From Ego Psychology to Psychoanalysis in the Year 2000: One Analyst's Journey

Challenged by clinical findings and necessity, psychoanalysts proceed on a lifelong professional journey of exploring, deleting, adding, and integrating from various theoretical and technical paradigms. This article briefly depicts one analyst's journey from ego psychology in the early 1970s to the year 2000. The emphasis on retaining early valuable tenets and adding new theoretical and technical concepts. As an example, conflicts involving problems of the self and ego ideal, brought to the fore through work with patients having significant self-esteem, shame, and envy difficulties, are singled out. These conflicts are found in cases such as those with anorexia, body image disturbance, gender identity and negative gender message problems, and cases having early denigrating environments. Shame dynamics are addressed. The presenting pictures for problems involving shame are usually new compromise formations prompted by signal shame. A case is reported to depict the use of modern conflict theory in analyzing such problems.