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Indecision is the inability of the ego to make a choice and carry it out. It follows the rule of multiple functioning in that it may serve as a defence, a symptom, a source of gratification of passive-aggressive needs, or an adaptive interlude before commitment or action. Indecision may be caused when it is pathological by the sexualization and aggressivization of the ego functions involved in decision-making, thus bringing them directly or through displacement under the influence of phallic,
anal or oral anxieties and guilts. Indecision is evidenced by the presence of doubt (cognitive), self-doubt, mistrust and feelings of uncertainty. The clinical syndromes in which such doubts arise run the gamut of psychopathology since making a decision and acting on it require the efficient operation of the autonomous ego (intelligence, rationality, intentionality, etc.), the organizing, synthetic and neutralizing functions, reality testing and the adaptational aspects of defence. Any conflictual process which interferes with these functions will interfere with the decision-making potential of the ego. States of indecision may lead to compulsive, impulsive, counterphobic or un realistic commitment or action taken in an attempt to alleviate the doubt. States of indecision may result from the need to avoid commitment and action as demonstrated in the case material in this paper where phobic anxiety and underlying claustrophobic fantasies are present. A particular event in the outside world may set off a chain of doubt because of its historical, symbolic as well as affective relationship to earlier unresolved conflicts.