The Aggression of Patients: Between the Kleinian and Kohutian Approaches

Abstract

This article presents two approaches concerning the aggression exhibited by patients. The Kleinian approach views aggression as innate and destructive, thus playing a crucial role in shaping personality. Consequently, a significant part of Kleinian therapy focuses on confronting the patient's aggression. In contrast, the Kohutian approach perceives aggression as always reactive. According to this perspective, the therapist should meet the patient's aggression not through confrontation "from the outside" but through an "inside" view. This perspective seeks empathetically, and from the patient's point of view, to explore the chain of events that led to their aggression. I will argue that the Kohutian approach allows for a multidimensional, comprehensive, diverse, and more exploratory engagement with aggression, and its therapeutic goals are more far-reaching. I will provide clinical examples to illustrate the principles described