Personality Theories in the Psychodynamic Tradition

Personality Theories in the Psychodynamic Tradition

Prior to beginning work on this discussion, read chapters 1 through 6 of the textbook and the required articles listed with the theorist assigned to you for the discussion. For your initial post, you will examine the contributions of a theorist who was instrumental in developing the psychoanalytic theoretical approach based on the first letter of your last name. In addition to the required articles for your assigned theorist, research a minimum of one peer-reviewed article on your theorist’s research and work within the field of psychology. Examine and describe your theorist’s contribution(s) to psychodynamic theory. Examine the major theoretical approaches proposed by your theorist including any related research methods and/or assessment instruments associated with him or her. Evaluate any issues and cultural considerations associated with your assigned theorist. Analyze and describe how the APA’s Ethical Principles and Code of Conduct might affect the implementation of your theorist’s personality assessments. Assess the types of personality measurements and research designs associated with your assigned theorist and describe how they have evolved. Your initial post should be a minimum of 500 words.

Please see below for your assigned theorist.

Neo-Freudians (Karen Horney): last names beginning with O through R:
Eckardt, M. (2006). Karen Horney: A portrait. American Journal of Psychoanalysis, 66(2), 105-108. doi: 10.1007/s11231-006-9008-4
· The full-text version of this article can be accessed through the ProQuest database in the Ashford University Library.

Smith, W. B. (2007). Karen Horney and psychotherapy in the 21st century. Clinical Social Work Journal, 35(1), 57-66. doi: 10.1007/s10615-006-0060-6
Required articles

Marianne, H. E. (2006). KAREN HORNEY: A PORTRAIT1. American Journal of Psychoanalysis, 66(2), 105-8. doi:

Smith, W. B. (2007). Karen horney and psychotherapy in the 21st century. Clinical Social Work Journal, 35(1), 57-66. doi:

  • Abstract Many ideas currently circulating in the psychological and psychoanalytic communities have

    correspondence with the theories put forth by Karen

    Horney during the first half of the twentieth century.

    This paper provides an overview of Horney’s theoret-

    ical departures from Freud and an introduction to her

    then controversial views of motivation and relation-

    ship. Compatibility between Horney’s ideas and

    attachment theory, self-psychology, intersubjectivity,

    and the person in the environment is discussed. Two

    clinical cases are presented, illustrating Horney’s the-

    ory and approach.

    Keywords Karen Horney Æ Theory of neurosis Æ Basic anxiety Æ Neurotic trends Æ Attachment theory Æ Self-psychology


    The work of Karen Horney, who died 50 years ago, is

    remarkably relevant to the problems faced by psy-

    chotherapists in the twenty-first century. Anxiety, a

    central and organizing theme in her work, is present in

    today’s world at a level which would have been

    unimaginable to Horney and her contemporaries. Her

    recognition of the role of the family in both engen-

    dering and mediating anxiety as well as in shaping the

    individual’s response to it is today reflected in systems

    and developmental theories.

    Many of her ideas are not only deeply compatible

    with theories currently circulating in schools of psy-

    choanalysis, but may also be seen as early versions of

    notions thought to be newly emerging in the areas of

    motivation, behavior, and development as well as in

    the theory and practice of psychoanalytic psychother-

    apy. This paper provides an overview of some of

    Horney’s fundamental departures from Freudian the-

    ory, such as her construct of neurosis and neurotic

    strategies and her view of the analyst’s role. In the

    contemporary context, I will discuss the ways in which

    her thinking is compatible with attachment theory,

    self-psychology, intersubjectivity, and the social work

    perspective of understanding the person in his

    environment. I then will offer some clinical material as

    seen through a Horneyan lens.

    Social Historical Context

    Karen Horney was born in 1885, in Hamburg, Ger-

    many, to a Protestant upper middle class family. Her

    Norwegian father was a sea captain and a Bible reader.

    Her mother was a free-thinking Dutch woman who

    encouraged her daughter to pursue medical studies,

    still a fairly unusual career for women at that time

    (Kelman, 1967). According to Horney’s daughter,

    Marianne Eckardt, her mother ‘‘pursued her profes-

    sional development with a remarkable sureness of aim.

    She knew early in her medical studies that she would

    study psychoanalysis’’ (Natterson, 1966, p. 451).

    An earlier version of this paper was presented at the 2004 National Meeting of the Committee on Psychoanalysis of the Federation of Societies for Clinical Social Work in New York.

    W. B. Smith (&) School of Social Work, University of Southern California, Los Angeles, CA 90089-0411, USA e-mail:

    Clin Soc Work J (2007) 35:57–66

    DOI 10.1007/s10615-006-0060-6


    O R I G I N A L P A P E R

    Karen Horney and Psychotherapy in the 21st Century

    Wendy B. Smith

    Published online: 8 August 2006 � Springer Science+Business Media, Inc. 2006



    Horney studied medicine at the universities of

    Freiburg, Gottingen, and Berlin and, after entering

    analysis with Karl Abraham, became a founding

    member of the Berlin Psychoanalytic Institute. In 1932,

    Franz Alexander asked her to become Associate

    Director of the Chicago Psychoanalytic Institute; she

    stayed 2 years before moving to New York and joining

    the New York Psychoanalytic Institute. There, her

    unorthodox views created controversy, and in 1941 she

    was disqualified from teaching at that institute. In the

    same year, she founded the American Institute for

    Psychoanalysis, serving as its dean until her death.

    Nineteenth century science had been based on

    closed systems and determinism; it was in this intel-

    lectual atmosphere that Freud began to develop his

    ideas. The early twentieth century saw the beginning of

    shifts toward less tightly structured views in which

    degrees of determinism might be recognized and moral

    and aesthetic values might have a place (Kelman,

    1967). This more open, less concrete way of thinking

    informs and, indeed, characterizes some of the differ-

    ences I shall outline between Freud’s ideas and those

    of Karen Horney.

    Horney and Freud

    In Freud’s schema, the present can only be understood

    in terms of infantile experience. It is determined by the

    biological development of the psychosexual structure,

    which is molded to some degree by environmental

    forces. Human behavior is seen as the result of the

    interaction of instinctual and counter instinctual forces

    within the person, who has a fixed quantity of energy.

