Psychotherapy Volume 26/Winter 1989/Number 4
HEINZ KOHUT AND CARL ROGERS: TOWARD
A CONSTRUCTIVE COLLABORATION
EDWIN KAHN
Queensborough Community College
City University of New York
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In order to foster a constructive
collaboration between the approaches
of Kohut and Rogers this article
discusses ways in which Kohut's work
is more helpful therapeutically: his
treatment goal of self-structuralization,
his interest in development and
transference, and his explanations for
behavioral excesses, including
idealization. Then ways in which
Roger's work is more helpful are
discussed: his emphasis on being
human, on "prizing" the other, and his
concern about the medical model and
interpretive excesses. Finally, it is
shown how Kohutians and Rogerians
will each benefit as a result
of incorporating the strengths
of the other approach.
An earlier article (Kahn, 1985) discussed the
similarities and differences between the work of
Heinz Kohut and Carl Rogers and showed that
Kohut's work provided a bridge between psy-
choanalysis and humanistic psychology. This ar-
ticle, which is an expansion of the earlier one,
will focus on the differences between Kohut and
Rogers in order to study the ways in which each
theorist's views may be more helpful in therapeutic
practice.
The author wishes to thank Marjorie T. White, Robert D.
Stolorow, and Stephen G. Wartel, for their help on aspects
of this article.
Correspondence regarding this article should be addressed
to Edwin Kahn, Dept. of Social Sciences, Queensborough
Community College, Bayside, NY 11364.
Kohut, as is known, had deep ties with the
orthodox psychoanalytic tradition.
I had throughout a professional lifetime been deeply committed
to the teachings of classical psychoanalysis and to the technical
prescriptions correlated with the established theoretical tenets.
It was, therefore, not easy for me to admit to myself that I
was seeing the psychological world in a way that differed
from the traditional view (Kohut, 1984, p. 87).
Stolorow (1986) has examined several of Kohut's
theoretical concepts that Stolorow found were
limiting because of Kohut's inability to disengage
himself from the mechanistic thinking of classical
drive theory. In contrast to Stolorow, who focuses
on the theoretical aspects of Kohut's work, we
are more concerned, in this comparison with Rog-
ers, with the therapeutic applications of Kohut's
self psychology. Also Rogerians, in their opposition
to aspects of the psychoanalytic approach (see
Kirschenbaum, 1979), may neglect some of the
valuable contributions of Kohut's self psychology,
contributions that may serve to promote the efficacy
of client-centered therapy and the person-centered
approach.
For the sake of review, we begin with a summary
of the similarities between Kohut and Rogers.
Next differences between them, where Kohut's
views, emanating from the psychoanalytic tradition,
are therapeutically more helpful, are discussed.
Client-centered therapists may strengthen their
therapeutic arsenal by considering these construc-
tive aspects of Kohut's self psychology. Then
differences between them where Roger's views
are more useful therapeutically are presented.
Roger's contributions, as they pertain to therapeutic
practice, may help further free self psychology
from some of the attitudes retained from psy-
choanalytic orthodoxoy. Finally, some of the ways
analytic self psychologists would benefit from a
greater familiarity with Rogers's work, as well
as some of the ways client-centered therapists
would benefit from a greater familiarity with Ko-
555
 Edwin Kahn
hut's work, are summarized.
Similarities
1. Both were concerned with the subjective
experiential life of people, as revealed to them in
their work as psychotherapists.
2. Both have been concerned with the concept
of "self," and the enhancement of self-regard
(Rogers) or self-cohesion (Kohut) in psychother-
apy.
3. Both agree that accepting, empathic responses
from others facilitates growth, and that all of us
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require such responses in life. For example, Kohut
(1980b, p. 478) said that just as we require oxygen
throughout life for our physiological survival, we
require empathic others throughout life for our
psychological survival. Rogers (1980, pp. 118-
119), comparing human development to gardening,
said that just as flowers grow and flourish from
proper care and nurturing, so will people. Rogers
felt that there were three conditions necessary and
sufficient for the growth of the person: 1) uncon-
ditional positive regard, that is, accepting, prizing,
and valuing the other; 2) empathy, that is, "de-
centering" from your own subjectivity and non-
judgmentally attuning to the other's experience;
and 3) "congruence," that is, the capacity to be
openly yourself, to be "human," in the relationship.
