It was treatment experiences such as these that prompted Kohut, in a letter dated May 16, 1974 (The Search for the Self, vol. 2), to respond so frankly to a fellow scientist, openly admitting that the one factor which had caused him to reconsider his theoretical perspective was the fact that he felt "stumped" by a large percentage of his cases in which treatment either stalemated or was prematurely terminated. In the letter he wrote:
If I tried to explain their relationship to me, their demands on me, as revivals of their old love and hate for their parents, or for their brothers and sisters, I had more and more the feeling that my explanations became forced and that my patients' complaints that I did not understand them...were justified. [pp. 888-889]
His prolonged empathic immersion in the inner world of these same patients opened him to new and previously unrecognized psychic configurations. He continued:
It was on the basis of feeling stumped that I began to entertain the thought that these people were not concerned with me as a separate person but that they were concerned with themselves; that they did not love me or hate me, but that they needed me as part of themselves, needed me as a set of functions which they had not acquired in early life; that what appeared to be their love and hate was in reality their need that I fulfill certain psychological functions for them and anger at me when I did not do so. [pp. 888-889]
He outlined his thoughts on narcissism in his paper, "Forms and Transformations on Narcissism," which was published in the Journal of the American Psychoanalytic Association in 1966 (5). This paper formed the nucleus of his first book, The Analysis of the Self, published in 1971 (6).
As his ideas began to spread in the late sixties, rejection of him by his friends and colleagues intensified. Naturally these rejections hurt Kohut deeply, but they did not deter him from continuing his work. Many wanted to brand him as a dissident and to accuse him of founding a new school. However, he remained steadfast in his belief that his theory of the self was a further development and extension of psychoanalysis.
Though he lost a number of his valued friends and supporters, not all of them turned away. Many younger colleagues, who were former students of his and candidates at the Chicago Institute, gathered around him to form a study group similar to Freud's Wednesday Evening Society. They met regularly to discuss his evolving ideas. The initial membership of the group consisted of John Gedo, Arnold Goldberg(11), Michael Franz Basch (7), David Marcus, Paul Tolpin, Marian Tolpin, Paul Ornstein (8), Anna Ornstein, and Ernest Wolf (9). Over the years many others joined. A valuable purpose of the group was to offer Kohut a buffer against the potentially distracting public attacks of critics and to support him in the completion of his work. The group brought with them an enthusiasm for his ideas that buoyed Kohut and eventually culminated in his 1971 monograph, The Analysis of the Self, followed by his 1977 book,The Restoration of the Self(10).
While many of the psychoanalytic community viewed his theory of the self as heretical, there were many who respected his ideas and applied them in their work. Evidence of the growing impact that his theories were having was seen in the high attendance at the annual conferences on self psychology that were held around the country. For example, in 1980, 1,100 mental health professionals attended the Boston conference.
As a result of fading health, Kohut felt an urgency to complete his work and was forced to conserve his energy by limiting his speaking engagements. In those instances when he chose not to accept an invitation, he on, he frequently sent his trusted colleagues to discuss his ideas and to answer his critics. Unfortunately, this was seen as being "isolationist." It was also interpreted by others as an expression of Kohut's avoidance of facing his critics.
Kohut's final speech, "Reflections on Empathy," was given at the 1981 self psychology conference in Berkeley, California. He was aware he was dying, and at the conclusion of his speech he announced his final farewell. The audience, moved by his words, stood to express its deep appreciation. When the applause went on and on, Kohut gently raised his hands, interrupting the ovation, and quietly said, "I know your feelings...I want to rest now." He died four days later on Thursday, October 8, 1981.