Notes Upon Defects of Ego Structure in Schizophrenia1

In the following, I wish to present a few observations I made during a certain phase of treatment of a schizophrenic patient. These observations and the conclusions I shall draw (which may have general validity) presuppose as valid three psycho-analytic assertions about emotions: First, the ego is the only province of the human personality in which emotions have their being. Second, emotions can effect human behaviour without reaching consciousness. Third, many, if not all, emotions can be reduced to signals. The most conspicuous deviation in my patient concerned the third assertion. In her case, the emotions did not function as signals (they had not undergone the process described by Freud in Inhibitions, Symptoms, and Anxiety). Instead of serving as signals, the emotions of my patient showed just the opposite tendency, namely that of reaching maximum intensity once they were activated. Anxiety always evolved into terror, liking into the feeling of ardent love, aversion into hatred.

In the normal, the maximum unfolding of an emotion is usually the exception. The average emotional process works against a resistance which reduces the emotion to a signal automatically giving direction to behaviour.

In the case of the patient, however, an emotion once activated carried all its potentialities to full concretization; that is to say, it engulfed the whole area of the ego and led to the cathexis of all ego functions. It charged the body image, the motor system, the perceptive systems, and the representations of external reality. Moreover, the patient regularly showed, fully and obviously, a characteristic of the emotions which can be observed in the normal, sometimes faintly and occasionally quite strongly; namely, the tendency of an emotion to accumulate new energy by the activation of all memories which are closely related to it, all memories whose contents support the emotion. Thus the emotion engendered out of itself new energy. I want to quote only one exam