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Kubie, L.S. (1967). The Relation of Psychotic Disorganization to the Neurotic Process. J. Amer. Psychoanal. Assn., 15:626-640.

(1967). Journal of the American Psychoanalytic Association, 15:626-640

The Relation of Psychotic Disorganization to the Neurotic Process

Lawrence S. Kubie, M.D.

SUMMARY

The neurotic process is a chain of distortions of psychological development which have a dual origin in unconscious conflicts and in the early imposition of central affective positions. The symptomatic expressions of these conflicts and of the central affective potential produce secondary conflicts, which in turn give rise to additional distortions and a secondary series of distorting consequences and then a third series of conflicts, etc. These reverberating chains evolve as the neurotic process.

The underlying conflicts arise between pairs of irreconcilable and often unattainable drives. They operate on all levels concurrently, and become pathogenic only when the unconscious components in this mixture of interacting processes are dominant. When additional sets of pathogenic conflicts arise between antagonistic symptoms, which occurs frequently yet has been largely overlooked, the consequence of this superimposition of irreconcilable conflicts among symptoms on the underlying neurotogenic conflicts among drives leads directly to psychotic disorganization. These facts make superfluous the assumption that so-called "structural" conflicts arise among subunits within the personality.

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