Psychoanalytic Psychology
Copyright 2000 by the Educational Publishing Foundulit
2000, Vol. 17, No. 2, 294-312
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Carl Rogers and Heinz Kohut
A Historical Perspective
Edwin Kahn, PhD
City University of New York
Arnold W. Rachman, PhD
Adelphi University
Earlier psychoanalytic thinkers, with their humanistic orientations, anticipated Heinz Kohut's theories and, therefore, contributed to the historical evolution of self psychology. Carl Rogers,
a founder of humanistic psychology in the United States, was a
theorist who struggled with many of the same issues as Kohut.
Rogers had new ways of looking at therapy, and especially at
the therapeutic ambience, ways that foreshadowed the discoveries of Kohut. This article discusses areas of compatibility of the
2 theorists, such as their focus on empathy and the self, to
encourage a rapprochement between humanistic psychotherapy
and self psychology. Kohut revolutionized psychoanalysis by
making it more humanistic. In that revolution, many of
Rogers's empirically tested ideas were incorporated into a
comprehensive psychoanalytic theory and clinical method.
Because of the areas of mutual concerns and overlap, a fuller
appreciation of Rogers's important ideas will be beneficial to
self psychology.
Edwin Kahn, PhD, Department of Social Sciences, Queensborough Community
College, City University of New York; Arnold W. Rachman, PhD, Derner Institute,
Adelphi University.
Correspondence concerning this article should be addressed to Edwin Kahn,
PhD, 50 West 97th Street, Apartment 6T, New York, New York 10025. Electronic mail
may be sent to [email protected].
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295
Different psychoanalysts, with their humanistic orientations, such as Ferenczi, Rank, Alexander, Winnicott, Guntrip, and Fairbairn, anticipated the
discoveries of Heinz Kohut and therefore made an important contribution
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to the evolution of self psychology (see Detrick & Detrick, 1989; Rachman, 1997a, 1997b). Carl Rogers, a co-founder of humanistic psychology
in the United States, was a humanistic theorist who can be seen as
struggling with some of the same issues as Kohut. Rogers, farm-raised in
the Midwest, developed a theory of psychotherapy that in many respects is
very American. Rogers's psychotherapy was optimistic, it focused on the
here and now, and it was usually short term (contemporary Rogerian
therapists report that long-term therapy is now common). Also, Rogers had
more interest in personality change than in development, and he thought
the relationship in the here and now was more important than transference
or countertransference issues. Importantly, Rogers's approach was American because it was influenced by the logical positivism and empirical
tradition of American philosophy. Personality change, expressed in terms
of the self, was central in Rogers's theory and was based, considerably, on
empirical data.
Rogers did, for his time, have some very new ways of looking at
therapy, and especially at the therapeutic ambience, ways foreshadowing
different discoveries of Kohut. For example, Stolorow (1976), in an early
comparison between Rogers's and Kohut's work, stated that
there appear to be striking parallels between the techniques, therapeutic
processes and ideal outcome formulated in the analytic treatment of narcissistic
disorders,... and the techniques, therapeutic processes and ideal outcome of
client-centered therapy as conceptualized by Rogers. The understanding and
treatment of the narcissistic disorders may thus provide an unexpected area of
rapproachement between psychoanalytic and client-centered therapists, (p. 28)
Other investigators, in addition to Stolorow, have made comparisons
between Rogers's and Kohut's work (see Bohart, 1991; Kahn, 1985,1989a,
1989b, 1995, 1996; Tobin, 1990, 1991). These comparisons show that a
rapproachement between humanistic psychology and psychotherapy and
psychoanalytic self psychology is meaningful and could be of benefit to
self psychology (as well as to client-centered therapy). A discussion of
Rogers's contributions as they relate to Kohut's is also important to
chronicle more thoroughly the historical evolution of self psychology.
To explore the potential contribution that Rogers's work can make to
self psychology, the following is a summary of those aspects of his work
that are relevant to a rapprochement. Rogers's basic premise was that there
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is a constructive striving in each individual (as well as in all of nature) to
reach his or her potentialities, which he called an actualizing tendency.
When a person experiences unconditional positive regard (nonjudgmental
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acceptance) and empathic understanding from a significant other who is
also experienced as genuine and human, the person develops unconditional
positive self-regard (self-esteem),
and the process of actualization is
promoted. Conversely, this natural growth tendency is thwarted when the
person experiences conditional acceptance or the absence of empathy.