4. Both have contributed to a changed psycho-
therapeutic ambience. Analysts are more willing
today to be open and self-revealing (Wolf, 1983)
as well as to prize or "mirror" an analysand in
treatment (Kohut, 1984). For example, Wolf
(1983), a leading self psychologist, said, "The
analyst may reveal that he or she is ignorant or
clumsy in attempting to understand the analysand,
or perhaps, the analyst's own selfobject needs
may seek some surcease in the psychoanalytic
situation, even at times using the patient as a
selfobject" (p. 500). Wolf (1983) added that the
patient may gain "courage from these self-rev-
elations of the analyst to know that the analyst
does not need to feed on the patient to achieve
cohesion and harmony" (pp. 500-501). And re-
garding "mirroring," Kohut (1984, p. 187) said
that it is natural for an analyst to respond with
joy to the joy of an analysand who is making a
developmental move forward.
5. For both there is a greater interest in manifest
content rather than latent meanings. Miller (1985a),
in describing his supervision with Kohut, said that
Kohut "enunciated a basic principle: one should
take analytic material first in a 'straight' manner,
556
as if it means what it seems to mean. . . . Kohut
felt the tendency of analysts to look first for a
hidden meaning and to ignore the simple and more
manifest meaning was a mistake" (p. 15). Also
Fosshage (1985) has shown that in dreams the
manifest content may be the most pertinent.
6. Both emphasized that a self is capable of
making free choices and constructing goals in life.
Each agreed that, although free will and deter-
minism seem contradictory, both, paradoxically,
can exist together. For example, Kohut (1980b)
said:
Man's self, once it has been established, is, in its essence,
an energized pattern for the future that, lying in the area of
free will and initiative, 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. It is this aspect of man . . . which
has been neglected by analysis heretofore, (p. 540)
7. Both were concerned that society today over-
emphasizes technology and the natural sciences,
and woefully neglects exploration of the inner
self. For example, Rogers (1977, pp. 71-72), in
the area of education, stressed that the goal is to
"grow persons," not merely teach subject matter,
and that knowledge of the self is as important as
learning academic subjects.
8. Both cautioned against the inadvertent im-
position of moral values on clients or analysands;
people, rather, should be allowed to develop in
accordance with their own inner purposes. Each
was critical of classical analytic theorists whose
concepts implied standards about how a well-ad-
justed person should think and behave (Kohut,
1982; Rogers, 1977).
9. Both felt that humans, at their core, have
an urge toward growth and complexity, and that
this maturational tendency will manifest itself in
a nurturing environment. Rogers (1980) said:
Thus, when we provide a psychological climate that permits
persons to be—whether they are clients, students, workers,
or persons in a group—we are not involved in a chance event.
We are tapping into a tendency which permeates all of organic
life—a tendency to become all the complexity of which the
organism is capable, (p. 134)
And Kohut (1982, p. 405) noted that "behind the
oedipal disturbance lie flawed selfobject responses.
And that behind them the primary hope for a
normal, self-growth-promoting milieu is still alive."
10. Finally, Kohut's and Roger's work can be
seen as part of a shift in clinical psychology away
from a preoccupation with the pathological to a
concern with the healthy aspects of personality.

Differences
Areas Where Kohut's Views May Be More
Helpful Therapeutic ally
1. The therapeutic goal for Kohut was struc-
turalization of the self, and he went on to comment
that widening of consciousness, if it occurs, is
secondary to this structuralization process (Kohut,
1984, pp. 77, 108, 152-153). The concept of
increasing the structure or cohesion of the self,
as the goal of cure, is one of Kohut's most important
contributions. Wolf (personal communication,
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October 1987) attempted to conceptualize this cu-
rative process as follows:
The self gets stronger, . . . the various parts of the self,
aspects of the self, that make for it being a cohesive structure,
that that cohesion increases, and that because of the increased
cohesion, the self can cope with things better, it can cope
with all the old conflicts and the old traumas. And it will still
be the same self, but what used to penetrate it and disrupt it
now sort of rolls off its back.
In contrast, for Rogers, the therapeutic goal was
congruence, which is the accessibility to awareness
of all organismic experience. Rogers believed that
when a person experiences unconditional positive
regard, empathy, and genuineness from others,
the self of that person will have access to all
experiences, because the person knows that no
matter what he or she thinks or feels, he or she
will be valued and understood. Rogers's therapeutic
goal of congruence seems identical to Freud's
topographical goal of widening consciousness
(making what is unconscious conscious). It is in-
teresting that in this one respect Rogers's views
are more similar to Freud's than are Kohut's.
