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October 25, 1955. EGO DEVIATION AND THE CONCEPT OF SCHIZOPHRENIA. David Beres, M.D.
Schizophrenia is here approached from the standpoint of development, maturation, and vicissitudes of ego function. Specific ego functions, ego deviations, and their relation to the concept of schizophrenia are the focus of consideration. The point of departure is taken from Freud's early perception of the importance of the ego in the psychoses, and his subsequent formulations of the genetic and developmental aspects of the ego and its defenses.
The functions which, taken together, comprise the ego are not evident in the newborn child. The ego develops partly out of conflict between instinctual drives and reality demands, and partly out of autonomous, conflict-free growth. In accordance with the thesis that the function of the total ego can be understood only in terms of the development of its separate functions, the author describes both development and deviations of specific ego functions in individual children over an extended period of time. The following ego functions annotated by detailed clinical observations are considered: 1, relation to reality; 2, regulation and control of instinctual drives; 3, object relationships; 4, thought processes; 5, defense functions of the ego; 6, autonomous functions of the ego; 7, synthetic function of the ego.
In his attempt to formulate a more precise evaluation of the general concept of 'ego strength' by a detailed analysis of the separate ego functions, the author's ultimate goal is not a return to a variation of 'factor analysis', but an approach which treats the human psyche as a unit reflecting in any given manifestation the resultant of many forces, genetic and dynamic, hereditary and environmental, intrapsychic and environmental, conscious and unconscious. The question of diagnosis is avoided in favor of specific observation of evidence of ego deviation with concomitant emphasis on growth process. In each case described the trend