Thus, there are three conditions, according to Rogers, that are necessary
and sufficient to facilitate the growth of a person: unconditional positive
regard (prizing the other), empathic understanding, and a nondefensive
integrated state characterized by openness and genuineness (also called
congruence). In the therapeutic relationship, which came to be called
client-centered therapy, Rogers focused completely on the subjective
experiences of the client, seeking to be a companion to the client and to
avoid imposing an agenda on or guiding the client in any way.
Rogers, beginning in the 1950s, and even more so in the last decades
of his life, came to emphasize that the ideas he discovered in the field of
psychotherapy applied to all human relationships: that "the boundary
between psychotherapy and ordinary life is necessarily thin" (Kramer,
1995, p. xii). In this respect, Rogers's ideas are quietly permeating today's
culture in sell-help groups, the classroom, and parenting. Rogers's ideas
were very simple, yet profound. With an accepting, understanding, and
genuine attitude and the relinquishing of power and control over others,
people will grow. This application of Rogerian ideas outside of therapy
came to be called the person-centered approach (for a complete description of the evolution of Rogers's ideas, see Raskin & Rogers, 1995).
As can be seen in these basic tenets of Rogers's humanistic psychotherapy, there are similarities and compatibilities with Kohut's thinking.
Coincidentally, Kohut and Rogers were at the University of Chicago at the
same time, from 1945 to 1957. Kohut was in the Department of Neurology
and Psychiatry, and Rogers was a professor of psychology. Rogers, curious
about the parallels between his work and Kohut's (personal communication, August 27, 1986), wrote:
I certainly acknowledge there is a large and important overlap between Kohut's
views and mine. What I wish I knew, and perhaps you may have some clues to
Ihis, is how much uf his thinking and his "new discoveries" were based on a
knowledge of my work. It certainly is not a coincidence that while at the
University of Chicago he developed an interest in empathy and the self, the two
major features which I had been formulating and writing about for quite a
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ROGERS AND KOHUT
297
number of years. I deeply regret that I never had personal contact with him. The
Department of Psychiatry at that time was attacking my work at the Counseling
Center, declaring that we were practicing medicine without a license. They did
not like the idea of psychologists doing therapy. I don't believe that Kohut had
any part in this at all, hut the estrangement between the two departments was
very deep and I never got to know any individuals except the chairman of
psychiatry.
It is of interest that Kohut was apparently aware of Rogers's work,
which he unfortunately described with some disdain, but it is not clear
whether any of Kohut's "discoveries" were influenced by this awareness.
According to Kohut (1973/1978b):
Certain forms of psychotherapeutic counseling, for example, which enjoy at
present a not inconsiderable popularity, restrict their technique in the main to
letting the patient say everything that occurs to him. The counselor's passive
attitude seems to be similar to the analyst's attitude of expectant silence; he
listens, and either says nothing or merely repeats what the patient has just said
himself. But while the analyst employs his method for a specific purpose—he
listens in order to understand and then explain, thus enabling the patient to
enlarge his knowledge of himself—for the counselor, the method of free
association appears to have become an end in itself. But when this use of free
association is extolled as being superior to psychoanalysis, then the analyst
cannot refrain from shaking his head in amazement. He understands, of course,
how, in certain instances, temporary improvements are quickly brought about in
this way. (pp. 523-524)
Kohut went on to compare this type of psychotherapeutic counseling with
the work of a repairman who managed to fix an old alarm clock of his. This
repairman knew nothing about clocks; what he did to restore its functioning was just clean and oil the clock's inner parts.
There is no need to spell out the analogy between the so-called watchmaker and
the practitioners of certain kinds of psychotherapy—except, T think, that my
so-called watchmaker had a higher percentage of successes and knew more
about what he was doing than most of the psychotherapists who borrow one or
the other insight or technical rule from psychoanalysis and apply it without
understanding. (Kohut, 1973/1978b, p. 525)
With these comments, Kohut obviously was not exhibiting much
appreciation of Rogers's therapeutic innovation of empathic listening, that
is, attempting to see things as completely as possible from the client's
framework. American psychoanalysts, in general, have rarely appreciated
Rogers's contributions, which have often been dismissed as shallow or
superficial. We believe that Rogers's therapeutic innovations are more
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profound than has been previously appreciated and that many of his ideas
have already been incorporated into psychoanalytic self psychology. One
possible reason for Kohut's dismissal of Rogers's therapeutic innovations
was that Kohut wanted to claim that he was the originator of the concept of
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therapeutic empathy. Rachman (1989, 1997a, 1997b) has noted that Ferenczi introduced "the rule of empathy" into psychoanalysis in the 1920s
and that Kohut also failed to acknowledge Ferenczi's contribution. Kohut
(1959/1978a) did discuss Freud's use of empathy and introspection as
observational tools to investigate a person's inner world (p. 211), but
nowhere, to our knowledge, did he give credit to any predecessors for the
therapeutic benefits of empathy.