2. Kohut, as a psychoanalyst, was very interested
in developmental and maturational issues. For
Kohut, psychopathology consisted of "arrested
development," and the goal of treatment was to
bring the archaic constituents of the self to maturity.
Rogers (1951, 1959), in contrast, showed no special
interest in maturational development. Rogers
(1986) indicated that he was "interested in the
process of change in personality and behavior . . .
and much less interested in the way in which
personality develops" (p. 135).
3. The main therapeutic vehicle, for Kohut,
was the reconstructive-interpretive approach, where
pathological childhood experiences are revived
and worked through in the transference. Kohut's
major clinical contribution was his discovery of
selfobject transferences, where the archaic needs
of the self are expressed and are then very gradually
Heinz Kohut and Carl Rogers
brought to maturity. However, it may be questioned
whether selfobject "transferences" are best con-
ceived of as "transferences" that are to be "ana-
lyzed" away through "insight." They may, rather,
reflect the expression of the self's archaic needs
that require, for the first time, a consistent optimal
responsiveness or "provision" (see Kahn, 1989).
In contrast, Rogers (1951) deemphasized the im-
portance of the transference and was primarily
concerned with the current existential encounter.
Rogers (1987) said: "When the therapist's un-
derstanding is accurate and his acceptance is gen-
uine, when there are no interpretations given and
no evaluations made, 'transference' attitudes tend
to dissolve, and the feelings are directed toward
their true object" (pp. 186-187). Although one
cannot disagree with Rogers's emphasis on the
attuned relationship in the present as essential for
growth, the present relationship is also influenced
by the kind of mental "schemas" that both the
patient and the therapist bring to it from past
experiences. An understanding of the mental con-
tent that is being "transferred" from the past into
the present can, at times, be very helpful. However,
I have noted elsewhere that the overemphasis in
psychoanalysis on transference analysis may be
a remnant of the deterministic approach of the
natural sciences (Kahn, 1987, 1989).
4. Kohut theorized that ideals and values are
acquired through the process of admiring and
idealizing an omnipotent other. According to Ko-
hut, the presence of a strong and soothing other
will, in early development, permit the self-soothing
capacity of the child to unfold. Exaggerated ideal-
ization, in the therapeutic situation, occurs when
childhood idealization is in some way interrupted.
Rogers (1951), in contrast, thought that ideals
and values are present a priori, as part of the
organism's experience, and do not have to learned.
Rogers (1977), legitimately, was concerned about
equality in the therapeutic relationship, so that
the therapist would not be in a position of power.
Stolorow (1976) noted that in attempting to fa-
cilitate equality Rogers may have inadvertently
thwarted the expression of this archaic idealizing
need, thereby unintentionally becoming unem-
pathic.
5. Kohut theorized that extreme aggression or
withdrawal are the responses of a person with an
immature or vulnerable self. Kohut also theorized
that sexual, eating, drug, or other behavioral ex-
cesses are attempts to excite, perk up, or soothe
an empty, depleted, or depressed self, so that
557
 Edwin Kahn
temporarily the person feels alive, vital, and strong.
He noted that in psychotherapy rational appeals
to utilize self-control with these behavioral excesses
are ineffective; it is the gradual strengthening of
the structure of the self that enables the person
to exert greater self-control. Also Kohut's insights
have helped therapists demonstrate to patients that
their "mirroring," "idealizing," and other depen-
dency needs are appropriate; that these needs were
never fully responded to in childhood and therefore
they persist in their demand for satisfaction during
adulthood. Rogers, in contrast, was reluctant to
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provide explanations for a person's "maladaptive"
or "unwholesome" behaviors or feelings.
