Meetings of the Psychoanalytic Association of New York

April 15, 1963. EGO IDEAL, EXCITEMENT, AND THE THREAT OF ANNIHILATION. M. Masud R. Khan.

Mr. Khan discusses a schizoid male patient in whom the special pathogenic creation of a highly organized secretive ego ideal was the defensive result of early disturbances in his infancy-childhood relations to his mother. A teacher

in his thirties, he sought treatment because of obsessive brooding over religion. In treatment it was discovered that he operated as four distinct characters, tenuously held together and labeled Mr. A, Mr. B, Mr. C, and Mr. D. Mr. A was the professional—meek, conscientious, exploited for unpleasant tasks, and devoted to his students though he did not think of them as individuals. Mr. B was prone to religious brooding. His God was cruel and demanded endless renunciations which were carried out with exhibitionistic thoroughness. Mr. C lived in a world of exhibitionistic fantasies and private perverse masturbatory practices, a gay, childishly frolicsome person whose existence was denied by retreating into a depressive religious obsession. Mr. D, who was partly unconscious, was recognized only after five years of treatment. He was a perfect person, blissfully merged with nature, capable of all feats (e.g., playing golf flawlessly with no previous experience). Mr. D also was disrupted by a religious obsession. This symptom screened the threat of disaster and annihilation which he always expected when he was in an ideal situation. He was a phobic, withdrawn, passive child who exploited his intellectual abilities to hide anxieties.

The father had a melancholic breakdown when the patient was seven, but little other information about him is given in this paper. A recurrent childhood experience involved being happily engaged in some activity (sitting next to mother drawing pictures), becoming panicky (feeling 'dread'), and displacing the panic onto a detail (breaking a pencil) with which mother would deal. Mr. Khan feels that such episodes contain