Self-psychology is a theory developed by an American psychiatrist, Dr Heinz Kohut, in the 1970s and 80s. It attempts to explain the development of mental health problems by identifying difficulties experienced during childhood when children are thought to be particularly sensitive to interactions with others, especially their parents.

The theory is that children require certain confirming or approving responses from their parents (which are usually automatic) in order to develop emotionally and psychologically. Healthy development allows a person to maintain good self-esteem and control anxiety by using learnt techniques.

These techniques act automatically to keep a person feeling calm and 'in control' emotionally. If children are raised in an emotional environment in which they do not receive these parental responses, or the responses are inadequate, then they may go through life continually looking for them. This may leave them overly dependent on others for the provision of those emotional responses they need in order to maintain a sense of emotional well-being because they lack the ability to do it for themselves.

Self-psychology does not refer to a person analyzing him or herself!

Treatment within a self-psychology framework involves the therapist attempting to understand the possible problems which a person may have had, related to his/her emotional development in childhood that may have led to the development of mental health problems such as depression, anxiety or relationship problems.

Therapy using self-psychology requires the therapist to interact emotionally with a patient, almost in the manner of a parent with a child. This is not to say that the therapist treats the patient like a child. Rather, the therapist is aware of, and particularly sensitive to, the emotional needs of the patient. To achieve this requires the therapist to recognise a patient's need for particular types of emotional responses, such as reflecting pride in something done well, that were lacking in the patient's early emotional life. The therapist then provides that emotional response in an appropriate way.

The aim of such therapy is to create an emotional environment in which it is possible for the patient to develop 'intrapsychic' structures (i.e. ones that are inside his/her internal emotional world) to control self-esteem and provide emotional calm.

This form of psychotherapy is practiced by many psychotherapists. Some will have completed formal courses in self-psychology and others will use some of the techniques of self-psychology combined with elements of other theories. This is called an eclectic or mixed technique of psychotherapy and is very common.

People undergoing psychotherapy may want to ask the therapist what model or models he or she uses.

Who does self-psychology help?

Self-psychology is used in treating many forms of depression and is usually used in conjunction with medication in the more severe forms of that condition. It would be very unlikely to be the only treatment used with a person with major depression with psychotic features.

The self-psychology approach to treating depression may be particularly useful when the depressed person has had longstanding problems with low self-esteem, self-confidence and relationships with other people and where these problems seem to be related to childhood experiences.