    The three structures of the id, the ego, and the super-

    ego comprise the person, and neurosis is seen as the

    result of conflicts among these three structures (Kel-

    man, 1967).

    In a major departure from Freud, Horney proposed

    that the person was ruled not by the pleasure principle

    but by the need for safety (Horney, 1945). She rejected

    the idea that the instincts were the source of all moti-

    vation; she saw instead a mixture of forces, both

    internal and external, at work in creating behavior.

    Like Freud, Horney believed that the past is always

    contained in the present. Unlike Freud, she viewed

    people as conditioned by early experience rather than

    fixated at a given point or stage (Paris, 1999a, b). She

    focused more on the current character structure than

    on infantile experience, and she was particularly

    interested in the strategies the person developed and

    employed to cope with what she called ‘‘basic anxiety.’’

    According to Horney, basic anxiety results when

    pathogenic conditions in childhood cause children to

    feel unsafe or unloved, leaving them with a sense of

    helplessness in a potentially hostile world (Paris, 1999a,

    b). Horney advocated a focus on understanding neu-

    rotic character structure and defenses in terms of their

    current function for the individual. Underlying her

    notion of basic anxiety is another fundamental differ-

    ence between her view and Freud’s. Freud postulated a

    destructive instinct present within us all; Horney be-

    lieved that people were not inherently either good or

    bad, but could become destructive as a result of neg-

    ative environmental circumstances that caused the

    constructive forces within them to be blocked. The

    defensive strategies that people adopt to fend off

    anxiety can and often do eventually become self-

    defeating or self-destructive.

    Freud emphasized biology as the source of instincts

    and therefore of behavior. Since biology is universal,

    he assumed that the course of development and the

    conflicts among people he observed were likewise

    universal. The result of this assumption was an

    undervaluing of the important roles played by other

    factors such as the immediate environment, the larger

    culture, the plasticity of human development, and the

    continuation of significant aspects of human develop-

    ment past the age of puberty. These other factors are

    now much more widely acknowledged as being central

    to the course of development.

    In contrast to Freud, Horney focuses on the world in

    which the child finds him or herself: the family, which is

    ‘‘the most important component of the child’s envi-

    ronment’’ (Horney, 1950, p. 159), peers, and the larger

    societal surround. Like such other ‘‘Neo-Freudians’’ as

    Fromm and Sullivan, she believed that the drives were

    given meaning by interpersonal, social, and cultural

    forces rather than the other way around (Eckardt,

    1984). Sexual difficulties, in her view, were the result,

    rather than the cause of personality disorders.

    Feminine Psychology

    The impact of culture is perhaps nowhere so clear in

    Horney’s departures from Freud as it is in her work on

    feminine psychology. Indeed, her collected papers on

    this subject were published posthumously in 1967, and

    it was this work which returned Horney to the public

    eye. These papers were written over a 14-year period

    during which her ideas about feminine psychology

    evolved and crystallized. As early as 1922, Horney was

    beginning to examine and to question the classical

    analytic view of women. In 1926, in ‘‘The Flight from

    Womanhood,’’ she pointed out that the psychology of

    58 Clin Soc Work J (2007) 35:57–66




    women was described from men’s point of view, and as

    such, represented ‘‘…a deposit of the desires and dis-

    appointments of men’’ (Horney, 1926, p. 56). She no-

    ted that women unconsciously yield to these notions

    and that it is necessary to ‘‘try to free our minds from

    this masculine mode of thought…’’ (p. 59).

    I will not review here her exhaustive unpacking of

    the logic (or illogic) of the classical view, including

    penis envy, as that has occupied many papers and

    books in feminist literature over the past three dec-

    ades. It is perhaps most important to note that her

    conviction that cultural factors exert a powerful influ-

    ence on our ideas of gender and development has

    passed into mainstream thought, but was radical for

    her time. Her comments about ideologies functioning

    to reconcile women to subordinate roles by presenting

    these roles as innate and unalterable likewise seem

    obvious now. Yet Horney was telling us 70 years ago

    that women presenting the traits specified by

    men—passivity, compliance, masochism, dependency,

    for example—are more frequently chosen by men, so

    that their erotic chances in life depend on conformity

    to the image of what constitutes their ‘‘true nature’’ as

    outlined by men (Horney, 1933). While much has

    changed in the status and understanding of women

    today, one need only glance at the fashion and men’s

    magazines on any news stand to see how these classical

    conceptions by men of men and women continue to

    have pervasive presence and influence in our culture.

    Horney’s Theory of Neurosis

    Horney believed that each person has a central inner

    force which is common to all people, yet possesses

    unique character in each individual. This force, she

    argues, is the source of growth. She calls this force the

    ‘‘real self’’ (Horney, 1950, p. 18). Each person needs

    both love and friction or frustration in order to develop

    healthily. If people in the environment cannot love the

    child or ‘‘even conceive of him as the particular indi-

    vidual he is,’’ (p. 18), he becomes alienated from his

    real self and develops basic anxiety.

    All people develop strategies to deal with the envi-

    ronment, but in the usual case—in Winnicott’s term the

    ‘‘good enough’’ environment—these can be flexibly

    taken up or discarded according to the situation. In the

    child who develops basic anxiety because of a perni-

    cious or indifferent environment, strategies become

    extreme and rigid, giving rise to internal conflicts be-

    tween and among strategies. The child attempts reso-

    lution of the conflict by making one strategy

    predominate, usually to his or her detriment.

    I shall describe the strategies or solutions in some

    detail, both to convey the power and applicability of

    the model and to set the stage for discussing the rela-

    tionship of the model to other current theories, and

    eventually, to the clinical examples that follow. First,

    however, an introduction to Horney’s view of the self

    will provide a foundation.

