Modern ego psychology

This paper reviews the history of ego psychology, describing problems in the theory that have perhaps contributed to subsequent theory development and theoretical splintering. The present status of ego psychology is then described, with a focus on broadly accepted general principles. A proposal/prediction is then made regarding efforts to integrate the main schools and splinter groups. It is argued that the ego's method of synthesizing aspects of experience will help integrate divergent metapsychological viewpoints.     

The growth and transformation of American ego psychology

The roots of ego psychology trace back to Sigmund Freud's The Ego and the Id (1923) and "Inhibitions, Symptoms and Anxiety" (1926), works followed by two additional fundaments, Anna Freud's The Ego and the Mechanisms of Defense (1936) and Heinz Hartmann's Ego Psychology and the Problem of Adaptation (1939). It was brought to full flowering in post-World War II America by Hartmann and his many collaborators, and for over two decades it maintained a monolithic hegemony over American psychoanalysis. Within this framework the conceptions of the psychoanalytic psychotherapies evolved as specific modifications of psychoanalytic technique directed to the clinical needs of the spectrum of patients not amenable to psychoanalysis proper. This American consensus on the ego psychology paradigm and its array of technical implementations fragmented several decades ago, with the rise in America of Kohut's self psychology, geared to the narcissistic disorders, and with the importation from Britain of neo-Kleinian and object-relational perspectives, all coinciding with the rapid growth of the varieties of relational psychoanalysis, with its shift in focus to the two-person, interactive, and co-constructed transference-countertransference matrix. Implications of this intermingled theoretical pluralism (as contrasted with the unity of the once dominant ego psychology paradigm) for the evolution of the American ego psychology are spelled out.     

Cognitive ego psychology and the psychotherapy of learning disorders

The single most common referral problem in middle childhood and adolescence is academic underachievement and learning failure. Yet, the term “learning disorder” lacks specificity as a diagnostic entity and offers no guidelines for psychotherapy. An appreciation of the developmental processes by which the undifferentiated, unstructured, self-less and objectless newborn becomes a more fully developed, self-sufficient individual, capable of adaptive functioning and formal academic learning is encompassed in contemporary psychoanalytic conceptions of the separation-individuation process. This theory provides an organizing, theoretical base for diagnosis and treatment of learning disorders. Based on these conceptions, we discuss therapeutic techniques which are appropriate to the level of developmental arrest at each of the phases of the separation-individuation process.     

Some technical implications of Klein's concept of 'premature ego development'

In this paper, the author revisits the problem of 'premature ego development' first introduced by Melanie Klein in 1930. She also highlights several developments in post-Kleinian thinking since the publication of that paper, which can be seen as offshoots of or complements to Klein's work. The author proposes a link between this category of precocious development and the absence of the experience of what Bion termed the 'containing object.' She puts forward several technical considerations relevant to analytic work with patients who suffer as a result of early developmental failures and presents various clinical vignettes in order to demonstrate the ways in which these considerations take shape in the analytic setting.