Self psychology as an avenue to pre-oedipal experience

Currently much attention is being devoted to narcissism and self psychology. The work of Kohut and his followers has allowed previously maligned aspects of personality such as narcissism to be viewed as part of the normal developmental process of achieving self. Self psychology has gained the attention of psychotherapists previously not enamored with classical psychoanalysis. The author views self psychology as a new twist in a highly viable tradition that has opened the doors to psychotherapeutic intervention in some of the more difficult aspects of personality development. Clinical vignettes are used to illustrate the interplay of psychosexual development and the development of self, the application of self psychology to the treatment of psychosomatic disorders, and the similarity of narcissistic and co-dependent issues. The vignettes reflect difficulties not only seen in those often referred to as mentally ill, but also in those characterized as the "worried well." Dyer warns that not responding to the suffering of the "worried-well" may be one of the great unmet health needs of our time.