Norman Polansky- Chapter 3

Ego Psychology and Communication
Norman A. Polansky
Chapter 3- Resilience and Energy in the Personality

We have been discussing conflict, defense and the occasional morbid resolution of a conflict into a symptom. We shall now look at the side of the ego that faces toward health. While the formation of a symptom is an attempt at self-healing which proved ill-advised, most such efforts have better outcomes.
     The original view of the ego was as an agglomeration of adaptive apparatus (Hartmann, 1939). This still holds. Indeed, it is hard to find a psychologically induced symptom that would be cause for alarm if it were to occur in a smaller amount. To be inadequately clean is to be a slob. But when you find a patient scrubbing his water closet with a toothbrush (and there continue to be such unfortunate souls outside the Army), you wonder what TV commercial he has been watching. A symptom, then, is often a normally useful mode of adaptation which is overworked and exaggerated.

The Case of the Rejected Suitor
     There are many pithy comments on the subject of marriage. We have Shaw's remark that marriage is a successful institution because it combines a maximum of temptation with a maximum of opportunity. There is the French saying that a bachelor may live like a king, but he dies like a dog; a married man lives like a dog, but he dies like a king. Such wisdom is not usually in the mind of a young man enamored of his girl. He knows only that he loves her, a state still not adequately described in ego psychology or any other. I commence the study of resilience in the ego with a series of examples drawn from a vicissitude that is all too frequent: falling out of love.
     The situation: A young man was attracted to a young lady. After some pursuit, they were in agreement on the desired outcome, and became engaged to be married. Fate, however, willed that they could not marry immediately. The young man had to be away for a number of months on "government business," as we used to say in the Army.
     While he was gone, his ladylove found that living without current and pressing attentions was hard to bear. At first she was "seen socially," then she was "seen often," and finally she really was not seen so much as she was with another young man. In the end, she decided to marry this handy alternative. When her fiance returned, expecting warm greetings and eternal bliss, she let him have the news--tenderly but with a sobriety befitting her condition. She handled her share of this interview well, considering the circumstance that it was not a lovely situation to be handling.
     This was not one instance, but several, for rejection is something that happens in this world. So we turn our attention to the reactions of four disappointed lovers, each of whom has suffered an irretrievable object loss.
     Tom "took his medicine" like a man. He said little, gulped, and left. Then he went home, wrote an oblique but gentlemanly note, and shot himself.
     Dick was also a gentleman, bred and born. He, too, commented with a wry grin that he "understood." He made a caustic remark or two about the idiocy of building one's future on a woman but said nothing really offensive. Then he joined the Foreign Legion, where he spent a number of years riding camels.
     Harry was quite a different sort. His reaction was to become insulted and to threaten both his ex-fiancee and her new lover with great bodily harm. He made a number of dreadful statements about his ex-lady's morals, and he was not above demanding the return not only of his ring but also of a coat or two she had naturally assumed he would not be needing during the forthcoming cold spell. He left and went to visit his drinking companions, where he continued to make vile comments about his erstwhile girl friend. It is not known whether he remained depressed beyond the second week of this encounter, for he left town to accept a good position with a construction firm. Later, he married and reared three children, one of whom wore braces on her teeth.
     George had still a different reaction. He became extremely quiet and pale during the meeting, but made one or two blundering attempts to talk his ex-fiancee into returning to him. Then he left her house, went to a neighboring bar where, fortunately, he found several college friends, and became so drunk he had to be taken home by a friendly patrol car. Although he wept for a time while in his cups, he never did tell his friends what was bothering him. Subsequently, he dated other girls, off and on. George became an alcoholic who never married. His mother, who provides him with money and occasional haphazard courses of psychiatric treatment, blames his lifetime of troubles on his having been so coarsely jilted.
     These are of course quite varied responses to the same life crisis. Which is to be seen as the healthiest? There are, as a matter of fact, cultures in which the only appropriate reaction to such loss of face would be suicide, or murder, although it is hard to image that destroying oneself might be taken for psychic health, much less destroying someone else. But one thing does stand out. Regardless of the specific dynamics, we have the impression that some personalities are better able to roll with life's punches than are others. The ego is said to be the arena for such .adaptations, so it must be in the ego that one absorbs, or fails to absorb, the punishment which life inevitably deals to all except the most lucky. We practitioners, who spend so much of our lives helping others cope with stress and loss, need a set of concepts to describe the over-all ability of the person to rally from disaster.

