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Khantzian, E.J. Mack, J.E. (1983). Self-Preservation and the Care of the Self—Ego Instincts Reconsidered. Psychoanal. St. Child, 38:209-232.

(1983). Psychoanalytic Study of the Child, 38:209-232

Self-Preservation and the Care of the Self—Ego Instincts Reconsidered

E. J. Khantzian, M.D. and John E. Mack, M.D.

WE NEED NOT LOOK BEYOND THE PAST TWO DECADES TO FIND ample evidence around us in society and our clinical work of threats to human survival and of self-destructiveness. Despite the fact that ego psychology and object relations theory have become part of the bedrock of psychoanalytic practice and theory, much of our understanding of survival and self-destructiveness continues to be influenced by Freud's early writings. The complex functions relating to self-preservation, self-protection, and survival are relatively neglected in contemporary psychoanalytic literature despite the special urgency of these matters for many of our patients. It is, in fact, surprising in view of the current interest of mental health workers in disadvantaged individuals and families, for whom survival issues including basic protection from real dangers are conspicuous, that so little attention has been given in psychoanalytic theory to the psychology of self-preservation.

The

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