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In my Paris Congress paper (Sandler, 1974) I suggested that the conceptualization of conflict in intersystemic terms (i.e. between id, ego, superego and the external world) has led to a divergence between clinical practice and psychoanalytic theory. I proposed that we could usefully consider the sort of conflicts we deal with in our psychoanalytic work by making a further differentiation between unconscious peremptory urges on the one hand, and the variety of forces which oppose these impulses on the other. The peremptory urges may have manifold and mixed origins. They may represent current or persisting derivatives of the id, but in all such derivatives the ego plays a part. At the other extreme they may represent predominantly adaptive or defensive tendencies which are, descriptively speaking, unconscious, and which have a quality of urgency. However, it is, in my view, a fundamental mistake to consider all such unconscious 'urgent' impulses as having their origin in instinctual drive forces operating in the present. For example, a recurring tendency to react to narcissistic hurt by turning immediately and imperatively to omnipotent fantasies may now arouse conflict because it goes contrary to the patient's adult ideal for himself. What is common to the class of peremptory conflict-arousing tendencies or impulses is that they were acceptable at one time in the person's life and later have become unacceptable. In our clinical practice we are constantly presented with conflicts which reflect the patient's present struggle against 'imperative' tendencies which can originate in or involve any aspect of the mental apparatus. I will not develop this argument any further here, as it is discussed in some detail in the Congress paper.
Dr Abrams' discussion (Abrams, 1974) makes it quite clear that, in spite of his manifestly kindly attitude towards my paper, he is in fundamental disagreement with the ideas put forward. He states his position succinctly in his Summa