Freud and Beyond
Stephen A. Mitchell & Margaret J. Black (1995)
Chapter 2- Ego Psychology

Freud saw himself as the discoverer of a previously unknown world (the unconscious). He'd had to make his way through complex expanses of psychic territory to expose the crucial unconscious infantile wishes and fears that deeply fascinated and excited him. What Freud wanted to find were the secrets, not the more ordinary levels of mental life within which the secrets were concealed. Like Schliemann intent on unearthing his long-buried city, Freud noted and identified a variety of more commonplace finds in the course of his exploration, but his passion for discovering remote and exotic relics inevitably shifted his attention back to the dig, propelling him beyond them into what he felt were the deeper, primitive recesses of human experience.
     As Freud continued his investigation, however, some of his followers gathered around the site became intrigued with the more ordinary features of mental life that Freud had unearthed and set aside as he pursued darker infantile secrets. Freud's excavation had opened up dramatic cross-sectional perspectives on the inner structure and developmental stratification of the psyche. These newly exposed vistas prompted an explosion of investigations into the early history of the human psyche and its functioning. The tradition known as ego psychology germinated in the 1930s in Vienna, was dispersed via the war into England, and eventually took firm root in America.
     Before 1923 Freud had used the term ego in a loose, unsystematic fashion to refer to the dominant, largely conscious mass of ideas from which the repressed was split off. In 1923, in The Ego and the Id, he began to use ego to represent one of the three fundamental psychic agencies of the mind (in addition to the id and the superego). The ego's major functions were to represent reality and, through the erection of defenses, to channel and control internal drive pressures in the face of reality (including the demands of social convention and morality). The kinds of questions that became central to the ego psychologists were natural extensions of Freud's vision of the mind as structured around drive impulses and defenses: Are there phases, a kind of progressive ability, to accomplish the ego's defensive tasks? Is this progression an inherently predetermined process, one that inevitably unfolds, or do environmental factors aid or inhibit its development? Although initiated well before the crucial oedipal phase, is the development of the ego, like that of the superego, affected by contact with and internalization of aspects of caregivers? Although depicted as functionally opposed to and controlled by the ego, do the libidinal and aggressive drives play any part in the initial development of ego capacities? Interest in these more "ordinary" features of the psyche also included attention to the differences in drive organization and expression over the course of development and a better understanding of how the superego becomes consolidated and its constructive functions established.
     Ultimately, attention to these questions produced an expanded understanding of normal psychological functioning and psychopathology that in turn both refined and invigorated psychoanalytic theory and significantly broadened its therapeutic range. As we shall see, the ego psychologists shared many concerns with other schools of psychoanalytic thought: interpersonal psychoanalysis, object relations theories, and self psychology. All these theoretical traditions that branched off from Freud's opus began to address, in one fashion or another, problems of normal development and the impact of the environment and early relationships. What distinguishes the ego psychology approach from other lines of thought is the careful preservation of Freud's drive theory that underlies it.

ANNA FREUD: THE BUILDING BLOCKS OF
DEFENSE THEORY
Sigmund Freud's early topographical model depicted a clash between conscious and unconscious mental functioning in which id impulses pushed against ego defenses erected to contain them. The success of psychoanalytic treatment was seen as depending on the innate pressure within id impulses to seize the moment and gain expression once the patient temporarily suspended defensive operations by obeying the "fundamental rule" of free association. The structural model, introduced in 1923, depicted a more complex psyche containing a struggle among three internal agencies: ego, id, superego. According to this model, neurosis is the result of a compromise formation worked out unconsciously among these fundamentally antagonistic parties: the id, pressing to gratify infantile wishes; the superego, striving to prevent this morally forbidden gratification; and the ego, mediating among the claims of the id, the superego, and the outside world. Displaying some sympathy for the id, the ego works out a strategy that allows a certain amount of instinctual gratification but channels this gratification through a complex system of clever defenses. The ego disguises the appearance of the id's impulses, thereby both preventing social censure and keeping the impulses under careful regulation. For the neurotic person, these compromises between forbidden impulses and defenses result in complex, uncomfortable symptoms and a constriction of functioning (often involving sexual inhibitions or an inability to work and compete successfully). One has to pay a price for maintaining and pursuing, even in disguised forms, socially unacceptable infantile longings. This inherent punishment is negotiated by the ego to satisfy the demands of the superego.
     Anna Freud (1895-1982), Freud's devoted daughter and a pioneer of child analysis, was a crucial figure in the further exploration of the ego. Pondering her father's 1923 structural model of the psyche, Anna Freud detected a strategic technical problem: If the crucial battle line of psychic conflict was no longer between unconscious impulses and conscious defenses but among three psychic agencies, each of which carried out significant aspects of its functioning unconsciously, then the clinical process by which these unconscious aspects of the patient's psychic life could be revealed needed to be reevaluated. The topographical model had explained that the id's impulses would seek expression in the treatment for purposes of gratification. But why would it be in the interest of the unconscious portions of the ego and the superego, the other two contributors to this conflict, to make themselves known to consciousness in the analytic situation?
     The patient's ego might be able to comply with the analyst's instruction to free-associate and hold back conscious objections to reporting all that comes to mind. However, the ego also contains complex unconscious defensive arrangements that have evolved to satisfy the demands of neurotic compromise, ways of thinking that keep repressed impulses out of conscious awareness in an ongoing way. Unlike unconscious id impulses that respond with enthusiasm to the prospect of liberation in making their presence felt in the analytic hour, unconscious ego defenses gain nothing from being exposed. Their unobtrusive, seamless presence in the patient's psychic life is perfectly acceptable (ego syntonic) to the patient; they often function as a central feature of the patient's larger personality organization.
     Consider the defense of reaction formation, whereby the ego obscures unacceptable hostile impulses by transforming them into their opposite. The angry person becomes overly nice, often insistently helpful, even suffocatingly kind; he may be regarded by many (including himself) as a pillar of the community. To undo this carefully crafted solution by unmasking the defensive aspect of it, to tell the patient that his niceness is actually a clever cover for his nastiness, is not just to release id impulses from the clever defensive constraints of the ego, but to threaten a whole way of life. The ego, charged with the daunting task of keeping the peace between warring internal parties and ensuring socially acceptable functioning, works more effectively if it works undercover. The psychoanalyst, whose interest is in making unconscious experience conscious, is the longed-for liberator to unconscious id impulses, but a menace to the embattled ego and its unconscious, characterological defenses. If psychoanalysis was still to be conceived of as a battle, it had become less a rescue mission to release captives behind the lines and more a full-scale attack against a culture.
      Sigmund Freud had abandoned hypnotism because he had learned that it was not enough to lull the defenses into temporary inactivity; they needed to be directly, consciously engaged and interpreted. But Anna Freud's exploration of the ego followed its defensive operations from specific, circumscribed, clearly discernible symptoms to its infusion into the entire character; aspects of one's basic style of personality functioning could be rooted in defensive processes. If these unconscious defensive processes are not decisively brought out into the open, Anna Freud came to believe, the therapeutic impact of psychoanalysis was severely curtailed. Simply bringing id impulses into consciousness is like a Cold War rescue of a few East Berliners, which fails to address the continuing existence of the Wall and the remaining intricate security system. Freeing some has little impact on the fate of others approaching the same border; the guards themselves must be won over, the defensive machinery dismantled.
     Anna Freud's study of the complexities of the ego and its characterological defenses led to a redefinition of the role and the focus of the analyst in the therapeutic process. Free association was increasingly viewed as an unavoidably compromised activity from the start, at best a goal of the analytic process rather than the immediately available vehicle it had been naively assumed to be. As much as the patient tries to be cooperative in choosing to suspend ego attitudes and conscious objections for some period of time, unconscious defensive patterns and corresponding unconscious superego attitudes are always operating, outside the patient's awareness and control. This revised understanding of unconscious psychic activity necessitated a shift in the analyst's role. As Anna Freud reconceptualized it,

It is the task of the analyst to bring into consciousness that which is unconscious, no matter to which psychic institution it belongs. He directs his attention equally and objectively to the unconscious elements in all three institutions ... when he sets about the work of enlightenment, he takes his stand at a point equidistant from the id, the ego, and the superego. (1936, p. 28)

