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Bychowski compares psychological techniques with clinical observation in diagnosis of latent psychosis. Particularly important indications are increased communication between the mental systems, prevalence of primary process, enhancement of regression by the analytic situation, and facility in understanding symbolism, dreams, and symptoms. Vulnerability of the weak ego causes poor tolerance of frustration and narcissistic hypercathexis of the ego causes megalomania and magical thinking. The ego boundaries are labile and weak and the transference is tainted by paranoid reactions, ideas of reference, and projection. Latent psychosis results from the coexistence of archaic states of the ego with later ego formations. Persistence of these early states causes breakdown of defenses and impairment of reality testing under stress.
Sometimes the latent psychosis is made manifest by relentlessly pursued analysis. The egos of these patients must be protected and strengthened. Therapy must be actively directed and some resistances must be respected. Interpretations that go too deep may flood the ego with impulses of the id and expose it to the sadism of the superego. Too much insistence on free association may encourage regression. In most cases free association may be used in moderation. By altering the frequency of sessions and the position of the patient, the analytic process may be slowed or speeded according to the demands of the therapeutic situation. Transference offers particularly delicate problems, and demands of the analyst great flexibility and security.