(1965) – International Journal of Psychoanalysis

Volume 46 – pages 323-331

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On Having the Right to a Life:

An Aspect of the Superego's Development

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Arnold Modell

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We cannot expect that psycho-analysis as a method of investigation will uncover facts that are entirely new. Our contributions, such as they may be, will consist of bringing older observations into accord with newer theoretical formulations.

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Psycho-analysts have long observed individuals who feel that they cannot justify their existence, and who must destroy every opportunity for happiness (Freud, 1916). Freud applied the term 'moral masochism' to such behaviour and he considered that the negative therapeutic reaction was the sign by which it could be recognized. In The Ego and The Id Freud (1923) says: There are certain people who behave in a quite peculiar fashion during the work of analysis. When one speaks hopefully to them or expresses satisfaction with the progress of the treatment, they show signs of discontent and their condition invariably becomes worse. One begins by regarding this as defiance, as an attempt to prove their superiority to the physician, but later one comes to take a deeper and juster view. One becomes convinced, not only that such people cannot endure any praise or appreciation, but that they react inversely to the progress of the treatment. Every partial solution that ought to result, and in other people does result, in an improvement or a temporary suspension of symptoms produces in them for the time being an exacerbation of their illness; they get worse during the treatment instead of getting better. They exhibit what is known as 'negative therapeutic reaction'.

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The existence of this phenomenon testifies to the presence of an unconscious sense of guilt, and the problem as a whole has long been known to be a manifestation of superego pathology. I wish here to review these observations in the light of more recent notions of superego formation.

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Psychoanalysis is at present experiencing a revival of interest in the concept of the superego. This is shown by the appearance of several extensive and excellent reviews (Beres, 1958); (Sandler, 1960); (Hartmann and Loewenstein, 1962). Despite the continuing interest in superego theory, there has been a gap between the application of theoretical knowledge and clinical observation and technique. Sandler, for example, found that the Hampstead Clinic group in their classification of clinical material had made little use of the superego concept. The failure to apply this theoretical construct clinically is due in part to the global nature of the superego concept. There is little differentiation between the different aspects of superego functions, such as we have become accustomed to discern with regard to the ego (for example, A. Freud, 1936). In Civilization and its Discontents Freud (1930) assumed that the 'original infantile stage of conscience ... is not given up after the introjection of the superego, but persists alongside of it and behind it'. Despite Freud's recognition of developmental stages of the superego, our observations of superego regression and fixation remain rudimentary. We know that this issue has become further beclouded as a result of the polemics that have developed around the Kleinian assertion (Klein, 1948) that the superego is formed in the first year of life. Zetzel has on many occasions (1949), (1953), (1956) attempted to clarify the differences between the Kleinian and Freudian theories of superego formation without necessarily rejecting in toto Klein's clinical contributions. Zetzel (1953): Mrs. Klein in her analytic work finds evidence to suggest the presence of superego-like introjections preceding the genital oedipus complex. Two possibilities are open: first, that the precursors of the superego antedate the oedipus complex; second, that the oedipus complex antedates the genital level. It is the latter alternative Mrs. Klein chooses.

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I became interested in the problem of diffuse unconscious guilt as the result of the particular composition of my analytic practice: I had chosen some patients who proved to be extremely refractory. These were not borderline cases—one might say that they were on the border of being borderline. They were not borderline in the sense that their object relations were predominantly of a transitional sort, as I have described previously (Modell, 1963), nor was there a major disturbance in reality testing. Nonetheless, there was a certain impairment in their capacity to feel for other persons which interfered with the establishment of a therapeutic alliance. But after some time it became apparent that their refractoriness to analysis was due not only to their impaired capacity to form object relationships, but resulted from something which, although related to this impairment, was more fundamental—they were possessed of a basic belief that they had no right to a better life. Such an attitude is, of course, completely incompatible with the aims of psycho-analysis. What I have been attempting to describe has been beautifully portrayed by Sharpe (1931, p. 81): The people who enjoy the greatest ease and to whom work and the conditions of life bring the greatest internal satisfaction are those who have justified their existence to themselves. They have won through to a right to live, and a right to live means a life in which physical and mental powers can be used to the ego's advantage and well-being of the community. For a 'right to life' is only ultimately based on the right of others to live. In a psyche that had attained that feeling of rightness to live there would be no obsession, no compulsion. ... I believe 'justification of existence' is the very core of our problems, whether we are thinking of the malaise of the so-called normal or the pathological manifestations of the so-called neurotic.

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I am attempting then to understand a human problem which influences to varying degrees the course of most people's lives. I have chosen to describe here extreme examples because the extremity of their pathology will illuminate certain processes that are common to all.

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CASE NUMBER 1

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The life of the man that I shall now describe is one that has been dominated by an urge to destroy all accomplishment, and any pleasure can be experienced only under conditions of self-debasement. He is an unmarried man in his late twenties, with a good intelligence and a considerable musical and scientific talent. Yet he was unable to make use of his gifts in a manner that would secure a role in life that would afford him any degree of pride or satisfaction. For, whenever a professional goal was in his grasp, he would be forced to prevent himself from attaining it. Despite a good academic record in college, he failed in a professional school. He later became a graduate student in an allied scientific field and, despite genuine ability in this field, presented himself in such an inadequate and infantile manner that he was considered unsuitable as a Ph.D. candidate. He did, however, obtain a Master's degree, but only after some work in analysis. Following this relatively minor achievement, he experienced an overwhelming panic reaction and sought treatment at a hospital Emergency Room, convinced that he was dying of a heart attack.

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The search for sensual pleasure dominated this man's conscious thoughts. Yet he was never able to have sexual intercourse. His one attempt with a prostitute in late adolescence was a fiasco. He was completely impotent and felt so humiliated that he never attempted intercourse again. But he was unable to secure even simpler pleasures for himself without experiencing self- debasement. For example, whenever the opportunity presented itself to enjoy the pleasures of food in a good restaurant or listen to music that he loved, the pleasure would be negated by an obsessive fear that he might vomit. This vomiting was later understood in part as a displacement upwards, for it was a fear of losing bowel sphincter control. It was an expression of the sadistic wish to degrade others, literally to splatter them and simultaneously to humiliate himself. This sado-masochistic formation was truly the core of his existence.

He could properly be classified as an autoerotic pervert. His erotic life was dominated by a specific sado-masochistic fantasy, a variation of which would provide a stimulation to masturbation. A woman is overcome with an urge to urinate. She dashes for a lavatory, does not arrive on time, and urinates in her underpants. Masturbation is invariably accomplished while lying on his back in the female position, and self-degradation is further insured as it is a necessary part of the act that he 'dirty' himself with his own sperm. He can be aroused sexually only by this specific fantasy of a woman suffering from urinary urgency.

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This bizarre symptom-formation is intelligible in the context of his early developmental history. He was an only child until the age of five, when a sister was born. Until that time, he experienced an unusual sensual intimacy with his mother which had as its focus the act of urination. In the middle of the night he would call out, 'Mommy, cissie.' His mother would than take him to the bathroom where he would first urinate and then watch his mother urinating, all the while experiencing great sexual arousal. He believed that his mother herself was preoccupied with her urinary functions and would frequently refer to her need to micturate, and on some occasions be so overcome with urinary urgency that she would run to the bathroom. He was not only aroused by her, but felt that his mother humiliated herself and for this reason he held her in profound contempt. In his adult life, just the sight of a woman running, for whatever reason, would be sexually arousing. Only the woman who humiliates herself arouses him; the sadistic wish towards mother is apparent.

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In his early years, before the birth of his sister, he experienced a sense of fusion to his mother. He said, 'It was as if she and I were one.' His primary identification with his mother persisted and was relatively unmodified by an identification with his father. I consider this failure to form an identification with his father as crucial to the understanding of his psychopathology and will enlarge upon this issue in the later theoretical discussion.

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He believed that his father, who was preoccupied with certain professional difficulties, abandoned him to his mother's ministrations. His only early memories of his father were the fear of being hit by him and feeling that his father avoided him for fear that he, the patient, might soil him. As he grew older, he related to his father in a peculiarly limited way: he would either arouse him to laughter or provoke his contempt. He developed a store of jokes with which he would amuse and stimulate his father, or, alternately, he would recount an event in which he had humiliated and debased himself, and would elicit his father's disgust. His relationship to his father was limited to this peculiar kind of arousal. An ordinary object relationship with periods of emotionally muted give-and-take seemed never to have been developed. This failure to form a good object relationship undoubtedly prevented his identification with father in the infantile-oedipal period. Instead of relating to his father he attempted to arouse him and to elicit a response of contempt in a manner reminiscent of the way his mother provoked contempt in him.

