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Throughout psychoanalytic literature, the words “grandiosity” and “omnipotence” have been used almost, but not quite, interchangeably. At the beginning of the century, the word “megalomania” was also used in the same connection. This interchangeableness may have led to some important confusions, not only of the words, but also as to which feelings or behavior are, or are not, pathological. And, of course, if there were questions as to pathology, then clearly there would be questions as to the approach of the therapist.
Freud (1909) himself contributed to this confusion. In the case of the Rat Man, he refers to the patient's “omnipotence which he ascribed to his thoughts and feelings, and to his wishes, whether good or evil” (p. 233, italics in the original). But only a bit later, referring to the same concept, Freud says “this belief is a frank acknowledgement of a relic of the old megalomania of infancy” (p. 234, italics added).
However, clinical experience leads to the impression that the emotional characteristics of grandiosity are very different than those of omnipotence. The most obvious example is the anxiety which accompanies the grandiosity of the patient compared to the peacefulness which is characteristic of the happy omnipotent baby. From a clinical point of view the question arises as to whether it is desirable to give up one's omnipotence, if it really is not the same thing as megalomania or grandiosity.
That question, in turn, leads to whether or not one can, let alone should, give up one's basic wishes. Freud (1937) says “At no other point in one's analytic work does one suffer more from an oppressive feeling that all one's repeated efforts have been in vain, and from a suspicion that one has been ‘preaching to the winds,’ than when one is trying to persuade a woman to abandon her wish for a penis on the ground of its being unrealizable …” (p. 252, italics added). Given Freud's