    Horney’s Conception of the Self

    Horney conceptualizes three versions of the self: real,

    ideal, and actual. The real self (see above) refers to the

    panoply of possibilities existing within each person,

    including temperament, talents, capacities, and pre-

    dispositions. This is the self that is the source of values,

    a healthy conscience, and a sense of vitality. The real

    self, which is a ‘‘possible self,’’ cannot develop fully

    without a positive environment (Horney, 1950; Paris,


    The ideal self arises in response to the anxiety

    generated by a problematic environment. The child

    becomes alienated from his/her real self when it does

    not evoke sufficiently positive or growth-affirming

    responses from significant others. He/she attempts to

    address feelings of isolation and/or hostility via a

    fantasied idealized self that holds the imagined

    promise of a felt positive identity and the satisfaction

    of inner needs for security and safety. Energies are

    shifted from true self-realization to the aim of actu-

    alizing the idealized self, which of course, cannot be

    actualized and is therefore an ‘‘impossible self.’’

    Horney refers to the pursuit of the ideal self as ‘‘the

    search for glory.’’ That search involves the need for

    perfection, neurotic ambition, and, often, the need for

    vindictive triumph (Horney, 1950). It is important to

    note that the ideal self also contains the despised self

    who cannot live up to the fantasied and impossible


    The despised self or image results from failure to

    meet the exaggerated compensatory demands of the

    idealized self. Self-hatred is the rage of the idealized

    self toward the actual self for not being what it

    ‘‘should’’ be. Horney’s concept of the ‘‘tyranny of the

    should’’ (Horney, 1950), describes the powerful need

    to live up to a grandiose self-conception, thereby

    avoiding the unbearable awareness of helplessness and

    weakness in a hostile or indifferent world. Thus, the

    ‘‘shoulds’’ are often extreme, as in ‘‘I should always be

    understanding of others,’’ or ‘‘I should never feel hurt

    by others.’’

    Finally, the actual self is the mixture of strengths and

    weaknesses, strategies and strivings that describe the

    Clin Soc Work J (2007) 35:57–66 59




    person’s current being in the world. In a good situation,

    the real and actual selves are close to each other; in a

    less positive situation, great disparities exist between

    the two (Paris, 1999a).

    Horney’s Schema of the Neurotic Trends

    The neurotic trends are the ad hoc strategies we all

    have at our disposal to cope with the worlds we find.

    Each strategy has a different emphasis, and all are

    present as potentials. The neurotic individual is unable

    to use them in flexible and situation-specific ways. Each

    basic attitude has a positive, as well as a negative value

    (Horney, 1945).

    The first strategy is moving toward people; it

    emphasizes compliance and helplessness. The individ-

    ual wants to be liked, wanted, accepted, protected, and

    has an insatiable need to feel safe. Self-sacrifice may be

    involved. The positive value here lies in the capacity to

    create a friendly relationship to the outside world.

    The second strategy, moving against people,

    emphasizes hostility and aggression. Life is seen here

    as a struggle of one against all; the individual has a

    need to control others, possibly to excel and to win

    recognition. This person chokes off feelings for the

    sake of expediency and must fight the softer feelings

    within. As with the person who moves toward people,

    however, the center of gravity lies outside oneself. The

    positive side of this strategy is that it enables the per-

    son to equip him/herself for survival in a competitive


    The third and last strategy is that of moving away

    from people, with an emphasis on isolation. This

    strategy addresses the desire for independence and

    self-sufficiency. The person becomes neurotically de-

    tached and attempts to prevent anyone or anything

    from mattering. The positive value here is that the

    individual may attain integrity and serenity in a dis-

    turbing world.

    These were the versions of the three basic strategies

    delineated by Horney in 1945 in Our Inner Conflicts. In

    1950, she published Neurosis and Human Growth, in

    which she further elaborated and fleshed out each of

    the neurotic solutions.

    In the later elaboration, moving toward people was

    described as the ‘‘self-effacing solution,’’ involving the

    appeal of love. The idealized self in this case glorifies

    suffering and martyrdom, and in the extreme, leads to

    a morbidly dependent relation to others. Moving

    against people was called the ‘‘expansive solution’’ and

    its main appeal was the sense of mastery. The idealized

    self here is superior, grandiose; it requires admiration.

    Finally, moving away from people was described as

    ‘‘resignation;’’ a sense of freedom is its goal. Horney

    saw this as the most radical solution to conflict because

    it restricts life and growth most severely. In every

    individual, all trends are present; in neurotics, one

    trend predominates in a self-destructive way.

    This truncated overview of some of the main points

    of Horney’s theory of neurosis shows evidence of

    compatibility with both self-psychology and attach-

    ment theory. At least two other writers have noted

    these affinities, as described in the following sections.

    Horney and Kohut

    In 1988, Jack Danielian published a fairly thorough-

    going analysis of the differences and similarities be-

    tween Kohut and Horney (Danielian, 1988). He points

    to the ‘‘remarkable resemblance’’ between Horney’s

    trends and the three selfobject transferences of ideal-

    izing, mirroring, and twinship. The wish to merge with

    the idealized parent or analyst selfobject is much like

    the compliant or self-effacing solution. The mirroring

    transference, in which the grandiose-exhibitionistic self

    is mobilized, is comparable to the expansive solution.

    And the twinship/alter ego transference, requiring ego

    alikeness and conveying a sense of anonymity in the

    midst of loneliness, has elements of the solution of


    Danielian also highlights the similarity between

    Kohut’s concept of empathic immersion (as an appli-

    cation of vicarious introspection) and Horney’s view

    that the analyst must embody ‘‘wholeheartedness’’ in

    his approach to the patient. I will discuss this further in

    a section below on the analyst’s role. Both Kohut and

    Horney recognize self-healing or curative forces within

    the human psyche, but where Horney suggests that

    once obstructions to self-realization have been dimin-

    ished, growth can and will continue, Kohut returns to a

    ‘‘mechanistic meta-psychology, namely that the child

    does not grow by unfolding his potentialities, but ra-

    ther by internalizing external qualities’’ (Danielian,

    1988, p. 12). Another difference between the two is

    that Horney’s theory is conflict-based, whereas Kohut’s

    is a deficit model in which there must be restoration or

    structure-building, as opposed to resolution of conflict.

