Tag: Empathy

What is Empathic Concern?

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Introduction

Empathic concern refers to other-oriented emotions elicited by and congruent with the perceived welfare of someone in need. These other-oriented emotions include feelings of tenderness, sympathy, compassion, soft-heartedness, and the like.

Empathic concern is often and wrongly confused with empathy. To empathise is to respond to another’s perceived emotional state by experiencing feeling of a similar sort. Empathic concern or sympathy not only include empathising, but also entails having a positive regard or a non-fleeting concern for the other person.

Definition

C. Daniel Batson is one pioneer of the term. His mature definition of the term is “other-oriented emotion elicited by and congruent with the perceived welfare of someone in need”.[4] Batson explains this definition in the following way:

First, “congruent” here refers not to the specific content of the emotion but to the valence—positive when the perceived welfare of the other is positive, negative when the perceived welfare is negative. … Third, as defined, empathic concern is not a single, discrete emotion but includes a whole constellation. It includes feelings of sympathy, compassion, softheartedness, tenderness, sorrow, sadness, upset, distress, concern, and grief. Fourth, empathic concern is other-oriented in the sense that it involves feeling for the other—feeling sympathy for, compassion for, sorry for, distressed for, concerned for, and so on.[4]

Many writers other than Batson use different terms for this construct or very similar constructs. Especially popular – perhaps more popular than “empathic concern” – are sympathy, compassion or pity. Other terms include the tender emotion and sympathetic distress.

Human beings are strongly motivated to be connected to others. In humans and higher mammals, an impulse to care for offspring is almost certainly genetically hard-wired, although modifiable by circumstance.

Evolutionary Origins

At the behavioural level it is evident from the descriptions of comparative psychologists and ethologists that behaviours homologous to empathic concern can be observed in other mammalian species. Notably, a variety of reports on ape empathic reactions suggest that, apart from emotional connectedness, apes have an explicit appreciation of the other’s situation. A good example is consolation, defined as reassurance behaviour by an uninvolved bystander towards one of the combatants in a previous aggressive incident.

Developmental Origins

Empathic concern is thought to emerge later developmental and to require more self-control than either emotional contagion or personal distress. Developmental research indicates a broad range of social competencies children bring to their interpersonal relationships. As early as 2 years of age, they show:

  • The cognitive capacity to interpret, in simple ways, the physical and psychological states of others;
  • The emotional capacity to experience, affectively, the state of others; and
  • The behavioural repertoire that permits the possibility of attempts to alleviate discomfort in others.

Both personal disposition such as temperament and social context contribute to individual differences in concern for others. Some developmental psychologists have hypothesized that empathic concern for others are essential factors inhibiting aggression toward others.

Contribution of Social Psychology

Empathic concern may produce an altruistic motivation to help people. The challenge of demonstrating the existence of altruistic motivation is to show how empathic concern leads to helping in ways that cannot be explained by prevailing theories of egoistic motivation. That is, a clear case needs to be made that it is concern about the other person’s welfare, not a desire to improve one’s own welfare, that primarily drives one’s helping behaviour in a particular situation.

Empirical studies conducted by social psychologist Daniel Batson have demonstrated that empathic concern is felt when one adopts the perspective of another person in need. His work emphasizes the different emotions evoked when imagining another situation from a self-perspective or imagining from another perspective. The former is often associated with personal distress (i.e. feelings of discomfort and anxiety), whereas the latter leads to empathic concern.

Social Neuroscience Evidence

Social neuroscience explores the biological underpinnings of empathic concern and more generally interpersonal sensitivity, using an integrative approach that bridges the biological and social levels. Neural systems, including autonomic functions, that rely on brain stem neuropeptides, such as oxytocin and vasopressin, are plausible correlates for empathic concern. Alternatively, vasopressin might be implicated in situations where a more active strategy is required for an effective response.

An association between executive functions, underpinned by the prefrontal cortex with reciprocal connections with the limbic system, the sense of agency, and empathic concern has been suggested based on lesion studies in neurological patients and functional neuroimaging experiments in healthy individuals.

The difference between imaging self versus imaging other is supported by a series of functional neuroimaging studies of affective processing. For instance, Lamm, Batson and Decety (2007) found that participants reported more empathic concern when imagining the pain of others when adopting another perspective, and more personal distress when imagining themselves to be in pain.

The fMRI scans revealed that imagining self in pain was associated with strong activation in brain areas involved in affective response to threat and pain, including the amygdala, insula and anterior cingulate cortex. Imagine-other instructions produced higher activity in the right temporoparietal junction (or TPJ), which is associated with self-other distinctiveness and the sense of agency.

