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DISCUSSION: Dr. Robert Bak discussed the question of the analyst's values. While standard technique stresses not imparting values, he felt this must be modified in dealing with patients with gross superego deficiency. One implicit value, however, is reflected in our ideal of free association, which conveys the analyst's not being judgmental toward any of the patient's mental productions.
Dr. Phyllis Greenacre commented that it was difficult to evaluate and predict changes in the superego. She mentioned other factors that might have been considered by the study group: 1, aberrant sexual identification leading to complexities in the castration complex and thus in the superego; 2, immutability of the superego due to its defensive exhibitionistic use and strong narcissistic investment; 3, gratification through erotization of the superego and its availability for sadomasochistic satisfaction; 4, defensive use for fantasied castration. Working with superego problems is particularly difficult as even cruelly demanding superego activities are usually ego-syntonic.
Dr. Martin Stein spoke of variations that may affect the functioning and integration of ego and superego, as manifested in the patient's tendency to find moral dicta in the analyst's interpretations. He regards the use of the terms 'superego analysis' and 'superego conflict' as inaccurate and misleading.