Heinz Kohut (3 May 1913, Vienna - 8 October 1981, Chicago) was an Austrian-born American psychoanalyst best known for his development of self psychology, an influential school of thought within psychodynamic/psychoanalytic theory which helped transform the modern practice of analytic and dynamic treatment approaches.
Kohut was born on 3 May 1913, in Vienna, Austria, to Felix Kohut and Else Kohut (née Lampl). He was the only child of the family. Kohut's parents were assimilated Jews living in Alsergrund, or the Ninth Disctrict, and they had married two years previously. His father was an aspiring concert pianist, but he abandoned his dreams having been traumatized by his experiences in World War I and moved into business with a man named Paul Bellak. His mother opened her own shop sometime after the war, something that few women would do at the time in Vienna. Else's relationship with her son can be described as "narcissistic enmeshment".
Kohut was not put into school until the fifth grade. Before that he was taught by several tutors, a line of "Fräuleins and mademoiselles". Special care was taken that he learned French. From 1924 on he attended the Döblinger Gymnasium in Grinzing or the 19th District, where the Kohuts would build a house. During his time at the school he had one more tutor, but the role of this person was to engage him in educational discussions, to take him to museums, galleries, and the opera. This man was the first friend in his life. Before that he had been isolated from his peers by his mother.
In 1929 Kohut spent two months in Saint-Quay-Portrieux in Brittany, in order to study French. At school he wrote his thesis on Euripides' play The Cyclops. His Latin teacher, who had anti-Semitic sentiments and later participated in the Austrian Nazi movement, accused him of having plagiariazed this work. The thesis was accepted after Kohut's father intervened.
Kohut entered the medical faculty of the University of Vienna in 1932. His studies took six years, during which time he spent six months in internships in Paris, first at the Hôtel-Dieu and then at the Hôpital Saint-Louis. The latter hospital was specialized in the treatment of syphilis, which provided shocking experiences for Kohut. In Paris he began acquainted with Jacques Palaci, a Jewish medical student from Istanbul, and paid a visit to him in 1936. The following year Kohut's father died of leukemia. Sometime after this Kohut went to psychotherapy with a man named Walter Marseilles, who does not seem to have been very competent at his trade. Early in 1938 Kohut began a psychoanalysis with August Aichhorn, a close friend of Sigmund Freud.
After Austria was annexed to Germany by Hitler on 12 March 1938, the new regime meant difficulties for Kohut, as he still had to take his final exams at the medical faculty. He was eventually allowed to take them, after all the Jewish professors had been removed from the university. The Nazis then effectively confiscated all property owned by Jews. The property had to be sold at much less than its real value, and much of the rest was taken by the state in taxes. Kohut eventually left Austria, landing first in a refugee camp in Kent, England. Many of his relatives, who had stayed behind, were subsequently killed in the Holocaust.
In February 1940 he was allowed to travel in a British convoy to Boston, from where he travelled to Chicago by bus. A friend from Vienna, Siegmund Levarie, who had earlier emigrated to live with an uncle in Chicago and would subsequently be a famous musicologist in the United States, arranged a visa for him and invited him to join him there. Kohut's mother Else also emigrated to Chicago, travelling via Italy. With the money she had smuggled out of Austria, she opened a shop that she called "De Elsie's".
Kohut was able to get his first position in the South Shore Hospital in Chicago, and in 1941 he began a residence in neurology at the University of Chicago's Billings Hospital, where he lived an worked until 1948. He was certified in neurology in 1947. Around this time he apparently decided that he would have a Christian identity, and chose the Unitarian Church[disambiguation needed] as his denomination.
However, Kohut was not happy with neurology and it seems he was bored in this field. Too much of his time was spent in the laboratory and there was not enough contact with real human feelings.
In late 1942 Kohut applied for the Chicago Institute for Psychoanalysis, which had been founded by Franz Alexander in 1932, modelling it on the Berlin Psychoanalytic Institute of the 1920s. Kohut was not accepted, and the rejection was decisive. The reason for this remains unclear, but Kohut was not even allowed to begin a didactic analysis. However, he found a clever way around this impasse by going into analysis, beginning in March 1943, with Ruth Eissler, who was a fellow Viennese and a fellow analysand of August Aichhorn and a training and supervising analyst at the institute. Furthermore, Ruth Eissler's husband Kurt R. Eissler, also an analyst, was regarded by August Aichhorn as the most promising future leader of psychoanalysis in America.