       In the case of defenses, then, rather than waiting until the patient's free associations were blocked and then interpreting the presumed underlying id content, the analyst needed to more actively discern subtle workings of defensive operations within the associations themselves, which compromised and distorted them. At such points, the analytic focus needed to turn from the pursuit of id impulses, concentrating instead on the out-of-awareness workings of the ego. Yet it is not always so easy to distinguish between defended and undefended communication. "We are aware of it only subsequently," observed Anna Freud, "when it becomes apparent that something is missing" (1936, p. 8).
     In the defense of isolation of affect, for example, conflictual ideas are allowed into consciousness in an intellectualized form; the disturbing feelings associated with them are blocked. The ego may permit a flow of ideas that looks like "free" associations, but the ideas are separated from their corresponding feelings. A patient might speak of intense sexual encounters, for example, but in a detached, dispassionate manner. Or, using the defense of projection, a patient might deny feelings of anger but be very sensitive to and preoccupied with angry feelings in others around her. The patient might seem to be talking "freely," but it is the impact of the unconscious defense as much as it is the impact of the instinctual pressure that shapes the verbalizations.
     Anna Freud's book The Ego and Mechanisms of Defense (1936) was a partial response to this problem. It became a psychoanalytic field marshal's handbook, documenting and illustrating various unconscious defensive strategies of the ego, alerting the clinician to telltale signs of their operation in the patient's psyche. Reorienting analysis from its concentration on tracking down id derivatives, Anna Freud defined the proper analytic attitude as "neutral," an evenhanded oscillation in attention among all three parties in the neurotic construction, the id, the ego, and the superego.
       Reports from the consulting room documented the value of this theoretical reorientation. Ernst Kris (1900-1957), a graduate of the Vienna Institute who moved to New York in 1940, was one of the most astute and subtle developers of the new ego psychology sensibility. He offered an account of his reanalysis of a young man who had undergone an earlier psychoanalytic treatment along more traditional lines. The first analysis, which had restricted interpretations to revealing the id aspects, the unconscious infantile longings inherent in the patient's neurotic struggle, had produced improvements, but had not significantly affected the paralyzing constriction in the patient's professional life.
     The patient, a capable scientist in his early thirties, was concerned about his inability to publish his research, which was impeding his professional advancement. In his first analysis he had learned that fear and guilt kept him from being productive. He became aware of a constant pressure to use other people's ideas as his own, in particular those of a well-known scientist friend with whom he spent long hours in conversation. The first analyst had interpreted the symbolic meaning of the problem by identifying and exposing the infantile instinctual wish that propelled it, seeing the wish to plagiarize as representing the patient's hidden wish to steal and aggressively devour someone else's ideas. Eventually the analyst exposed the earliest and most defended form of this unconscious instinctual current: primitive oral aggression.
     Kris, content with the first analyst's identification of the id aspects of the problem, turned his attention to the ego's unconscious defensive operations. Since the patient's work inhibitions had not been resolved, were there unconscious ego defenses still at work? Was the patient's very account of what was happening itself skewed by unconscious defensive operations that made things seem different from how they actually were? Kris undertook an "extended scrutiny," inquiring into the texts the young man feared plagiarizing, learning about his research ideas and about the specific interchanges in the conversations he had with his friend. Eventually Kris discovered something quite startling. Rather than being a potential plagiarist, it was actually the patient himself who had introduced, in discussion with his distinguished friend, ideas that the friend then eagerly used as his own, developing and eventually publishing them, giving no credit to the patient in the process. Later, upon reading the friend's writings, the patient was unaware of his part in creating them and was under the mistaken impression that he was encountering, for the first time, an idea crucial to his own point of view, but one he could not claim without being guilty of plagiarism. He wasn't a plagiarist, but a ghostwriter!
      Behind this complex defensive distortion, Kris discovered a persisting boyhood wish to admire and learn from a disappointing father whose own inhibitions prevented his professional success. In his unconscious efforts to redress this childhood disappointment and create an impressive father worthy of admiration, the patient infused his older friend with his own intellectual substance, sabotaging his own progress. Using the defense mechanism of projection, he had attributed his own abilities to his friend, whom he then regarded with awe and admiration.
     Subsequent oedipal conflicts further complicated this patient's life. His attempts to get something from an admired man by building him up over time evoked competitive feelings and the unconscious and prohibited oedipal wish to steal the father's penis, a wish that, so long as it survived even in symbolic action, had to be punished. Unavoidably and painfully, this guilt-ridden patient was sentenced to play out an experience in relation to his friend that sapped him of his own ideas and resulted in mortifying accusations of stealing, effectively preventing him from publishing his own work.
     Kris (1951) described the shift in technique that made his inquiry successful. Beyond revealing the instinctual conflict unearthed in the previous, more traditionally Freudian analysis, he had added a detailed analysis of the ego's operations and the surface behavior of the patient.

The second set of interpretations ... implemented [those from the first analysis] by its greater concreteness, by the fact that it covered a large number of details of behavior and therefore opened the way to linking present and past, adult symptomatology and infantile fantasy. The crucial point, however, was the "exploration of the surface." The problem was to establish how the feeling, "I am in danger of plagiarizing," comes about. The procedure did not aim at direct or rapid access to the id through interpretations; ... [rather,] various aspects of behavior were carefully studied. (p. 86)

In chapter 1 we noted the ways Freud himself had become increasingly interested in defenses as well as the secrets they were protecting. Anna Freud greatly extended this shift in clinical focus by cataloging and studying various defensive operations of the ego, noting both their modus operandi as well as locating them, in terms of appearance and operational sophistication, along a developmental continuum. Her investigations produced interesting observations on aspects of defensive functioning that had not received careful attention. While internally arising conflict and ensuing superego guilt had been offered as the common formula for prompting the ego's defensive activity, Anna Freud clarified that defenses, such as denial, can also be called into action by displeasure that has its source in the external world. She also observed that while this defense had been generally associated with severe psychopathology (e.g., psychotic delusions), her work with children gave evidence of the early developmentally normal appearance of this kind of defensive operation. Children regularly simply "get rid of unwelcome facts" (1936, p. 83) by negating their existence, while their overall reality testing remains unimpaired. Her work suggested that the use of denial, as well as that of projection and introjection, signaled, in the adult, disturbances that were rooted in developmentally early phases of childhood.
      Depicting the pervasiveness of ego processes throughout all areas of personality functioning, Anna Freud established the ego itself as an object of psychoanalytic inquiry worthy of study in its own right. At the same time, she expanded the range of applications of psychoanalytic ideas from symptoms to character style and from psychopathology to varieties of normal personality functioning.

The experiences of an analyst with a difficult patient illustrate the impact of ego psychology on clinical issues. Angela, a twenty-three-year-old bank teller, was at a crisis point in her life; her usual style of ignoring her feelings and keeping herself under control was failing her. A friend had advised her that her behavior at work was increasingly inappropriate. She was seen as inconsistent, often snapping at her coworkers with no provocation and with little warning. Angela said she cared for no one and felt dead inside. She had recently been attending wild all-night parties, where she had her first sexual experiences with partners she later could not identify.
     In the midst of the initial consultation, following the analyst's expression of concern, Angela exploded and attacked the analyst as inept. She demanded to know her credentials and what she planned to do with her. This ineptitude, she went on, reminded her of her mother, who had been no help to her at all and whom she "should have told to fuck off a long time ago." Her mother had had too many children, had no time for her, and expected her to be another mother instead of a child. Angela described her rage at her mother's repeated pregnancies; she remembered how she had hoped, at age six, that the hot coffee her mother drank would burn and kill the fetus then growing inside her.
     The following session began with Angela's concern about what would happen if she really "got into things" in therapy. She seemed tentative and anxious. To be in therapy required trust in another person; that, she felt, was too much for her. Her manner then abruptly changed. She announced that whatever the analyst wanted to know, she couldn't tell her, because she was "behind a wall"; no one could get in, and she couldn't get out. "Go ahead," she taunted, "try and get me to talk."
     Angela is a dramatic example of a resistant patient; far from freely revealing "all that comes to mind," she was unwilling to report anything at all. The analyst's initial tack, along classical Freudian lines, had been to think of her behavior as a kind of (transference) resistance: perhaps she was circumventing the (verbal) analytic process by engaging the analyst in some interaction that would gratify an instinctual pressure. A fight with the analyst would allow hostile feelings originating in her relationship to her mother to be played out with the analyst rather than described and analyzed. This interpretation fell on deaf ears.
     Clinical problems encountered in efforts to help difficult patients such as Angela came to represent a new frontier of psychoanalysis for ego psychologists eager to implement Anna Freud's directive to study the ego "in its own right." This focus encouraged a clinical approach that more directly engaged the patient; it placed less emphasis on uncovering hidden secrets and more on assessing psychic structure.
     With Angela, the analyst ignored her provocativeness, commenting instead that there seemed to be something about having the wall between them that felt important; she encouraged Angela to tell her about the wall. Rather than interpreting her (id) aggression, the analyst described and expressed interest in Angela's (ego) need to protect herself. Assured that this crucial aspect of her psychic makeup was respected by the analyst, very gradually, Angela allowed a dialogue to develop.
     Angela's wall appeared whenever she felt anxious, often after someone was "too nice" to her, or when she was very angry and feared a loss of self-control. Behind the wall she felt protected, but at a price, because the wall made her feel distant from people and not a part of life. Her earliest memory of the wall-like experience was at age five, when she started school and was frightened to be close to the other children lest she throw something at them. During that year she began to feel there was a large hazy circular space all around her. Once this sensation began, Angela felt paralyzed and unable to move or to respond. Her increasing social withdrawal apparently went unnoticed. She began to feel she was "an idea in someone else's head."
     Angela's mother was a chronically frustrated, overworked, and emotionally volatile woman. In her youth something of a radical, she had left her native Italy, where cultural expectations severely limited her aspirations. In her new country, she had been fiercely intent on developing a career, but because religious beliefs precluded birth control, she felt overwhelmed and defeated by her steadily increasing family and its accompanying obligations. "When you were little," Angela's mother once commented to her daughter, "all I did was scream at you." Angela reported one occasion when her mother pulled a sharp knife from the kitchen drawer, thrust it into the hands of her terrified daughter, and commanded, "Go ahead, get it over with quickly, instead of killing me with all these little things." As a child, Angela was convinced that her inevitable shortcomings in completing household chores accounted for her mother's erratic, frightening behavior.
     While quiet and obedient, trying to be Mother's perfect helper, Angela developed an intense and active fantasy life. She recalled her internal world becoming peopled, somewhere between the ages of three and seven, with what were to become certain familiar presences. There was a "fat and greedy" baby, wanting things "to be there forever," who was easily frustrated and could "rip people's eyes out if they left" her. There was a man "who lives in the basement and is just waiting for me to do something wrong so he can come up and hurt me." This man ordered a sequence of punishments for wrongdoings, however minor, that took the form of inescapable preoccupying fantasies of initially physical and later sexual torture. Deeply envious of the care and attention other children were given, Angela often wished them ill, fantasizing horrible accidents or cruel punishments. When one such highly envied schoolmate was hit by a car and killed, Angela became terrified that her hostile thoughts had caused the tragedy. Subsequently the man in the basement upped the ante, demanding actual experiences of torture and self-mutilation whenever Angela made a "mistake." She began to secretly mutilate her body in an effort to exert more control over her thoughts.