    Horney and Attachment Theory

    Attachment theory is increasingly in the foreground of

    psychological and psychoanalytic thinking. It draws on

    ethology, evolution theory, cognitive psychology, and

    60 Clin Soc Work J (2007) 35:57–66




    object relations theory, and it emphasizes the primary

    status and biological functions of the intimate emo-

    tional bonds between people from birth forward. As I

    have noted, Karen Horney also accorded centrality to

    human relationships, especially those in the family, as

    fundamental shapers of motivation, behavior and, in-

    deed, character structure. An ethological basis can be

    seen for her formulation of the strategies of aggression,

    withdrawal, and compliance, which are as noted by

    Paris (1994) complex human versions of the basic

    mechanisms of defense in the animal kingdom: fight,

    flight, and submission.

    Attachment theory suggests that individuals orga-

    nize their behavior and their self and world views

    (internal representations) in relation to their experi-

    ence of the early caregivers in their lives. These char-

    acteristic views and behaviors become enduring and

    have continuity. Like Horney’s trends or solutions,

    they tend to lose flexibility: in both theories, what be-

    gins as an adaptive response becomes a characteristic

    of the person.

    It is true that Horney, whose theories emerged from

    her clinical observations, observed adult neurotics,

    whereas attachment theory grew out of observations of

    infants and their caregivers. Interestingly, the strate-

    gies described in both theories have remarkable cor-

    respondence, and in both, the goal of the strategy is

    security. In both systems, healthy development de-

    pends on the ability to use the full range of strategies.

    In attachment theory, this translates as being able to

    use the secure base and being able to explore the

    environment apart from the base (Feiring, 1983).

    The child with a secure attachment (Group B in the

    literature) may belong to any of four subtypes, from

    those with most ability to explore and least need for

    proximity to those needing the most proximity and

    having least ability to explore comfortably. Although

    most of the securely attached would not be considered

    neurotic in Horney’s schema, this last group at the

    edge of the range and moving toward being overly

    compliant might be close to demonstrating a self-

    effacing solution.

    Group C, those with anxious resistant attachments,

    sound much like individuals who employ Horney’s

    expansive solutions—that is, moving against people.

    They are ambivalent about the caregiver, distressed by

    separation, and yet not comforted by contact. They

    may be hostile and controlling, and are conflicted in

    their longings.

    Group A, those with avoidant attachments, are

    clearly similar to Horney’s solution of detached resig-

    nation. They avoid proximity or interaction with the

    caregiver, exploring the world, but moving away from

    people. They expect little from others, choosing to

    avoid conflict rather than to experience or resolve it.

    What might we say about Group D, those with a

    disorganized, disoriented attachment pattern, in rela-

    tion to Horney’s model? The attachment theorists re-

    gard these as individuals who cannot develop a

    coherent strategy (Main & Solomon, 1985), so no one

    strategy can be said to predominate. Unable to use any

    of the strategies successfully, they can find no real

    solution. They can neither form relationships, nor

    avoid them entirely. They may be hypervigilant and

    compulsively compliant, so in some senses self-efface-

    ment may be dominant, yet avoidance and attempts to

    be invisible interrupt these behaviors. Such people

    probably cannot construct an ideal self in any direction:

    they flail.

    Horney and Psychotherapy

    However contemporary her understanding of the

    interpersonal and intrapsychic underpinnings of human

    behavior, Horney’s views on the psychotherapeutic

    enterprise are no less so. Her conception of the ther-

    apeutic relationship and the analyst’s role within it are

    so compatible with current intersubjective and rela-

    tional views as to make one wonder why she is not

    taught and spoken of regularly and with respect today

    in training institutions.

    Horney’s ideas about therapy were based on her

    understanding of the cultural/interpersonal contribu-

    tions to neurosis, the continuing nature of develop-

    ment, and the nature and functions of the patient’s

    current defensive strategies as displayed in the inter-

    action with the therapist. The purpose of therapy, she

    suggested, was to lessen the patient’s anxiety to the

    extent that he or she is able to give up the neurotic

    trends and abandon the drive to actualize the idealized

    self, thus permitting further self-realization and growth

    to take place (Paris, 1999b).

    She placed great importance on self-realization and

    growth. Freud had emphasized the removal of neurotic

    symptoms and increasing the capacity for enjoyment

    and work. Sullivan’s goal was to help the patient to

    establish good human relationships. Horney added to

    these the improvement of relations not only with oth-

    ers but also with the self, as well as greater freedom,

    inner independence, and self-realization in every way

    (Horney, 1956a).

    The patient’s motivation—the desire to suffer less

    and to unfold one’s true potential—is crucial: the

    therapist must foster the patient’s initiative and

    resourcefulness in an ‘‘exquisitely cooperative enter-

    Clin Soc Work J (2007) 35:57–66 61




    prise’’ (Horney, 1946 in Paris, 1999b). The patient’s

    tasks are to express him/herself as completely as pos-

    sible, to become aware of unconscious driving forces

    and their effects, and to change those patterns of

    behavior that disturb the patient and others (Paris,

    1999b). The unconscious forces, in a Horneyan sense,

    have less to do with repressed drives from early

    childhood, and much more to do with conflicts between

    neurotic trends pressing for dominance (Paris, 1994).

    Transference and countertransference likewise arise

    from and are expressions of character structure and, as

    such, can provide insight into the nature of the person’s

    defenses and conflicts (Horney, 1939). Symptoms are

    seen as arising from the character neurosis, which is the

    focus of attention and treatment (M.H. Eckardt,


    Horney describes the therapist’s tasks as observa-

    tion, understanding, interpretation, help with resis-

    tances, and something called ‘‘general human help,’’ a

    phrase that refers to an attitude of friendliness and

    serious interest that helps the patient to regard his/her

    own growth as important and to accept his/her less

    than perfect self (Paris, 1999b, p. 80). Horney includes

    interpretation as an analytic task, but she is referring

    more to the interpretation of the unconscious aspects

    of the neurotic character or patterns than to interpre-

    tation of transference or dreams, which are rarely

    mentioned (M.H. Eckardt, unpublished).

