Psychoanalytic Quarterly, Vol. XV, No. 2, p. 161.

The author states 'that the ego considers perceptions to be internally originated when they can successfully be rejected and considers those it cannot avoid to be externally originated'. By use of a discussion of the traumatic neurosis, the generalization is formulated that all perceptions of internal origin which can be kept within bounds and neutralized in the ego by counter-cathexis, are not subjectively considered as originating in external reality. External perceptions become conscious more easily because the ego is less capable of using counter-cathexis against them. The sense of reality will vary with the strength of the counter-cathexis—if diminished the perception is less effectively dispelled and is judged to be external in origin. Contrariwise, if the counter-cathexis increases, the perception becomes less real, dispels its origination in the outer world.