An Assessment of Psychic Structure
Let us compare Angela's clinical picture to that of Kris's scientist patient. From the perspective of the structural model, neurosis is a long-standing compromise arrived at by the psychic agencies of id, ego, and superego. The analytic process envisions inviting this triumvirate to the negotiating table. By maintaining a balanced interest in each side of the story (Anna Freud's "neutrality"), the analyst can help the patient achieve a more serviceable resolution among the competing claims.
     Successful negotiations at this summit depend heavily, of course, on the participants, and here the ego psychologists' ability to assess psychic structures (id, ego, and superego) in terms of the quality of their functioning becomes crucial. Consider the appearance and quality of the cast of characters who emerged for the anticipated negotiations in Angela's analysis in comparison to those of Kris's patient. The latter's infantile (id) wish to deprive his father of his penis had been smoothly integrated into his personality, obtaining gratification only in highly disguised, symbolic forms. It was consciously available only after years of interpretation by two different analysts. By contrast, Angela's equally unacceptable murderous (id) fantasy of snuffing out the life of her anticipated sibling rival took no hard work to uncover; it was conscious and readily reported by her at the very outset of treatment.
     The superego objection to the oedipal plot of Kris's patient is easily detectable in his telltale feeling of guilt; this superego made certain that a morally unacceptable wish was effectively held in check and that the punishment for the wish was integrated into the patient's personal experience through a troubling professional inhibition. Angela, by contrast, felt no guilt signaling an internalized, functioning moral code. Her "man in the basement," the part of her experience most suggestive of superego functioning, was envisioned as not really part of her at all, but as an aggressive "other," who had taken up residence inside her. More a sadistic tyrant than a reasoned standard-bearer, he brought no defined code of ethics, no better course of action to recommend. Although post hoc explanations were supplied by Angela, no clear pattern could be found in his censure to serve as a guide for personal improvement.
     Kris's patient's ego successfully mediated the conflict between infantile longing and the superego's moral code, instituting a clever system of defenses utilizing symbolism, displacement, and projection to hide the conflict and seamlessly absorb it into ongoing personality. Angela's wall, an aspect of her ego functioning called into play to protect her throughout childhood (and in the analysis as well), seemed both primitive and obvious. Allowing none of the camouflaging fluidity of Kris's patient's defenses, it announced itself glaringly and desperately, interrupting anything remotely resembling smooth functioning. Noteworthy also was the difference in the quality of emotional expression between these two people, an issue that was to become of increasing importance as a dimension of clinical assessment. Kris's patient's wish to castrate his father was somewhat remote for him, coming to him, even after he accepted Kris's crucial interpretation, more as an upsetting yet compelling idea. The murderous wish when conscious was intrinsically conflictual, because Kris's patient valued and appreciated his father. Angela's wishes have a very different feel to them. Intense and powerful, primitive and uninhibited, when Angela was angry she seemed unconcerned about hurting or damaging others; she spoke as though she had no positive feelings for them at all.
     Angela's analyst was charged with renegotiating compromises among the claims of her ego, superego, and id. There was compelling evidence to suggest, however, that in this case, the three psychic agencies each needed remedial work before meaningful negotiations could proceed. Should, for example, Angela's ego defenses against her id impulses be encouraged to relax a little? Was it best to convince these guards that their services were no longer needed, or was returning them to boot camp for additional training more the issue? Angela's "summit" was most striking, not the complexity of issues struggled over, or the eloquence of competing claims, but for the shabby demeanor of its participants. Improving, not removing, seemed the task at hand.
     Prior to the development of ego psychology, the clinical goal of psychoanalysis had been the release of trapped, unconscious energies. Freud had stressed a nondirective, nonsuggestive approach. Removing the debris clogging the stream was the task, not strengthening the channel through which it flowed. Improving defenses and encouraging the development of ego functions for patients like Angela required an engineering blueprint of the basic architecture of the channel, including a documentation of the materials it was made of so that it could be repaired.

HEINZ HARTMANN: THE TURN TOWARD ADAPTATION
The person most responsible for developing this kind of blueprint was Heinz Hartmann (1894-1970), who came to be known as the father of ego psychology. Like Anna Freud, Hartmann was intrigued by the unexamined psychic artifacts Sigmund Freud's excavation had unearthed in his pursuit of infantile aims and longings. The ancient spearhead Hartmann cradled in his hand did not, however, evoke images of battle and a fascination with defensive strategies, as it had for Freud's daughter. Rather, Hartmann moved beyond conflict and pondered what might be considered the broader technological implications of the discoveries themselves. How had the spearhead been crafted? The metal melded? Who participated in this creation? What other abilities did they have? Did they meld coins as well? How did the community function on a day-to-day basis? One cannot understand a country by studying only its wars. And with that seemingly simple shift in focus, Hartmann powerfully affected the course of psychoanalysis, opening up a crucial investigation of the key processes and vicissitudes of normal development.
     Hartmann's contributions broadened the scope of psychoanalytic concerns, from psychopathology to general human development, from an isolated, self-contained treatment method to a sweeping intellectual discipline among other disciplines. This was not an easy task. Hartmann had to maintain a delicate balance between extending psychoanalysis to problems outside its original purview and preserving what Freudians considered essential to a distinctly psychoanalytic approach. Sullivan and the interpersonalists (see chapter 3) stressed, like Hartmann, the shaping influence of the environment on personality, but Sullivan had abandoned Freud's drive theory and thus his contributions were not considered psychoanalytic within the Freudian mainstream. Hartmann, on the other hand, carefully and ingeniously developed his innovations as extensions and elaborations of Freud's basic vision.
     Heinz Hartmann was well suited for the pivotal expansive role he would play in the field of psychoanalysis. His Viennese family of origin was renowned for its scholarly and artistic achievements. His father was an eminent historian and ambassador to Germany, his mother a sculptor. Noted musicians, philosophers, physicians, politicians, and intellectuals from Vienna and the world beyond streamed through the family home, exposing young Heinz to a panoply of cultures, ideas, and points of view. Trained as a physician and a psychiatrist, he was deeply respectful of Freud and his contributions; in 1934, at Freud's invitation, he entered analysis with him. He was, however, similarly stimulated and intrigued by the world of science outside psychoanalysis and also pursued wide-ranging interests in psychology, history, music, and philosophy.
     Hartmann's groundbreaking book, Ego Psychology and the Problem of Adaptation (published in German in 1937), was highly abstract and largely nonclinical. However, it provided others with the conceptual framework to support clinical exploration, experimental studies, and eventually new and powerful therapeutic approaches aimed not so much at revealing repressed primitive impulses within the human psyche as at repairing structural dimensions of the psyche itself.
     Sigmund Freud, Anna Freud, and Wilhelm Reich had all attributed an increasing complexity to the ego's operations. Yet, prior to Hartmann, the ego's functions were still perceived as being embedded in psychic conflict. Sigmund Freud regarded the baby as initially and fundamentally self-absorbed, preoccupied with internal tensions and sensations and not oriented toward external reality. The baby only slowly begins to realize that hunger pangs remain unquelled by dreamy pleasure-seeking fantasies. He must, regretfully, deal with what Freud called the "brick wall of reality," forcibly reorienting himself. Like the traditional slap on the bottom jolting the newborn into taking account of the necessity of breathing, the rude exigencies of the external world ultimately force the infant to become aware of external reality. Freud saw purposive action and higher-order thinking (secondary process, as opposed to the primary process of fantasy-based wish fulfillment) as eventually developing out of this unwelcome encounter. The infant has to think and respond realistically to avoid the discomfort of mounting instinctual pressures. This model of psychic development had provided the conceptual underpinnings for the design of the classical therapeutic approach. Nongratification (e.g., not answering the patient's questions) and interpretive confrontations were aimed at forcing the id-generated fantasies to seek gratification out in the open, exposing them to conscious scrutiny and analytic interpretation, thereby transforming them into more realistic, mature ways of thinking, generating increased ego functioning. "Where id was, there ego shall be. It is a work of culture--not unlike the draining of the Zuider Zee" (Freud, 1933, p. 80).
     Hartmann's vision of human development radically challenged this picture. Like Freud, Hartmann took his inspiration from Darwin's theory of the evolution of the species, but Hartmann drew on a different dimension of Darwin's account.
     Freud had derived from Darwin the notion, commonplace today but stunning to those living in the nineteenth century, that having evolved from other species, humans were not wholly different creatures from other animals. Much of Freud's vision of the instinctual source of human motivation, the primitive forces of infantile sexuality and aggression, could be traced to this Darwinian view. Hartmann put his emphasis on the notion that animals were designed, through the process of survival of the fittest, to be highly adapted to their surroundings, so that there would be a continual "reciprocal relationship between the organism and its environment" (1939, p. 24).
     If humans, like all organisms, are intrinsically designed to fit into their environment, this must also be true of not just their physical but their psychological self, Hartmann reasoned. Conversely, the natural environment must be, by design, specifically suitable to humans' psychological existence. Consequently, Hartmann envisioned not a dreamily drifting baby who is suddenly forced to get to work, but a baby who arrives with built-in ego potentials, waiting, like the seed awaits the spring rains, for the proper "average expectable" environmental conditions to spark their growth. Rather than being forged in conflict and frustration, certain "conflict-free ego capacities" were seen as intrinsic potentials, part of people's birthright, functions that would emerge naturally in a suitable environment, enabling them to fit into their surround. These capacities included language, perception, object comprehension, and thinking.
     While retaining an appreciation of the established psychoanalytic understanding of conflict, Hartmann launched an investigation into nonconflictual adaptive development. He began sorting out and labeling ego operations in terms of their origin, their current and changing function, and the specificity of their relationships with one another. He noted that an adaptive apparatus of primary autonomy (speech, for example) could become secondarily entangled in conflict (stuttering). And defenses originally born in conflict could eventually become autonomous by evolving an adaptive capacity.
     Reaction formation, for example, is a defense called into play to keep one consciously unaware of the continuing, socially unacceptable pleasures involved in bathroom activities; the toddler's original fascination with his bowel movements is transformed into a conscious attitude of disgust. Yet reaction formation, originating in conflict, may eventually serve a highly adaptive function in the overall personality as genuine pleasure in good hygiene and tidiness and thus graduate into a role outside of conflict, becoming "secondarily autonomous." Similarly, the defense of intellectualization, which employs abstract thinking in an effort to prevent awareness of conflictual emotions, is often the predominant defense of highly intelligent people, whose capacity for abstract thinking has significant adaptive uses. For the analyst to interpret only the defensive aspect ("You intellectualize rather than feel") is to risk leaving the patient with the sense that there is something wrong with his or her capacity to think. Hartmann's precise distinctions offered clinicians greater specificity in pinpointing both conflictual and adaptive aspects of psychic functioning.
      But Hartmann's depiction of "conflict-free" ego functions also posed a problem. Where do these functions get their energy? If the mind is primarily fueled by libido and aggression, which manifest themselves in conflictual demands for largely forbidden gratification, what fuels adaptive processes such as perception and capacities for learning?
     Freud had struggled with the same problem in different terms, in his efforts to reconcile higher cultural pursuits (such as literature and the arts), which he deeply loved, with a motivational theory that regarded all intentions as fundamentally sexual and aggressive. Freud's solution was the concept of sublimation, a quasi-defensive process that harnesses the power of the sexual impulse and channels it into acceptable, productive pursuits. Thus a voyeuristic fixation might be transformed into a talent for photography.
     But even when drives are sublimated, they retain, in a disguised form, their sexual and aggressive qualities. If the ego's conflict-free functions are truly autonomous, they seem to require an energy without such qualities. Hartmann proposed a process he termed neutralization, through which the ego strips the drives of their sexual and aggressive qualities. Unlike sublimation, neutralization actually changes the nature of the drives themselves, much as a hydroelectric plant transforms the raging, muddy river into clean, usable electrical energy.
     Hartmann's notion of a child born with an innate potential that unfolds naturally in a receptive environment opened up a host of questions that were pursued by subsequent developmental ego psychologists. How might we envision this necessary environment to which the human child is born preadapted? What elements are intrinsic to the "average expectable environment" on which psychic development depends? Are there factors in children's early relationship with their environment that facilitate the process of drive neutralization, toning down instinctual conflicts and making that energy source available to fuel the ego's nonconflictual activities?