    In a paper entitled ‘‘What Does the Analyst Do?’’

    (Horney, 1946 in Paris, 1999b), Horney comments on

    the analyst’s stance in a way that can only have been

    revolutionary at the time and provides a dramatic

    illustration of her ability to think outside the analytic

    box. She describes the special nature of the analyst’s

    attention: it must be wholehearted. ‘‘…It can be pro-

    ductive only if he enters into the task completely and

    without reservation… letting his own emotional reac-

    tions come into play.’’ She goes on to argue that ana-

    lysts should not try to suppress their emotions because

    they play an important role in the therapeutic process;

    indeed, analysts’ feelings are ‘‘the most alive part’’ of

    themselves (p. 98). This is quite a different picture

    from the so-called ‘‘blank screen’’ and sounds much

    more like contemporary relational analysts.

    There is, today, greater attention to affect, in both

    patient and analyst, than there was when Horney lived

    and wrote. Yet she includes affect explicitly in her

    description of the analyst’s role, discussing it as an

    aspect of optimal analytic behavior. Perhaps this re-

    flected an implicit recognition of the need for full or

    complete participation by both members of the dyad if

    therapeutic healing is to occur.

    Horney defined understanding as a ‘‘process of

    moving toward another person’s position while still

    maintaining our own’’ (Horney, 1956b). This suggests

    that the analyst, in the optimal situation, is able to

    ‘‘feel into’’ the other person with all of his/her own self

    (p. 199). She might be regarded as a conservative in-

    tersubjectivist in that she clearly acknowledges the

    presence, importance, and irreducibility of the two

    subjectivities in the room; yet, for her they remain

    separate. A more radical intersubjective view assumes

    a continuously coconstructed reality—one in which,

    while the analyst’s subjectivity is subordinated to the

    needs of the patient, there is always some measure of

    contribution by both, instead of an immersion by only

    one party, the analyst, into the patient’s reality.

    Case examples from a Horneyan Perspective

    Case #1: Ms. H

    When she came for treatment, Ms. H was a single, 26-

    year-old woman of English and Scottish descent. She

    grew up in a middle-class suburb of San Diego and

    moved to Los Angeles in her early twenties to pursue a

    retail business opportunity. She was a middle child and

    only girl, with a brother 9 months older and a brother

    1 year younger. Ms. H was a strikingly attractive young

    woman of above-average intelligence who finished

    1 year of college before deciding it was not for her. She

    was successfully working in a retail business with plans

    to open a business of her own in the future.

    Ms. H’s reasons for seeking treatment were problems

    in a love relationship, lack of self-confidence, difficulty

    with confrontation, family issues, and intense negative

    feelings about her own body. I saw her for 3 years,

    initially twice a week and then three times per week.

    Ms. H’s mother, described as immature and mer-

    curial in mood, was divorced when Ms. H was 5 years

    old. Her father sought the divorce; the mother was

    both devastated and enraged. She remarried 3 years

    later, but her bitter competitiveness with her ex-hus-

    band regarding the affections of the three children

    continued. Father had an active social life until he

    remarried 10 years later; during his single years, he was

    an inattentive and erratic parent.

    Stepfather, by contrast, was deeply but destructively

    involved with the children, on the one hand spending

    enjoyable time with them, and on the other, physically

    and verbally abusing the boys, and sexually abusing

    Ms. H from the time she was 8 until he and her mother

    divorced when Ms. H was 13. Mother remarried twice,

    62 Clin Soc Work J (2007) 35:57–66




    and had at least two other engagements. She was

    preoccupied with her love relationships or depressed

    and isolated in her room, on one occasion overdosing

    on pills while the children were in the house. Between

    men, she could be a sporadically involved or demon-

    strative mother, but more frequently was angry,

    unhappy, or simply not present. When in their mid-

    teens, the children chose to live with their father and

    his new wife. Mother fought this in court and lost.

    Following the change of custody, mother refused all

    contact with the children for years.

    During childhood and early adolescence, Ms. H

    successfully repressed awareness of her stepfather’s

    molestation of her; after moving to her father’s home,

    however, troubling dreams led to the therapy that re-

    sulted in a report to the authorities. The stepfather was

    fired from his job, but the case was not prosecuted, as

    Ms. H’s mother stated she would be a hostile witness.

    The police told my patient it would be a matter of her

    word against his and was likely to be a very difficult


    As an infant, Ms. H entered a problematic world.

    She had two siblings so close in age that her mother

    barely had time to recover from one pregnancy and

    childbirth before the next, and none of the children had

    a period of being alone with her. That marriage was

    unhappy, and it ended unhappily. It is likely that the

    needs of three very small children overwhelmed the

    recently divorced mother. The ‘‘basic anxiety’’ of Ms.

    H’s life was intense from the moment of birth, perhaps

    from conception. What gifts she had could not possibly

    blossom in an environment in which, in Horney’s

    terms, her parents were too wrapped up in their own

    neuroses to love her or even to conceive of her as the

    person she was (Horney, 1950). In addition, her step-

    father, experienced by her as the most attentive of her

    parents, invaded and abused her over a period of years.

    What was Ms. H’s ‘‘solution’’ to the powerful anxi-

    eties generated by the circumstances of her childhood?

    What became of her ‘‘real self’’? It is unlikely that she

    had the requisite space and care to begin the devel-

    opment of her real self in early childhood. The lack of a

    dependable source of care and response compromised

    her development from the outset. She could not begin

    to construct any confidence, in herself or in others, and

    the world must have seemed indifferent at best. It

    would soon become hostile and dangerous.

    Ms. H was encouraged early on to concentrate on

    her feminine and body attributes. Her appearance was

    the aspect of her that her mother, father, and stepfa-

    ther paid most attention to, and was, in fact, what

    differentiated her from her brothers. She was con-

    stantly reinforced for her cuteness, prettiness and later

    her lovely skin and body. Stepfather told her, even as

    he made use of her, ‘‘Your mother is jealous of your

    body.’’ This was both exhilarating and alarming, pro-

    viding fertile ground for the development of her own

    body preoccupations. A strong component of Ms. H’s

    idealized self has to do with bodily perfection and the

    striving to obtain it through exercise and diet. Horney

    (1950) points out that the difference between healthy

    strivings and neurotic drives for glory is the difference

    between spontaneity and compulsion, between wanting

    to and having to.

