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The author opens his discourse with the Psychoanalytical questions of how and why, the Ego, in its struggle with the instinctual demand, manifests its ailment in one way and not in another. Why and when is a perversion and not a neurosis formed, is asked. Through the examples of two analyses: a masochist and a homosexual, Eidelberg shows that “approval of a component instinct is not present in these perversion”. The difference lies in the attitude of the ego towards the “defense mechanism”. The pervert's ego, contrary to the neurotic's ego approves the defense. And it is approved because it is more satisfying a defense to all aspects of the personality. Each defense mechanism has a multiple function; an ego aspect, an id aspect, a super-ego aspect and an external aspect. The author concludes with Freud that the choice of the is ego determined by the developmental stage it has reached and by the libidinous type.
From this essay he proceeds to an interesting contribution in the study of Masochism, in which he destroys the masochistic mechanism by successfully bringing it to the conscious level.
He next applies his therapeutic efforts to a case of paranoia, and inspite of the difficulty in treating schizophrenia by analysis, maintains it. The case is commendably presented, as are all his illustrative cases, and shows the author to be a profound student of Freud and a master of psychoanalysis.
Throughout the other fourteen papers of varying subjects, he presents a mixture of theory and fact, which may be challenged by less penetrating followers of Freud as a departure from the true line of psychoanalysis, but the logical conclusions he reaches are strengthened by the success he has had in their application.
A distinct contribution is his effort to formulate a comparative the of neuroses.