Historical Truth & Narrative Truth
What is the nature of truth in psychoanalysis? Is the analyst’s task to uncover what actually happened in a patient’s early life, or to construct a meaningful narrative that lends coherence to present suffering? In his landmark case study The Two Analyses of Mr. Z (1979), Heinz Kohut offers a rare opportunity to examine these questions by recounting two distinct treatments of the same patient—one grounded in classical psychoanalysis, the other in his developing self-psychological model. The shift between these two frameworks not only reorients the clinical theory of change, but also challenges our epistemological assumptions about the analytic endeavor itself. Kohut’s claim that the second analysis succeeded by uncovering the historical truth of Mr. Z’s trauma invites scrutiny in light of Donald Spence’s (1982) provocative distinction between historical truth and narrative truth.
This paper will critically examine Kohut’s two treatments of Mr. Z through Spence’s lens, interrogating whether the curative power of the second analysis lies in the accuracy of its reconstructions—or in the compelling coherence of its narrative. By exploring the overlap, slippage, and potential confusion between these two modes of truth, we will raise enduring questions about the nature of interpretation, the ethical limits of analytic knowing, and the transformative power of story in clinical work. In doing so, we may articulate not only the philosophical stakes of the case, but also its deep clinical implications.
Kohut’s First Analysis of Mr. Z: A Classical Lens
In his 1979 paper, Heinz Kohut recounts the case of Mr. Z, a young man who underwent two separate treatments with the same analyst. The first analysis used classical psychoanalytic technique, which emphasizes the phantasy world of the mind—Oedipal conflict, castration anxiety, and preoedipal fixations; the second, conducted four years later, rested on Kohut’s emerging self-psychology perspective, focused on empathic responsiveness to selfobject needs and the ‘reconstruction’ of the historical truth of traumatic childhood experience.
Mr. Z entered the first analysis presenting mild somatic symptoms, severe social isolation, and relational masochistic tendencies. His father had died four years earlier, and Mr. Z lived with his widowed mother; he had few social contacts aside from her and one male friend. His earliest infancy seemed happy, although this was only hinted at by photos, recollections, and the ‘overall flavor’ of his personality. According to Kohut’s initial classical lens, the treatment explored oedipal and preoedipal material at the time of the first analysis: the absent father became a feared rival who possessed Mr. Z’s mother sexually. At the same time, Mr. Z clung to unrealistic grandiosity to deny his competitive Oedipal impulses. Masochistic sexual fantasies involving submission to a commanding woman were linked to preoedipal guilt about possessing his mother. Despite outward improvements—diminished rage, new career ambitions, less compulsive masochism, and some progress in dating—Kohut that the analytic content had a marked emotional shallowness. Termination arrived with Mr. Z more upset about losing the analyst than any emotional charge over the oedipal and preoedipal interpretations.
Kohut’s Second Analysis of Mr. Z: A Self-Psychology Perspective
Roughly four and a half years later, Mr. Z returned for a second analysis, having felt little lasting relief from the first. By this time, Kohut had developed a self-psychology model emphasizing empathic responsiveness to archaic selfobject longings, such as mirroring, idealization, and twinship. Mr. Z initially produced dreams in which he idealized the father, a camp counselor he had known, and the analyst all in one figure, signaling an idealizing transference that gradually shifted into mirror-type narcissistic demands. During the first analysis, Kohut had labeled such reactions as ‘defensive resistance,’ but now he treated them seriously as significant reactivations of archaic selfobject needs and an opportunity to re-examine Mr. Z’s early enmeshment with his mother. Kohut claims that through his narcissistically informed modified approach, the extent to which Mr. Z’s mother offered him complete attention only if he was absolutely compliant was revealed in the treatment. This revelation put a new light on the first analysis, where Mr. Z’s difficulty was not about unconscious competitiveness with his father or the analyst but about real trauma experienced under the domination of a psychotic mother.
Once Mr. Z recognized his mother’s personality disorder, he felt intolerable disintegration anxiety because his core selfobject identity felt enmeshed with the psychotic core of her personality. Yet, Kohut claims that through steadfast empathic attention in the analytic dyad, Mr. Z’s dread gave way to memories of his traumatic experiences, thus beginning to break the compulsion to repeat sadomasochistic relationship dynamics. Kohut’s narrative is that the emerging historical truth of Mr. Z’s early life evoked disintegration anxiety in him, and Kohut’s empathic attunement enabled Mr. Z to continue to discover more and more historical truth that aided the burgeoning narrative coherence about why he had the psychological symptoms that he did. The power of this narrative fit was the therapeutic action of the case.