6. Kohut distinguished between two kinds of
empathy: understanding, a lower form, and inter-
pretation, a higher form. Kohut (1981, 1982, 1984)
believed that both were essential to the therapeutic
process, and he stressed that the interpretive phase
was necessary for a psychoanalytic cure. According
to Rogers (1986), in Kohut's self psychology, the
analyst rather than the patient is responsible for
movement in therapy, that is, the analyst cures
by giving interpretations and explanations. This
approach, Rogers thought, is a reflection of the
medical model: having an expert, the doctor, curing
an illness. In the Rogerian approach, with empathic
understanding alone, the client has the capacity
to discover his or her own answers and is re-
sponsible for the movement in therapy. Rogers's
belief that the client knows more about himself
or herself than the therapist is valid, and, as a
matter of fact, Kohut, on several occasions, ac-
knowledged this philosophy as well. For example,
Kohut (1984) said:
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 be true—that many times when I believed that I was right
and my patients were wrong, it turned out, though often only
after a prolonged search, that my Tightness was superficial
whereas their lightness was profound, (pp. 93-94)
From this quote, it appears that Rogers, before
Kohut, and without going through a prolonged
search, recognized the truth of the notion that the
patient's Tightness is more profound. Apart from
Rogers's worthy desire to avoid the excesses of
the medical model, why has he so strongly cau-
tioned against interpretations? Perhaps Rogers,
early in his career, became irritated by the unem-
pathic interpretations offered by his medical, psy-
choanalytic supervisors (Kirshenbaum, 1979). It
would seem that empathic, self-confirming genetic
explanations, tentatively offered, may at times be
helpful, and that Rogers's approach may miss
558
something in its reluctance to utilize them.
7. For awhile it seemed that a contradiction
existed in Rogers's theorizing. While advocating
unconditional positive regard, prizing, and ac-
ceptance, Rogers (1986) also stressed the impor-
tance of congruence, that is, "a genuineness or
realness in which the therapist is being him/
herself" (p. 131). Rogers (1986) said congruence
indicated a willingness to communicate one's
feelings, "even negative ones—when they are
being persistently experienced" (p. 131). Rogers
(1986) went on to say, "Thus boredom, anger,
compassion or other feelings may be expressed,
when these are a significant and continuing part
of the therapist's experience" (p. 131). Raskin
(1986), in support of the client-centered approach,
said, "Congruence or genuineness [that is, ex-
pressing persistent feelings] does not contradict
the therapist-offered conditions of empathy and
unconditional positive regard, but supplements
them" (p. 238). Therefore, in an atmosphere in
which the client feels accepted and cared about,
the client may be able to benefit from the honest
expression of feelings by the therapist (this
expression of feelings by the therapist may be
similar to the exploration of the transference in
psychoanalysis). Kohut (1971, pp. 273-276) de-
scribed how narcissistic patients, in their self-
preoccupation, will tend to instill boredom and,
defensively, anger in the therapist. Kohut noted,
however, that the expression of these negative
feelings by the therapist may inflict added injury
on an already vulnerable self. Kohut (1971) felt
that the acquisition of a deeper understanding of
the patient's narcissism might help diminish some
of the therapist's difficulties in this area.
8. Rogers's emphasis was on brief therapy. He
did not advocate the long-term treatment that is
characteristic of psychoanalysis. In a conversation,
(C. R. Rogers, personal communication, Aug.
23, 1983) he continued to wonder about the ne-
cessity for long-term therapy. However, Raskin
(1986) recently noted that client-centered treatment
does not have to be brief.
Areas Where Rogers's Views May Be More
Helpful Therapeutically
1. Rogers (personal communication, December
1985) responded to a question from the audience
on what the profession of psychotherapy has 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, I

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." Elsewhere he
commented that what is most healing is being
openly oneself in the relationship (Rogers, 1986,
p. 133). For Kohut, humanness in the therapeutic
relationship, although helpful, did not seem es-
sential for a psychoanalytic cure (what is essential,
it seems, is interpretation [Kohut, 1981]). For
example, while acknowledging that he believed
that self psychologists tend to work in a more
open, relaxed manner, Kohut (1984) said:
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There is a by no means negligible number of self psychological
analysts who, whether because of their personality makeup,
their general convictions concerning the doctor-patient re-
lationship, or their particular convictions about the proper
behavior of an analyst toward his analysand, are conforming
to the straitlaced reserve that is still espoused by many traditional
analysts, (p. 82)
However, while expressing the belief that analysis
is possible using the reserve of the orthodox tech-
nique, Kohut (1984) affirmed that because of the
increased understanding offered by self psychology,
"I have come to feel freer and, without guilt and
misgivings, to show analysands my deep involve-
ment and concern via the warmth of my voice,
the words that I choose, and other similarly subtle
means" (p. 22In.). It is noteworthy that, because
of his classical analytic background, Kohut first
had to shed guilt and misgivings before being able
to show deep involvement and warmth.