DEVELOPMENTAL EGO PSYCHOLOGY: RENE SPITZ
Rene Spitz's heartbreaking publication Hospitalism (1940) played a seminal and dramatic role in deepening the interest in issues of environment. It left no doubt that whatever inborn psychological potential humans may have, its realization is doomed in the absence of emotional connectedness with another person. Spitz (1887-1974) studied children left, from birth, in a foundling home, whose physical needs were adequately met but who were deprived of any ongoing nurturing interaction. They invariably became depressed, withdrawn, and sickly. If this emotional starvation continued beyond three months, eye coordination deteriorated and motor retardation developed. The infant became increasingly listless, the mattress in her crib progressively hollowing out in a little groove cradling her quiet body. By the end of the second year, one-third of these children had died. By the time the survivors had reached their fourth year, few could sit, stand, walk, or talk. If, however, the mother returned within the first three months of life, this deteriorating course reversed itself. While Freud had heralded deprivation as a stimulant to ego development that forced the crucial turn toward reality, Spitz's study of "failure to thrive" infants dramatically suggested that the "brick wall of reality" is deadly in the absence of a loving caregiver's touch.
     The question remained, however, as to the exact nature of the tragedy Spitz had witnessed. If food and other physical needs were not the crucial elements, what exactly does involvement with a nurturing person provide? Hartmann had offered that an average expectable environment is essential to the emergence of ego capacities such as object comprehension and perception, but what are the essential features of this environment? How does what is outside affect what develops inside?

The Libidinal Object
Spitz devoted much of his professional life to these questions. Using methodology borrowed from experimental psychology, he conducted what many would regard as the first analytic research on object relations between infants and their primary caregivers, carrying out a systematic large-scale study of controlled, direct observations of infants and mothers over a span of many years. Spitz watched, he filmed, he interviewed, he tested, tracking the transformation of the biologically adaptive tie between infant and mother into complex psychological resources for the child. In so doing, he fundamentally recast the basic psychoanalytic concept of the libidinal object.
     Freud had introduced the term object to refer to the target of instinctual impulses, through which the instinctual tension is discharged. This object could be a person, but it could also be inanimate. A shoe is a libidinal object for the fetishist, for example, as it provides the opportunity for expression of his or her sexual impulse. In this schema, the libidinal object itself has no intrinsic value. It is tacked on to the drive through experience because of its functional utility in reducing drive tension. Thus, in the beginning, the mother as person has no singular importance to the child, but is grouped in the "variable" category of object only to the extent that she functions as one of the "thing(s) in regard to which or through which the instinct is able to achieve its aim" (Freud, 1915, p. 122). The mother becomes important because she provides gratification, he believed; human love is built on both direct and disguised (aim-inhibited) gratifications, as the ego finds ways to repress, sublimate, and refine instinctual impulses so they find a place in more complex object relations.
     Freud did not assume that libidinal connections with others are sought in their own right. Consider his approach to identification, the process through which the child makes someone or an aspect of someone a part of himself. Children become a great deal like their parents, and this identificatory process greatly facilitates learning to live in the world and culture to which they are born. But why and how does identification take place? As with so many of Freud's developmental explanations, the process of identification was conceptualized not as primary but as defensive in nature, a psychical maneuver attempting to soften the frustrating experience of loss. One may take on some qualities of a loved one following her death; the five-year-old identifies with his father's moral code in response to the oedipal frustration of being denied mother as a sexual partner. As long as gratification is available via objects in the real world, identification is irrelevant. When gratification is interrupted, when the object is lost or becomes unavailable because of conflict, the object is internalized to permit fantasy gratification. Identification with an object, for Freud, is a second-best solution, a compensation reluctantly accepted when instinctual gratification is itself not possible.
     Spitz cut a conceptual course for theory-building midway between Freud's drive theory and radical object relations theories (see chapter 5). Spitz preserved Freud's notion that libido itself is pleasure-seeking, but added new dimensions to pleasure-seeking that deepened and filled out Freud's vision of development of early relations to objects. Spitz added to the id's libidinal purposes a set of capacities that originate and develop in the ego, parallel to the libido's pursuit of pleasure, that allows for the unfolding of a sense of caring and a deeply gratifying personal connection. In Spitz's system, having a libidinal object is not a given, something easily obtained with even the most impersonal experience of gratification. Rather, having a libidinal object is a developmental achievement reflecting the complex psychological capacity to establish a selective, very personal attachment that is retained even in that person's absence. Spitz's libidinal object is not simply a means to an end, drive discharge, nor the consequence of defensive internalization, but fundamentally important in its own right. The libidinal object provides the essential human connectedness within which all psychological development occurs.