Kohut’s psychoanalytic self-psychological reformation considered the gradual process of establishing and maintaining empathic contact with selfobject needs as the key mechanism of psychoanalytic change. Rather than treating the narcissistic transferences as mere resistance, as he did in the first classical analysis, he later viewed them as windows into developmental deficits. As Mr. Z felt emotionally understood, he could confront how profoundly entangled he had been with a mother who herself needed continuous selfobject reinforcement. Through empathic reconstructions of his real relationship with his mother, Mr. Z reactivated and relinquished that archaic bond by seeing his past more clearly. This, Kohut proposed, let him recognize genuine attributes of his father for the first time—no longer only the absent, rival figure. By the end of the second analysis, Mr. Z achieved a deeper internal reorganization of his self; his shame-filled sadomasochistic fantasies gave way to a fuller sense of aliveness, no longer simply a ‘compliant resistance’ but an expression of a newly consolidated self.
Historical Truth vs. Narrative Truth: Spence’s Distinction
Donald Spence (1982) emphasizes that a good psychoanalytic narrative must meet two criteria: adequacy (coherence, self-consistency, comprehensiveness) and accuracy (correspondence to actual events). He warns that an interpretation that feels adequate is often treated as if it were accurate:
“A particular clinical event—an association, for example, or a partly recovered memory—may seem to clarify the unfolding account of the patient’s life history so precisely that both patient and analyst come to the conclusion that it must be true. … Under these conditions, narrative fit is usually taken to be conclusive.” (p. 181)
In the Two Analyses of Mr. Z, the storyline of the second analysis provided a cohesive explanation for Mr. Z’s struggles: an enmeshed mother stifling his emerging self, an absent father failing to model independent masculinity, and a patient who transferred these dynamics onto Kohut. The result was a ‘perfect fit’ between Mr. Z’s problems and Kohut’s self-psychology, improving Mr. Z’s life. But, as Spence would say, that coherence can encourage us to accept the story as truth without further scrutiny. Narrative success does not guarantee historical accuracy.
Kohut posits that the improvement that results from the first analysis was a transference cure because, he claims,
“…within the analytic setting, the patient complied with my convictions by presenting me with oedipal issues. Outside the analytic setting, he acceded to my expectations by suppressing his symptoms (the masochistic fantasies) and by changing his behavior, which did not take on the appearance of normality as defined by the maturity morality to which I then subscribed (he moved from narcissism to object love, i.e., he began to date girls) (p. 16).
In the second analysis, Kohut then asks whether Mr. Z shifted to new compliance with the new convictions to which Kohut now adhered. He cites as evidence that this was not the case because:
“Not only was his need to comply—particularly the fears that stood in the way of non-compliance—extensively investigated and worked through; the intense emotions which accompanied his struggles with the issues that were activated now and the zest with which he ultimately turned towards life had a depth and genuineness that had been absent during the first treatment” (p. 16).
Here, he claims that the depth and genuineness were also felt in the analytic relationship. Was this empathy used in the service of verifying historical truth claims? The clinical facts seem to support the narrative fit of the reconstructions because of the resulting greater interpersonal depth and genuineness of Mr. Z’s relationship toward life.
A part of the second analysis hinges on Mr. Z’s full recognition and conceptual accommodation of his mother’s psychopathology. But how can a patient without psychological training fully understand personality pathology without the help of the analyst? Suppose the analyst does help the patient understand the full implications of the mother’s personality disorder. How can the analyst ever know (especially given the revisionary nature of memory) what is true about the patient’s history regarding what the patient tells him? This is a question of historical truth vs. narrative truth. How can Kohut purport to know historical truth when all we have in the analysis is narrative truth and the immediate emotional reality of the session? One major criticism that may be raised of this case is how in-depth Kohut goes into diagnosing Mr. Z’s mother. By what evidence can he make such diagnoses as ‘borderline with a psychotic core’ without ever having met her? Does this go against our code of ethics to not diagnose someone we have not assessed? Additionally, did he tell his patient his working diagnosis of the mother? And what was the result? A diagnosis is a narrative; Kohut’s diagnostic constructions certainly were adequate to understanding Mr. Z’s traumatic early life, but what importance should we also give to reconstructive accuracy?
I posit that Mr. Z’s cure in the second analysis amounted to a new narrative about his life. For instance, in talking about Mr. Z’s masochistic masturbation fantasies, Kohut says,
“The recall of these memories was at first extremely painful and the reactivation of his childhood sadness or shame seemed at times of overwhelming intensity. Still, in the context in which the recall took place, Mr. Z’s experiences were well within tolerable limits because he had come to understand for the first time, in empathic consonance with another human being, that these childhood activities were neither wicked nor disgusting, but that they had been feeble attempts to provide for himself a feeling of aliveness, manifestations of that surviving remnant of the vitality of a rudimentary self which was now finally in the process of firm delimitation” (p. 17, italics added).
This amounts to a movement from the original narrative about the phenomena of masochism, where the act or self is seen with disgust or shame, to the narrative of the act and self seen as surviving and preserving that ‘remnant of vitality’ that still could exist.
Construction vs. Reconstruction
Spence claims that Freud sometimes blurred construction (creating a coherent story) with reconstruction (uncovering what actually happened). Spence points out the risk of assuming an initial guess about an infantile event is correct once it fits the narrative. A successful narrative is not necessarily historically accurate but can still transform the patient’s internal world. The psychoanalytic narrative must meet criteria of both adequacy (narrative truth) and accuracy (historical truth). Narrative truth may become a poor substitute for historical truth when an almost infinite number of items can be woven into a single overarching story.