2. Rogers believed that prizing, valuing, and
treating a client with unconditional positive regard
was important for therapeutic progress. When a
person experiences unconditional positive regard
that person develops "positive self regard," ac-
cording to Rogers. Kohut and his coworkers may
not be so active in prizing the person in psy-
choanalytic therapy. For example, R. D. Stolorow
(personal communication, June 1983) wrote:
For Kohut, mirroring is not 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 trans-
ference 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.
Also Kohut (1983) denied the criticism "that we
gratify our patients by 'mirroring' them" (p. 402n.),
and Basch (1981) said, "A patient's need to be
mirrored . . . can be met with an analytic response
. . . no . . . indulgence of the patient is called
for" (p. 343). However, in his last book (Kohut,
1984), he seems to acknowledge the importance
Heinz Kohut and Carl Rogers
of mirroring the analysand without stating in a
clear-cut way that this is what he is doing. For
example, when discussing the overvaluation of
analysands by their analysts, Kohut said, "This
overvaluating attitude too is 'normal' . . . and
that an analyst who consciously eradicates this
attitude and replaces it by cold objectivity is "mis-
guided" (p. 190). Elsewhere, he said, in describing
a developmental move forward, "the normal re-
sponse to this event is joy on the part of the self
of the forward-moving subject (the child, the an-
alysand) and the self of the observing selfobject
(the parent, the analyst)" (Kohut, 1984, p. 187).
If a self psychologist encourages idealization to
occur to facilitate maturation of the idealizing
component of the self, logically it follows that
"mirroring" should also be provided to facilitate
maturation of the grandiose-exhibitionistic com-
ponent as well.
3. Rogers sat face to face with his clients,
whereas in the psychoanalytic approach the an-
alysand lies on a couch and cannot see the analyst.
Infant research (e.g. Beebe, 1985; Stern, 1985)
has stressed the importance of the mother providing
visually contingent or matching responses to the
infant's behavior. According to Beebe (1985),
whether or not the mother provides such attuned
responses will affect the development of a variety
of the infant's capacities. Also, in the self psy-
chology literature, several authors (Bacal, 1985;
Miller, 19856; Stolorow, 1983, 1986; Terman,
1986) have suggested that structuralization of the
self may occur more readily during empathic re-
sponsiveness, rather than during minor lapses of
empathy (optimal frustrations), as Kohut specu-
lated. Recognizing that in psychotherapy contingent
empathic responses occur in the auditory as well
as the visual modes, and that we are dealing with
adults, not infants, it is apparent that an optimal
attunement is facilitated by a face-to-face inter-
action. For example, the therapist can learn more
about the patient if the therapist is able to see
clearly his or her facial expressions. If the goal
of psychotherapy is the widening of consciousness,
as in traditional psychoanalysis, then the couch
serves the useful function of facilitating regression
and encouraging free association. However, if the
goal is the establishment of an empathic attunement
to permit strengthening of self-cohesion, then face-
to-face interaction is more appropriate. The patient,
at least, ought to be given a choice as to which
mode of interaction he or she prefers.
4. Rogers expressed concern about the harmful
consequences of unnecessary diagnostic labeling.
559
 Edwin Kahn
He believed that there were quantitative rather
than qualitative differences between someone with
minor problems in living and another person with
very serious psychopathology. He said, "When
you are focused on the person, diagnostic labels
become largely irrelevant" (Rogers, 1977, p. 28).
In contrast to Rogers, Kohut used diagnostic labels
more freely, for example, distinguishing between
"neurotic" and "narcissistic" disorders that were
treatable by the psychoanalytic method, and "bor-
derline" and "psychotic" disturbances that were
not because the core self was too weak to become
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activated in the transference (Kohut, 1984). Also
Kohut (1979), in the oft-cited "Two Analyses of
Mr. Z," may have used diagnostic labels unne-
cessarily, and perhaps with some hostility, when
commenting about the patient's mother.
5. Rogers was interested in providing therapy
services to persons in all socioeconomic categories.
He participated in conflict-resolving groups con-
sisting of drug addicts and narcotics officers;
professional health insurers and health consumers
who belonged to minority groups and were poor.