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Intense pre-oedipal, sado-masochistic fantasies remained unmodified throughout his life. The fantasies themselves were so intact that one had the impression that one was examining an archaeological artifact. He was obsessed with the rack, that medieval instrument of torture. He was completely preoccupied with the visual fantasy of a strong man being broken and stretched on the rack. He would be alternately the tormentor and the victim. In all of his human relationships this motif would be reenacted. The analysis was a torture situation; the couch was a rack and I was the tormentor, forcing him to confess. We later learned that the man on the rack was not a man but a woman, and the stretching corresponded to his fantasy of the woman's role in sexual intercourse. Oedipal fantasies did develop, but what was most striking was the extent to which they remained unrepressed. At puberty he was conscious of a wish to 'fuck my mother' and did not understand why other boys would be embarrassed or ashamed to talk about such matters. He wasn't quite sure what 'fucking' meant but had a vague idea that it involved the genitals in some sort of sexual union. Voyeuristic interest in his mother's genitals was extreme and was not subject to repression or inhibition, for he did manage to see his mother's genitals by constructing an ingenious system of mirrors in his mother's bathroom. It appeared as if the failure to achieve an infantile-oedipal identification with his father had impaired the development of the forces of repression and guilt. Although he had suffered from diffuse, unconscious guilt to the extent that he truly felt he had no right to a life, conscious guilt was relatively absent. He could gaze at his mother's genitals through these mirrors without experiencing conscious guilt or anxiety. He could state in analysis, with great intensity, that he wished to 'fuck my mother', again without the conscious experience of guilt or anxiety. His life, however, was under the complete domination of unconscious guilt.

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CASE NUMBER 2

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Another patient had achieved the external trappings of success. She had married well; her husband, who was a lawyer, was both wealthy and kind. She had an interesting job at which she displayed considerable talent. But she was compelled to negate whatever she possessed. She dispelled the pleasure in her marriage by unceasing provocations. And what she had in fact achieved in life —for she had risen above the economic and social status of her parents—she dispelled by means of the conviction that it was all unreal. She was only acting. She was simply acting the part of a young matron culled from the pages of a women's magazine.

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Psycho-analysis was something that she was much too guilty to accept. She could enter analysis if she used the rationalization that she was doing it for her husband's sake. She could not bear having a better life for herself. She had too much already. Her deepest conviction was that she had no right to a life better than that of her mother, which was perceived by her as a life of hardship and degradation. At the beginning of the analysis her unconscious mind did all it could to sabotage the work of the analysis. There was a massive effort, completely unconscious, to present herself in such a manner that I would be convinced that she was unsuitable for analysis. In addition, I suspect that she was able to sense that analysts find it most difficult to accept those who have no feeling for others, and she correspondingly presented herself as someone entirely devoid of human feeling. For example, she related the death of a friend's child without revealing the slightest trace of an emotional response. She presented herself as bizarre, with the unconscious wish that I would think her psychotic; she recounted how she threw her cat against the wall of her apartment in a fit of rage, how she masturbated with a fireplace poker, etc. In short, she tried to present herself to me as a thoroughly repulsive person. It was only when I realized that the underlying issue was her conviction that she had no right to the analysis, that she had no right to a better life, that we were able to establish the beginning of a therapeutic alliance.

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I then learned of an unconscious fantasy that was fundamental and dominated the course of her life. She was the oldest of three children, spaced many years apart. She was convinced that she had taken for herself the best that there was of her mother's love (i.e. milk), had in fact drained her and robbed her siblings of their birthrights. Her basic conviction was that love was a concrete substance, and that its supply was limited; if she possessed anything that was good, it meant that someone else was deprived. I developed a corresponding concrete image in my own mind: it was as if she and her siblings and parents were all sucking on a closed container, and there was just so much to go round. Whatever she consumed meant that there was so much less for the others. Her life was dominated by intense envy and a correspondingly intense fear of the envy of others. Whatever someone else had, she felt was taken away from her, and, correspondingly, whatever she had must be kept hidden for fear of the envy of others. Thus, to have a better life, to obtain something good for herself, meant literally that the rest of her family would starve.

