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In examining our discipline, psychoanalysis, and its practitioners and clients in the broad context of social evolution, I feel that althøugh we are fully evolved organically and have reached an advanced degree of technological development, we are nevertheless in an early stage of civilization. Societies and their institutions are the primary shapers of personality and, via human agents especially in early life, are the major sources of developmental personality constrictions and distortions. I feel that the tensions of discrepancy between the vast constructive and creative developmental potentials of people and the limited fulfillment of such potentials, chiefly account for the agonies and personality pathologies which bring patients to our offices. The patients all, including the grandiose, suffer from low self-esteem. Nearly all are, and sense they are, less than they might be.
It is important to recognize that no matter what personality evolves it is a product of human potential. It would be romantic to regard the human being as naturally destined to become healthy, to fulfill some form as does a flower, if only left to itself and provided with the biological necessities for survival. “There is an etiology of health as well as of pathology” (Bonime, 1966). Human beings once born into society have the potential for an enormous variety of developments. “Constrictions” and “distortions” as I use these terms to describe personality development refer to personality formations that fall far short of an optimal operational state, relative to the individual's given potential. “Constriction” and “distortion” relate to forces that create destructive, painful, function-limited evolution of human potentials.