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J. Sandler: … so a defense can be initiated, it seems to me, against a combined id-ego movement which is unconscious and which comes from early childhood but which is ‘consciousness dystonic’ in a sense, rather than ego dystonic (in the structural sense of ‘ego’). Or we could say that it is dystonic for the latter developmental levels.
A. Freud: It is present dystonic.
J. Sandler: And involves the more mature levels of the ego.
A. Freud: Because the contrast here is not so much between conscious and unconscious, but between past and present. The question for the patient is: “Why do I behave in the present—or why am I forced to behave and feel in the present—in a manner which is only appropriate to a past situation”?
J. Sandler: The clinical importance of this seems tremendous, Miss Freud. We can see in analysis that what people defend against are impulses which at one time were ego syntonic. These impulses do move toward the surface up
Dr. Antal F. Borbély is assistant professor of Psychiatry, New York Medical College.
Page 459to a certain point, but then, in the present, they give rise to anxiety, they arouse conflict, and defenses are mobilized [Sandler with A. Freud, 1981].
Freud's structural or tripartite theory of mind describes every mental act as a compromise formation between id, ego, and superego. The id is construed as the psychic agency dealing with drives and the repressed (Freud, 1915). The ego is the agency dealing with thinking, problem solving, and adaptation; in these capacities, it regulates the discharge of the drives. Finally, the superego is the agency dealing with moral demands and prohibitions. The activity of defense is ascribed to the ego, whereas the forces to be controlled by the ego are assigned to the id and the superego. It follows that the three psychic agencies are ascribed both specific dynamic functions (vis-à-vis defense and the defended against) and specific content-related functions (motivation, thinking, normative imperatives).