He was also a consultant to the Louisville, Ken-
tucky school system to attempt to improve the
education of the poor (Kirschenbaum, 1979, pp.
387-390). Kohut, I believe, showed less practical
interest in the social problems of his time. For
example, Kohut (1973/1978, p. 513; 19806, pp.
531-536) advocated "pure" psychoanalysis, that
is, four to six visits per week, which is usually
available only to the affluent and well educated.
Also when Kohut (1977, pp. 276-278) speculated
that the large family size and servant class of
Freud's time led to an overstimulated child and
neurotic disorders, while the absent parents and
lack of servants of today's society has led to an
understimulated child and narcissistic pathology,
his concern with the era-specific kinds of psy-
chopathology is directed toward only a portion of
the population, that is, those from more affluent
families who are able to afford psychoanalytic
treatment.
6. Rogers was sensitive to feminist issues and
had an egalitarian view of men and women,
whereas Kohut had a more traditional, orthodox
perception of the sex roles. Kohut (1980a; 1984)
discussed several examples of fame achieved after
finding a "mirroring selfobject," and in each in-
stance it was the man who achieved fame and the
woman who provided "mirroring." For example,
in one instance, Kohut (1984) cited a "world famous
scientist," who, after finishing treatment, became
560
very famous when he "provided his self with the
support of an empathically responsive selfobject:
he married a woman who fit his needs in every
respect" (p. 218/z.). Also Kohut did not avoid
using sexist language; he referred to the parent
as "she" and the analyst as "he" (Kohut, 1981),
and he always spoke of "mankind." Finally, Ko-
hut's (1981, 1984) continued use of the concept
of "castration anxiety" may reflect the sexist bias
of orthodox analytic theory, since the outcome of
castration is reversion to the supposedly less de-
sirable female anatomy. ("Annihilation" anxiety
may be a more appropriate and sexually neutral
term to depict the fear from excessive oedipal
competitiveness.)
7. As noted, Rogers (personal communication,
August 1983, 1986, p. 128; Kirschenbaum, 1979,
pp. 88-90) was critical of the use of interpretations
by psychoanalysts. Rogers (1986), in one of his
last essays, took issue with several of Kohut's
comments made in Kohut's final lecture, "On Em-
pathy," given just three days prior to his death.
First we present what Kohut said, next quote Rog-
ers's reply, and then offer a comment. Kohut's
remarks come from the end of his talk where he
is describing his work with a strongly suicidal
woman. Kohut (1981) said:
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. I 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 (1986), in commenting on the above
remarks, said:
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)
Kohut's genetic interpretation that "it was the
toothless gums of a very young child clamping
down on an empty nipple" does seem confusing.
If the patient experienced Kohut's two fingers as
an empty nipple, how is it that the gesture "over-
came a very, very difficult impasse, at a given
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dangerous moment?" It seems, rather, that she
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experienced the two fingers as an important nur-
turing symbol, a replication of the barely minimal
nurturing she received in infancy. The alternative
transference interpretation—that she experienced
the nipple as empty, and hence couldn't receive
anything from Kohut because she never received
anything in infancy—seems implausible. Kohut's
silent genetic interpretation seems to illustrate his
deep conflict between his classical psychoanalytic
roots and loyalties, with their interpretive emphasis,
and his realization that it may be the human and
caring quality of the therapeutic relationship that
is most crucial to healing.
Comment
It is of interest that Kohut, on one occasion,
seems to refer critically to Rogers's work, without
identifying him by name. Kohut (1973/1978) said:
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 goes on to describe an amusing incident
during the war when he had an old alarm clock
that didn't work, and none of the repairmen would
agree to repair it. Kohut eventually found someone
who was able to fix it, but it turned out that this
repairman knew nothing about clocks; what he
did to restore its functioning was just clean and
oil the clock's inner parts. Kohut then says:
Heinz Kohut and Carl Rogers
There is no need to spell out the analogy between the so-
called watchmaker and the practitioners of certain kinds of
psychotherapy—except, I 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 psy-
choanalysis and apply it without understanding (p. 525).