In 1944 Kohut decided to leave neurology and move into psychiatry, and in1947 he was appointed associate professor of psychiatry at the University of Chicago. He got his certification psychiatry in 1949.
In the fall of 1946 he had already been accepted to the Chicago Institute and began immediately on its courses. In the summer of 1947, he was given his first two "control" cases, followed by a third and a fourth case in early 1948. He began to receive patients on a permanent basis in 1949. In October 1950 he took his exams, passed them and became officially an analyst. He became a training and supervising analyst as well as a member of the institute's staff in 1953.
Unlike Franz Alexander, who had sought to shorten analyses, Kohut took as long as it took for the patients to get well in analysis. The agenda came entirely from the patient, whose job it was to say whatever occurred to him or her. He said to one of his patients: "I will do what I can to help you try and understand yourself."
He received his patients at the institute. All his patients are said to have adored him, although in the beginning of his career he had one case with which he failed miserably. Also, during the early years of his career as an analyst, his success was mixed.
Kohut analyzed several persons, who were already analysts but who felt they had not benefited as much from their didactic analyses as they had hoped. Some did their training analyses with him. These persons included Peter Barglow, Michael Franz Basch, George Klumpner, Paul Tolpin.
Kohut's work in teaching at the institute became his primary commitment for the rest of his life. He soon became known as the most gifted and creative analyst in the Chicago Institute. Together with Louis Shapiro and Joan Fleming, he rewrote the curriculum of the institute and taught its two-year theory course for a decade. The course was not one of the history of psychoanalysis but a study of "psychoanalytic psychology presented according to historical principles." It was a very Freudian course and contained no hints of where he would later move in his theoretical views. Kohut appeared as a master of metapsychology in these lectures.
He later gave the course over to Philip Seitz, how had been auditing the course and had made notes of it that he had discussed with Kohut and then amended those notes in accordance of those discussions. This collaboration resulted in a joint article, entitled "Concepts and Theories of Psychoanalysis: Relation of Method and Theory" (1963). Seitz published his notes more than three decades later in the form of a book.
Kohut's teaching style is said to have been brilliant, but at the same time it eclipsed the minds of the listeners, and according to Paul Ornstein, took the course, the style was pedagogically a failure. Other commentators have also said that Kohut's brilliance made his students passive and did not encourage independent thinking.
Kohut felt that analysts should be scientists and not technicians who just applied a set of rules to their work. If the latter were to be the case, the whole field of psychoanalysis would be assimilated to dynamic psychiatry and disappear forever.
Kohut was active in the American Psychoanalytic Association from the 1950s. He served on the board of the Journal of the American Psychoanalytic Association, and in a number of committees. But in the 1960s he rose to the top of this organization. First he was its secretary during 1961-62, then president-elect during 1962-63, and finally the president during 1964-65. This further cemented his friendship with Kurt and Ruth Eissler. Kurt Eissler was now one of the leading figures of the New York Psychoanalytic Society & Institute. He also became friends with Heinz Hartmann, who was a very important figure for him.
The last of these positions meant an incredible amount of work, preparing all kinds of meeting and working in a number of committees, as well as putting out all kinds of bush fires within the association. There was e.g. a question of whether analysts should or could express publicly their views about the mental health of Barry Goldwater.
Kohut was at time very much a representative of traditional Freudian analysis, and he was very careful not to do anything that could have been interpreted as a departure from traditional views. He was also careful about "his reputation as the chosen one to provide leadership for the next generation of psychoanalysts." Much later he jokingly said that in the 1950s and early 1960s he was "Mr. Psychoanalysis."
During this time Kohut became acquainted with everyone who mattered in psychoanalysis worldwide. For Kohut, the most important of these figures was Anna Freud. He first met her in 1964 in a meeting in Princeton. After that they were constantly writing to each other.
