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The problem of finding an appropriate theoretical framework for Freud's discovery that ethical dilemmas are at the root of neurotic symptoms has afflicted psychoanalysis since its inception. Freud's (1926) agonizing reappraisal of his libido theory of anxiety is just one example of our theoretical difficulties. In her paper on masochism as a defense reaction of the ego, Esther Menaker (1953) offered clinical evidence that a chronically devalued self-image is the outcome of unconscious guilt. Guilt was conceptualized, however, not only as a product of hostility, but as a consequence of the need to maintain a good, loving image of the beloved. This is a theoretical distinction that emphasizes the social nature of humanity, and it is a concept to which Freud was particularly unsympathetic in his theorizing.
In this contribution to Esther Menaker's Festschrift, I shall be drawing on my recently completed Freud and Modern Psychology, the first volume of which has already been published (Lewis, 1981) and the second volume of which has just appeared (Lewis, 1983). This work reviews Freud's seminal ideas from the viewpoint of the social nature of humanity. This viewpoint derives from a special focus in psychopathology that I have developed over the past 25 years, namely, the power of undischarged states of guilt and shame in symptom formation.
A few words are in order about the background experiences out of which this focus grew. Over the years as a practicing psychoanalyst, I became convinced that unanalyzed shame in the patient-therapist interaction is a frequent source of negative therapeutic reactions and indeed of therapeutic failure. I have the hunch that some of the cases Kohut (1971) and Kernberg (1975) call “narcissistic” personality are