Pertinent to this discussion is the fact that both
Kohut and Rogers were at the University of Chicago
at the same time. Kohut became Assistant Professor
in Neurology and Psychiatry in 1944 (Strozier,
1985), while Rogers was Professor of Psychology
at the University of Chicago from 1945 to 1957
(Kirschenbaum, 1979). Rogers (personal com-
munication, August 1986) wrote just prior to his
death:
What I wish I knew . . . is how much of 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 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, but the estrangement between the two
departments was very deep and I never got to know any
individuals except the chairman of psychiatry. Do you know
whether he ever acknowledged any indebtedness to me? I
would be interested in knowing.
The only apparent reference to Rogers's work,
that I am aware of, beside Kohut's (1977, p. xix)
reference to Stolorow's (1976) comparison of Ko-
hut's work with Rogers's, were the above com-
ments by Kohut. It may be impossible to know
whether Rogers's ideas, in some way, had any
impact on Kohut's. It is remarkable, though, that
these two men, with such similar ideas, each of
whom made important contributions to the practice
of psychotherapy, were at the same university for
over a decade.
Conclusion
Both self psychologists and client-centered
therapists have something to gain from a careful
study of each other's work. For example, Rogers's
contributions, which overlap Kohut's considerably,
may serve to enhance the effectiveness of Kohut's
self psychology by further freeing it from the
orthodoxy of classical psychoanalysis. Actually,
several self psychologists, such as Jule Miller and
Ernest Wolf, are now echoing some of Rogers's
ideas. For example, Miller (1985/7) said:
561
 Edwin Kahn
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. It 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 believed that the qualities of the therapist
as a person, rather than any specific technique,
is most therapeutic. And Wolf (personal com-
munication, October 1987), discussing the issue
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of whether interpretation is necessary, sounded
just like Rogers, when he said, "It really doesn't
matter what you do, what matters is who you
are." The willingness of the therapist to reveal,
nonintrusively, aspects of his or her own personality
may encourage the analysand to be more revealing;
such therapeutic openness and genuineness will
also facilitate greater equality between analyst and
analysand, helping to correct the unfortunate im-
balance that grew out of the medical model. Wolf
(personal communication, October 1987) said:
One can think of the analytic situation as being sort of tilted,
with the analyst up here and the patient down there, and a
really consistent application of selfobject theory would bring
that tilt up to a more equal kind of level, and it's our defen-
siveness, our narcissistic defensiveness, that tries to keep us
up there.
Genuinely prizing and valuing, as well as "mir-
roring" the analysand in treatment is obviously
not harmful and will enhance self-esteem; while
face-to-face interaction will usually increase em-
pathic attunement. A fuller appreciation of the
Rogerian approach may help reduce some of the
often unfounded fears of the analyst about ex-
cessively indulging or gratifying the analysand.
It is true that a therapist may sometimes have to
protect himself or herself from the excessive de-
mands of needy patients; however, to rationalize
such necessary protective maneuvers as in the best
interest of the patient, as is often done, may be
inaccurate.
On the other hand, Rogerians may gain con-
siderable insight from a careful study of Kohut's
work. They may come to appreciate, if they do
not already, that clients are often "arrested de-
velopmentally," and that satisfying the necessary
and sufficient conditions of the therapeutic en-
counter encourages belated maturation. Also be-
yond the attuned interaction of the moment, clients
as well as therapists are always transferring mental
"schemas" from the past into the present, and the
562
contents and origins of these schemas can be use-
fully explored. For example, a client-centered
therapist may note that, in the therapeutic rela-
tionship, a female client is unable to report positive
thoughts about the therapist, just as in her current
life outside of therapy she is unable to say anything
positive about her boyfriend. Utilizing the trans-
ference concept, the therapist may go beyond dis-
cussing the issue in the here and now, and initiate,
if the client is willing, an exploration of the kind
of relationship the client had with important male
figures in her childhood.
Kohut's work will also help the client-centered
therapist understand that the client's idealization
of the therapist is the expression of an important
developmental need, and that this idealization
should be allowed to thrive in the present, and
that it will only very gradually diminish as a result
of unavoidable optimal frustration. Kohut (1971)
noted the dangers of countertransference pitfalls
as a result of being excessively idealized, a warning
that client-centered therapists may also have to
come to appreciate. Finally, client-centered ther-
apists may begin to admire the value of some of
the explanations for behavior that Kohut uncovered.
For example, Kohut's explanations for the com-
prehensible ways in which a depleted self seeks
invigoration (through sex, aggression, eating,
drugs, etc.), may help the client-centered therapist
better understand the person in treatment.
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