What is Transportation Theory (Psychology)?

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Introduction

Narrative transportation theory proposes that when people lose themselves in a story, their attitudes and intentions change to reflect that story.

The mental state of narrative transportation can explain the persuasive effect of stories on people, who may experience narrative transportation when certain contextual and personal preconditions are met, as Green and Brock postulate for the transportation-imagery model. As Van Laer, de Ruyter, Visconti, and Wetzels elaborate further, narrative transportation occurs whenever the story receiver experiences a feeling of entering a world evoked by the narrative because of empathy for the story characters and imagination of the story plot.

Defining the Field

Deighton, Romer, and McQueen  anticipate the construct of narrative transportation by arguing that a story invites story receivers into the action it portrays and, as a result, makes them lose themselves in the story. Gerrig was the first to coin the notion of narrative transportation within the context of novels. Using travel as a metaphor for reading, he conceptualizes narrative transportation as a state of detachment from the world of origin that the story receiver – in his words, the traveller – experiences because of his or her engrossment in the story, a condition that Green and Brock later describe as the story receiver’s experience of being carried away by the story. Notably, the state of narrative transportation makes the world of origin partially inaccessible to the story receiver, thus marking a clear separation in terms of here/there and now/before, or narrative world/world of origin.

Relevant Features

Most research on narrative transportation follows the original definition of the construct. Scholars in the field constantly reaffirm the relevance of three features.

  1. Narrative transportation requires that people process stories – the acts of receiving and interpreting.
  2. Story receivers become transported through two main components: empathy and mental imagery. Empathy implies that story receivers try to understand the experience of a story character, that is, to know and feel the world in the same way. Thus, empathy offers an explanation for the state of detachment from the world of origin that is narrative transportation. In mental imagery, story receivers generate vivid images of the story plot, such that they feel as though they are experiencing the events themselves.
  3. When transported, story receivers lose track of reality in a physiological sense.

In accordance with these features, Van Laer et al.  define narrative transportation as the extent to which:

  • An individual empathizes with the story characters; and
  • The story plot activates their imagination,

Which leads them to experience suspended reality during story reception.

Similar Constructs

Narrative transportation is a form of experiential response to narratives and thus is similar to other constructs, such as absorption, narrative involvement, identification, optimal experience or flow, and immersion. Yet several subtle, critical differences exist. Absorption refers to a personality trait or general tendency to be immersed in life experiences; transportation is an engrossing temporary experience. Flow is a more general construct (i.e. people can experience flow in a variety of activities), whereas transportation specifically entails empathy and mental imagery, which do not occur in flow experiences. Phillips and McQuarrie demonstrate that immersion is primarily an experiential response to aesthetic and visual elements of images, whereas narrative transportation relies on a story with plot and characters, features that are not present in immersion. Identification emphasizes the involvement with story characters, while narrative transportation is concerned with the involvement with the narrative as a whole.

Narrative Persuasion

Since narrative transportation’s conceptualisation, research has demonstrated that the transported “traveller” can return changed by the journey. Subsequent studies have confirmed that a story can engross the story receiver in a transformational experience, whose effects are strong and long-lasting. The transformation that narrative transportation achieves is persuasion of the story receiver. More specifically, Van Laer et al.’s literature review reveals that narrative transportation can cause affective and cognitive responses, beliefs, and attitude and intention changes. However, the processing pattern of narrative transportation is markedly different from that in well-established models of persuasion.

A 2016 meta-analysis found significant, positive narrative persuasion (i.e. narrative-consistent) effects for attitudes, beliefs, intentions and behaviours.

Rival Models

Before 2000, dual-process models of persuasion, especially the elaboration likelihood model and heuristic-systematic model, dominated persuasion research. These models attempt to explain why people accept or reject message claims. According to these models, the determination of a claim’s acceptability can result from careful evaluation of the arguments presented or from reliance on superficial cues, such as the presence of an expert. Whether receivers scrutinise a message depends on the extent to which they are able and motivated to process it systematically. As important variables, these models include empathy, familiarity, involvement, and the number and nature of thoughts the message evokes. If these variables are mainly positive, the receiver’s attitudes and intentions tend to be more positive; if the variables are predominantly negative, the resulting attitudes and intentions are more negative. These variables also exist in narrative persuasion.