Kohut, following Freud, works with Mr. Z to ‘reconstruct’ his early life trauma and claims to be ultimately successful at this endeavor. This is along the same lines as Freud’s ‘archeological model.’ Spence says,
“In the archeological model, the past is prologue, and discovery is the key. Truth is waiting for us, hidden in the patient’s life; it simply remains to be uncovered. The role of interpretation is to assist in the process of discovery. Once we shift to the idea that we can create truth by statement—the concept of becoming true—we have left the domain of archeology and opened up new and dangerous doors. Now the concept of construction takes on new significance because it represents a shift from discovery to creation” (p. 176).
What does Spence mean by the difference between construction and reconstruction? Reconstruction puts the emphasis on reconstructing the historical truth of what happened. Alternatively, construction is the attempt at listening to the material that the patient brings in analysis and constructing a narrative around the psychological symptoms. Spence continues his criticism of Freud, “The construction, initially hypothetical, gradually changes into a piece of reality in the clinical situation; in almost every instance, his initial guess about an infantile event is assumed to be correct” (p. 176). This same criticism could perhaps be applied to Kohut in the Two Analyses, in which he speaks about the reconstruction work. There is confusion between the case's historical truth (factual reality) and narrative truth (psychical reality).
An important aspect of narrative truth is that it lies within the hermeneutic realm of interpretation. About interpretation, Spence says:
“The interpretation is designed to open up new possibilities, to bring separate ideas together in a new and potentially evocative combination. Its fate will be determined by how the patient responds and by what new associations come to mind. The analyst has not attempted to reconstruct a specific piece of the past by listening to the patient’s associations; rather, he has attempted to create a new cluster of ideas, a cluster that has probably never been expressed in exactly that way…” (p. 178).
Kohut does not actually share with us much interpretive content of the sessions in the second analysis. Regarding narrative veracity and coherence, Spence suggests an important dialectic between adequacy and accuracy. He says,
“Criteria of adequacy include self-consistency, coherence, and comprehensiveness and serve to define what we have called narrative truth; criteria of accuracy cover the truth value of the individual assertations and the degree to which they correspond to what is actually uncovered in the course of the analysts—what we have called historical truth. Again, we see that historical truth, by itself, is not sufficient because the pieces must be fitted into an understandable Gestalt (narrative truth); and, of course, narrative truth could not be maintained if all pieces of the narrative were fabricated (zero historical truth) (p. 180).
This is the essential conundrum. Kohut appeals to the historical truth (i.e., reconstruction) in his case study, but upon deeper inspection, we can see that he relies as much on narrative construction than his emphasis on reconstruction would have us believe. Spence notes that “the construction not only shapes the past—it becomes the past” (p. 175) when previously inchoate experiences find words for the first time. Freud clung to the archeological model of discovering the actual past, whereas Spence highlights the creative aspect of interpretation. The analyst’s interventions open up new possibilities, linking separate ideas in a new combination; whether that combination is “true” historically is another matter. Once a construction fits the emerging narrative too well, it may be treated as an established fact.
Kohut’s two analyses of Mr. Z show how a particular clinical narrative can gain its own coherence. The second treatment emphasized Mr. Z’s merger with a pathological mother, which explained the patient’s masochistic tendencies and sense of stifled autonomy. Spence would say this narrative coherence does not prove the interpretation’s historical accuracy, but constitutes a therapeutic action nonetheless. Arlow (1979) describes how repeated themes, convergence of data, and striking contextual patterns give interpretations credibility. Yet narrative flexibility is enormous, and psychoanalysis often risks substituting interpretive fit for historical verification. The satisfaction that comes from a good narrative fit can be mistaken for the excitement of genuine discovery.
Kohut’s Two Analyses of Mr. Z illustrate his shift from classical interpretations of Oedipal conflict to a self-psychology approach emphasizing empathic responsiveness to narcissistic transferences. The second analysis provided a powerful narrative that helped Mr. Z achieve deeper structural change. Whether this was because the second analysis uncovered historical truth or because it provided a compelling, empathic new story remains an open question. Donald Spence’s differentiation between narrative truth and historical truth alerts us to how psychoanalytic constructions can transform a patient’s internal reality even when the ‘facts’ cannot be independently confirmed.
References
Arlow, J. A. (1979). Problems of interpretation in psychoanalytic therapy. Journal of the American Psychoanalytic Association, 27(2), 371–393. https://doi.org/10.1177/000306517902700207
Kohut, H. (1979). The two analyses of Mr. Z. The International Journal of Psycho-Analysis, 60(1), 3–27.
Spence, D. P. (1982). Narrative fit and becoming true. In Narrative truth and historical truth: Meaning and interpretation in psychoanalysis (Vol. 15, pp. 175–214). W. W. Norton.