One note: "constructs" or "structures" are permanent psychological patterns. This is not to say that they do not change - they are capable of slow change. Kohut and his self-psychology disciples believed that the only viable constructs are comprised of self self-object experiences and that these structures are lifelong ones. Melanie Klein believed more in archaic drives, splitting defences and archaic internal objects and part objects. Winnicott [and Balint and other, mainly British researchers] as well as other ego-psychologists thought that only infantile drive wishes and hallucinated oneness with archaic objects qualify as structures. Karen Horney's Contributions Horney is one of the precursors of the "object relations" school of psychodynamics. She said that the personality was shaped mostly by one's environment, society, or culture. She believed that the relationships with other humans in one's childhood determine both the shape and functioning of one's personality. She expanded the psychoanalytic repertoire. She added needs to drives. Where Freud believed in the exclusivity of the sex drive as an agent of transformation (later he added other drives) - Horney believed that people (children) needed to feel secure, to be loved, protected, emotionally nourished and so on. She believed that the satisfaction of these needs or their frustration early in childhood were as important a determinant as any drive. Society came in through the parental door. Biology converged with social injunctions to yield human values such as the nurturance of children. Horney's great contribution was the concept of anxiety. Freudian anxiety was a rather primitive mechanism, a reaction to imaginary threats arising from early childhood sexual conflicts. Horney argued convincingly that anxiety is a primary reaction to the very dependence of the child on adults for his survival. Children are uncertain (of love, protection, nourishment, nurturance) - so they become anxious. Defences are developed to compensate for the intolerable and gradual realisation that adults are human: capricious, arbitrary, unpredictable, non-dependable. Defences provide both satisfaction and a sense of security. The problem still exists, but it is "one stage removed". When the defences are attacked or perceived to be attacked (such as in therapy) - anxiety is reawakened. Karen B. Wallant in "Creating Capacity for Attachment: Treating Addictions and the Alienated Self" [Jason Aronson, 1999] wrote: