Changes in the Self and Identity During Psychoanalysis: A Round Table Discussion

With The Increasing emphasis in recent years upon such functions as integration and synthesis, self-awareness and self-consciousness, identity, self-realization and creativity, the focus of clinical psychiatry and psychoanalysis has shifted from concern with change in particular psychopathological symptoms to that of more total change in character structure. The aims of effective therapy, therefore, must be redefined in terms of basic emotional and attitudinal change. The direction of this change should lead from anxiety-charged compulsive patterns to more spontaneous, more flexible and more autonomous attitudes in relation to self, to others, and to the world.

The patient enters analytic therapy with a relatively weak, rigid, and constricted self. His real identity has become consciously or unconsciously rejected, or otherwise blurred, and in the service of safety and security he has assumed a precariously maintained pseudo-identity which involves different aspects of his functioning.

During the therapeutic process the efforts and energies bound up in the protection of the patient's neurotic defense systems are redirected; his weak self becomes stronger, his pathological self-esteem is transformed into a more realistic evaluation of his worth, and his false identity is replaced through recovery of his truer personal and sexual identity.

Just as the loss of self and identity is an active neurotic process, so must their recovery be an active movement whereby increasing autonomy and self-direction change the quality of his previous relationships—whether dependently symbiotic, hostile or withdrawn—into more mutual, more mature ones. But the changes in identity are a fundamental prerequisite for the changes in his attitudes toward others, including the analyst, and toward himself.

The panelists here represent varying schools of psychoanalytic thought. In our discussion we shall have to deal with many basic issues which are involved in our subject. We shall have to consider