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Though the psychopathology here differed in many respects from that described in the previous patient, there were also certain striking parallels. Her life, too, was dominated by sadistic fantasies. She, too, had failed to develop a sense of identity separate from that of her mother. What had developed in this patient was a counter-identification: where her mother was slovenly, she was neat; where her mother was fat, she was thin, etc. But the counter-identification had to be slavishly and compulsively maintained. It was as if there was nothing else to her; as a separate person she did not exist. As was true with the previous patient, she too failed to develop a good object relationship with her father and was entirely entrusted to her mother's care. Her father, because of his work, spent considerable time away from the home. Here, again, the relationship with her father was highly eroticized: her father was the source of much erotic stimulation, exposing his penis to her from her earliest years and continuing to do so until she left home for college. In short, she perceived her relationship to him to be unbearably stimulating and devoid of warmth and tenderness. Here again incestuous sexual fantasies of the oedipal period were not repressed but remained conscious.

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DISCUSSION

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I shall not attempt here to review the extensive literature on the development of the superego, but wish merely to recall certain familiar concepts which will provide the background for the discussion. There has been a considerable controversy in psycho-analysis regarding the time of the development of the superego, and the extent to which it is determined innately—that is, biologically —and the extent to which it is moulded by the parents' behaviour, that is moulded by the environment. It would be an oversimplification to state that the lines of the controversy can be drawn to include, on one side, the Kleinian analysts, who date the onset of the formation of the superego to the second quarter of the first year of life, and attribute its development entirely to the death instinct; and, on the other, the orthodox or classical analysts who date its onset to the oedipal period, and attribute the content of the superego to both the character of the parents and the innate instinctual development of the individual. I would say it would be an oversimplification to present the lines of the controversy as so clearly drawn. For some classical analysts agree that the superego has a pre-history (Zetzel, 1953); that is, it has determinants prior to the onset of the oedipal period (see also Ritvo and Solnit, 1960); and, further, all analysts have come to recognize the importance of infantile sadism in the formation of the superego, which was first observed by Klein, although many would wish to separate this observation from the more speculative concept of the death instinct.

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There is also agreement that the early development of the superego is inextricably connected to the early development of the ego. Reich's paper on 'Early Identifications as Archaic Elements in the Superego' (1954) describes an omnipotent ego ideal as a pre-oedipal phase of superego development. As we know, it is extremely difficult to separate archaic omnipotent fantasies which remain the core of the self-image, from identical fantasies that become an ego ideal. Reich's views of the omnipotent ego ideal as an early phase of superego development have recently been elaborated in a paper by Lampl-de Groot (1962). In an earlier paper (Modell, 1963), I have described similar fantasies in the archaic self-image of the borderline patient. In these patients it appears that ego and superego processes are undifferentiated, and it is very difficult to decide whether such fantasies are part of the self-image, and therefore, of the ego system, or part of the ego ideal, and therefore, of the superego system: the differentiation between archaic elements in the ego and superego are blurred. My work on the interpretation of auditory hallucinations (Modell, 1958) led to the same conclusion, for it was not possible to state that the voices heard by schizophrenic patients were exclusively a superego function. Certain ego executant functions were co-mingled with the superego functions of control and prohibition. How are we then to conceptualize the preoedipal development of the superego? I have found that a model based on embryological development implicit in the writings of Hartmann, Kris, and Loewenstein (1946) and Spitz (1959) provides a framework for a discussion of early superego development.

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In the early stages of embryological development, structures remain undifferentiated. Differentiation occurs in a specific time sequence under the control of organizers. The infantile oedipal phase is analogous to an embryological organizer that provides the structural differentiation, that separates out early ego from superego determinants. Hartmann, Beres, and others make this point when they distinguish superego genesis from superego function. Function is determined by structural organization which does not occur until the oedipal phase. In the preoedipal phase, ego and superego determinants are not fully differentiated; certain primordial superego determinants may exist side by side with relatively more mature ego structures. Freud (1930) observed: We ought not to speak of a conscience until a superego is demonstrably present. As to a sense of guilt, we must admit that it is in existence before the superego, and therefore before conscience too.

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This observation of Freud's, that a sense of guilt exists before conscience is structuralized, is of great importance, for it permits one to differentiate the guilt associated with pregenital, sadistic impulses, such as Klein has observed, from guilt that is a function of a structural system, that is, the superego itself. As I shall show later, this distinction is not simply of academic interest.

