... In his paper on narcissistic rage (1972), Kohut describes certain kinds of patients as follows:

"These patients initially create the impression of a classical
neurosis. When their apparent psychopathology is approached by
interpretation, however, the immediate result is nearly
catastrophic; they act our wildly, overwhelm the analyst with
oedipal love demands, threaten suicide - in short, although the
content (of symptoms, fantasies, and manifest transference) is all triangular oedipal, the very openness of their infantile wishes, the lack of resistances to their being uncovered, are not in tune with the initial impression…." [p 625-626]

The nuclear psychopathology of these individuals concerns the self. Being threatened in the maintenance of a cohesive self because in early life they were lacking in adequate confirming responses ('mirroring') from the environment, they turned to self-stimulation in order to retain the precarious cohesion of their experiencing and acting self. The oedipal phase, including its conflicts and anxieties, became, paradoxically, a remedial stimulant, its very intensity being used by the psyche to counteract the tendency toward the breakup of the self - just as a small child may attempt to use self-inflicted pain (head banging, for example) in order to retain a sense of aliveness and cohesion." [1972 626-627].

(hence the notion that erotic attachment and positive transference is a defence)

Kohut suggests that psychodynamic conflict is used itself as a defence against the deeper danger - the breakup of the self. He refers to the cohesion of the experiencing and acting self as 'precarious'. Thus the fundamental danger is of fragmentation. Kohut did not have much to say about states of fragmentation per se, appearing to view them as characterising psychosis and inherently beyond the reach of analysis. He was more concerned with the threat of fragmentation and defences against this.

Disintegration anxiety is difficult to articulate and communicate, compared with other more specific anxieties (such as the series Freud described: loss of the object, loss of love, castration). Kohut (1977) wrote:

"… the expression of the ill-defined yet intense and pervasive
anxiety that accompanies a patient's dawning awareness that his
self is disintegrating (severe fragmentation, serious loss of
initiative, profound drop in self-esteem, sense of utter
meaninglessness) … may initially be veiled; the analysand may
attempt to express his awareness of the frightening alterations in the state of his self through the medium of verbalisations about circumscribed fears - and it is only gradually and against
resistances that his associations will begin to communicate the
central content of his anxiety, which, indeed, he can only describe with the aid of analogies and metaphors." [p 103].

Even secure attachment is built on a substrate of the fragmented self, since it is, for any human baby, only the ministrations of the mother that hold back the threat of bio-psychological disintegration. This is the background threat of annihilation - which I think corresponds to what the Kleinians viewed as the manifestation of the terrifying death instinct.

I have encountered other instances in which the patient has not suffered overt abuse in childhood, but the mother's rejection of the child's own communicative initiatives and his or her needs for understanding and empathy have been so profound that the potential authentic self is pervaded by shame and its development is blocked. In such instances the early environment was perceived as fundamentally opposed to the child's actual authentic self and as intent on replacing it with a preferred alternative. In these circumstances the child may internalise the psychically murderous environment and the murder of the authentic self then continues internally throughout later life - the process being particularly activated whenever genuine emotional intimacy and attachment threatens.

http://www.selfpsychologypsychoanaly...g/mollon.shtml