The Interface of Self Psychology, Infant Research, and Neuroscience in Clinical Practice

This article focuses on the integration of self psychology with findings from infant research and neuroscience. While Kohut's psychology of the self provides a useful theoretical model for psychoanalytic practice, aspects of infant research and neuroscience offer specificity and nuance to basic self-psychological concepts. Kohut proposed that self-psychological psychoanalysis ameliorates derailed development through patient-analyst interaction, while a listening stance of empathic immersion begins the curative process of derailed development and sets the stage for reparative psychoanalytic work. Findings from infant research delineate much more specifically the nature of attunement both in early mother-infant and analyst-patient interactions. Findings from neuroscientific research delineate how early mother-infant experiences are encoded in implicit memory and explicates the emotional substrate of affects and feelings. This emotional substrate exists at birth and provides a means of communication both in infancy and adulthood. Additionally, infant research delineates the mutuality of the interactive process. Thus, both infant research and neuroscience add subtlety and nuance to basic self-psychological concepts. This subtlety opens up new ways of understanding patients and expands the clinical repertoire. Three clinical vignettes demonstrate how this nuance and expansion of self-psychological concepts are applied in the context of an ongoing psychoanalytic treatment.