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A feedback model is also relevant. For we would also anticipate a high degree of interrelationship (or feedback) between events in the pre-oedipal phase and the degree to which the oedipal experience can successfully structuralize and differentiate the pre-oedipal elements of superego development. That is to say, a good object relationship with the father at a later phase of development may mitigate a primary identification with the mother and lead to a more functional and structuralized superego. Personality development may proceed in a manner reminiscent of the way Russians write history textbooks; later events determine how earlier events are organized. Such general statements as these have the danger of becoming too abstract and lacking in clinical content so that it is now necessary to return to the specific clinical observations.

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An early paper by Hendrick (1936) foreshadowed some of these concepts. Although his discussion was limited to ego defects, his remarks have relevance to the consideration of superego development as well. Hendrick considered that ego defects were a partial development failure. Intense infantile sadism leading to certain critical fantasies, such as that of oral ejection, interfered with the completion of an identification process. A feedback concept was implicit in his thinking, for he stated that this process of identification would normally terminate the special phase of infantile aggression that preceded it.

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In the material presented, we have also observed sadistic fantasies of a special intensity: the male patient was dominated by a wish to destroy and humiliate others; the female patient was consumed by envy—she wished to take away anything of value that others possessed and, in turn, feared similar retaliation. It seemed that the guilt of these patients was not only associated with the content of their sadistic wishes, as Klein has emphasized, for in both patients there was a failure of development in the phase of self-object differentiation. Although the identification with the maternal object in these patients was not quite so complete as in borderline cases, there was a similar failure here to develop a sense of self as distinct from those fantasies that form the nexus of a maternal image. The content of the guilt, as I have been able to observe it in these patients, was not only based upon the wish to destroy others, but was also related to the belief that they had no right to a separate existence, so that it is reasonable to suppose that the guilt is in some way associated with failure of development in the phase of self-object differentiation. I would like to suggest that the belief that one does not have the right to a life is a derivative of what I would like to call separation guilt. For the right to a life really means the right to a separate existence. Separation anxiety is a familiar subject and requires no further elaboration here. But we have paid less attention to the experience of separation guilt. In those individuals who are burdened with intense ambivalence, from whatever source, separation is unconsciously perceived as resulting in the death of the object. A schizophrenic patient, whose treatment I have been supervising for several years, had finally, after a great struggle, achieved some consolidation of her ego and was beginning to deal with problems of separation from her mother. She directly expressed the belief that in order for her to have a separate existence her mother had to be killed. We see again the working of circular processes, for intense infantile ambivalence will interfere with the development of self-object differentiation. Where there is poor self-object differentiation, there is confusion between self and object, and, in the infantile mind, the fear of dying upon separation from mother can be confused with the fear of destroying mother.

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Although I have drawn my illustrations from very disturbed patients, I do not wish to leave the impression that guilt in having a separate existence is limited to the most pathological cases. I believe that vestiges of this problem remain, to some extent, in many if not most people and can be observed in a more disguised form. For example, another patient, whose life was also dominated by a profound sense of unconscious guilt, believed that if she were to become more mature through the efforts of psycho-analysis, her mother could not bear it and would kill herself. She too believed, as did the schizophrenic patient, that if she separated from her mother she would cause her mother's death. One can also discern remnants of this fantasy in the terminal phase of analyses, where patients struggle with feelings of guilt at being permitted to express values and a way of life that are different, that is to say, are separate, from those of the analyst.