Psychological Fusion
Hartmann had characterized the immature psyche as internally "undifferentiated," to suggest that at birth, the ego, superego, even the basic drives of libido and aggression are not yet articulated and distinguishable from one another. Spitz reoriented psychoanalytic focus on early life by describing the infant as initially both undifferentiated (a term reflecting the state of the infant's individual psyche) and nondifferentiated (a term recasting the basic image of crucial developmental concern from that of the infant alone to a new image of "infant-with-mother").
     Spitz envisioned the infant as extending the physiologically parasitic relationship with the mother in the womb into a state of psychological fusion with the mother after birth. Like a conjoined twin who depends on the life flow between self and partner, the infant is in grave danger if abruptly separated from the mother or in any way deprived of the gradual process that eventuates in his acquiring the capacity for independent functioning. The mother, with her more developed psychical capacities, is the environment for the essentially helpless, vulnerable baby. Spitz likens the newborn to a blind person whose sight is restored. Far from being overjoyed, the newborn, like the newly sighted, is initially overwhelmed by a maelstrom of meaningless stimuli that he cannot process. The mother mediates this encounter. Processing the experience, she functions as the baby's "auxiliary ego," regulating the experience, soothing him, shielding him from disorganizing overstimulation, until he develops the ego capacity to process and regulate experience on his own.
     Spitz was particularly interested in how the infant acquires the capacities that the environment-mother initially provides. Exactly how do Hartmann's primary autonomous ego functions develop, thereby enabling the infant to cull out and recognize what is meaningful in the flood of experience? Spitz concluded that complex interactional patterns develop between infant and mother, a kind of "dialogue," a "sequential action-reaction-action cycle within the framework of the mother-child relations ... that enables the baby to transform step by step meaningless stimuli into meaningful signals" (1965, pp. 42, 43).
     This dialogue takes place initially outside the verbal and gestural channels of adult communication that rely on the capacity for symbolic understanding. Through physical contact, body tension, posture, motion, rhythm, and tone, the mother communicates with her baby using a "total sensing system." The infant is receptive to expressive signals, rather than perceptive; that is, he soaks up the sense of the mother's message, which is strongly shaped by the affective climate she creates with him: Is it safe? Is it good? Is it food? Is it frightening? Through expression, tone, and touch she mediates every perception, every action, every piece of experience, in repetitive patterns, gradually building up recognizable systems of meaning out of the chaos of stimulation, laying the groundwork for what will be the infant's emerging perceptual capacity.
     Spitz brought to life Hartmann's principle of adaptation, detailing the psychic plasticity between mother and infant as they fit together, reciprocally influencing each other. Exquisitely sensitive to her infant's nonverbal messages, the "good" mother empathically divines the needs of her baby with near clairvoyant accuracy, relying on her capacity to regressively revive in herself this early communication channel that, Spitz felt, is lost to most adults. She senses why her infant is crying, a mystery to others, and is able to respond correctly. Each accurate reading and satisfying intervention--picking him up, feeding him, jostling him, soothing him--becomes another interaction in the essential cycle of meaning-making. Spitz saw these repetitions as also helping the infant sort out feeling states into discernible, sequential categories with beginnings and endings (for example: I was upset, then I felt better), contributing to the laying down of memory traces of recognizable experience. Thus Spitz offered psychoanalysis a very different kind of developmental progression, adding to the unfolding psychosexual sequence of drive discharge (from oral to anal to phallic to oedipal) the increasing structuralization of ego capacities which emerge, in the first year of life, within crucial transformations in the relationship to the libidinal object.
     Noting that certain predictable shifts take place in the infant's behavioral attitudes toward others, Spitz concluded that these external manifestations, which he called "indicators," were signposts of increasing internal psychological complexity, marking critical developmental turning points, which he called "organizers of the psyche." The first indicator is the baby's first social response, the smiling response which occurs predictably at three months of age. Babies of this age will smile at mother, at Uncle Oscar, at the bank teller, as well as at a properly configured mask of a human face, but still show a clear preference for the gestalt of the human face over other things in their environment.
     Gradually this response specifies and deepens; by eight months, the infant not only recognizes the mother's face, distinct from all others, but reacts with anxiety and retreats from a stranger's face. This external indicator of the second organizer of the psyche Spitz labeled "stranger anxiety." He reasoned that this emotional retreat was based not simply on what the infant was seeing, but also on what the infant was not seeing. Since the baby, now capable of storing memory traces, had had no bad experience with this total stranger, his distress must be caused by the contrast to his now internally held image of his mother. The stranger's presence alerts him to his mother's absence. For Spitz, this behavioral reaction signaled the attainment of psychological capacities that make a singular, personal attachment possible. "There is no love until the loved one can be distinguished from all others" (1965, p. 156).
     Spitz's third organizer of the psyche, the mastery of the "no," encouraged a consideration of the developmental aspects of superego formation, a topic taken up more fully by Edith Jacobson. In 1936, Anna Freud had introduced a defensively motivated process, identification with the aggressor, to account for the internalization that had conceptually accounted for the establishment of the superego (i.e., Father the aggressor prohibits me from taking Mother as a love object; I will give up my quest for gratification and become like him instead). Spitz likened the child's acquisition of "no," which occurs at about fifteen months, to this phenomenon later in development, noting that once the child acquires locomotion, the mother must function increasingly as a prohibitor, curbing his intentions. For Spitz, the child's "no" is the external indication of a deeply enriching preoedipal identification with her, also evidencing dramatically enhanced psychic capacities, including those for judgment and rudimentary abstract conceptualization.
     Thus Spitz demonstrated that virtually every aspect of early psychic development is mediated through the maternal environment. This revised conceptualization shifted attention to issues concerning the infant's emergence from psychological embeddedness with the mother and establishment of a personal sense of separate identity. How did an infant, psychically merged with his mother, grow into an autonomous child? Were there predictable phases and pitfalls in this developmental process?

DEVELOPMENTAL EGO PSYCHOLOGY:
MARGARET MAHLER
Margaret Mahler (1897-1985), a child analyst and former pediatrician who trained in Vienna before moving to New York, shed considerable light on the normal and abnormal features of this process. She carried the framework Spitz developed into some of the darker corners of childhood experience: families and hospitals that housed psychotic children. While psychoanalysis had creatively grappled with the knotty complexities of neurotic conflict, psychosis had remained largely outside the reach of psychoanalytic treatment.
     First, the demands of the treatment process itself seemed to screen out those with more severe disorders. A patient in psychoanalysis must be able to lie on the couch, suspend ego functioning, detach herself from "reality" concerns, and say whatever occurs to her, no matter how illogical it may sound. Once having thus "regressed," the patient must be able to bounce back to normal functioning at the hour's end. The psychotic seems lost in her own world of fantasy and illogical thought from the start. Since the capacity for normal reality-testing is already compromised, encouraging selective regression in which reality-testing is abandoned altogether seemed therapeutically pointless, if not dangerous. While some analytic pioneers like Carl Jung, Paul Federn, and many followers of Melanie Klein explored therapies for more disturbed patients, in general psychotics were not candidates for psychoanalytic treatment.
     Second, Freud envisioned the therapeutic action of the analytic process as provided by the patient's transference of unconscious libidinal longings, originally directed toward forbidden infantile objects, onto the person of the analyst. Freud assumed that in its earliest form libido was directed toward objects in the outer world. In his efforts to stretch libido theory to account for schizophrenia as well as neurosis, in 1914 Freud revised this conceptualization now depicting early libido as inwardly directed (primary narcissism). In the mind of the psychotic, libido was understood to have secondarily withdrawn back into this state of self-contained pool of narcissism, its most primitive condition, detached completely from external objects, even from memories or unconscious longings for childhood objects. Hence, in psychosis, it was believed, there is nothing to transfer onto the person of the analyst, no unconscious longings for gratification from others discoverable in the analytic process, because all energy is bound up in narcissistic self-absorption.
     Psychoanalytic theory offered few compelling explanations for this massive unavailability of productive psychic energy. Treatment prospects for psychotics, including psychotic children, were at best grim. "Childhood autism," the psychiatric diagnosis then given to most severely disturbed children, was more a verdict than a contribution to understanding. But Mahler, extending Spitz's emphasis on the crucial role of early relationships, initiated a more constructive exploration of severe disturbances of childhood.
     For example, Stanley, a six-year-old psychotic boy described by Mahler (1968, pp. 82-109), responded with a "total emotional reaction" to his experience. His behavior alternated between complete listlessness and uninterrupted frenetic action. All feelings seemed to overwhelm him; he often cried uncontrollably. Presented with a picture book, he would confuse the picture of a baby behind the slats of a crib with the picture on the facing page of a panda in a cage. Seemingly caught by the visual similarity of the vertical lines in both pictures, he appeared unable to perceive the obvious differences; the two images became fused and were used interchangeably.
     Perhaps, Mahler speculated, the kind of massive problem evidenced in children like Stanley is not best formulated in terms of the direction of libidinal energy. What appears to be psychotic self-absorption might more meaningfully be described as a failure in the basic formation of the self, a profound confusion about who one is: what is self and what is other. Through Mahler's eyes, Stanley seemed not so much detached from objects as caught between powerful early needs for others and a sense of grave danger in having those needs met, a consequence of a disturbance in the expectable and necessary boundary between himself and his object world. If Spitz was correct that a sense of identity develops out of a crucial early merger experience with the mother, perhaps specific failures in this early experience or in its resolution could be linked with specific kinds of disturbance in the formation of personal identity.
     What disrupts the normal developmental passage through and healthy emergence from symbiotic relatedness? Mahler continued to consider hereditary and constitutional factors and the impact of early traumatic experience as key in symbiotic dysfunctions. Stanley, for example, had suffered from an inguinal hernia, causing severe, unexpected, and unrelievable attacks of pain from six months on. When exposed to painful shocks that cannot be patterned or avoided, experimental mice become catatonic. Mahler described the similar impact of this kind of unmanageable pain on the immature psyche: Selective repression is impossible and the child is driven inward, away from developing any capacities that would help him order and make sense of his experience.
     But, like Spitz, Mahler also emphasized the importance of the human environment. The infant needs "an optimal level of pleasure" to secure "safe anchorage" (p. 17) and psychic growth within the symbiotic orbit. The mother provides for her infant's immature ego the crucial "mirroring frame of reference" (p. 19). If she is unpredictable, unstable, anxious, or hostile, the frame will be compromised and eventual independent functioning of the child is less likely. As an infant, Stanley could not regulate or protect himself from his environment. His intense distress was considered a dangerous risk to further complications. Although functionally present, his mother was emotionally detached and preoccupied with issues in her own life, seeming to have trouble really connecting with him emotionally. She attempted to interrupt his violent crying and distract him, for example, by force-feeding him while he was in pain. Stanley, Mahler concluded, "did not experience her ministrations as a real and efficient rescuing from the traumatic situations that suffused his `rudimentary ego"' (pp. 93-94). Safe anchorage was impossible. His mother was unable to create a strong enough presence as his desperately needed auxiliary ego, as a stimulus regulator, helping him sort out and eventually identify different kinds of experiences and laying the groundwork for what would have been his perceptual capacity. Her force-feeding interventions only added to his experience of being assaulted by unprocessible, distressing stimulation.
     Unable to use the symbiotic experience as a safe milieu in which to grow, Stanley was instead trapped in a developmental phase beyond its appropriate time. His psychic states, reflected in his external behavior, oscillated between lapses into a kind of personal formlessness and desperate attempts to establish a sense of his own separate identity. When his attention was not externally engaged, he would typically drift into a completely listless state apparently devoid of any aim or focus. Then he would suddenly wrench himself into action, purposefully touching his therapist's arm to prompt a kind of "switching on" of agitated energy expressed in paroxysms of jumping, twisting, and cramping. Because Stanley lacked a reliable experience of himself as a discrete entity when not externally engaged, Mahler felt, he lapsed into an internal state of symbiotic merger in which he experienced himself dissolving into total psychical nonbeing. "At those times," Mahler observed, when Stanley was quiet, "he seemed to be no more than a quasipart of the environment ... in a state of cohesion with it and undifferentiated from it" (p. 87). Feeling himself psychically disappearing, he was compelled to call on external mechanisms for reassurance, trying to establish some outside definition containing some inside substance. Mahler saw the touching of the therapist as a deliberate attempt to flood himself with intense directionless excitement, revving himself into agitated action and thus forcibly contriving a feeling of distinctness, a boundary feeling, "as if to defend against his apathetic state, as if to ward off the danger of symbiotic fusion, through which his entity and identity would otherwise become entirely dissolved into the matrix of the environment" (pp. 87-88).

