In the 16 years since its inception, self psychology has provided a comprehensive theory of psychopathology and treatment. It has articulated a new group of developmental needs and transferences: mirroring, idealizing, and alter ego. The failure of parental empathy to meet those needs during childhood results in the inability to develop intrapsychic structures that can reliably regulate self-esteem and calm the self, leaving the person overly dependent on those in the surround to provide those functions. Treatment requires careful understanding of the early failures and provides an environment in which the intrapsychic structures may belatedly and effectively develop.