Beyond Kohut: From Empathy to Affection

This article concerns the analyst’s affection for her/his patient and its importance in the therapeutic process. The analyst’s affection, when available, can act as a vitalizing enactment (Fosshage, 2007) but more importantly acts as a vitalizing, implicit foundation for the ongoing interaction between analyst and patient. The dearth of discourse in psychoanalytic literature on the analyst’s affection and the reluctance to overtly declare its importance is noted. In the currently evolving “paradigm shift from explicit conscious cognition to implicit unconscious affect” (Schore, 2011, p. 77), there is a recognition that there is an underpinning of emotion to all human interaction, and as such, it is incumbent upon us to at all times monitor our own affect state, including whether we feel affection and its nuances if present. Self psychologists tend to valorize empathy but doing so without considering the contribution of the analyst’s emotion, including the quality of his/her affection, which is an important part of the emotional spectrum, unduly constricts our consideration of the intersubjective field of analyst and patient. I postulate that the analyst’s ongoing empathy, in the context of a hermeneutics of trust, is not only the optimal psychoanalytic path to understanding but also leads to changes in the emotional organization of the analyst so as to facilitate the possible emergence of the analyst’s affection. As well, the good-enough satisfaction of the analyst’s selfobject needs contributes to the development of the analyst’s affection. Given its importance, it is advisable to monitor the state of our affection for our patients and determine how to proceed if our affection is not possible. “Affectionate understanding” is a term that better bridges our theoretical language with the felt quality of affection.