Interestingly, there is a link between Rogers and psychoanalysis in
his early training at Rochester, when he became familiar with the work of
Otto Rank and several of Rank's students. For example, his "reflection of
feeling" response was influenced by a Rankian-trained social worker,
Elizabeth Davis (Raskin & Rogers, 1995, p. 133).
Relevant to the rapprochement of Rogers's views with self psychology is Robert Stolorow's (1976) article, "Psychoanalytic Reflections on
Client-Centered Therapy in the Light of Modern Conceptions of Narcissism." Stolorow (1976) described how Rogers, with his empathic reflection of feeling and his acceptant attitude, encouraged the development of a
mirror transference:
Indeed, Rogers' technical recommendations (which are in many respects similar
to those of Kohut with regard to the unfolding of the grandiose self) seem ideally
suited to promote the development of a narcissistically sustaining mirror
transference. The therapist is enjoined to reflect the patient's experiences with an
attitude of unconditional positive regard and acceptance, with an eye toward
affirming the client's worth, significance and value to the therapist. The client
thus comes to experience himself as "prized" . . . by the therapist, much as does
the narcissistically disturbed patient immersed in a mirror transference, (p. 28)
Stolorow (1976) then selected abeautiful quote from Rogers's 1951 book,
Client-Centered Therapy:
The therapist endeavours to keep himself out as a separate person . .. his whole
endeavour is to understand the other so completely that he becomes almost an
alter ego of the client.... The whole relationship is composed of the self of the
client, the counselor being depersonalized for the purposes of therapy into being
"the clienl's olher self." (Rogers, 1951, pp. 42, 208)
Stolorow (1976) eloquently noted the similarity of this way of being to
Kohut's description of narcissistic patients who use the analyst imperson-
ROGERS AND KOHUT
299
ally to fill in missing parts of their self-structure. According to Stolorow
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(1976):
The therapist who follows Rogers' recommendations thus divests himself of his
own selfhood and embraces the role of a part, extension or duplicate of the client,
a "pure mirror image" of the client, a depersonified medium in which the client's
sense of self may germinate and consolidate. As in the handling of the mirror
transference, the client-centered therapist accepts (and even promotes) his role as
an impersonal function substituting for missing or defective segments in the
client's own self-structure. Tt is not surprising, then, that the recipient of
client-centered therapy would report a buttressing of his sense of self-cohesion,
self-identity and self-esteem by virtue of his immersion in the therapeutic
relationship. It is also not surprising that Rogers describes individuals in
client-centered therapy who, like patients involved in a mirror transference,
experience temporary states of self-fragmentation when there is a disruption in
the narcissistically sustaining therapeutic relationship, (p. 28)
With this comparison, Stolorow highlighted the remarkable similarity of
the therapeutic relationship for Rogers and Kohut.
In the remainder of this article, we further elaborate Rogers's ideas as
they relate to Kohut's on a variety of issues. This comparison will be useful
to self psychology, because Rogers's humanistic psychotherapy provides,
in many respects, a foundation for Kohut's thinking. In other words, self
psychology, with its more comprehensive theory and clinical methods,
may be seen as an analytic evolution of Rogers's client-centered psychotherapy.
Self-Concept
Rogers and Sanford (1984) stated that
very early, it was found that clients in therapy frequently focused their problems
and their progress in terms of self. "I feel I'm not being my real self." "It feels
good to let myself go and just be myself here." Gradually, the crucial importance
of the self and its changing quality became evident, (p. 1382)
Rogers became interested in the enhancement of self-regard or self-esteem
in psychotherapy; that is, with unconditional positive regard, positive
self-regard develops. He also described the integrated, healthy self as being
able to experience nondefensively all thoughts and feelings in its organism,
a way of being that he termed congruence. Incongruence occurs when
experiences in the organism are blocked off from or distorted in selfawareness. Rogers's description of an incongruent client experiencing
more congruence from psychotherapy appears very similar to the lifting of
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repression for Freud (Kahn, 1985). However, this lifting of repression, for
Rogers, came about not from interpretations but, rather, from a safe human
relationship that provided unconditional positive regard and empathic
understanding. Kohut, on the other hand, was more interested in self-
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cohesion and various expressions of narcissistic deficit, as when the self is
either fragile or vulnerable.
