You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
This paper is adapted from a talk which the author gave to a circle of former students of Paul Federn on the occasion of the publication of his
book Ego Psychology and the Psychoses in December, 1952.
Freud's revision of his instinct theory facilitated the development of Federn's concepts. He thought of the ego cathexis as a biological fusion of libido and 'mortido' (death drive). He did not consider that the term narcissism covered all the manifestations and modes of operation of the ego libido.
The wealth of new ideas which Federn provided to explain many details of the ego's dynamic functioning and of psychotic processes may be gathered from numerous examples—two of these being (a) states of estrangement and depersonalization were due to a deficiency of ego cathexis, (b) Federn distinguished between the sense of reality and reality testing. The psychotic patient, owing to changes in the inner ego boundary cathexes, experiences mental data as external reality. Only later does the patient break with reality under the influence of an already distorted reality.
In the latter section Weiss points out that in certain phobias the danger is sensed as an inner one. Here an ego feeling disturbance is the specific cause of anxiety. Very often the body ego may be affected by feelings of depersonalization. Typical ego experiences often appear only when the patient ventures a certain distance from the place of security. The factors most responsible for the ego disturbances consist of repressed ego states and intense unconscious identifications with parent figures, siblings, or children.
Ego disturbance, dependence upon persons who can give reliable support, intolerance of any personal restrictions, constitute a triad in the symptomatology of agroraphobia. Treatment must be pursued with caution. Male therapists must often face difficult transference situations with female phobics. Such patients cannot tolerate frustration. Too much forcing to overcome the phobia can l