In the fall of 1966 the University of Chicago gave an honorary doctoral degree. Kohut may have been among the people who initiated this idea, and when Freud came to Chicago for this event, she stayed with the Kohuts in their apartment. Various activities were arranged for her in Chicago, and for Kohut this visit was a great success.
In the long run Kohut began to feel that his work as the president drained his energies and kept him from developing his own ideas. He was also beginning to have ambivalent feelings about classical analysis. In addition, this position exposed him to people who were self-centered, full of themselves and narcissistic in the worst sense of the word. There was nothing wrong in the science of psychoanalysis, he felt, but the problem was in the people "who are carrying on their work on the basis of these ideas." One could say that this was his higher education in matters related to narcissism.
Since he left his position of the president of The American, Kohut was in 1965 elected vice-president of the International Psychoanalytical Association (IPA). In 1968 he was encouraged by Anna Freud and the Eisslers to run for the presidency of this world-wide organization, as in 1969 it was the Americans' turn to have their representative elected. In the end it turned out that the European members of IPA were beginning to favour Leo Rangell, and thus Kohut would not stand a chance in the election. Anna Freud advised him not offer himself for a defeat, and Kohut withdrew from the race. He then explained this situation to his colleagues by saying that the presidency would have interfered with his creative work, which was a self-invented myth that many colleagues duly bought. Had Kohut been elected, it would have been likely that his first monograph, The Analysis of the Self would have remained his only main contribution to psychoanalytic theory.
Beginning in 1946, Kohut's friend Siegmund Levarie organized a series of concerts at the University of Chicago. In 1947, the response of the audience to a piece composed by Béla Bartók led him to write an article on some general principles of the psychology of music, which was published in 1950 in the Psychoanalytic Quarterly with the title "On the Enjoyment of Listening to Music." Also in 1947 Kohut began to ponder Thomas Mann's novella Death in Venice. In 1950 he wrote the final version of his thoughts on this novella and presented it as his graduation paper. He decided, however, not to publish it, as Mann was still alive. This article was finally published in 1957, also in the Psychoanalytic Quarterly, two years after Mann's death.
Kohut's first truly scientific contribution was his 1959 article on empathy, entitled "Introspection, Empathy, and Psychoanalysis: An Examination of the Relationship Between Mode of Observation and Theory", which was written for the twenty-fifth anniversary meeting of the Chicago Institute for Psychoanalysis in November, 1957, and also presented by Kohut in a psychoanalytic congress in Paris the same year.
This theme actually relates to the very foundation of psychoanalysis, the ability of one human being potentially to gain access to the psychological states of another human being. Interestingly, Sigmund Freud only mentioned this phenomenon in passing in a footnote in one of his articles ("A path leads from identification by way of imitation to empathy, that is, to the comprehension of the mechanism by means of which we are enabled to take up any attitude towards the life of another soul." Kohut now took up the matter and gave a very thorough presentation on this subject, outlining what kind of subject matter can be approached with empathy and what cannot be approached with it. Essentially it means that empathy as a method defines the field that can be observed with its aid.
The basic thesis is that those phenomena that can be approached by means of empathy are called psychological (i.e. relate to the inner life of man), and those that cannot be approached with it, are non-psychological, i.e. physical phenomena and must be approached with our sensory equipment. The approach thus is epistemological.
Despite the warm reception of this paper in Chicago, it was initially turned down by the editors of the Journal of the American Psychoanalytic Association, on the grounds that it presented too basic a challenge to psychoanalytic theory and thus not appropriately psychoanalytic. After an intervention by Max Gitelson, who argued that the journal should engage itself in ideological censorship, the editorial board reconsidered the paper and eventually published it in 1959.
In 1960 Kohut published in the Journal of the American Psychoanalytic Association an article entitled "Beyond the Bounds of the Basic Rule. Some Recent Contributions to Applied Psychoanalysis." In it he deals with four psychoanalytic biographic works that had recently been published:
With regard to using a psychoanalytic approach to works of art and to the lives of artists, Kohut lists three problems:
The article entitled "On Courage", first published posthumously in 1985, is said to have been the most personal one Kohut wrote, with the exception of the article entitled "The Two Analyses of Mr. Z." He examines here the actions of Franz Jägerstätter, Hans and Sophie Scholl during Hitler's reign in Germany and their willingness of accept death as their only reward. According to Kohut, these people were not crazy, but "they represented a higher and deeper psychological truth that they reached in their actions. Their values gave them no other choice than to refuse to go along with the demands of the Nazi regime.