Differences between Analytical and Narrative Persuasion

Analytical persuasion and narrative persuasion differ depending on the role of involvement. In analytical persuasion, involvement depends on the extent to which the message has personally relevant consequences for a receiver’s money, time, or other resources. If these consequences are sufficiently severe, receivers evaluate the arguments carefully and generate thoughts related to the arguments. Yet, as Slater notes, even though severe consequences for stories are relatively rare, “viewers or readers of an entertainment narrative typically appear to be far more engrossed in the message.” This type of involvement, or narrative transportation, is arguably the crucial determinant of narrative persuasion.

Though the dual-process models provide a valid description of analytical persuasion, they do not encompass narrative persuasion. Analytical persuasion refers to attitudes and intentions developed from processing messages that are overtly persuasive, such as most lessons in science books, news reports, and speeches. However, narrative persuasion refers to attitudes and intentions developed from processing narrative messages that are not overtly persuasive, such as novels, movies, or video games. Addressing the strength and duration of the persuasive effects of processing stories, narrative transportation is a mental state that produces enduring persuasive effects without careful evaluation of arguments. Transported story receivers are engrossed in a story in a way that neither is inherently critical nor involves great scrutiny.

Sleeper Effect

Narrative transportation seems to be more unintentionally affective than intentionally cognitive in nature. This way of processing leads to potentially increasing and long-lasting persuasive effects. Appel and Richter use the term “Sleeper effect” to describe this paradoxical property of narrative transportation over time, which consists of a more pronounced change in attitudes and intentions and a greater certainty that these attitudes and intentions are correct.

Plausible explanations for the sleeper effect are twofold:

  1. According to post-structural research, language’s articulation in narrative format is capable not only of mirroring reality but also of constructing it. As such, stories could cause profound and durable persuasion of the transported story receiver as a result of his or her progressive internalization. When stories transport story receivers, not only do they present a narrative world but, by reframing the story receiver’s language, they also durably change the world to which the story receiver returns after the transportation experience.
  2. Research demonstrates that people analyse and retain stories differently from other information formats. For example, Deighton et al. show that analytical advertisements stimulate cognitive responses whereas narrative advertisements are more likely to stimulate affective responses.

Following this line of reasoning, Van Laer et al. define narrative persuasion as:

the effect of narrative transportation, which manifests itself in story receivers’ affective and cognitive responses, beliefs, attitudes, and intentions from being swept away by a story and transported into a narrative world that modifies their perception of their world of origin.

The conceptual distinction between analytical persuasion and narrative persuasion and the theoretical framework of sound interpretation of narrative persuasion both ground the extended transportation-imagery model (ETIM).

Moderators

ETIM contains three methodological factors that moderate the overall effect of narrative transportation, as van Laer, Feiereisen, and Visconti detail. The narrative transportation effect is stronger for stories:

  • In the commercial (vs. non-commercial) domain;
  • By users (vs. professionals); and
  • Received alone (vs. with others).

What is Psychological Projection?

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Introduction

Psychological projection is the process of misinterpreting what is “inside” as coming from “outside”.

It forms the basis of empathy by the projection of personal experiences to understand someone else’s subjective world. In its malignant forms, it is a defence mechanism in which the ego defends itself against disowned and highly negative parts of the self by denying their existence in themselves and attributing them to others, breeding misunderstanding and causing untold interpersonal damage. A bully may project their own feelings of vulnerability onto the target, or a person who is confused may project feelings of confusion and inadequacy onto other people. Projection incorporates blame shifting and can manifest as shame dumping. Projection has been described as an early phase of introjection.

Refer to Emotional Conflict and Splitting (Psychology).

Brief History

A prominent precursor in the formulation of the projection principle was Giambattista Vico. In 1841, Ludwig Feuerbach was the first enlightenment thinker to employ this concept as the basis for a systematic critique of religion.

The Babylonian Talmud (500 AD) notes the human tendency toward projection and warns against it: “Do not taunt your neighbour with the blemish you yourself have.” Religious people of the Christian faith believe that in the New Testament, Jesus also warned against projection: “Why do you look at the speck of sawdust in your brother’s eye and pay no attention to the plank in your own eye? How can you say to your brother, ‘Let me take the speck out of your eye,’ when all the time there is a plank in your own eye? You hypocrite, first take the plank out of your own eye, and then you will see clearly to remove the speck from your brother’s eye.”

Psychoanalytic Developments

Projection (German: Projektion) was conceptualised by Sigmund Freud in his letters to Wilhelm Fliess, and further refined by Karl Abraham and Anna Freud. Freud considered that, in projection, thoughts, motivations, desires, and feelings that cannot be accepted as one’s own are dealt with by being placed in the outside world and attributed to someone else. What the ego refuses to accept is split off and placed in another.