    We can see in Ms. H the presence of all three of the

    Horneyan strategies—moving toward, moving against,

    and moving away from people. Her predominating

    strategy is the ‘‘self-effacing solution,’’ or compliance

    and moving toward. Her longing for love and protec-

    tion are expressed in her attempts to please the sig-

    nificant others in both her early and current life. She

    has difficulty with assertiveness and aggression; prob-

    lems with confrontation had been one of her expressed

    presenting problems.

    Her relationships with men are characterized by the

    attention she and they pay to her idealized self—if she

    looks perfect enough, the man will/does love her, and

    she feels confident and worthwhile. If she does not look

    good enough, she feels guilty, inferior, or contemptible.

    It is worth noting that what she regards as her out-of-

    shape self would look to anyone else like a physical self

    to be admired.

    There are also elements of withdrawal and resigna-

    tion, or moving away. Ms. H struggles with a tendency

    to self-isolate, spending many weekends alone in her

    apartment, avoiding social contact. The idea of not

    needing or depending on anyone is appealing to her, as

    her disappointments have been manifold. She similarly

    fears investing herself in new achievements; she be-

    haves as if she can protect herself from pain only by

    avoiding longing for anyone or anything. This repre-

    sents a further restriction of her real self in favor of a

    desired totally self-sufficient self.

    Traces of the expansive solution are less apparent,

    but may make more of an appearance as Ms. H’s angry

    feelings emerge more fully. The neglect and brutality

    of some of her childhood experiences are bound to

    have engendered considerable rage. Her femaleness is

    bound up with interpenetrating strategies as well, in

    that it was a source of inferiority (to her brothers) and

    vulnerability as well as a source of potential perfection

    and power. Ms. H provides a good illustration of

    Horney’s view that the familial and cultural views

    of gender play crucial roles in determining the meaning

    of sex, one’s sexual equipment, one’s sexual role. Ms.

    H reported wanting a penis when she was little; in her

    Clin Soc Work J (2007) 35:57–66 63




    family, being a boy looked safer and freer. It would

    have protected her from the way in which she was

    defined and exploited. At the same time, she feels that

    being female is her most important advantage.

    The Horneyan therapeutic goals with Ms. H would

    involve reducing the anxiety over safety and security so

    that she can relinquish her compulsive focus on bodily

    perfection as a substitute source of security. Because

    her self-effacing trends (longing for love via compli-

    ance) are in conflict with her expansive trends (longing

    for mastery via grandiose triumphs), the expansive and

    aggressive aspects have been subordinated. The

    reduction of the need to quash all aggressive feelings

    should permit a less rigid reliance on self-effacement.

    The relaxation of the drive to actualize her idealized

    self through physical perfection could make room for

    her real self to emerge and unfold, in turn allowing for

    the development of goals and relationships that reflect

    her inner longings and abilities rather than more rigidly

    adopted stereotypically feminine behaviors and modes.

    Her human relations might then evolve more flexibly

    so that they can comfortably include aggressive as well

    as compliant aspects.

    In the relationship with me, there was an unavowed

    idealizing transference, tempered by fears of depen-

    dency and disappointment. In Horneyan terms, my

    impression was that Ms. H tried to be motionless in the

    transference—moving neither toward nor away, and

    certainly not against me. It was as if she were holding

    herself as still as she could, watching me carefully

    without seeming to watch—perhaps not even allowing

    herself to know she was watching. In early life, she had

    known no truly benign yet caring figures; it is unlikely

    that she could conceive of me other than as an ideal-

    ized fantasy of the perfect mother. On occasions when

    I attempted to take this up, Ms. H could respond only

    minimally; she seemed to need me not to be too real a


    In a lecture on ‘‘The Quality of the Analyst’s

    Attention’’ (Horney, 1959), Horney gives us a pierc-

    ingly sensitive admonition—one that has general

    application and that in the case of Ms. H has special

    relevance: ‘‘We must be careful not to let the intensity

    of our attention convert a mutual analytic situation

    into one where the patient is in the brilliant spotlight

    on a clinical stage while we are in the darkened audi-

    ence. With both of us sharing more subdued light in the

    same room, we can become more open and real to one

    another’’ (p. 189). A more muted exchange, necessi-

    tated by Ms. H’s understandable wariness, may have

    led to the problems I shall describe.

    At the time I wrote (and presented) an earlier ver-

    sion of the paper, Ms. H was deeply engaged in the

    treatment. Some months later, Ms. H changed jobs and

    reduced the frequency of her appointments to two

    sessions/week because of her new work schedule. After

    several months at this job, Ms. H decided to change

    careers, from retail sales to becoming a physical trai-

    ner, again an indication of the high valuation of the

    body and its appearance and properties. As the train-

    ing required was costly, she moved in with a friend’s

    family in an informal au pair arrangement. The family

    lived much of the time in a community some distance

    away; Ms. H withdrew even further from therapy,

    coming in only once each week, and eventually dis-

    continuing altogether.

    Ms. H’s departure from therapy was both more

    complicated, and from my point of view, more pre-

    cipitous, than these facts suggest. During the course of

    the therapy, Ms. H had explored and experimented

    with her relationship with her mother. When she began

    therapy, there had been no contact for many years;

    about 1 year into the therapy she made telephone

    contact, and followed that with sporadic additional

    phone calls, many of which were disappointing to her

    because of her mother’s substantial self-involvement.

    Her mother wanted very much to have a photograph of

    her, yet showed no real desire to actually meet or be

    with her. The pain of her mother’s preoccupations

    during early life reverberated again. I too had a pow-

    erful reaction to her mother’s renewed, but apparently

    limited interest in a real relationship with her, and

    probably unconsciously conveyed to her my own sense

    of disappointment and anger, putting more psycho-

    logical burden on her.