Empathy and a Changed Listening Stance
Both Rogers and Kohut stressed the importance of empathy, that is,
listening to and accurately understanding the subjective experience of the
client or patient. Different writers have noted how special Rogers's
capacity for empathy was. Stolorow (1976), for example, commented that
"Rogers's discussion of the critical importance of the communication of
acceptance and empathy in client-centered therapy, and his suggestions as
to how this communication may be achieved, are probably unsurpassed in
the clinical literature" (p. 29). And Kramer (1995), in describing Rogers's
empathic stance, stated that "Rogers does what generations of psychology
students have satirized him for doing, namely, repeat clients' words. But he
also summarizes clients' feelings with precision, beauty of expression, and
generous tentativeness" (p. xiv).
Schwaber (1983, pp. 380-381) believed that Kohut's most important
contribution was his shift in listening stance, that is, his making a sustained
effort to listen from the patient's perspective. She described how that
change occurred with Kohut's well-known patient, Miss F (Kohut, 197]).
Kohut (1984) summed up this changed listening stance in the following
way:
If there is one lesson that I have learned during my life as an analyst, it is the
lesson that what my patients tell me is likely to he Irue—that many times when t
believed that I was right and my patients were wrong, it turned out, though often
only after a prolonged search, that my lightness was superficial whereas their
lightness was profound, (pp. 93-94)
Recently, Magid (1996) echoed Schwaber's sentiment: "Kohut's great
contribution was conceptualizing the centrality of the empathic stance, by
which the subjective validity of the patient's inner world was explored and
acknowledged, without any implication that this perspective be viewed as
distorted and ultimately relinquished" (p. 619).
An attitude of attempting to just listen to what the client is experienc-
ROGERS AND KOHUT
301
ing, without interpretation, is the attitude that Rogers was advocating as
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early as the ] 940s. At that time, Rogers (1942) wrote:
This course of action imposes much self-restraint upon the counselor. The reason
is simple. As the client reveals himself more and more fully in the counseling
interviews, the counselor begins to develop insight into the client's problems....
There is the greatest temptation to most counselors, whether they are psychiatrists, psychologists, guidance counselors, or social workers, to inform the client
as to his patterns, to interpret his actions and his personality to h i m . . . . The more
accurate the interpretation, the more likely it is to encounter defensive resistance.
The counselor and his interpretations become something lo be feared. To resist
this temptation to interpret too quickly, to recognize that insight is an experience
which is achieved, not an experience which can be imposed, is an important step
in progress for the counselor, (pp. 195-196)
It is important to see how early Rogers was appreciating the validity of the
subjectivity of the client. We believe that Rogers deserves historical credit
for his role in articulating the therapeutic benefits of empathy. Psychoanalytic thinkers of today tend to overlook Rogers's original contribution in
this area.
Of course, Rogers did not have to extricate himself from an orthodox
psychoanalytic theory that emphasized interpretations, as Kohut did.
However, in the 1920s, at his doctoral internship in New York City, Rogers
was trained in the dynamic Freudian approach (N. J. Raskin, personal
communication, January 19, 1998), and in the 1930s he used an interpretative therapy that he eventually found unhelpful and discarded (Kirschenbaum, 1979, pp. 86-92).
Unconditional Positive Regard
According to Rogers and Sanford (1984):
The therapeutic process is enhanced when the therapist both experiences and
communicates to clients a deep and genuine caring for them as persons with
many constructive potentialities. When this caring is uncontaminated by
judgments or evaluations of the thoughts, feelings, or behaviors, it deserves the
term "unconditional positive regard." (p. 1379)
Kohut would surely agree that nonjudgmental acceptance of the person is
an important quality for therapeutic effectiveness. Rather than unconditional positive regard, Kohut emphasized mirroring, or "the gleam in the
mother's eye," as essential for the healthy development of the self. These
concepts, unconditional positive regard and mirroring, are similar but not
identical. Unconditional positive regard is an attitude of consistent accep-
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tance and nonpossessive wannth and care held by the therapist (or parent)
toward the person as a whole. Mirroring is a sharing of joy or pleasure, an
"acceptance and confirmation of the self in its grandness, goodness, and
wholeness" (Wolf, 1988, p. 184). Whereas unconditional positive regard is
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ever present, mirroring seems contingent on some action or responsiveness
in the person and, therefore, may not be so unconditional.
