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This paper might well be titled “Psychotic Ego Function Patterns.” It is based on research in which we are currently engaged together with a number of colleagues.* For the purpose of this presentation, we follow Freud in describing the ego by its functions. Our conception of the ego construct has formal similarities with the model of intelligence underlying the Wechsler Adult Intelligence Scale: a general factor (total I.Q. in the Wechsler test being roughly parallel to “ego strength”) and some less general group factors (Verbal I.Q. in the Wechsler test parallel to clusters of intercorrelated ego functions).
A brief historical resume of important psychoanalytic conceptions of the role of the ego in psychosis will be followed by a list of 12 ego functions and some illustrations from ego function profiles of individual patients.
In 1911 Freud17 considered the crucial factor in the development of psychosis to be the withdrawal of libidinal cathexis from the mental representation of other individuals and from the external world generally, and its attachment to the ego or self (pp. 72-76). Freud18 later expanded this to the formula: loss of reality, remodeling