The Concept of the Self: Its Significance in the Etiology and Therapy of Psychic Disorders

The world of the self is the world of man's inner reality. It is of manifold significance to the therapeutic endeavor since the aim of therapy is to help the patient to relate to the world of objects with appropriate affects—tenderness and joy, understanding and sympathy; to experience grief and loss, yet to be able to maintain a sense of one's own continuity as a whole person and as an object. When, however, a person has lost the narcissistic complete awareness of his own self, he experiences a serious defect in the totality of his living, even though he may not be conscious of it.

The sense of one's own self can be defined as a stable, yet continuously changing, subjective, or at least never entirely objective, frame of reference through which one views the world of external objects as well as oneself. This frame of reference presupposes a personal history. Man does indeed see himself in the here and now, yet the manner of each person's beholding himself on the various developmental levels of childhood, adolescence, and maturity colors not only his view of himself, but also his relationship to the external world.

The sense of one's own person has its genesis in the biologically determined patterns of the instincts which are at once a property of the unconscious as well as of the psychic systems of the ego and the superego. It is irritated into being at about six months of age through the intense oral frustration that arises from the inevitable beginning of separation anxiety. Although it is derived from the perception of the