Whereas Rogers, from the 1940s onward (see Rogers, 1951, pp.
159-172), advocated the consistent acceptance or prizing of a client, Kohut
and other self psychologists, at least through the 1970s and 1980s, were
more hesitant to "prize" or "mirror" a patient in analytic therapy. For
example, Stolorow (personal communication, June 1983) wrote:
For Kohut, mirroring is nvl something that the analyst actually tries to provide.
Rather it is something that the patient is permitted to experience subjectively as
an aspect of the transference revival of an early selfobject tie. The patient's need
for mirroring is accepted, understood, empathically interpreted, and ultimately
worked through in the transference according to Kohut.
Kohut (1983) also denied the criticism "that we gratify our patients by
'mirroring' them" (p. 402), and Basch (1981) stated that "a patient's need
to be mirrored . . . can be met with an analytic response . . . no . . .
indulgence of the patient is called for" (p. 343).
One does find, however, examples in Kohut's writings in which he
advocated providing positive experiences for patients. For instance, in his
seminal paper on introspection, empathy, and psychoanalysis, Kohut
(1959/1978a) wrote, when describing addicts:
Their addiction must not, however, be confused with transference: the therapist
is not a screen for the projection of existing psychological structure; he is a
substitute for i t . . . The patient now really needs the support, the soothing of the
therapist. His dependence cannot be analyzed or reduced by insight; it must be
recognized and acknowledged, (p. 225)
And, in his final book, when discussing the overevaluation of patients by
their analysts, Kohut (1984) stated that, "this overevaluating attitude too is
'normal' .. . and that an analyst who consciously eradicates this attitude
and replaces it by cold objectivity... is as misguided as the Watson-guided
'objective' mother of half a century ago" (p. 190). Kohut (1984, pp. 78,
153) and other self psychologists (e.g., Miller, 1990; Wolf, 1990) also
emphasized the importance of providing a "corrective emotional experience," as described by Alexander (1956). And Orange (1995), echoing
Rogers's humanistic beliefs, has commented that "psychoanalytic understanding is, among other things, a form of loving, and it can be experienced
ROGERS AND KOHUT
303
in that way by the patient. It differs from empathy, which is value-neutral
and can be used to hurt people" (p. 171).
At this point, it may be useful to briefly discuss the relationship
between unconditional positive regard and empathy. As noted, with uncon-
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ditional positive regard the person as a whole is prized, whereas empathy is
the ability "to perceive the internal frame of reference of another with
accuracy" (Rogers, 1980, p. 140). Empathy, as pointed out by Kohut
(1981) and others (e.g., Shlien, 1997; Orange, 1995), in addition to having
a therapeutic function, can also be used to harm or manipulate people. In
his final address, Kohut (1981) said, "If you want to hurt somebody, and
you want to know where his vulnerable spot is, you have to know him
before you can put in the right dig." Appreciating this negative use of
empathy, Orange (1995) distinguished, in psychoanalytic epistemology,
between empathy and empathic understanding: "Empathy defines the way
of knowing—vicarious introspection—and the nature of the known—
complex psychological configurations—that we seek to understand in
depth" (p. 23). In contrast, empathic understanding includes a helpful
response, such as a therapist adjusting the heat and light for a patient's
comfort or a parent protecting a child from mistreatment (Orange, 1995,
pp. 22-23). It seems that, for Orange, empathic understanding (in contrast
to empathy by itself) includes caring responsivity (i.e., unconditional
positive regard).