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What has just been described as separation guilt does not constitute a superego. To confuse the existence of feelings of guilt with a psychic structure is the error that Kleinians have made. For Freud stated that guilt can exist before the formation of a superego; the superego as a structure is defined by means of its functions. Separation guilt is a genetic component of the superego but it is not the superego itself. In this sense Freud's formulation that the superego is the heir to the Oedipus complex is still valid. Although Freud (1923) was unequivocal in assigning to the father a special role in the formation of the superego: 'the superego arises, as we know, from the identification with the father taken as a model, ' more recent commentators tend to blur the father's role and describe the formation of the superego as consisting of identifications with the parents, implying that the mother has an equal influence (Sandler, 1960). The current view may be that Freud was unduly influenced by his own authoritarian, paternalistic society, and for this reason assigned to the father a dominant influence in the formation of conscience. However, our material tends to support Freud's view of the importance of the father in the formation of the superego. The two cases I have chosen to illustrate the greatest diffusion of unconscious guilt are conspicuous in that in both instances there was a seriously impaired object relationship with their fathers, which led subsequently to a failure to achieve a good identification with the father in the oedipal period. I recognize that the problem is somewhat more complicated in the female patient, yet we know that a good father identification based on a love relationship can mitigate the intense ambivalence towards the pre-oedipal mother and can further the process of self-object individuation. In spite of the waning position of the father in our contemporary culture, in the unconscious mind strength is still equated with the male. It is the internalization of this male strength that provides the unconscious source of instinctual control. I believe that in these patients the diffuse separation guilt of the pre-oedipal period would have been modified had an identification with the father been successful, and the structural formation of the superego would have been furthered. The failure to achieve a good identification with father resulted in a partial developmental failure of the superego. We have noted the failure to experience conscious guilt that would lead to repression of forbidden thoughts. For example, I have told how the male patient in puberty had conscious wishes to 'fuck' his mother. The existence of diffuse unconscious guilt, such as I described earlier, suggests a failure to function, that is, a failure of structural formation. Yet the developmental failure is only partial, for these patients are no amoral sociopaths. What is conspicuous, however, is the extent to which unconscious guilt pervades the entire personality structure. It is not contained and bound up in symptoms, nor do we see guilt leading to restrictive inhibition of a segment or a sector of the personality as, for example, would occur where oedipal guilt in a male might lead to a work inhibition, but would permit him to function in other areas. For the patients I have described all pleasure that can be experienced with dignity and self-respect is undone and negated. Pervasiveness of diffuse unconscious guilt is unquestioned, but this should not lead one to describe the superego as strong. Intensity of guilt, as I have tried to show, is a result, I believe, of a partial developmental arrest of the superego.

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Although a knowledge of ego development cannot be literally transposed to the area of the superego, there are certain evident parallels and useful analogies to be drawn. Freud recognized a certain parallel between the affects of anxiety and guilt. He stated (1930): The sense of guilt is at bottom nothing else but a topographic variety of anxiety; and in its later phases it coincides completely with the fear of the superego. We would certainly not describe as strong an ego that experiences intense anxiety. We have made much use of the concept of primary and secondary anxiety (see Zetzel, 1949), the former existing where the ego is overwhelmed, and the latter where there has been some ego development so that anxiety can be used as a signal for the institution of ego defenses. Primary anxiety can be catastrophic, whereas secondary anxiety is adaptive. I would like to suggest a similar analogy between primary and secondary anxiety of the ego, on the one hand, and what I would tentatively refer to, on the other hand, as primary and secondary guilt. Like all analogies, this one should not be extended too far. I would describe as primary guilt that guilt, whether unconscious or conscious, that is experienced prior to the development of the superego, and which may persist in those individuals whose superego development is imperfect. Secondary guilt is guilt that is present after the formation of superego structure. Similar to secondary anxiety, it serves an adaptive function and can be used to institute a variety of ego defences. Primary guilt is diffuse, pervasive, and, at its worst, can interfere with all personality functioning. Secondary guilt tends to be circumscribed and limited. When it leads to ego inhibitions, they remain partial.

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It would be incorrect to say that guilt is experienced by the superego in the same manner as anxiety is experienced by the ego. For it is only the ego that controls perceptual processes. Guilt as well as anxiety can be experienced only by the ego. However, we assume that guilt arises as a result of certain tension between the ego and the superego, and that the state of maturation of the superego will determine the nature of this tension. I shall later return to this problem.

The concept of unconscious guilt has been criticized as semantically inconsistent, for, strictly speaking, as Freud (1923) has indicated, feelings cannot properly be considered unconscious. Unconscious guilt is an inference of an affect and not, of course, an actual feeling. Whether or not the affect of guilt is experienced is not the crucial issue, for the effects of the tension between the superego and the ego will influence behaviour regardless how conscious the guilt is. The life history of the patients that we have described, who feel they have no right to life, illustrates the manner in which this superego-ego tension can pervade all of their actions. The situation is really not so different with regard to the status of unconscious anxiety. Although we do not often use the term unconscious anxiety, it is a basic clinical inference regarding the acting out patient or the counterphobic patient which can be confirmed when acting out is controlled as a result of analysis and intense anxiety results. Further, we know that signal or secondary anxiety, when used as a motive for defence, need not be, and frequently is not, conscious. Whether guilt is experienced by the ego or warded off through projected rage or in a variety of character defences is an extremely complex issue which attests to the extent to which ego and superego functions are interrelated (see Brenman, 1952).