Freud would later come to believe that projection did not take place arbitrarily, but rather seized on and exaggerated an element that already existed on a small scale in the other person. The related defence of projective identification differs from projection in that the other person is expected to become identified with the impulse or desire projected outside, so that the self maintains a connection with what is projected, in contrast to the total repudiation of projection proper.

Melanie Klein saw the projection of good parts of the self as leading potentially to over-idealisation of the object. Equally, it may be one’s conscience that is projected, in an attempt to escape its control: a more benign version of this allows one to come to terms with outside authority.

Theoretical Examples

Projection tends to come to the fore in normal people at times of personal or political crisis but is more commonly found in narcissistic personality disorder or borderline personality disorder.

Carl Jung considered that the unacceptable parts of the personality represented by the Shadow archetype were particularly likely to give rise to projection, both small-scale and on a national/international basis. Marie-Louise Von Franz extended her view of projection, stating that “wherever known reality stops, where we touch the unknown, there we project an archetypal image”.

Psychological projection is one of the medical explanations of bewitchment used to explain the behaviour of the afflicted children at Salem in 1692. The historian John Demos wrote in 1970 that the symptoms of bewitchment displayed by the afflicted girls could have been due to the girls undergoing psychological projection of repressed aggression.

Practical Examples

ExampleDescription
Victim BlamingThe victim of someone else’s actions or bad luck may be offered criticism, the theory being that the victim may be at fault for having attracted the other person’s hostility. In such cases, the psyche projects the experiences of weakness or vulnerability with the aim of ridding itself of the feelings and, through its disdain for them or the act of blaming, their conflict with the ego.
Projection of Marital GuiltThoughts of infidelity to a partner may be unconsciously projected in self-defence on to the partner in question, so that the guilt attached to the thoughts can be repudiated or turned to blame instead, in a process linked to denial. For example, a person who is having a sexual affair may fear that their spouse is planning an affair or may accuse the innocent spouse of adultery.
BullyingA bully may project their own feelings of vulnerability onto the target(s) of the bullying activity. Despite the fact that a bully’s typically denigrating activities are aimed at the bully’s targets, the true source of such negativity is ultimately almost always found in the bully’s own sense of personal insecurity or vulnerability. Such aggressive projections of displaced negative emotions can occur anywhere from the micro-level of interpersonal relationships, all the way up to the macro-level of international politics, or even international armed conflict.
“Reading”People in love “reading” each others’ mind involves of a projection of the self into the other.
Projection of General GuiltProjection of a severe conscience is another form of defence, one which may be linked to the making of false accusations, personal or political.
Projection of HopeAlso, in a more positive light, a patient may sometimes project their feelings of hope onto the therapist.

Counter-Projection

Jung wrote, “All projections provoke counter-projection when the object is unconscious of the quality projected upon it by the subject.” Thus, what is unconscious in the recipient will be projected back onto the projector, precipitating a form of mutual acting out.

In a rather different usage, Harry Stack Sullivan saw counter-projection in the therapeutic context as a way of warding off the compulsive re-enactment of a psychological trauma, by emphasizing the difference between the current situation and the projected obsession with the perceived perpetrator of the original trauma.

Clinical Approaches

Drawing on Gordon Allport’s idea of the expression of self onto activities and objects, projective techniques have been devised to aid personality assessment, including the Rorschach ink-blots and the Thematic Apperception Test (TAT).

Projection may help a fragile ego reduce anxiety, but at the cost of a certain dissociation, as in dissociative identity disorder. In extreme cases, an individual’s personality may end up becoming critically depleted. In such cases, therapy may be required which would include the slow rebuilding of the personality through the “taking back” of such projections.

The method of managed projection is a projective technique. The basic principle of this method is that a subject is presented with their own verbal portrait named by the name of another person, as well as with a portrait of their fictional opposition (V.V. Stolin, 1981).

The technique is suitable for application in psychological counselling and might provide valuable information about the form and nature of their self-esteem Bodalev, A (2000). “General psychodiagnostics”.