Being Human
In a conference commemorating the 100th anniversary of psychotherapy,
Rogers (1985) was asked by a participant what the profession of psychotherapy had learned over the past 100 years. Rogers thought about the
answer for several moments and then said, "I don't know what the
profession has learned, 1 really don't. I've learned to be more human in the
relationship, but I am not sure that that's the direction the profession is
going." For Rogers, what is most healing is being openly oneself in a
relationship. In a lovely passage, Rogers and Sanford (1984) wrote:
The kind of caring that the client-centered therapist desires to achieve is a
gullible caring, in which clients are accepted as they say they are, not with a
lurking suspicion in the therapist's mind that they may, in fact, be otherwise. This
attitude is not stupidity on the therapist's part; it is the kind of attitude that is most
likely to lead to trust, to further self-exploration, and to the correction of false
statements as trust deepens, (p. 1379)
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Kohut (1984), although probably more reserved than Rogers, did
write that, because of self psychology, "I have come to feel freer and,
without guilt and misgivings, to show analysands my deep involvement
and concern via the warmth of my voice, the words that I choose, and other
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similarly subtle means" (p. 221). And Wolf (1987), in a speech discussing
whether or not interpretation should be used, stated, "It really doesn't
matter what you do, what matters is who you are," which surely relates to
the human qualities of the therapist.
But for Rogers, Kohut did not go far enough in emphasizing the
human qualities of the therapeutic relationship. For example, Rogers
(1986) had interesting comments to make after viewing Kohut's (1981) last
lecture, "On Empathy," given 4 days before Kohut's death. We present
what Kohut said, followed by Rogers's reply. Kohut's (1981) remarks
came at the end of his talk, as he described his work with a strongly suicidal
I suddenly had the feeling . . . "how would you feel if I let you hold my fingers
for a little while, now while you are talking, maybe that would help you";
doubtful maneuver, I am not recommending it, but I was desperate, I was deeply
worried. So I gave her two fingers. Moved up a little bit in my chair, gave her two
fingers, now I'll tell you what is so nice about that story, because an analyst
always remains an analyst—I gave her my two fingers, she took a hold of them
and I immediately made a genetic interpretation to myself, "it was the toothless
gums of a very young child clamping down on an empty nipple." That's the way
it felt. I didn't say anything. I don't know whether it was right, but I reacted to it
even there as an analyst to myself. [It] was never necessary any more. 1 wouldn't
say that it turned the tide. But it overcame a very, very difficult impasse, at a
given dangerous moment, and gaining time that way, we went on for many, many
more years, with reasonably substantial success.
Rogers's (1986) reaction to Kohut's remarks was as follows:
It seems clear that in this interaction Dr. Kohut is experiencing desperation,
caring, and compassion. He found a beautifully symbolic gesture that enabled
him to express something of what he was feeling. Yet he is apologetic about this,
about giving her his fingers to hold. Even more astonishing—and sad—is his
interpretation to himself that he is giving her a dry nipple. He appears unaware
that by giving something of himself—of his own deep and persistent feelings—he is giving her the nourishing human caring and compassion that she so
desperately needs. Being thus openly feeling with her is most therapeutic. Yet he
seems dubious and apologetic about his action. He appears to be unaware that
being openly himself in the relationship was the most healing thing he could
have done. It is obvious that I differ deeply from Dr. Kohut in the value I give to
being one's own whole person in the relationship, (pp. 132-133)
ROGERS AND KOHUT
305
Rogers, we imagine, was unable to fully appreciate the orthodox tradition
that Kohut, with considerable conflict, was seeking to separate from.
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Toward More Equality
Rogers called for a greater equality in the therapist-client relationship. He
was critical of the psychoanalytic approach of his era, in which interpretations were often imposed on patients. There is no "expert" in the
client-centered approach: The client's power in the relationship is protected as much as possible, and power is not invested in the therapist or
specialist. Kramer (1995) stated that, "for Rogers, the cardinal sin in
therapy, or in teaching or family life, is the imposition of authority" (p.
xiii). The very labels he chose for his form of therapy (at first he called it
nondirective therapy) illustrate this wish to relinquish any influence or
control over another. In a speech, Wolf (1987) agreed with Rogers's
sentiments:
One can think of the analytic situation
up here and the patient down there,
selfobject theory would bring that tilt
it's our defensiveness, our narcissistic
there.
as being sort of tilted, with the analyst
and a really consistent application of
up to a more equal kind of level, and
defensiveness, that tries to keep us up
Also important is that Kohut, with his changed listening stance, corrected
some of the more obvious power inequities of traditional psychoanalysis.
Transference as a Distortion
Rogers did not elaborate a developmental theory and was not especially
interested in the phenomenon of transference. He was interested in the real
existential encounter in the here and now. A student of Rogers's, John
Shlien (1987), in an interesting article that emphasized Anna O's erotic
attachment to Josef Breuer, criticized the transference concept. Shlien
argued that transference was a fiction or, rather, a defense mechanism used
by therapists "to protect themselves from the consequences of their own
behavior" (p. 15). According to Shlien, when a client falls in love with or
gets angry at a therapist, therapists, starting with Breuer, have used the
concept of transference to deny their culpability in eliciting these feelings.