Kohut spoke and wrote on the post-war psychological problems of the German people when he was invited to speak in Frankfurt am Main in October 1969. He was chosen as the laudator when the Peace Prize of the German Book Trade was awarded to Alexander Mitscherlich, with whom Kohut had become acquainted since the 1950s. Mitscherlich was a medical doctor and a psychoanalyst who had written several well received books on Germany's guilt concerning World War II and the Holocaust. Kohut's main thesis was that Mitscherlich had applied the "analytic principle of individual cure to the therapeutic transformation of a whole population." The audience included the President of the Federal Republic of Germany Gustav Heinemann, and the speech was broadcast live to an estimated audience of 20-30 million people.
In the aftermath of World War II and the Holocaust, Freudian analysis focused on individual guilt and tended not to reflect the new zeitgeist (the emotional interests and needs of people struggling with issues of identity, meaning, ideals, and self-expression).  Though he initially tried to remain true to the traditional analytic viewpoint with which he had become associated and viewed the self as separate but coexistent to the ego, Kohut later rejected Freud's structural theory of the id, ego, and superego. He then developed his ideas around what he called the tripartite (three-part) self.
According to Kohut, this three-part self can only develop when the needs of one's "self states", including one's sense of worth and well-being, are met in relationships with others. In contrast to traditional psychoanalysis, which focuses on drives (instinctual motivations of sex and aggression), internal conflicts, and fantasies, self psychology thus placed a great deal of emphasis on the vicissitudes of relationships.
Kohut demonstrated his interest in how we develop our "sense of self" using narcissism as a model. If a person is narcissistic, it will allow him to suppress feelings of low self-esteem. By talking highly of himself, the person can eliminate his sense of worthlessness.
Kohut expanded on his theory during the 1970s, a time in which aggressive individuality, overindulgence, greed, and restlessness left many people feeling empty, fragile, and fragmented.
Perhaps because of its positive, open, and empathic stance on human nature as a whole as well as the individual, self psychology is considered one of the "four psychologies" (the others being drive theory, ego psychology, and object relations); that is, one of the primary theories on which modern dynamic therapists and theorists rely. According to biographer Charles Strozier, "Kohut...may well have saved psychoanalysis from itself". Without his focus on empathic relationships, dynamic theory might well have faded in comparison to one of the other major psychology orientations (which include humanism and cognitive behavioral therapy) that were being developed around the same time.
Also according to Strozier, Kohut's book, The Analysis of the Self: A Systematic Analysis of the Treatment of the Narcissistic Personality Disorders, "had a significant impact on the field by extending Freud's theory of narcissism and introducing what Kohut called the 'selfobject transferences' of mirroring and idealization". In other words, children need to idealize and emotionally "sink into" and identify with the idealized competence of admired figures. They also need to have their self-worth reflected back ("mirrored") by empathic and caregiving others. These experiences allow them to thereby learn the self-soothing and other skills that are necessary for the development of a healthy (cohesive, vigorous) sense of self. For example, therapists become the idealized parent and through transference the patient begins to get the things he has missed. The patient also has the opportunity to reflect on how early the troubling relationship led to personality problems. Narcissism arises from poor attachment at an early age. Freud also believed that narcissism hides low self-esteem, and that therapy will reparent them through transference and they begin to get the things they missed. Later, Kohut added the third major selfobject theme (and he dropped the hyphen in selfobject) of alter-ego/twinship, the theme of being part of a larger human identification with others.
Though dynamic theory tends to place emphasis on childhood development, Kohut believed that the need for such selfobject relationships does not end at childhood but continues throughout all stages of a person's life.
With the exception of such persons as Louis Shapiro and Jerome Kavka, Kohut's peers were not receptive to his new ideas. However, younger analysts, such as Arnold Goldberg, Michael Franz Basch, Paul Ornstein, Anna Ornstein, Paul Tolpin, Marian Tolpin and Ernest Wolf and in the early days John Gedo were interested in his work, and David Marcus was also involved for a while.