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To summarize: certain forms of the negative therapeutic reaction can be understood as a manifestation of a more basic feeling of not having a right to a life, that is, not having a right to a separate existence. I have traced the origin of this feeling to a difficulty in the early preoedipal phase, especially in the phase of self-object differentiation. Those individuals who, for whatever reason, experience a heightened degree of sadism also experience a heightened degree of separation guilt. Separation from the maternal object in these people is unconsciously perceived as causing the death of the mother; to obtain something for one's self, to lead a separate existence, is perceived as depriving the mother of her basic substance. This guilt, I suggest, is a genetic element of the superego but is not the superego itself. The failure to resolve adequately the preoedipal phase of self-object differentiation leads to a persistence of this diffuse form of preoedipal guilt. The failure of this earlier phase is, in a circular sense, related to the failure to form an adequate identification with the father in the infantile oedipal period. Or, to state it differently, if there is a good relationship with the father or a paternal substitute in the oedipal period, the pathology of this earlier phase may be mitigated and the diffuse sense of separation guilt may be partially resolved. The identification with the father, as Freud stated, provides the basis for the formation of the structure of the superego. When the superego is adequately structuralized, guilt, such as it is experienced, may be cirumscribed, limited to a sector of the personality, and serve a signal function analogous to secondary anxiety.

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In this proposal I have bypassed many complex and controversial issues. For example, it is by no means certain that the superego and ego identifications proceed along similar lines. Freud noted that the superego was closer to the id and by inference that its energy was less neurtralized, that is, closer to instinctual energy. To the extent that we have attempted to differentiate primary from secondary guilt and to account for this differentiation on the basis of increased formation of superego structure, we have been consistent with the model of psychic development derived from observations of the ego. However, observations suggest that this analogy should not be drawn too far. For the lines between primary and secondary guilt are perhaps not so clearly drawn as between primary and secondary anxiety. In terms of degree of structuralization the superego has not proceeded as far in neutralizing instinctual claims as has the ego. It may be that for this reason the superego is, in a sense, a more immature structure, and so more liable to arrest in development and regression as compared with the ego. This would account for the fact that vestiges of primary guilt may exist in all of us, whereas in the relatively mature ego primary anxiety is absent.

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What I have presented is a facet of the problem of the superego's development, and it is by no means intended to be comprehensive; for example, I have not considered the relationship between the concept of the ego ideal and the concept of the superego (for a recent contribution, see Murray, 1964).

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Since the last decades of psycho-analysis have been almost exclusively devoted to ego psychology, there has come, I believe, a tendency to consider that resistance to psycho-analysis is almost exclusively an ego process, to be dealt with by means of analysis of the ego defenses. Although, as A. Freud (1936) has taught us, all psycho-analysis is a process that proceeds via the ego, she did not imply that all analysis is ego analysis. No analyst can, of course, afford to ignore the superego, and no analysis could survive in the absence of some superego analysis. But the superego may be ignored clinically in a systematic sense. Freud discussed the sources of resistance to analysis in Inhibitions, Symptoms, and Anxiety(1925). With regard to the resistance arising from the superego, he said: It is the last to be discovered, it is also the most obscure though not always the least powerful one. It seems to originate from the sense of guilt or the need for punishment; and it opposes every move toward success, including, therefore, the patient's own recovery through analysis.

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And in The Question of Lay Analysis Freud (1926) states: The unconscious sense of guilt represents the superego's resistance; it is the most powerful factor, and the one most dreaded by us. All analysis is in a sense ego analysis, but I believe we are forced to agree with Freud that the greatest resistance to analysis may arise outside of the ego, that is, in the superego. In her paper on 'The Negative Therapeutic Reaction', Riviere (1936) noted that piecemeal interpretations of the determinants of unconscious guilt are not sufficient, that we must attempt to discern the overall pattern in a systematic fashion. She observed as a leading feature in those patients who display the negative therapeutic reaction a degree of unconscious falseness and deceit in the transference. She states: A false and treacherous transference is a blow to our self-esteem and narcissism and so poisons and paralyzes our instrument for the good.

