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Brandchaft, B. (1988). Chapter 10 A Case of Intractable Depression. Progress in Self Psychology, 4:133-154.

(1988). Progress in Self Psychology, 4:133-154

Chapter 10 A Case of Intractable Depression

Bernard Brandchaft, M.D.

Heinz Kohut's last paper (1982), written shortly before his death, summarized some of his most important differences with classical psychoanalysis and constituted his own legacy to succeeding generations of psychoanalysts. He had arrived at this point, painfully but inexorably, by his persistent dissatisfaction with the clinical results of the application of classical theories of development and pathogenesis and by his return, 25 years earlier, to the “field-defining observational stance of introspection and empathy” (p. 402).

In particular, Kohut took passionate issue with the concepts of intrapsychic conflict that have continued to provide the foundations for traditional psychoanalytic theories and practice. It was a tragic mistake, he insisted, to continue to treat people as if their essence were defined by a lifelong struggle between drives and the civilizing influences of their social environment as embodied in the superego. Error was compounded by the tendency of psychoanalysts to view their patients who fail to respond or who respond negatively to psychoanalytic attempts to understand and treat them from this perspective as “resisting therapeutic analysis because of unwillingness or inability to tame their aggressive/destructive wishes” that characteristically led them to become engaged in wars and self-destruction (p. 402).

To the classical view Kohut counterposed his own.

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