    Horney believed that repressed hostility was the

    early affect which we most fear and most need to con-

    tact (Paris, 1994). Ms. H’s rage, which emerged pow-

    erfully in her dreams, had begun to surface more

    consciously during the last year of her treatment.

    Shortly before discontinuing therapy, Ms. H had what

    she described as a ‘‘wonderful’’ telephone conversation

    with her mother, in which they were able to talk openly

    about some of the events of Ms. H’s childhood and

    adolescence. She then told me, with considerable anger,

    that I had failed to push her strongly enough to rec-

    oncile with her mother. Indeed, I had not pushed in this

    direction. I had told myself that this was a path which

    must be traveled as it unfolded and that I could not/

    should not influence it. After the fact I could recognize

    that not doing something is also a way of influencing

    events and behavior. It is likely that my unspoken dis-

    approval of her mother’s abandonment did play an

    unrecognized part in the intersubjective unfolding of

    events. While I may have internally, as Horney sug-

    gests, been letting my ‘‘own emotional reactions come

    64 Clin Soc Work J (2007) 35:57–66




    into play’’ (Horney, 1946 in Paris, 1999b), I had not

    fully recognized what they were and how they might be

    entering into the encounter. As a result, Ms. H may

    have felt me to be inattentive to her true needs and

    feelings, much as her mother had been. She may have

    fled from me much as she fled her mother at age 16.

    In Horneyan terms, the compliant solution had

    weakened its neurotic grip enough to make way for her

    repressed aggression, which now rose to the fore. In a

    more grandiose state perhaps, she no longer needed

    me and could be in control of our situation. Unfortu-

    nately, the work was interrupted before the events and

    responses could be analyzed and understood, and a

    true flexibility of responses achieved.

    Case #2: Mr. Y

    Mr. Y, a 40-year-old accountant, came in for couples

    therapy with Ms. X, his live-in girlfriend of 5 years who

    had been in treatment with another therapist for many

    years. His girlfriend’s real wish was that Mr. Y have

    individual therapy, but while he was (barely) willing to

    have couples therapy, he had no desire at all to come

    on his own. I saw the couple weekly for several months.

    When their relationship had begun, both had needed

    considerable distance. Ms. X had progressed in her

    own therapy and development to the point where she

    longed for greater communication and closeness, but

    Mr. Y was as closed off as he had always been and their

    lives were more parallel than emotionally interwoven.

    In the joint sessions, Ms. X spoke at length about her

    feelings, but Mr. Y was almost completely unable to do

    so. She could not tolerate the snail-like pace of the

    conjoint therapy and wished Mr. Y to continue on his

    own. Despite deep ambivalence, Mr. Y correctly

    sensed that his relationship with her depended on his

    doing this, and so he began individual therapy.

    After the first few months of individual sessions,

    during which Mr. Y related to me in a most guarded

    fashion, he began to open up, remembering and

    speaking about intensely painful and isolating experi-

    ences of his childhood for the very first time in his life.

    Mr. Y was the youngest, by several years, of four

    children from a depressed industrial town in the Pacific

    Northwest. Both parents were alcoholics, and an older

    sister who also became alcoholic committed suicide

    when Mr. Y was a young adult. The family was poor,

    requiring welfare at times, and marginal at best. Family

    life was chaotic and emotionally barren. Mr. Y’s par-

    ents fought frequently and violently, and divorced

    when Mr. Y was in junior high school. After the di-

    vorce, contact with father was sporadic and, when it did

    occur, had a dead quality. Mr. Y’s mother remarried,

    but her alcoholism and resulting arguments continued

    in the new marriage. The stepfather was somewhat

    more available to Mr. Y than his own father had been.

    Due to the unpredictable and highly charged

    atmosphere at home, Mr. Y’s siblings were out as often

    as possible, and all three left home by late adolescence.

    Mr. Y recalls a childhood lived largely by himself, ei-

    ther at home alone while parents were out drinking or

    lying still in his room, hoping they would not fight. He

    spent his adolescence experimenting with drugs, up to

    and including IV drugs. His one great strength was his

    intelligence, and he resolved to leave home and attend

    college—the only member of his family to do so.

    Mr. Y provides a poignant example of the strategy

    of withdrawal from the battlefield of human emotions

    and relations. Though he maintained formal social and

    work relations, he never spoke of his feelings to other

    people. He wanted neither to be touched nor to touch

    others, and cultivated as much detachment as he could.

    His relationship with Ms. X had been possible for him

    only because she too had been incapable of intimacy

    when he met her. The couple shared a house and social

    engagements, but nothing else—not money, not meals,

    not communication, very little sex.

    Mr. Y’s idealized self was one that needed no one

    and never felt anything. He tried not to be aware of his

    own conflicts, and concerned himself as entirely as

    possible with material things. He focused on cars,

    sports, recreational activities, did a fair amount of

    drinking, and had the most minimal contact with family


    A conflicting trend for Mr. Y, however, is moving

    against people—he would be deeply troubled at mo-

    ments when he felt the surfacing of the rage and hos-

    tility within. This occurred in traffic, sometimes at

    work, occasionally in relationship to Ms. X. Indeed,

    Mr. Y’s deep anger, and his fear of exploding unpre-

    dictably and uncontrollably as people in his family so

    often did, contend powerfully with his longing to feel


    The squelching of the more expansive angry trends

    resulted, in the treatment, in the tight, flat quality of

    relating that so frustrated his girlfriend. It was only

    marginally less frustrating in the consulting room. His

    early transference to me was indicative of both avoi-

    dant and combative trends. Sometimes he appeared to

    feel utterly neutral, while I struggled to locate some

    affect in the room. At these times I felt it was all I

    could do to maintain some feeling of connectedness to

    Mr. Y. At other times, it seemed as if he experienced

    me as an enemy at the gate, threatening to attack him.

    In both modes, the atmosphere was deadening,

    reflecting his need to render the environment less

    Clin Soc Work J (2007) 35:57–66 65




    dangerous to him. For me, the struggle was between

    fully experiencing the deadness (surrendering to or

    weathering it) and provoking some contact just to feel

    more alive in the room.

