Ego-Disturbances and their Treatment1

It has frequently been pointed out in recent years that the ego has taken the place originally occupied by the instincts as the chief object of psycho-analytical investigation. Freud, in his book The Ego and the Id, opened up the realm of ego-psychology by introducing the so-called structural point of view: that is, the conception that, under the influence of the external world, an organ resembling an exterior layer covering the pith of the unconscious instinct reservoir of the id gradually becomes differentiated and acts as a mediator between the organism and the external world. In accordance with the traditions of psycho-analysis, which was from the first a genetic psychology that attempted to understand the finished structure from a developmental point of view, ego psychology has become primarily concerned with the origin and development of the ego. As a matter of history, it is by no means the case that systematic analysis was employed from the beginning to reduce to their unconscious components and historical genesis the resistances preventing the discovering of the id; to begin with, on the contrary, unsystematic analysis and every variety of suggestion had the effect of putting these resistances out of action. Only the knowledge thus gained of the instincts—the so-called 'biological' part of the human personality—made the study of the rise of the opposing forces possible. With ego research, as has repeatedly been said, psycho-analysis once more approaches the nonanalytical psychologies. Adler was right in saying that problems of character, in particular those of 'directive lines', 'fictions' and 'arrangements'—all the tricks by which the defensive ego avoids facing unpleasant realities—had long been neglected. But it was owing to this neglect that psycho-analysis was able to obtain the means it lacked, so that to-day it is possible for us to make an approach to the problem which is not merely descriptive or teleological. The problem of form also admi