However, with the elaboration of a two-person paradigm in self psychology, the idea of transference as a distortion disappears. Shlien's criticism
becomes moot, because in contemporary self psychology it is acknowl-
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KAHN AND RACHMAN
edged that, in their mutual interaction, the different
qualities of the
therapist are influencing the patient, and vice versa.
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Interpretations
Kohut (1981, 1982, 1984) distinguished between two kinds of empathy—
understanding, a lower form, and interpretation, a higher form—and he
believed that an interpretative phase was necessary for a psychoanalytic
cure. Rogers came to oppose interpretations; he believed that they were a
manifestation of the medical model, having an expert cure an illness. For
Rogers, the client has the capacity to discover his or her own answers and,
as a result, will become self-empowered. After viewing Kohut's (1981)
lecture, Rogers commented:
Our purposes in being empathic are nol Ihe same. Kohut planned to use his
perception of the inner world of the patient to make interpretations of the
patient's behavior. My purpose was, through a sensitive empathy, to be a
companion to my client, giving him the courage to go on in his voyage of
self-discovery. . . . Kohut's patient, receiving an interpretation, is illuminated by
the insight when he is ready to accept it. It is also very likely, judging from the
analyst-patient relationship portrayed in the film, that he perceives Dr. Kohut as a
wise and gifted person who can provide him with these understandings of self.
My client, sensing that I am a companion to him in his search, discovers Ihe
same insight and feels equally illuminated. But he also gains confidence in
himself as he realizes that he has the capacity and the power to discover and learn
the meanings of his own behavior. Thus, it appears to me that Kohut's patient
learns and profits from the insight and becomes a bit more dependent on the
analyst. My client learns and profits from the insight, perhaps a trifle later, and
becomes a bit more independent and self-empowered. (Rogers & Sanford, 1984,
p. 1379)
The questions raised in Rogers's remarks are interesting: whether a patient
becomes more dependent on an analyst as a result of an empathic
interpretation and, furthermore, whether such dependency feelings, if they
occur, are necessarily detrimental. Tt is noteworthy that some contemporary
self psychologists have deemphasized the use of interpretations. For
example, according to Miller's (1985) speech:
The stressing of interpretation is an ancient tradition in analysis, a tradition that
has been perpetuated through the passing of analytic generations, without, in my
opinion, open-minded reexamination based upon empirical data. Tt is possible
that if one attempted to maintain an empathic resonance with one's patient, in so
far as possible continuously to maintain the mutual efforts at understanding the
patient's inner state, that this might be the most productive way to promote
increasing self-awareness and maximum therapeutic effectiveness.
ROGERS AND KOHUT
307
And Wolf (1986) stated that "crucial is the proper attunement of affect,
guided by empathy, and not the verbal message that is being conveyed, or
what explanations the therapist gives or does not give to the patient."
Offering a slightly different position, Merton Gill (personal commu-
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This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
nication, August 28, 1991) wrote, "Rogers certainly performed an important service by pointing to the authoritarian way in which many analysts
employ interpretation, but a misuse of a technique does not mean the
technique is to be abandoned." Finally, Orange (1995) stated, "I think
much of the therapeutic effect of analytic interpretation may lie, not so
much in the insights provided or even jointly found, but instead in the
patient's experiencing for the first time being important enough to a
parent-substitute to be thoughtfully considered" (pp. 30-31). One may add
that important selfobject needs of the therapist are also satisfied when, as a
result of a constructive interpretation, a patient expresses appreciation.
Free Will and Determinism
For Kohut (1980), a self with ambitions, skills, and talents, as well as ideal
goals, is poised to the future and "has a significance all of its own,
independent of the genetic factors that—in the area of cause-and-effect
determinism—had originally laid down its contents and had given it its
shape" (p. 540). This view of the self, making choices and exercising free
will, is central to Rogers's humanistic philosophy as well. Rogers echoed
Kohut's ideas when he stated, just as in physics,
where you can prove that the wave theory of light is supported by evidence; so is
the corpuscular theory. . . . I think one would be narrowing his perception of
physics to deny one of these and accept only the other. And it is in this same
sense... that I regard these two dimensions [free will and determinism] as both
real, although they exist in a paradoxical relationship, (cited in Kirschenbaum,
1979, p. 269)
Freudian Instinct Theory
Both Kohut and Rogers opposed the Freudian model of human nature: that
sex and aggressive instincts need to be tamed by the influences of
civilization. With humor, Gill (personal communication, December 17,
1990) wrote, "You may be amused to know by the way that once I was on a
platform with Rogers and he criticized psychoanalysis for believing in
original sin. I told him I felt the criticism was justified but that he
apparently believed in original virtue."