    After some months, he began to arrive in a more

    open state, having thought about something he actually

    wanted to talk about. His basic anxiety had diminished

    to the point where I could be experienced as a benign

    presence who would maintain an even and predictable

    attentiveness to his process. In his relationship with

    Ms. X, who of course has an agenda and needs of her

    own, his comfort in sharing has come much more

    slowly. The couple shares more time and more varied

    mutual experiences than when they first came to see

    me, and Mr. Y has developed greater range of feeling

    and expression. He now welcomes his awareness of his

    inner state, where before he tried to be as far removed

    from it as possible.


    There are many alternative ways to describe both Ms.

    H and Mr. Y psychologically: one might speak of

    internalized bad objects and the compromises neces-

    sitated by the unavoidable splitting, managing, and/or

    projecting of these internalizations. One could discuss

    the anxious attachment resulting from Ms. H’s early

    mother–infant experiences or the avoidant attachment

    pattern of Mr. Y. One could discuss the selfobject

    functions desperately needed by Ms. H, and the ide-

    alizing transference, followed by the devaluing trans-

    ference which accompanied her exit from treatment.

    Certainly, one could discuss Mr. Y’s problems in affect

    regulation, and the sparsity of his internal life.

    What Karen Horney offers us is a glowingly human

    set of constructs—constructs that allow us to situate

    our patients in relation to their inner and outer worlds

    within a positive, growth-minded and open system. Her

    conception of the person affords the individual his or

    her unique, even if yet unrealized qualities, while rec-

    ognizing the more common ways in which people ar-

    range themselves to accommodate otherwise shattering

    experiences in early life.

    Born over 100 years ago, Karen Horney was in

    many ways a woman ahead of her time. Her ideas

    about human behavior and about psychotherapy have

    a remarkably contemporary feel. Her appreciation of

    the impact of environment and culture on develop-

    ment, long a staple of social work thinking, has ac-

    quired more and more currency in analytic circles. Her

    optimistic view of the plasticity of development and the

    unending human potential for growth is supported by

    recent and current brain and infant research. Perhaps

    the most impressive aspect of Karen Horney’s work is

    that it was conceived and propounded by a woman in a

    time and place that were professionally and culturally

    steeped in a male-dominated paradigm. To think these

    thoughts and then to proclaim them publicly were

    extraordinary acts of imagination and courage.


    Danielian, J. (1988). Karen Horney and Heinz Kohut: Theory and the repeat of history. American Journal of Psycho- analysis, 48, 1.

    Eckardt, M. H. (1984). Karen Horney: Her life and contribution. American Journal of Psychoanalysis, 44, 3.

    Feiring, C. (1983). Behavioral styles in infancy and adulthood: The work of Karen Horney and attachment theorists col- laterally considered. American Journal of Psychoanalysis, 44, 2.

    Horney, K. (1926). The flight from womanhood. In K. Horney (Ed.), Feminine psychology. New York, NY: W. W. Norton & Co., 1967.

    Horney, K. (1933). The problem of feminine masochism. In K. Horney (Ed.), Feminine psychology. New York, NY: W. W. Norton & Co., 1967.

    Horney, K. (1939). New ways in psychoanalysis. New York, NY: W. W. Norton & Co.

    Horney, K. (1945). Our inner conflicts. New York, NY: W. W. Norton & Co.

    Horney, K. (1950). Neurosis and human growth: The struggle toward self-realization. New York, NY: W. W. Norton & Co.

    Horney, K. (1956a). Aims of analytic therapy, lecture I. In B. Paris (Ed.), Karen Horney: The therapeutic process: Essays and lectures. Yale University Press: New Haven, 1999.

    Horney, K. (1956b). Understanding the patient, lecture 5. In B. Paris (Ed.), Karen Horney: The therapeutic process: Essays and lectures. Yale University Press: New Haven, 1999.

    Horney, K. (1959). The quality of the analyst’s attention, lecture 3. In B. Paris (Ed.), Karen Horney: The therapeutic process: Essays and lectures. Yale University Press: New Haven, 1999.

    Kelman, H. (1967). Karen Horney on feminine psychology. In K. Horney (Ed.), Feminine psychology. New York, NY: W. W. Norton & Co.

    Main, M., & Solomon, J. (1985). Discovery of an insecure-dis- organized/disoriented attachment pattern. In T. B. Brazel- ton, & M. Y. Yogman (Eds.), Affective development in infancy (pp. 95–125). New Jersey: Abbey.

    Natterson, J. (1966). Karen Horney: The cultural emphasis. In F. Alexander et al. (Eds.), Psychoanalytic pioneers (pp. 450– 456). New York: Basic Books.

    Paris, B. (1994). Karen Horney: A psychoanalyst’s search for self- understanding. New Haven: Yale University Press.

    Paris, B. (1999a). Karen Horney’s vision of the self. In A. Horner (Ed.), Visions of the self. American Journal of Psychoanal- ysis, 59, 2, 1999.

    Paris, B. (1999b). Karen Horney: The therapeutic process: Essays and lectures. New Have: Yale University Press.

    66 Clin Soc Work J (2007) 35:57–66




    Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.


    • Karen Horney and Psychotherapy in the 21st Century
    • Abstract
    • Introduction
    • Social Historical Context
    • Horney and Freud
    • Feminine Psychology
    • Horney hxx2019 s Theory of Neurosis
    • Horney hxx2019 s Conception of the Self
    • Horney hxx2019 s Schema of the Neurotic Trends
    • Horney and Kohut
    • Horney and Attachment Theory
    • Horney and Psychotherapy
    • Case examples from a Horneyan Perspective
    • Case #1: Ms. H
    • Case #2: Mr. Y
    • Conclusion
    • References
    • CR2
    • CR3
    • CR4
    • CR5
    • CR6
    • CR7
    • CR8
    • CR9
    • CR10
    • CR11
    • CR12
    • CR14
    • CR15
    • CR16
    • CR17
    • CR19
    • CR20

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/ENU <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> >> >> setdistillerparams << /HWResolution [2400 2400] /PageSize [2834.646 2834.646] >> setpagedevice

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