Separation-Individuation
Documenting the devastating impact of severe symbiotic disruption, Mahler at the same time was conducting a systematic investigation into the intricacies of these earliest phases of development. Drawing on extensive observation of both normal and disturbed infants and their mothers, as well as of toddlers and older children, Mahler began by reformulating the nature of the early phase of life that Freud had characterized as essentially objectless, the stage labeled "primary narcissism." Within these earliest months, Mahler argued, the child breaks out of an "autistic shell," entering into the earliest of human connections, "normal symbiosis." She delineated the normal progression in the complex yet powerful interplay among the child's physical and cognitive maturation, his psychological evolution, and the crucial function of the maternal partner in his evolving identity.
     Mahler subdivided the overarching process, which she defined as separation-individuation, into identifiable subphases, each with its own onset, normal outcome, and risks. Hatching, the first subphase, is signaled by the infant's increased alertness and "prototypical biphasic visual pattern" (p. 16), the regular alteration in the gaze, now more outwardly directed, now checking back to the mother as a point of orientation. This phase culminates at about nine months, when active locomotive capacities and physical development usher in the practicing subphase. Now an increasingly capable toddler launches himself into the world, elated with his new abilities, infused with a sense of omnipotence: despite actual moving away from his mother, he experiences himself, psychically, as still at one with her, sharing in her perceived omnipotence.
     During rapprochement, which occurs between fifteen and twenty-four months, the child experiences a crucial psychic disequilibrium, Mahler theorized. Now psychological development catches up with physical maturation, bringing the distressing awareness that this very mobility demonstrates psychic separateness from the symbiotic union with the mother. Previously fearless in action, the toddler may now become tentative, wanting his mother to be in sight so that, through action and eye contact, he can regulate this new experience of apartness. The risk is that the mother will misread this actually progressive need as regressive and respond with impatience or unavailability, precipitating an anxious fear of abandonment in the toddler, who does not yet possess the psychic capacities to function as an independent agent. Mahler reported that a basic "mood predisposition" may be established at this point: a "significant lack of acceptance and 'emotional understanding' by the mother during the rapprochement subphase" contributes to an ongoing "proclivity to depression" (1966, pp. 157, 161, 166).
     In breaking down the developmental journey through successive states of psychic organization, Mahler enabled clinicians to understand more deeply and treat more effectively children and adults who came to be officially diagnosed as borderline patients, whose severe pathology fell between the classifications of neurosis and psychosis.
     Such problems were categorized as preoedipal in nature, to distinguish them both in origin and in dynamic composition from maturationally later pathology. Oedipal dynamics emphasize competitive sexual and aggressive conflict, exploring primarily the role of the father as the little girl's longed-for oedipal object and the little boy's feared oedipal rival. Preoedipal dynamics center on the role of the mother, and consider developmental disruption in the formation of the psychological structures that would eventually play a part in these oedipal struggles. If defective, these structures can, in their own right, contribute to a host of earlier, often crippling disturbances.
     Preoedipal pathology manifests not so much in discrete symptoms or guilty, conflictual indecision as in more pervasive disturbances of psychological function: intense, unregulatable feeling states, extreme fluctuation in images of self and/or other, impaired capacity for steady relatedness--disturbances that characterize pathology like masochism and severe depression.
     But the contributions of Spitz and Mahler had a relevance far beyond their application to psychopathology. They provided what amounted to a new myth of origin for the human psyche. The baby Freud had envisioned is a creature filled with untamed instinctual tensions, a prehuman beast, that is brought under control, only incompletely, by social regulation. The unconscious, Freud stressed, is timeless; these infantile instincts always remain in a state of tension beneath the social veneer of adults. The baby envisioned by the developmental ego psychologists emerges sequentially out of a symbiotic union with the mother. The psychological birth of this baby is not coincident with his physical emergence from the womb. The mother's care contains his fragile psyche in much the same manner as her body contained his fetal development. This vision of the symbiotic prehistory of human development that emerged in Freudian ego psychology has provided a new vantage point for understanding many features of human experience. For example: Ernst Kris (1952) understood the creative freedom of the artist as reflecting a regression to less structured preoedipal states "in service of the ego"; Martin Bergmann (1973) has explored the episodic return to symbiotic fusion that characterizes some of the deepest aspects of mature romantic love.