Goldberg eventually emerged as the central figure of the group, whereas Paul Ornstein would become the editor of Kohut's collected works. Basch was the most original thinker of the group, but he chose to remain on its fringes.
The group met originally in Kohut's apartment in order to discuss his manuscript of what would become The Analysis of the Self. There were nine such meetings during the spring and early summer of 1969. The manuscript was considered to be difficult by the group, and the comments convinced Kohut that he had to write a new beginning to this book, which then became its first chapter, entitled "Introductory Considerations." In reality this may actually have made the book even more difficult to digest than what it had been prior to the writing of this new first chapter.
In 1948 Kohut presented case material in a seminar at the Chicago Institute, and one of the listeners was a social worker from the institute, Elizabeth Meyer. They fell immediately in love. For Kohut the decisive thing about her, as he wrote to Aichhorn, was her connection to Vienna. Meyer had spent some time in this city, had gone to analysis as Jenny Waelder's patient and had also been Aichhorn's student. They got married on October 9, 1948. They had one son, Thomas August Kohut (his first name being a reference to Mann, the middle name a reference to Aichhorn), born in 1950. After Thomas was born, Elizabeth Kohut gave up her day job at the institute, returning to work only in 1961 to work half days. The Kohuts also adopted informally the son of a colleague who had died and whose mother had committed suicide.
Thomas Kohut studied at the University of Chicago Lab School and eventually went through psychoanalytic training, but then decided to make a career as a historian and a psychohistorian.
Although Kohut enjoyed holiday trips to Europe, often in connection with psychoanalytic events, his favorite place for holidays was the town of Carmel in California. Beginning in 1951, the Kohuts usually spent two months there, from mid-July to mid-September. This way he could escape the hot and humid summers of Chicago, which caused him various problems due to his allergies. They always rented the same house, which was owned by an English couple that wanted to spend the summers in their native country. This house in Carmel is where Kohut did most of his writing.
In addition to the holidays in Carmel, the Kohuts also had a country house in Wisconsin, where they could spend weekends, often during the winter.
Kohut was psychologically unable to visit his native Vienna until 1957. He then visited his maternal uncle Hans Lampl, who had got back his old position as an executive of the Leykam-Josefsthal A.G. paper company. Lampl treated the Kohuts to a dinner, and used his position of influence to give a special gift to his nephew's son.
Kohut's mother Else also lived in Chicago, not far from Kohut's apartment. In the 1950s and 1960s she visited the Kohut family regularly for dinners and major holidays. She is said to have been the only person who could really get under Kohut's skin. Apparently no one in the family liked her. She would be pushy and aggressive, speak directly at other people's faces and poke people with her finger.
After 1965, when Else was getting close to 75 years of age, she began to "demonstrate a set of circumscribed paranoid delusions." This, together with her declining health, made it necessary for Kohut to place his mother in a nursing home in 1970. For Kohut, the fact that his mother had turned out to be crazy, was a liberating experience. He now realized that his whole life had been spent trying escape from his latently psychotic mother. He could now also understand why his father had been absent in his childhood. Strozier argues that Else's craziness liberated Kohut's creativity and made it possible for him to study the deeper meanings of highly regressed states and thus to write his first and most important monograph, The Analysis of the Self. Else Kohut died in late 1972.
Kohut was not a political person. According to his biographer Strozier, Kohut barely noticed the Nazis when they took over Vienna.
In America, he was viewed as a liberal, and he was for state control of gun ownership. He considered the Vietnam War to be immoral and stupid, yet he did not initially understand his son's anti-war attitude. Thomas Kohut was at the time studying at Oberlin College, which had a long history in opposing all kinds of social injustice, beginning with opposition to slavery and being an important station in the Underground Railroad. Eventually Kohut came to see reason in his son's views, and their anti-Nixon sentiments presumably gave them some common ground.
In the final week of his life, knowing that his time was at an end, Kohut spent as much time as he could with his family and friends. He fell into a coma on the evening of October 7, 1981, and died of cancer on the morning of October 8.