A Neurotic Conflict*

I am aiming in this paper to illustrate my understanding of a neurotic conflict. I shall try to show how the ideal aims of the analytic treatment for such a case were clarified and to some extent, modified during the progress of six years analysis.

In Freudian terms, a neurotic conflict may be defined as an intra-psychic conflict between the inner structures of the personality. Freud's structural approach to mental phenomena greatly increased our understanding of them. In this approach, the ego is seen as the executive organ of the mind which has to mediate between the often conflicting claims arising from internal and external demands. It has to meet the pressure for discharge from instinctual sources contained in the id; it has to deal with the moral imperatives of the super-ego; and it has to meet the demands of external reality in promoting adequate adaptation to its environment.

The relative strength of the ego in relation to the demands made upon it is therefore, the essential factor in the degree of conflict within the personality. This ego strength may, of course, be disturbed by any dislocation in the balance between the forces involved. This may arise from an increase in the instinctual drives as at puberty or at menopause; or from excessive demands of a severe, punishing super-ego preventing legitimate instinctual discharge; or from the ego itself being intrinsically weakened as in brain damage.

Neurosis may result when the ego, unable to meet the internal and external demands, resorts to various compromises to cope with otherwise insoluble conflicts. Drive discharge is blocked by the ego's pathological defence activities which cripple and distort the ego's functioning. Its ability to test and adapt to reality is hindered by the process of neurotic symptom formation which involves regressive changes reactivating infantile patterns of adaptation. Object relations may be distorted and character abnormalities appear.

Freud thought analytic therapy could help to