Ego-Distortion

Judged by its terms of reference, this Symposium is the lineal descendant of that earlier Congress Symposium on 'Ego-Strength and Ego-Weakness' which reached, as I fear this symposium will reach, unsatisfying and even confusing conclusions. It will be inconclusive for the same reason that the earlier symposium was inconclusive, viz., that general descriptive terms such as 'strength', 'weakness', 'deformity', 'distortion', 'restriction', 'constriction' 'impoverishment', 'deviation', or 'immaturity' have not acquired and scarcely merit a scientific connotation in the sense that the term 'repression' has acquired an exact scientific connotation. To say that the ego is distorted is simply to say that the mental apparatus is in a state of disordered function, and we cannot pursue this matter fruitfully unless we know exactly what part or layer of the ego is distorted and how and when and why, and with what other psychic reactions the ego-distortion is associated. Regarded clinically, etiologically, and metapsychologically, the term is worse than useless; it is positively misleading. It is of no use in the consulting room (where it is important to ascertain whether the function of the mental apparatus is on balance so disturbed as to justify the recommendation of treatment); it gives no hint of the etiological factors involved; and, metapsychologically regarded, it only adds confusion to the already complicated problem of classification of mental disorders. For classification in the long run depends on our capacity and willingness to apply metapsychological criteria to the clinical data in a manner sufficiently detailed and systematic to satisfy our diagnostic, prognostic, and therapeutic needs.

Indeed, the clinical terms of reference of this very Symposium amply illustrate the unsuitability and inadequacy of the term 'distortion'; for the conditions set as paradigms of ego-distortion vary not only descriptively but in depth, extent, gravity, the instincts involved, t