The enduring presence of Heinz Kohut: empathy and its vicissitudes.
ABSTRACT This paper expands upon and further develops the centrality of empathy in psychoanalysis as offered by Heinz Kohut. Using clinical examples, it differentiates sustained empathy as the distinctive component of psychoanalysis, and it demonstrates some of the difficulties in determining the boundaries of empathy in the practice of psychoanalysis. A further distinction is from mind reading, a purely cognitive exercise, as is intuition (Carruthers 2009). To pursue a psychoanalytic perception of empathy one must confront its limitations and go beyond the somewhat simplistic claim of its unquestioned therapeutic effect. Empathy is more than a cognitive act, and as sustained over time it can be difficult to achieve, can be misunderstood, and can at times have no therapeutic effect.
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ABSTRACT: Objective. To increase Aboriginal participation in mainstream health services, it is necessary to understand the factors that influence health service usage. This knowledge can contribute to the development of culturally appropriate health services that respect Aboriginal ways of being. Design. We used a community-based participatory approach to examine the reasons for underutilization of health services by Aboriginal Australians. Results. Based on three focus groups and 18 interviews with Aboriginal health professionals, leaders, and community members in rural, regional, and urban settings, we identified five factors that influenced usage, including (1) negative historical experiences, (2) cultural incompetence, (3) inappropriate communication, (4) a collective approach to health, and (5) a more holistic approach to health. Conclusion. Given that these factors have shaped negative Aboriginal responses to health interventions, they are likely to be principles by which more appropriate solutions are generated. Although intuitively sensible and well known, these principles remain poorly understood by non-Aboriginal health systems and even less well implemented. We have conceptualized these principles as the foundation of an empathic health system. Without empathy, health systems in Australia, and internationally, will continue to face the challenge of building effective services to improve the state of health for all minority populations.Ethnicity and Health 07/2014; DOI:10.1080/13557858.2014.921897 · 1.28 Impact Factor
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ABSTRACT: Failure is part of the development process in analysis and psychotherapy, and, by implication (and taken up a level), the study of failure in broad terms will be part of the development of the profession going forward. The analyst and therapist must give up the rescue fantasy, give up being right and justified, give up misplaced ambition, but also give up guilt, self-blame, and disappointment, and embrace an approach in which the interpretation of the pathogenic situation of early childhood (in which traumatic deidealization of the parent occurred), becomes inherently transformative. It reactivates the process of structure-building internalization. Learning to live within one’s limitations invites a process of risk taking that sometimes results in failure and sometimes results in—redefining one’s limitations outwards towards an endless horizon of progress in satisfaction and meaning making. Our thanks to Arnold Goldberg both for the journey and the end result.International Journal of Psychoanalytic Self Psychology 03/2014; 9(2). DOI:10.1080/15551024.2014.883686
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ABSTRACT: Psychoanalytic models have a commonly held view of necessary and accurate mirroring in the dialectic of emergent and already formed aspects of the self. Mirroring-perplexity, however, is a cognitive and affective state found in a group of patients for whom reflective mirroring results in a dissociative rather than a unifying experience of body and mind. A review of the myth of Narcissus reveals that mirroring requires a relational mediation of self and mirror image through another. This ontological organization affectively links the simultaneous sense of being in the body and in the reflected image after experiencing a state of dyadic union. Clinical vignettes illustrate the effects of missing maternal relational response initially made evident in unmirrored selfrepresentations in the transference.Psychoanalytic Review The 06/2014; 101(3):411-29. DOI:10.1521/prev.2014.101.3.411