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Moriarty, D.M. (1961). Observations of the Superego in a Schizophrenic Patient. Psychoanal. Rev., 48B(2):3-18.
   

(1961). Psychoanalytic Review, 48B(2):3-18

Observations of the Superego in a Schizophrenic Patient

David M. Moriarty, M.D.

Relatively little has been written on the subject of the superego in schizophrenia. Even in Bellak's monumental work, there are few references to the superego. Bellak 3 states that “since we conceive of the treatment of schizophrenia in terms of ego weakness, coexistent with great intensity of id impulses and a strong superego or a taxing reality situation, therapy would have to consist of either strengthening the ego directly and/or weakening the id impulses, and/or the superego directly, and/or decreasing the burdens of reality.” Divergent views exist. While Bellak mentions the superego in schizophrenia as strong, Alexander 2 at least at one time (1931), maintained that there is no superego in some types of schizophrenia while clearly describing it in the paranoid type. We would tend to go along with Hartmann's 14 notion that strength refers to adaptive capacity rather than how archaic it may be. Pious 21 feels the defective superego plays a central role in the development of schizophrenia. We quote:

Freud, Alexander, Menninger and others have pointed out that suppression of aggressiveness increases the aggressivity of the superego to the ego. Freud says, Theoretically, as a matter of fact, we are in doubt whether we ought to suppose that all aggressiveness that has turned back from the external world is bound by the superego to the ego. Freud says, “Theoretically, as a matter of fact, we are in doubt whether we ought to suppose that all aggressiveness that has turned back from the external would is bound by the superego to the ego. Freud says, “Theoretically, as a matter of fact carries on its silent, sinister activity as a free destructive instinct in the ego and the id …. It is quite likely that when on subsequent occasions aggressiveness is suppressed, the instinct follows the path which was opened to it at that decisive period (development of the superego).” Again Freud says, “It is remarkable that the more a man checks his aggressive tendencies towards others, the more tyrannical, that is aggressive, he becomes in his ego ideal.”

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