Criticism

Some studies were critical of Freud’s theory. Research on social projection supports the existence of a false-consensus effect whereby humans have a broad tendency to believe that others are similar to themselves, and thus “project” their personal traits onto others. This applies to both good and bad traits; it is not a defence mechanism for denying the existence of the trait within the self. A study of the empirical evidence for a range of defence mechanisms by Baumeister, Dale, and Sommer (1998) concluded, “The view that people defensively project specific bad traits of their own onto others as a means of denying that they have them is not well supported.” However, Newman, Duff, and Baumeister (1997) proposed a new model of defensive projection in which the repressor’s efforts to suppress thoughts of their undesirable traits make those trait categories highly accessible – so that they are then used all the more often when forming impressions of others. The projection is then only a byproduct of the real defensive mechanism.

What is Rigidity (Psychology)?

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Introduction

In psychology, rigidity or mental rigidity refers to an obstinate inability to yield or a refusal to appreciate another person’s viewpoint or emotions characterised by a lack of empathy.

It can also refer to the tendency to perseverate, which is the inability to change habits and the inability to modify concepts and attitudes once developed. A specific example of rigidity is functional fixedness, which is a difficulty conceiving new uses for familiar objects.

Background

Rigidity is an ancient part of our human cognition. Systematic research on rigidity can be found tracing back to Gestalt psychologists, going as far back as the late 19th to early 20th century with Max Wertheimer, Wolfgang Köhler, and Kurt Koffka in Germany. With more than 100 years of research on the matter there is some established and clear data. Nonetheless, there is still much controversy surrounding several of the fundamental aspects of rigidity. In the early stages of approaching the idea of rigidity, it is treated as “a unidimensional continuum ranging from rigid at one end to flexible at the other”. This idea dates back to the 1800s and was later articulated by Charles Spearman who described it as mental inertia. Prior to 1960 many definitions for the term rigidity were afloat. One example includes Kurt Goldstein’s, which he stated, “adherence to a present performance in an inadequate way”, another being Milton Rokeach saying the definition was, “[the] inability to change one’s set when the objective conditions demand it”. Others have simplified rigidity down to stages for easy defining. Generally, it is agreed upon that it is evidenced by the identification of mental or behavioural sets.

Lewin and Kounin also proposed a theory of cognitive rigidity (also called Lewin-Kounin formulation) based on a Gestalt perspective and they used it to explain a behaviour in mentally retarded persons that is inflexible, repetitive, and unchanging. The theory proposed that it is caused by a greater “stiffness” or impermeability between inner-personal regions of individuals, which influence behaviour. Rigidity was particularly explored in Lewin’s views regarding the degree of differentiation among children. He posited that a mentally retarded child can be distinguished from the normal child due to the smaller capacity for dynamic rearrangement in terms of his psychical systems.

Mental Set

Mental sets represent a form of rigidity in which an individual behaves or believes in a certain way due to prior experience. The reverse of this is termed cognitive flexibility. These mental sets may not always be consciously recognised by the bearer. In the field of psychology, mental sets are typically examined in the process of problem solving, with an emphasis on the process of breaking away from particular mental sets into formulation of insight. Breaking mental sets in order to successfully resolve problems fall under three typical stages:

  1. Tendency to solve a problem in a fixed way;
  2. Unsuccessfully solving a problem using methods suggested by prior experience; and
  3. Realising that the solution requires different methods.

Components of high executive functioning, such as the interplay between working memory and inhibition, are essential to effective switching between mental sets for different situations. Individual differences in mental sets vary, with one study producing a variety of cautious and risky strategies in individual responses to a reaction time test.

Causes

Rigidity can be a learned behavioural trait for example the subject has a Parent, Boss or Teacher who demonstrated the same form of behaviour towards them

Stages

Rigidity has three different main “stages” of severity, although it never has to move to further stages.

  • The first stage is a strict perception that causes one to persist in their ways and be close-minded to other things.
  • The second involves a motive to defend the ego.
  • The third stage is that it is a part of one’s personality and you can see it in their perception, cognition, and social interactions.

Accompanying Externalising Behaviours

They could be external behaviours, such as the following:

  • Insistently repetitious behaviour.
  • Difficulty with unmet expectations.
  • Perfectionism.
  • Compulsions (as in OCD).
  • Perseveration.

Accompanying Internalising Behaviours

Internalizing behaviours also are shown:

  • Perfectionism.
  • Obsessions (as in OCD).

Associated Conditions

Cognitive Closure

Mental rigidity often features a high need for cognitive closure, meaning that they assign explanations prematurely to things with a determination that this is truth, finding that resolution of the dissonance as reassuring as finding the truth. Then, there is little reason to correct their unconscious misattributions if it would bring uncertainty back.