A REVISED THEORY OF INSTINCTUAL DRIVE:
EDITH JACOBSON
The rich account of the early years of life formulated by Hartmann, Spitz, and Mahler posed increasingly knotty problems for existing Freudian theory. In particular, the emphasis on the formative impact of very early relations with caregivers was in direct conflict with some of Freud's established tenets.
     Two of the particularly problematic classical concepts in this regard were Freud's closely related notions of the death instinct and primary erotogenic masochism, both introduced in 1919. Freud was stunned and deeply saddened by the scope of human destructiveness displayed in World War I; he had also struggled in the consulting room with certain masochistic patients who seemed impervious to help, seemingly relentless in their pursuit of pain and suffering. The apparent attraction of painful experience posed a challenge for the fundamentally hedonic framework of Freud's libido theory, according to which the mind operates on the pleasure principle (always reducing pain and seeking pleasure).
     We noted in chapter 1 that Freud's view of human instinctual endowment turned darker in 1919, when he concluded that aggression was a second instinctual drive equal in importance to libido. Libido, in Freud's account, begins as inwardly (narcissistically) directed, and is only secondarily directed toward objects. Freud used this pattern as a template for understanding the aggressive drive as well. Thus he suggested that aggression also begins as inwardly directed, derived from a death instinct. The baby begins life with both self-directed love and self-directed destructiveness. This revised Freudian infant, now infused with both sexual and aggressive energies, is often in a state of heightened tension, within which she may be indiscriminately aroused, stimulated by both libidinal and aggressive feelings, pleasure and pain. From Freud's perspective, the masochism of patients like Angela derives from a permanent psychic channel (a phenomenon he termed primary erotogenic masochism) that is often employed for disguised oedipal gratification as it allows pain to feel sexually stimulating."
     When Freud encountered intractable problems, he often fell back on constitution as an explanation. His formulation of the death instinct and primary erotogenic masochism derived these early, fundamental energic channels wholly from constitutional sources, largely unaffected by the infant's relationship to the human environment. Yet the developmental ego psychologists viewed the infant as psychically merged with the primary caretaker, continually receptive to and dependent on the mother's psychological participation. Is masochism a basic instinctual state or a consequence of problematic caretaking? How can vulnerability and receptivity to environmental impact be reconciled with an overarching theory that depicts the human psyche in fundamentally constitutional terms?
     Edith Jacobson (1897-1978), originally a member of the Berlin Psychoanalytic Society, arrived in New York in 1938 shortly after her release from a Nazi prison and her escape from Germany. A courageous woman of strong convictions, she had returned to Germany from safety to defend a former patient who was in trouble with the Nazis. There she was imprisoned by the Gestapo for refusing to give information on the political activities of her patients (Kronold, 1980). Despite her exposure to these horrifying forms of human behavior, once out of Germany Jacobson was instrumental in revising the darker cast Freud's late revisions had lent to the psychoanalytic depiction of human nature.
     How could Freud's emphasis on the constitutional be reconciled with the developmentalists' emphasis on the environmental? Biology and experience, Jacobson proposed, mutually influence each other and are in ongoing interaction throughout development. Drawing on the contributions of many, including Anna Freud, Hartmann, Spitz, and Mahler, and without heralding her innovations as fundamental revisions, Jacobson, in The Self and the Object World (1964), effectively reworked the entirety of Freud's energy theory, his account of the psychosexual stages of development, and his conceptualization of id, ego, and superego.
     In agreement with Hartmann, Jacobson proposed that instinctual drives are not "givens" but rather are biologically predetermined, innate potentials. While responsive to internal maturational factors, their distinctive features are acquired in the context of early relationships. Experience is, from the start, registered in terms of how it feels to the baby and is organized by what Spitz had termed "affective perception"; memory traces cluster, like iron filings in a magnetic field, around the distinctive poles of feeling good or feeling bad. Normally, the baby's experience is predominantly satisfying; libido gradually emerges from a collection of good experiences into a strong, solid motivating force in the infant's life. Ideally, aggression is present in lesser levels. Early experience can, however, shift this balance. If it is largely frustrating and registers negatively, a more powerful and intense aggressive drive will consolidate that distorts the still vulnerable normal developmental processes.
     Because experience is subjectively processed, Jacobson stressed, there is no such thing as simply "good" mothering, in some objective sense, only mothering that feels good to this particular baby. Issues of temperamental predisposition (e.g., an easily frustrated infant), fit or misfit (e.g., a calm baby and an excitable mother), affective matching or mismatching (e.g., a happy baby and a depressed mother), and the mother's capacity to sense and respond to her baby's changing developmental needs--these will all be crucial in determining what affect is elicited in the infant at any given time. Ultimately, the basic drive constitution that finally emerges depends on the collective impact of many moments.
     Jacobson's model thus offered a description of the interplay between actual experience and drive development. Further, she argued that the balance in the subjectively registered feeling tone of earliest experience not only contributes to the consolidation of libido and aggression as drives, but also lays the groundwork for ongoing tendencies in the ways we feel about ourselves and others. This aspect of experience was felt to be represented in features of psychic development termed self images and object images. Following Hartmann, Kris, and Loewenstein (1946), and in agreement with Spitz, Jacobson proposed that when experiences feel good, images of a loving, giving mother and a happy, contented self accumulate in the infant's psyche; conversely, when experiences feel frustrating or upsetting, images of a frustrating, unloving mother and an angry, frustrated self accumulate. Since the newborn is at first unable to distinguish self from other, Jacobson believed that these earliest images are often fused and confused rather than distinct, self-contained units. Just as drives emerge from the registering of good and/or bad experience, so is one's deepest subjective sense of self and others an eventual outgrowth of the consolidation of these earliest images, providing a set of lenses through which subsequent experience is continually filtered.
     By about six months of age, the infant is maturationally capable of distinguishing images of himself from images of others, and more realistic depictions of each become possible. He is now capable of picturing his mother as a discrete presence who is gratifying but also sometimes frustrating, and similarly, of experiencing himself as generally feeling good and loving but also capable of feeling bad and angry. This integration of good and bad images (i.e., the same mother who is bad and frustrating is also good and loving) must, Jacobson observed, facilitate the capacity to integrate conflictual feeling states. In this fusion of loving and hating feelings (a concept introduced by Hartmann), the raw primitive nature of the earliest forms of both drives (the demanding neediness of infantile libido and the violent eruptiveness of infantile aggression) is toned down. As a consequence, the affective singularity of intense love alternating with intense hate is replaced with more varied and subtle feeling states.
     The attainment of affectively integrated images of self and of other allows a greatly increased capacity for more complex experience: an ability to register and to tolerate differences between one's emotional state and that of an important other; gradations in emotional response enhancing capacities to think and to learn that are jeapordized by unqualified acceptance or complete rejection; the ability to be disappointed by someone but still love her; and tolerance of anger without an internal collapse and a loss of a sense of one's being worthwhile or loving.
     Jacobson's new model deftly rendered Freud's conceptualizations of primary erotogenic masochism and the death instinct logical impossibilities. If the newborn arrives with libido and aggression only as unformed, undirected potentials and without a distinct, articulated self, libidinal and aggressive drives cannot be initially self-directed. Into the conceptual vacancy created by removing key energic building blocks of Freud's drive metapsychology, Jacobson inserted new ego psychology formulations, detailing a fascinating interplay between richly elaborated processes of psychic development and the human environment within which they evolve. This included an expanded vision of the development of the superego. Jacobson described the superego as evolving over a long period of time, during which the child's experience of the human environment is continually internalized, transforming the child's drive-derived impulses and wishes. According to Jacobson (elaborating Spitz), early preoedipal experiences with the mother have two kinds of broad impact on the development affecting superego formation. Experiences of gratification and frustration shape the formal consolidation of the drives themselves, and experiences of maternal constraints and prohibitions leave behind early images as precursors around the which the later (oedipal) superego is formed. The formation of the superego was thus rendered more broadly dependent on the complex interpenetration between passions and experiences with others.
     Jacobson not only revised Freud's derivation of libido and aggression, but also extended the functional impact of the drives. Freud had, in his later writings (e.g., 1940), described libido as a synthetic force that brings things together, aggression as a force that undoes connections. Jacobson applied these sensibilities to the recently articulated processes of separation and individuation which the ego psychologists had found to be so fundamental in early development. Libido, in Jacobson's account, provides the psychic glue in developmental processes, integrating, for example, opposing images of good and bad objects and a good and bad self. Aggression, in developmental processes, energizes an awareness of differences, promoting separation and the establishment of differentiated images of self and other.
     For Jacobson, libido and aggression function as indispensable counterbalances to each other. Libido (evoked in moments of gratification) encourages pulling close, taking in; aggression (evoked in moments of frustration) prompts pushing off, moving out. Both libido and aggression figure cyclically in the evolution of a stable identity, an achievement that ultimately depends on one's capacity to function autonomously, building up and continually enriching oneself by taking in from one's environment.
     Jacobson felt that the libidinally motivated yearning to merge remains highly gratifying throughout life. Merger fantasies are evocative at all stages of psychic development, although the quality of one's ego boundaries greatly affects one's subjective experience of them. Normally, in later life, with boundaries between self and others clearly delineated, fusion fantasies can provide one of the deepest sources of gratification. They are an important dimension, for example, of the satisfaction experienced in sexual intercourse. For one newly launched into self-definition, however, or for whom ego boundaries are not clearly delineated, fusion fantasies are dangerous and deadly, a powerful regressive pull toward psychic dissolution. Aggression-evoking experiences of frustration and limit-setting can function constructively here, balancing against the regressive pull. They remind the young voyager with necessarily weak ego boundaries of her separateness, encouraging her to push off from destructive indulgence in experiences of gratification and the ego-undermining shoals of fusion fantasies.
     Evoking aggression can function similarly in emotionally vulnerable adults who, when confused or depressed, pick fights with others in order to experience greater psychic clarity. Aggression operates here not as a drive per se, but as an experience actively called up in the self to promote self-delineation. Such temporary relief is, however, not always to be had. For aggression to come to function in this capacity, it must have consolidated in an atmosphere modulated by sufficient gratifying libidinal experience. If this balance is lacking the aggression evoked will feel too powerful, overwhelming and disrupting the attempt at self-delineation with fears that one has been too hurtful or destructive in the interaction.

CLINICAL APPLICATIONS OF
DEVELOPMENTAL EGO PSYCHOLOGY
Freud regarded the repression of conflictual impulses as the core of neurosis. The ego psychologists, as we have seen, came to pay increasing attention to disruptions in developmental processes that were felt to result in a broad range of problems in the structuralization of the psyche itself. Freud's focus was on oedipal conflict, organized in the more mature cognitive and linguistic schemata of later childhood. The ego psychologists investigated preoedipal disturbances, those that often take place prior to the emergence of language. But how would an adult patient in analysis recall experience that occurred before language was available to define it? How could the analytic process identify and constructively engage these early disturbances?
     Freud viewed the transference as the centerpiece of the analytic process, providing access to the patient's hidden and forbidden wishes as she expressed and tried to gratify them with the analyst. The ego psychologists began to view the analytic relationship in broader terms. Particularly with more disturbed patients, the transference came to be understood not only as expressive of forbidden longings but as an arena within which remnants of ill-fated attempts at building normal psychic structure could be discerned in particulars of the relationship that the patient established with the analyst. By attending to specific features of the experiences and images that emerge in this relationship, and using them as indicators of the fate of important developmental processes, the analyst could determine which aspects of psychic structuralization had been compromised and, with the patient, develop a verbal account of what went wrong in the patient's early experience, using this very processing as an aspect of repair.
     But how can an analyst determine from the transference whether the patients' problems are oedipal or preoedipal in nature? In contrast to oedipal transferences, which generally unfold slowly and only with analytic clarification come to center on some specific emotionally charged experience in relation to the analyst, the preoedipal transference is more frequently characterized by a kaleidoscopic presentation of images of self and other, dominated by intense emotional immediacy. This qualitatively different presentation is well illustrated by specific features of the transference of Angela, the patient described earlier in this chapter.
     From the outset, Angela expected the analyst to scream at her, to attack her and to disappear; the gripping intensity of these anticipations was apparent in her cowering fearfulness. Alternatively, she would become manifestly transformed, fearless, eyes glittery, face contorted in a cruel smile, as she contemptuously berated the analyst for a broad range of failings. These shifting images and affective states, indicating a failure in consolidation of positive and negative self and object images, proved a distorting lens through which life was viewed, and precluded, as Jacobson had predicted, Angela's ability to develop any consistent, reliable perspective on herself or others in her life.
     Other experiences seemed suggestive of unprocessed, preverbal memories reflecting developmentally traumatic aspects of her early life. For example, Angela persistently experienced the analyst as emotionally disconnected and uninterested in helping her, "just watching" her. This experience, characterized by near-frantic anxiety, seemed to represent not a frustration of instinctual longing, but a chronic sense of being anxiously adrift in an ambiguous, unresponsive environment.
     Sometimes Angela would offer her own explanation for this unbearable experience of aloneness: she was bad, too needy and ugly, undeserving of the analyst's concerned attention. For a patient such as Angela, this kind of transference expression would suggest disruption of the early maternal environment, where empathic sensitivity and containment of the child's emotional experiencing are crucial elements of "safe anchorage" within the symbiotic experience. A chronic emotional misattunement in Angela's early environment would have precluded her building up a store of safe, gratifying experiences around which a solid libidinal drive could consolidate. Early experiences that register as frightening or anxiously unproccessable mobilize, as Jacobson had described, a stronger aggressive drive which itself becomes a dominant factor in the child's ongoing attempts at meaning-making. If one is often anxious, frustrated, and angry, one might well feel unlovable, perpetuating a cycle of continuing negative experience of self and other. These understandings of the meaning of Angela's transference experience would, within Mahler's developmental schema, suggest a disruption in the fundamental process of separation-individuation and a resulting disturbance in the ability to maintain a reliable sense of individual identity which would continue to compromise experience into adulthood.
     Consider a nightmare reported by Angela following her expressing more positive feelings for the analyst.

Someone called me into a castle. He was in an upstairs window. It was impressive and beautiful. I get inside. I can't find him. Then there are hands reaching out to me. I move closer, but then I see the hands are on arms coming out of the walls. They reach around my neck and are trying to pull me into the wall. I am terrified and try to fight. I don't want to disappear.

