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.
Individual human life develops around a few fundamental conflicts, which are solved on different levels according to the ego's growing capacity for integration. The specific striving of the human mind for continuous higher integration is the basic concept of Dr Arlow's paper. This is accomplished by the process of learning, which, as Dr Lampl-de Groot reminds us, goes on as long as we live.
Following the developmental approach, I would like to make a few comments about the function of the neurotic symptom and of anxiety in phases of necessary re-orientation, when the individual has to adapt his inner dynamics to new demands from the outside. At such moments the need for higher and more adequate integration of basic conflicts arises. The initial reaction to it can be a phase of disintegration, anxiety, and symptom formation. From this point of view the neurotic symptom represents the regressive step backwards, which, as Anna Freud has pointed out, is a necessary component of learning.
The already established symptom does not only hamper the ego-function involved, be it perception, memory or motility. The secondary gain of illness derived from the symptom also comes into conflict with the ego-ideal. An important source of wish-fulfilment does not function any longer. This is felt as a serious blow to the individual's self-esteem. The fear of conscience, which in itself is not a source of symptom formation, arises whenever one is unable to shape one's life according to one's ideals and aims. This fear should not be underestimated in the present era when belief in celestial rehabilitation is dwindling and failures in life have to be solved here and now. In such cases the struggle against the symptom is initiated by a change in the relationship between the self and the ego-ideal when a certain amount of narcissistic cathexis of the ego has been restored.
At the end of adolescence, a change of the fusion of identifications, which con