Autism Spectrum Disorder

Cognitive rigidity is one feature of autism and its spectrum (ASD), but is even included in what’s called the Broader Autism Phenotype, where a collection of autistic traits still fail to reach the level of ASD. This is one example of how rigidity does not show up as a single trait, but comes with a number of related traits.

Effects

Ethnocentrism

M. Rokeach tested for ethnocentrism’s relatedness to mental rigidity by using the California Ethnocentrism Scale (when measuring American college students’ views) and the California Attitude Scale (when measuring children’s views) before they were given what is called by cognitive scientists “the water jar problem.” This problem teaches students a set pattern for how to solve each one. Those that scored higher in ethnocentrism also showed attributes of rigidity such as persistence of mental sets and more complicated thought processes.

Strategies for Overcoming Rigidity

Consequences of Unfulfillment

If a person with cognitive rigidity does not fulfil their rigidly held expectations, the following could occur:

  • Agitation.
  • Aggression.
  • Self-injurious behaviour.
  • Depression.
  • Anxiety.
  • Suicidality.

These are clearly maladaptive, and so there must be other ways to overcome it.

What is Self Psychology?

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Introduction

Self psychology, a modern psychoanalytic theory and its clinical applications, was conceived by Heinz Kohut in Chicago in the 1960s, 70s, and 80s, and is still developing as a contemporary form of psychoanalytic treatment.

In self psychology, the effort is made to understand individuals from within their subjective experience via vicarious introspection, basing interpretations on the understanding of the self as the central agency of the human psyche. Essential to understanding self psychology are the concepts of empathy, selfobject, mirroring, idealising, alter ego/twinship and the tripolar self. Though self psychology also recognises certain drives, conflicts, and complexes present in Freudian psychodynamic theory, these are understood within a different framework. Self psychology was seen as a major break from traditional psychoanalysis and is considered the beginnings of the relational approach to psychoanalysis.

Origins

Kohut came to psychoanalysis by way of neurology and psychiatry in the 1940s, but then ’embraced analysis with the fervor of a convert … [and as] “Mr Psychoanalysis”‘ took on an idealising image of Freud and his theories. Subsequently, “in a burst of creativity that began in the mid-1960s … Kohut found his voice and explored narcissism in new ways that led to what he ended up calling a ‘psychology of the self'”.

Major Concepts

Self

Kohut explained, in 1977, that in all he wrote on the psychology of the self, he purposely did not define the self. He explained his reasoning this way: “The self…is, like all reality…not knowable in its essence…We can describe the various cohesive forms in which the self appears, can demonstrate the several constituents that make up the self … and explain their genesis and functions. We can do all that but we will still not know the essence of the self as differentiated from its manifestations.”

Empathy

Kohut maintained that parents’ failures to empathize with their children and the responses of their children to these failures were ‘at the root of almost all psychopathology’. For Kohut, the loss of the other and the other’s self-object (“selfobject”) function (see below) leaves the individual apathetic, lethargic, empty of the feeling of life, and without vitality – in short, depressed.

The infant moving from grandiose to cohesive self and beyond must go through the slow process of disillusionment with phantasies of omnipotence, mediated by the parents: ‘This process of gradual and titrated disenchantment requires that the infant’s caretakers be empathetically attuned to the infant’s needs’.

Correspondingly, to help a patient deal in therapy with earlier failures in the disenchantment process, Kohut the therapist ‘highlights empathy as the tool par excellence, which allows the creation of a relationship between patient and analyst that can offer some hope of mitigating early self pathology’.

In comparison to earlier psychoanalytic approaches, the use of empathy, which Kohut called “vicarious introspection”, allows the therapist to reach conclusions sooner (with less dialogue and interpretation), and to create a stronger bond with the patient, making the patient feel more fundamentally understood. For Kohut, the implicit bond of empathy itself has a curative effect, but he also warned that ‘the psychoanalyst … must also be able to relinquish the empathic attitude’ to maintain intellectual integrity, and that ’empathy, especially when it is surrounded by an attitude of wanting to cure directly … may rest on the therapist’s unresolved omnipotence fantasies’.

The conceptual introduction of empathy was not intended to be a “discovery.” Empathic moments in psychology existed long before Kohut. Instead, Kohut posited that empathy in psychology should be acknowledged as a powerful therapeutic tool, extending beyond “hunches” and vague “assumptions,” and enabling empathy to be described, taught, and used more actively.