With this dream, Angela had been able to visualize the nameless terror that haunted her, making intimate relationships impossible. While Mahler had speculated that a fear of disappearing into one's environment lay behind the behavior of young children like Stanley, this dream of Angela's expresses such a terror in clear and unambiguous terms.
     If she let herself feel warmly for someone, she feared she would disappear into the other, and enter a marginal, formless world, part human, part inanimate. Here hands, symbolic for her of human connectedness, reached out to her to lure her into a nonhuman nightmare.
     Jacobson emphasized that to be used for constructive projects, such as efforts at separation or boundary establishment, aggression must be available to the child's psyche in a manageable form. One cannot put a wild bronco in harness and hope for a comfortable ride through Central Park. The toning down of aggression is an outcome of the developmental accomplishment of tolerating separateness and then of simultaneously holding good and bad feelings for self and for other. How difficult this is to do depends on the relative strength of each set of feelings. If the aggression is too powerful, bringing it together with loving feelings risks the internal experience of destroying those loving feelings and the loved person altogether.
     Angela's aggression had a raw and eruptive quality. When someone upset and angered her, she experienced them as totally bad, devoid of any redeeming features, herself now a singularly destructive person with unmitigated power to damage. At times, she felt convinced she had destroyed the analyst "with the hate in my eyes." She expected to return and find "you wouldn't be here, and no one would have heard of you." Angela was not simply describing the feeling "I could kill you"; she envisioned her aggression as annihilating, effecting a complete psychic erasure of the analyst as well as any internal record of her existence.
    Freud had depicted the ego as arbitrator in a high-level conference with strong and competitive participants. The ego psychologists offered a different vision of the central struggle in severe psychopathology: How does one function with defective equipment? How does one get close, move away, pursue pleasure, regulate feelings, do the things that most people take for granted, if fundamental psychological structures are not in place? Hartmann's principle of adaptation became a standard feature of the clinical version of ego psychology, applied not just to normal functioning but to pathological structures. Angela's "wall" can be understood as her ego's attempt to force a psychic boundedness when a more naturally evolving separation between herself and others was impossible. Angela's sadomasochistic masturbatory fantasies can be viewed similarly. In her fantasies, Angela pictured herself tied on a conveyer belt, passing helplessly through a variety of strangely stimulating sexual tortures, while Mega, the one in charge, sadistically, methodically thrust hot pokers into her vagina.
     Although Angela's sadomasochistic fantasies were sexual in content, from an ego psychology perspective they reflect a more fundamental and formidable psychological dilemma. From this perspective, she was not sneaking forbidden oedipal gratification by disguising it as pain. Rather, she was struggling with how she might satisfy her need for human contact and pleasure when it led to a terrifying sense of psychic dissolution, trying to construct a barrier against the threat of disintegrating merger when the very act of pushing away required her calling on aggressive forces within herself that seemed murderous in potential. Her sadomasochistic masturbatory fantasy offered a kind of makeshift yet creative structure in the face of this dilemma, allowing and regulating needed contact with others, while simultaneously expressing and containing her aggression.
     In this fantasy, there was pleasure and there was contact; she could reach orgasm and was not totally alone. The pleasure, however, was always mixed with pain. This formula would keep her ever on guard, never comfortable, the conveyer belt imagery further underscoring how strongly she needed to defend against any awareness of herself as voluntarily moving toward another person. And the aggression she so needed to draw on to help maintain boundaries was not out of control but channeled through a personification, who reminded her, by title and action, that there was a greater authority to whom she must answer. For Angela, the sadistic quality of the punishment seemed reassuringly appropriate, as it provided the necessary counterforce to the intensity of her negative feelings; a wimpy controller would be no match for the rageful, murderous person she felt herself to be. And, as Angela would later conclude, the harsh and hurtful tone of this controller's communication reminded her very much of her mother's forceful, aggressive ways of "curbing and prohibiting" which, as predicted by Jacobson, had contributed powerfully in the formation of this superego presence.

Developmental Transformation in the Transference
For ego psychologists, the experience between patient and analyst becomes an occasion to understand the nature of the patient's psychic disruption and her adaptive efforts to compensate. The analytic relationship also has powerful transformative potential, the transference providing an opportunity for reworking early disruptions, for the patient to use the analyst to try to fill unmet developmental needs, for the patient now as an adult to verbalize and experience with the analyst early fears and terrors that had, in childhood, seemed overwhelming.
     These opportunities can manifest in a variety of forms. At one point, for example, Angela became increasingly passive and provocatively reluctant to talk. "Go ahead," she taunted the analyst, "you get me into it." Angela eventually acknowledged that she longed for the analyst to aggressively push her into things because this kind of interaction had been one of the few ways she had felt any sense of her mother's interest in her. After both the sexual and aggressive dimensions of this request were addressed, attention turned to what it was Angela felt she needed to be pushed into and how the analyst might be with her in this experience. (Spitz had seen as crucial the impact on the child's perceptual development of the mother's jointly processing, organizing, and making sense of his early chaotic experience.) Angela began to articulate the underlying fears that had infused her experience: fears that thoughts could kill; fears that closeness meant disappearing.
     Over time Angela found the process of naming and clarifying feelings with the analyst increasingly comforting and tolerable. She had begun treatment describing herself as a "nervous wreck" with "no idea of what my problem is." Helping her track and articulate her experience, putting it into words that made sense, encouraged a greater sense of self-definition and gave her more insight into her feeling states. Eventually, she could call up feeling states from memory rather than finding herself precipitously infused and controlled by them.
     Angela's increasing reservoir of good experience both of the analyst and of herself bolstered her confidence in bringing negative feelings into the analytic relationship, where they could be examined. Analyst and patient explored the ways Angela's child's mind had processed certain traumatic experiences, such as the death of her envied classmate, confusing aggressive fantasies with responsibility for actual events. In this context, they also learned how Angela's experience with her mother, who seemed always on the verge of emotional collapse and too fragile to grapple with aggression in any meaningful way, deprived her of an important opportunity to process her worrisome fantasies and greatly contributed to her isolation. Angela's stubbornness was explored, not as aggressive resistance needing removal, but as reflecting a wish to "come up against" the analyst, thus reaffirming her own self as separate, her ideas as different. Aggressive transference expressions with the analyst ("I wish I had a big knife, and I would cut you into pieces") were accepted as expressions of Angela's frustration, and she was encouraged to try to put the specific frustration into words. She was interpretively reminded, when deeply involved with a "totally bad" image of the analyst, of previously shared better moments in the treatment when she had felt helped or cared about. (Recall Jacobson's emphasis on the crucial ability to bring together, in a single experience of another, both good and bad feelings.) In this way, the analyst functioned in the transference as a kind of container for both positive and negative experience, repeatedly demonstrating to Angela that the good could survive exposure to the bad, eventually helping her tone down her singularly aggressive emotional state and develop more balance in her emotional life.

CONCLUSION
The psychoanalytic process can be, and has been, conceptualized in many different ways. The metaphors that are chosen to illustrate principles of clinical technique often provide the best indication of the underlying assumptions of each analytic model. Freud's metaphors all have an adversarial quality: war, chess, hunting wild beasts. As the ego psychologists shifted the focus from the id to the ego, from the repressed to the central nexus of psychological processes, their models of the analytic process also began to change. Initially, in taking on the analysis of the unconscious aspects of the ego's defensive functioning, analysts came to appreciate that what had been identified as the broader functions of the ego, evidenced in the patient's self-observation, reflection, and the maintenance of a reality orientation, could be put to good use in this project.
     Much as early explorers came to appreciate the invaluable advantage of engaging natives as scouts and trappers, analysts became increasingly appreciative of the patient's potential as a therapeutic ally in the process of documenting and revealing unconscious conflict. Calling upon her ego capacities, the patient could reveal to the analyst the "inside story" on crucial psychic terrain, enabling the analyst to more effectively discern the competing psychic claims and crafty defensive strategies of neurosis. As a consequence, techniques were developed aimed at encouraging the patient to enter into what would eventually be called a "working alliance," within which analyst and patient could share the work (see Zetzel, 1958, and Greenson, 1965). Although cure itself was still understood in terms of making the unconscious conscious, the process was now envisioned as occurring within a dyadic context, within a metaphoric partnership rather than a battle.
     A second fundamental change in understanding the analytic process came with the growing realization that for the patient, the experience of working in this kind of partnership could prove therapeutic in its own right. Operating as an effective scout, the patient developed her abilities to better observe herself, to be reflective rather than simply reactive, to delay gratifying herself (for Hartmann, a process synonymous with drive neutralization) in favor of describing what she needed, to work toward anticipating consequences rather than leaping to action.
     Finally, a deepening understanding that psychic structure itself consolidated within a human partnership spawned innovation in clinical technique aimed at attempts to reactivate, between patient and analyst, some form of the early developmental reciprocity that existed between mother and infant. In her early treatment efforts with children, Mahler began looking to the treatment experience itself as a potential corrective, symbiotic experience. In the treatment of adult depressives, Jacobson stressed not the power of accurate interpretation, not the content of the analyst's words, but the crucial role of emotional resonance. "There must be a continuous, subtle, emphatic tie between the analyst and his depressive patients," she observed, to that end encouraging the analyst, for example, to "adjust to the slowed-up emotional and thought processes of such patients," to "not let empty silences grow," and "not to talk too long, too rapidly, or too emphatically" (1971, p. 299). Thus, as developmental ego psychologists further explored the role of parental functions in building strong and healthy psychic structure, depictions of the patient as an effective ally began to shade into images of dyadic analytic provisions that might remedy faulty parental input. The analytic process came to be understood not only as a partnership with work to be done, but also as a growth experience in its own right, the relationship with the (quasi-parental) analyst providing opportunity to rework early developmental experience.