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.
The dynamic psychopathological substratum of the so-called psychopathic personality is similar to, if not identical with, the basic defects in the structure of the ego found in the neurotic character and in 'impulse neurotics' (Fenichel). The structure of the psychopathic character rests upon the same defenses against strivings for forbidden instinctual gratifications from
the early oral phases of infantile development as those found in the neuroses. The presence of anxiety, feelings of guilt, repression of instinctual urges and substitutive gratifications makes it difficult to view the psychopath as dynamically dissimilar to symptomatic neurosis. Theoretically, psychopathic personality should be a remediable condition. However, the ever-present attitudes of society towards psychopaths requires recognition in psychotherapy. The defenses of society are so strongly intrenched, so infiltrated with punitive attitudes, and such infinite patience and resourcefulness are required of psychotherapists, that spectacular results cannot be expected in the treatment of this neurotically ill group.