Selfobjects

Selfobjects are external objects that function as part of the “self machinery” – ‘i.e. objects which are not experienced as separate and independent from the self’. They are persons, objects or activities that “complete” the self, and which are necessary for normal functioning. ‘Kohut describes early interactions between the infant and his caretakers as involving the infant’s “self” and the infant’s “selfobjects”‘.

Observing the patient’s selfobject connections is a fundamental part of self psychology. For instance, a person’s particular habits, choice of education and work, taste in life partners, may fill a selfobject-function for that particular individual.

Selfobjects are addressed throughout Kohut’s theory, and include everything from the transference phenomenon in therapy, relatives, and items (for instance Linus van Pelt’s security blanket): they ‘thus cover the phenomena which were described by Winnicott as transitional objects. Among “the great variety of selfobject relations that support the cohesion, vigor, and harmony of the adult self … [are] cultural selfobjects (the writers, artists, and political leaders of the group – the nation, for example – to which a person feels he belongs)”.

If psychopathology is explained as an “incomplete” or “defect” self, then the self-objects might be described as a self-prescribed “cure”.

As described by Kohut, the selfobject-function (i.e. what the selfobject does for the self) is taken for granted and seems to take place in a “blindzone”. The function thus usually does not become “visible” until the relation with the selfobject is somehow broken.

When a relationship is established with a new selfobject, the relationship connection can “lock in place” quite powerfully, and the pull of the connection may affect both self and selfobject. Powerful transference, for instance, is an example of this phenomenon.

Optimal Frustration

When a selfobject is needed, but not accessible, this will create a potential problem for the self, referred to as a “frustration” – as with ‘the traumatic frustration of the phase appropriate wish or need for parental acceptance … intense narcissistic frustration’.

The contrast is what Kohut called “optimal frustration”; and he considered that, ‘as holds true for the analogous later milieu of the child, the most important aspect of the earliest mother-infant relationship is the principle of optimal frustration. Tolerable disappointments … lead to the establishment of internal structures which provide the basis for self-soothing.’

In a parallel way, Kohut considered that the ‘skilful analyst will … conduct the analysis according to the principle of optimal frustration’.

Suboptimal frustrations, and maladaptations following them, may be compared to Freud’s trauma concept, or to problem solution in the oedipal phase. However, the scope of optimal (or other) frustration describes shaping every “nook and cranny” of the self, rather than a few dramatic conflicts.

Idealising

Kohut saw idealising as a central aspect of early narcissism. “The therapeutic activation of the omnipotent object (the idealized parent image) … referred to as the idealizing transference, is the revival during psychoanalysis” of the very early need to establish a mutual selfobject connection with an object of idealisation.

In terms of “the Kleinian school … the idealizing transference may cover some of the territory of so-called projective identification”.

For the young child, “idealized selfobjects “provide the experience of merger with the calm, power, wisdom, and goodness of idealized persons””.

Alter Ego/Twinship Needs

Alter ego/twinship needs refer to the desire in early development to feel alikeness to other human beings. Freud had early noted that ‘The idea of the “double” … sprung from the soil of unbounded self-love, from the primary narcissism which holds sway in the mind of the child.’ Lacan highlighted ‘the mirror stage … of a normal transitivism. The child who strikes another says that he has been struck; the child who sees another fall, cries.’ In 1960, ‘Arlow observed, “The existence of another individual who is a reflection of the self brings the experience of twinship in line with the psychology of the double, of the mirror image and of the double”.’

Kohut pointed out that ‘fantasies, referring to a relationship with such an alter ego or twin (or conscious wishes for such a relationship) are frequently encountered in the analysis of narcissistic personalities’, and termed their transference activation ‘the alter-ego transference or the twinship’.

As development continues, so a greater degree of difference from others can be accepted.

The Tripolar Self

The tripolar self is not associated with bipolar disorder, but is the sum of the three “poles” of the body:

  • “grandiose-exhibitionistic needs”.
  • “the need for an omnipotent idealized figure”.
  • “alter-ego needs”..

Kohut argued that ‘reactivation of the grandiose self in analysis occurs in three forms: these relate to specific stages of development … (1) The archaic merger through the extension of the grandiose self; (2) a less archaic form which will be called alter-ego transference or twinship; and (3) a still less archaic form … mirror transference’.

Alternately, self psychologists ‘divide the selfobject transference into three groups: (1) those in which the damaged pole of ambitions attempts to elicit the confirming-approving response of the selfobject (mirror transference); (2) those in which the damaged pole of ideals searches for a selfobject that will accept its idealisation (idealising transference); and those in which the damaged intermediate area of talents and skills seeks … alter ego transference.’

