practice. I'm not saying that at all. But I think that there's more prevalence this in my, what I've seen in my experience, of Kohut being more practiced narcissists and Kernberg being more in institutional. But both, I think, are very true. And I've seen both of those types of transferences, but again, not with the same types of patients. I think that Kohut nailed that, um, should I say, edge of normal type of narcissism, where it's still pathological narcissism, but not to the extent where it's completely self-destructive. Whereas Kernberg has nailed, I think perfectly, this very destructive, um, form of it.
And I think that both, I mean, I know there's been a whole controversy on who gets it right, but I do believe that, and this is my perspective on both having read both, they're not quite talking about the same type of patients. If we were to consider a spectrum of narcissistic behavior, I think Kohut's are in the basically the lighter cases, whereas Kernberg is the more extreme one. And basically, I think that some of them fall better in one category or the other, but that both categories are so very important and essential. So, I'm not saying that I'm right or that I'm true or that I haven't, um, said everything that needs to be said, or perhaps I have, how can I say, skipped over a lot of nuance, a lot of fundamental aspects, but that's my understanding of both those authors' ideas of transference and why they're so different, yet they're talking about the same people. But I think they're talking about the same people on a spectrum, right? As a bit, all proportions are kept, right? But as we can't necessarily compare autism, for example, on the side of classical autism to Asperger's and other syndromes, right? It's a whole spectrum, but there's a form of continuum. I think it's the same for narcissism, at least that's my perspective. Feel free to disagree or feel free to leave your comment if you want to add something, if this has been interesting to you, or if you've seen the limitations. I'll see you in the next one. Bye.