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KAHN AND RACHMAN
Transcripts and Empirical Testing
A significant contribution of Rogers is that he was the first to attempt to
demystify the nature of psychotherapy by making sessions open to public
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This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
scrutiny. In the 1940s, he published verbatim transcripts of therapeutic
encounters. For more than 50 years, investigators such as Porter (1943),
Snyder (1945), and, more recently, Bradley (1994), using these transcripts,
have measured how therapists actually behave with clients. Regarding this
issue, Gill (personal communication, August 28,1991) wrote, "I also think
Rogers deserves a great deal of credit for being the first person to present
verbatim sessions. Since him, a number of people have plucked up the
courage to do so but he was the first." These transcripts, along with
Rogers's persistent effort to construct a theory of the self with postulates
testable through empirical means, stimulated considerable research on
client-centered therapy.1 Raskin summarized Rogers's contributions in the
1940s:
In a very short time, an entirely new approach to psychotherapy was born, as was
the field of psychotherapy research. This approach and its accompanying
research led to the eventual acceptance of psychotherapy as a primary
professional function of clinical psychologists. (Raskin & Rogers, 1995, p. 135)
Conclusion
Magid (1996) wrote:
I think it is ironic that much of what has come to be thought of as progress in
psychoanalysis has in fact been the result of subtraction from, rather than
addition to, our theories. As analysts we have increasingly learned to get out of
our patients' way. (p. 626)
' There has been some controversy about the empirical status of Rogers's
theoretical propositions. For example, a number of reviews in the 1970s concluded that
research evidence supporting Rogers's postulates was weak (Mitchell, Bozarth, &
Krauft, 1977; Rappaport & Chinsky, 1972). However, the studies cited as evidence for
this conclusion had serious methodological flaws (Patterson, 1984). More recent
reviews of the literature indicate that the critical variables for therapeutic effectiveness
are (a) the client—therapist relationship and (b) extratherapeutic variables (factors that
are part of the inner resources of the client and his or her environment that aid in
recovery; Bohart & Tallman, 1996; Bozarth, 1998; Duncan & Moynihan, 1994;
Patterson, 1984). Bozarth (1998), after reviewing the last three decades of psychotherapy research, concluded that the evidence for the importance of the person-toperson relationship of therapist and client lends support to Rogers's attitudinal qualities
as the foundation for effective psychotherapy (p. 173).
ROGERS AND KOHUT
309
Magid's observation would please Rogers, because he, too, wanted to
avoid burdensome, unverifiable theory and "learned to get out of his
clients' way."
This article has discussed different areas where Rogers's contribu-
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This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
tions are a precursor to some of the discoveries in self psychology. In fact,
there may be more similarities between Kohut and Rogers than between
Kohut and some of his psychoanalytic predecessors. For example, as noted
by Stolorow (1976), Rogers's descriptions of empathy in the therapeutic
relationship ("being the client's other self") anticipate Kohut's understanding of the archaic needs of narcissistic patients. Rogers's theory that
unconditional positive regard and empathy encourage positive self-regard
and congruence anticipates Kohut's ideas about self-cohesion and the
importance of mirroring for the maturation of the self. Both Kohut and
Rogers were able to free themselves from the early overemphasis on
interpretation in psychoanalysis and learn to listen with empathic understanding to what the patient or client was saying. Rogers, with more
freedom (but also Kohut), emphasized the human quality of the therapeutic
relationship. Rogers sought to make the therapeutic relationship more
equal, and Kohut, with his changed listening stance, highlighted this value
as well. Each acknowledged that one can observe human existence through
deterministic lenses, but to have a complete view of human psychology it is
necessary to include the concept of a self that makes choices and exercises
free will. Kohut revolutionized psychoanalysis by making it more
humanistic. In that revolution, many of the empirically tested ideas that
Rogers arrived at independently were incorporated into a comprehensive
psychoanalytic theory and clinical method. For all of these reasons, a fuller
understanding of Rogers's profound ideas will be beneficial to self
psychology.
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