Ego-Activating Approaches to Psychotherapy*

It is the central thesis of this paper that successful basic personality change in psychotherapy is brought about by arousing into action any part of the ego other than the defensive function. The construct, ego, as defined by contemporary psychoanalytic theorists (Rappaport, Hartmann, Kris, Lowenstein, and others) is one of the three structural systems of the personality and controls or performs the contactual, adaptive, defensive, cognitive, ratiocinative and mediative functions. It is recognized, although it may be stated differently, that all therapies have as their goal a more efficient and gratifying utilization of the above ego activities, for it is through their exercise that the individual copes with both his internal and external environment. However, experience indicates that the traditional therapeutic approaches—whether impulse-oriented, superego-removing, relationship concentrating, or rationality training—could be a great deal more effective, especially with certain types of patients: character disorders, character neurotics, schizophrenics, and autistic children. Symptom neurotics have become more and more rare and character problems more evident. Many character traits maintain themselves relatively free from drives. Newer measures, therefore, must be developed to deal more effectively with such patients. Also, until rather recently the emphasis in therapy has