The tripolar self forms as a result of the needs of an individual binding with the interactions of other significant persons within the life of that individual.

Cultural Implications

An interesting application of self psychology has been in the interpretation of the friendship of Freud and Jung, its breakdown, and its aftermath. It has been suggested that at the height of the relationship “Freud was in narcissistic transference, that he saw in Jung an idealised version of himself”, and that conversely in Jung there was a double mix of “idealization of Freud and grandiosity in the self”.

During Jung’s midlife crisis, after his break with Freud, arguably “the focus of the critical years had to be a struggle with narcissism: the loss of an idealized other, grandiosity in the sphere of the self, and resulting periods of narcissistic rage”. Only as he worked through to “a new sense of himself as a person separate from Freud” could Jung emerge as an independent theorist in his own right.

On the assumption that “the western self is embedded in a culture of narcissism … implicated in the shift towards postmodernity”, opportunities for making such applications will probably not decrease in the foreseeable future.

Criticism

Kohut, who was “the center of a fervid cult in Chicago”, aroused at times almost equally fervent criticism and opposition, emanating from at least three other directions: drive theory, Lacanian psychoanalysis, and object relations theory.

From the perspective of drive theory, Kohut appears “as an important contributor to analytic technique and as a misguided theoretician … introduces assumptions that simply clutter up basic theory. The more postulates you make, the less their explanatory power becomes.” Offering no technical advances on standard analytic methods in “his breathtakingly unreadable The Analysis of the Self”, Kohut simply seems to blame parental deficit for all childhood difficulties, disregarding the inherent conflicts of the drives: “Where the orthodox Freudian sees sex everywhere, the Kohutian sees unempathic mothers everywhere – even in sex.”

To the Lacanian, Kohut’s exclusive “concern with the imaginary”, to the exclusion of the Symbolic meant that “not only the patient’s narcissism is in question here, but also the analyst’s narcissism.” The danger in “the concept of the sympathetic or empathic analyst who is led astray towards an ideal of devotion and samaritan helping … [ignoring] its sadistic underpinnings” seemed only too clear.

From an object relations perspective, Kohut “allows no place for internal determinants. The predicate is that a person’s psychopathology is due to unattuned selfobjects, so all the bad is out there and we have a theory with a paranoid basis.” At the same time, “any attempt at “being the better parent” has the effect of deflecting, even seducing, a patient from using the analyst or therapist in a negative transference … the empathic analyst, or “better” parent”.

With the passage of time, and the eclipse of grand narrative, it may now be possible to see the several strands of psychoanalytic theory less as fierce rivals and more “as complementary partners. Drive psychology, ego psychology, object relations psychology and self psychology each have important insights to offer twenty-first-century clinicians.”

Pragmatism & Empathy in Mental Health Nurses

Published on by Andrew Marshall1 Comment

Research Paper Title

Mental health nurses’ understandings and experiences of providing care for the spiritual needs of service users: A qualitative study.

Background

Mental health nurses have a professional obligation to attend to service users’ spiritual needs, but little is known about specific issues related to provision of care for spiritual need faced by mental health nurses or how nurses understand this aspect of care and deliver it in practice.

To explore mental health nurses’ ́understandings of spiritual need and their experiences of delivering this care for service users.

Methods

A qualitative study was conducted in one NHS mental health service. Interviews were undertaken with seventeen mental health nurses practising in a variety of areas.

Results

Four themes were generated from thematic analysis of data in the template style:

  1. Expressing personal perspectives on spirituality;
  2. Expressing perspectives on spirituality as a nursing professional;
  3. Nursing spiritually; and
  4. Permeating anxiety (integrative).

Conclusions

Participants had complex understandings of spiritual need and evident anxieties in relation to this area of care.

Two different approaches to nursing spiritually are characterised as:

  • Pragmatic (concerned with procedural aspects of care); and
  • Spiritually empathetic.

Mental health nurses were uncertain about the acceptability of attention to spiritual issues as part of care and anxious about distinguishing between symptoms of mental ill health and spiritual needs.

Educational experiences need to emphasise both pragmatic and empathetic approaches, and work needs to be organised to support good practice.

Reference

Elliot, R., Wattis, J., Chirema, K. & Brooks, J. (2020) Mental health nurses’ understandings and experiences of providing care for the spiritual needs of service users: A qualitative study. Journal of Psychiatric and Mental Health Nursing. 27(2), pp.162-171. doi: 10.1111/jpm.12560. Epub 2019 Sep 16.