The Clinical Estimation of Ego Libido Content

Freud's libido concept has been a helpful component of psycho-analytic theory because it provides a convenient model for 'intuitive' understanding of two phenomena: the internal origin of motivation, and the displaceability of instinctual impulse from object to object and from one contact apparatus (erotogenic zone) to another. But in daily clinical practice we seldom use these concepts explicitly, though we may employ such terms as cathexis and libido in our discussions with our colleagues.

Freud used the libido concept (or psychic 'economics') in two ways. He spoke of a quantum of libido which was attached to a specific impulse in the id, or to its representations and derivatives in the ego (2), (3). Then again, he spoke of libido as a fluid substance or entity which was provided to the ego by the id, and which was required by the ego for its work (4), (6). I shall deal only with this second concept, leaving the problem of the reconciliation of the two to another occasion.

Starting with Freud's suggestion (4, p. 253 f.) that the ego is depleted ('impoverished') of libido in melancholia, and surfeited in mania, let us assume a continuum of ego states varying from minimal libido, as in melancholia, to overwhelming libido, as in mania. (I speak here indifferently of quantity and pressure of libido because I do not know how to distinguish between the two.) Now let us try to find some clinically observable variables which correlate with position in the continuum, that is, with amount of ego-libido. We shall then be able to use these variables as indicators of the prevailing ego state at any moment. We may anticipate two different kinds of correlation between clinical variables and ego states. First, there are those variables that will increase (or decrease) steadily as the ego passes from a low to a high energy state. Second, there are those variables that will have one extreme value toward the middle of the ego-libido continuum, and the opposite extreme value