In this stimulating paper Kubie takes up the fundamental problem of the critical differences between pathological and normal psychological processes, and especially between psychotic and neuroticprocesses. He reviews briefly the failure of the attempts that have been made so far to distinguish between these processes. He contends that one feature of all ego functions, the symbolic process, is peculiar to the maturing human animal. The disturbance in the symbolic function is what definitely characterizes adult human psychopathology. But Kubie does not claim that human psychopathology consists exclusively of a disturbance in symbolic functions, and he separates those forces which arise through the impact of early emotional stresses on presymbolic stages of human life from those which arise through a distortion of the symbolic process itself. He limits his consideration in this paper to the latter. He discusses the continuity of symbolic function in conscious, preconscious, and unconscious levels and in three forms, namely, literal, allegorical, and dreamlike or analytic. The significance of the symbolic function in man's development is considered.
In its early formation, every concept and its symbolic representatives develop two points of reference, one internal with respect to the boundaries of the body, and one external. Thus every symbol has a dual anchorage in the 'I' and in the 'non-I'. This double reference of every symbol is inherent in the process by which we gainknowledge and by which we orient ourselves to ourselves and to the outer world. The symbolic process is a bridge between the inner and outer worlds. There is a neuroanatomical and neurophysiological basis for this bipolarity of the symbol: the 'I' components have roots in the archipallial cortex, the 'non-I' in the neopallium, and the 'nose brain' constitutes a link between them.
Psychopathology appears whenever there is any distortion of the relation of a symbol to its substrate at either the 'I' or 'non-I' pole of reference. The primary point of rupture in any psychological illness, however, is always at the 'I' pole of reference. This rupture alone produces only the neurosis. In the psychosis
- 293 -
there is an additional distortion, namely between the symbol and its pole of reference to the outer world, the 'non-I'. In actuality there is always some distortion at both poles, which is why neurotic and psychotic processes can never be mutually exclusive.
The author applies his concepts to hallucinatory processes in the normal, the neurotic, and the psychotic state.
- 294 -
(1954). Journal of the American Psychoanalytic Association. I, 1953. Psychoanal. Q., 23:293-294