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These patients unconsciously attempt to sabotage the analysis through manipulation of the countertransference. That is to say that the negative therapeutic reaction may be more covert than Freud had described. It is not only that they become worse following a successful interpretation, but also that through their unconscious manipulation of the countertransference they attempt to bring about an attitude in the analyst that would be inimical to the analysis. I believe that they tend to select and exaggerate those qualities in themselves that they correctly perceive the analyst will find repellent. For example, the woman I described earlier, who could not bear having something for herself, had nearly convinced me at the start of her analysis that she was devoid of humanity. Provocation and manipulation of the countertransference is, of course, an everyday occurrence and does not require special comment, if it were not for the fact that the interpretation of the wish to sabotage the work of the analyst must recognize the all-pervasive unconscious guilt. That is to say, the underlying truth that such patients feel unworthy of having a separate life must be made conscious. Our best efforts with such difficult problems may, of course, be to no avail. However, without an attempt at systematic analysis of the early determinants of this diffuse unconscious sense of guilt, we will have no chance of success.

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REFERENCES

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BERES, D. 1958 'Vicissitudes of superego functions and superego precursors in childhood.' Psychoanal. Study Child 13

 

BRENMAN, M. 1952 'On teasing and being teased.' Psychoanal. Study Child 7  FREUD, A. 1936The Ego and the Mechanisms of Defence (London: Hogarth, 1937 New York: Int. Univ. Press, 1946.)

 

FREUD, S. 1916 'Some character types met with in psycho-analytic work.' S.E. 14 

 

FREUD, S. 1923 The Ego and The Id. S.E. 19

 

FREUD, S. 1925 Inhibitions, Symptoms and Anxiety. S.E. 20 FREUD, S. 1926 The Question of Lay Analysis. S.E. 20

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FREUD, S. 1930 Civilization and its Discontents. S.E. 21

 

HARTMANN, H., KRIS, E., and LOEWENSTEIN, R. 1946 'Comments on the formation of psychic structure.' Psychoanal. Study Child 2

 

HARTMANN, H., and LOEWENSTEIN, R. 1962 'Notes on the superego.' Psychoanal. Study Child 17

 

HENDRICK, I. 1936 'Ego development and certain character problems.' Psychoanal. Q. 5

 

KLEIN, M. 1948Contributions to Psycho-analysis (London: Hogarth.)

 

LAMPL-DE GROOT, J. 1962 'Ego ideal and superego.' Psychoanal. Study Child 17

 

MODELL, A. 1958 'The theoretical implications of hallucinatory experiences in schizophrenia.' J. Am. Psychoanal. Assoc.

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MODELL, A. 1963 'Primitive object relationships and the predisposition to schizophrenia.' Int. J. Psychoanal. 44

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MURRAY, J. 1964 'Narcissism and the ego ideal.' J. Am. Psychoanal. Assoc. 12 REICH, A. 1954 'Early identifications as archaic elements in the superego.' J. Am. Psychoanal. Assoc. 2 

RITVO, S., and SOLNIT, A. 1960 'The relationship of early ego identifications to superego function.' Int. J. Psychoanal. 41

 

RIVIERE, J. 1936 'A contribution to the analysis of the negative therapeutic reaction.' Int. J. Psychoanal. 17

SANDLER, J. 1960 'On the concept of the superego.' Psychoanal. Study Child 15

SHARPE, E. 1931 ' Variations of technique in different neuroses.' In: Collected Papers on Psycho-Analysis (London: Hogarth, 1950.)

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SPITZ, R. 1959A Genetic Field Theory of Ego Formation (New York: Int. Univ. Press.)

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ZETZEL, E. (under Rosenberg, E.) 1949 'Anxiety and the capacity to bear it.' Int. J. Psychoanal. 30

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ZETZEL, E. (under Rosenberg, E.) 1953 ' The depressive position.' In: Affective Disordersed. Greenacre. (New York: Int. Univ. Press.)

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ZETZEL, E. (under Rosenberg, E.) 1956 'An approach to the relation between concept and content in psychoanalytic theory.' Psychoanal. Study Child 11

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