On Ego Distortion1

In opening the symposium on Ego Distortion it was my primary intention to provide a clinical foundation on which the discussion of a difficult problem might be firmly based. Therefore, while this report begins with some rather discursive theoretical remarks I shall be chiefly concerned with the presentation of fragments from the analysis of what I think is a relevant case. And I shall try to pose some of the questions presented by the clinical material of that case.

A variety of designations have been applied to ego manifestations which are considered pathological. Usually the disturbance is referred to by its chief symptom.3 Our thinking is thus channelled in a direction which assumes an ego-specific defect. But we soon find that the peculiarity which attracts our attention is embedded in a morass of idiosyncratic adaptations which we commonly refer to as 'borderline'.4 Compared with the classical neurotic symptoms, the eccentricity in such a patient is seen more clearly as only one aspect of a disturbance which has developed on a broad base in the patient's earliest history (5).

Actually, ego distortion is an inevitable consequence of conflict. If, with Hartmann, we define the ego in terms of its functions, then, transiently or durably, even in the case of the transference neuroses, the ego suffers some impairments (14). Practically, we tend to disregard such 'limited' interferences with the ego's functions since they are clinically insignificant, in many ways well compensated, and the ego as a whole continues to operate according to the reality principle and the principle of multiple functions (30). But the point is sharper if we consider the ego of the presumably 'normal' adult. Here, though not all ego functions have attained equivalent degrees of autonomy and stability, a significant number of them have attained virtual independence from conflict and regressive pulls. Adaptive functions are sufficiently separated from those of defence and are thus pr