Heinz Kohut and John Bowlby: The Men and Their Ideas

Abstract

Heinz Kohut and John Bowlby, working independently, contributed to a paradigm shift within psy- choanalysis. Their combined work dramatically changed the way many psychoanalysts understand the effect of parent-child relationships on human development, as well as the very nature of psychopathology. This, in turn, transformed clinical practice as their ideas spread and many analysts became more emotionally responsive, creating a friendlier, more respectful therapeutic ambiance. Essential to both men's thinking is a deep and abiding belief in the central need for relation- ships beginning at birth and lasting throughout life. Further, they recognized how a parent's re- sponsiveness to a child's needs for comfort and protection plays a crucial role in the child's psy- chological development with an outcome of either healthy adjustment or psychopathology hanging in the balance. In articulating these positions, they differed with the mainstream psychoanalytic views of their time. The classical psychoanalytic perspective focused on intrapsychic conflict over a set of drives, libido, and aggression. In both the theory and practice of the prevailing Freudian tradition, the greatest attention was given to exploring a patient's instinctual life as expressed in fantasy, rather than to actual experiences during childhood. Kohut and Bowlby came to see that such an intrapsychic focus on drives and fantasies came at the expense of recognizing important develop- mental needs for relatedness. Also, they saw how an exclusive preoccupation with elucidating a patient's intrapsychic conflicts could interfere with the therapist's ability to grasp the very real and adverse impact of unresponsive (or abusive) parenting during childhood. Kohut's and Bowlby's individual journeys as psychoanalytic clinicians and revolutionary theo- rists were dramatically different, yet both men broke with the predominant psychoanalytic dogma of their time and came to essentially the same viewpoint concerning the deep importance of rela- tionships. Their body of work has proven to have tremendous impact on the clinical practice of psychoanalysts and psychodynamic psychotherapists over the last 40 years as they ushered in new ways of interacting with patients that were more compassionate, engaged, and flexible. Most im- portant to their clinical approach is their acceptance of the patient's desire for an emotional con- nection with the analyst as a basic human need, rather than conceptualizing that need as a defense against instinctual longings that must be relinquished. Further, they saw the new relationship with