Ego Strength and Psychic Energy
     Modern casework practice utilizes what we call a psychosocial diagnosis. This is an attempt to pin down what is causing distress, both within the person and in his total life situation. In making the diagnosis, it is now common to appraise strengths and weaknesses. Similarly, in discussing the functioning of the personality, it has become habitual to talk about clients who have strong egos or weak egos. These terms are not used with much pretension to precision. They mean simply that the personality is more or less efficient in adapting to the environment. Strength may come from being born with a highly salable talent, or from having some way to profit from one's disasters and vicissitudes. Some comedians do this expertly. Fritz Redl used to say, "It 'ain't' your neurosis, it's how you use it. "
     Perhaps the best way to lend precision to the term ego strength is to bring in the concept of psychic energy. In a general way, we assume there is in each person a relatively constant amount of such energy. Predicting the functioning of the personality involves, among other things, estimating how much psychic energy is free and available for solving life problems. Persons with strong egos, let us say, are able to pay attention to what is going on around them; indeed, they probably get a fair amount of pleasure out of being involved in day-to-day happenings. They can concentrate without becoming distracted by internal preoccupations, and therefore they think more effectively and creatively. Beyond that, they have reserve supplies of psychic energy. Struck by a sudden crisis, they are able to deal with the situation. Given events requiring extraordinary decisions, they can think logically for a long period until able to find the means to solutions. All of us experience impulses to panic or withdraw when struck by the unexpected, but those with a sufficient amount of free energy are able to put forth the effort needed to control such urges and to act in spite of them. For all such reasons, it seems reasonable to accept that the availability of free energy is to be seen as a major index of the health and strength of the ego.
     A question that has plagued theoreticians concerns the source of the energy at the ego's disposal. A view that was widely offered during my student days saw the ego as a weak jockey borne at the whim of the willful id, who was the horse. This still begged the question of whether the ego, if it were even to guide the horse around holes in the path, did not have force of its own. By now, it is generally agreed that the ego does, for all practical purposes, have energy "at its own disposal." This energy derives ultimately from the great instinctual drives which, at a most abstract level, can be dichotomized into sex and aggression. However, as the energy in these drives becomes neutralized and sublimated it is channeled into adaptation and is available as part of ego functioning.
     It is now being accepted that another source of energy is available to the ego. This derives ultimately from the parts of the brain and body involved in sensation--the so-called perceptual apparatus. Certainly, there is now evidence that in the absence of stimulation to the sensory organs we develop a yearning for it, which has been called, appropriately enough, stimulus hunger. But these are abstruse questions, beyond the scope of the present book. Meanwhile, we shall deal with a simpler issue: Given that there is a quantum of psychic energy, how is it depleted?

The Loss of Psychic Energy in Conflict and Defense
     Individual psychology had been studied for half a century or so before serious and detailed efforts were made to probe the dynamics of groups. As a result of comparative ignorance, it was common to talk about groups as if they fitted individual dynamics. People even went so far as to discuss the birth of a group, its adolescence, and its senescence. It was not always clear whether such writers were indulging in elaborate figures of speech or whether they thought they were indeed describing a living organism. I have worked on problems of both individual and group dynamics, and my experience runs in the reverse direction. Certain individual processes and dynamics can often be better understood and illustrated by looking at what happens in groups. In so doing, however, we realize that we are only making the processes more vivid for the reader. These are examples only, not direct reflections of reality.
     In the last chapter, we talked about conflicts which the person experiences. As I write this, I am aware of a group conflict involving our neighborhood. We live on a long, meandering street which has homes bordering, on their rear, a large tract owned by a local operator. The developer wishes to build a shopping center, and has used his considerable local influence to have the zoning commission and the city council rezone his land from "residential" to "roadside trading." In the course of this change, bowing to anguished yelps from the voters on our street, they did compose an ordinance that he would leave a fifty-foot buffer zone undisturbed. Now the developer is encroaching on the zone, cutting the trees, and those affected are naturally upset. There is nothing unusual about this situation. It is as American as apple pie and the greed of wealthy men. Equally American is the urge to protect oneself. An organization within our neighborhood existed, and the members met to hire a lawyer. The next step was to request a voluntary assessment from each affected family for a "retainer" for the lawyer. Immediately, two schools of thought arose. One felt that the fee asked was expectable; the other preferred to wait and see what this lawyer would do before making an investment in him.
     One advantage the developer has over the neighborhood is that he can make decisions rapidly, while ours must be filtered through a group process. If there is disagreement in the group, then the whole decision process may be stymied. At a minimum, energy that might properly be spent combating "the enemy" becomes dissipated in debating strategy and in dealing with vague suspicions about the intentions of those who have accepted leadership. Such dissension can become so bitter that it leaves neither strength nor money with which to protect ourselves.
     The process is similar within a person. By analogous dynamics, we may note that while he struggles within himself and against himself, nothing is left with which to try to manipulate his environment. A prime example is the person who is immobilized by obsessive indecision. T. S. Eliot presents J. Alfred Prufrock:

"I grow old ... I grow old ...
I shall wear the bottoms of my trousers rolled.
Shall I part my hair behind? Do I dare to eat a peach?
I shall wear white flannel trousers, and walk upon the beach.
I have heard the mermaids singing, each to each.
"I do not think that they will sing to me."
And elsewhere,
"I have measured out my life with coffee spoons..."

     We shall have ample opportunity later to examine at more leisure some of the mechanisms of the obsessive compulsive personality. For the moment, however, our point is simply to illustrate the manner in which psychic energy can be exhausted in the inability to resolve conflict.
      Psychic energy is also consumed in great amounts in the effort it takes to sustain a defense. To review, a defense is any maneuver--an action, an idea, a way of thinking--which we use to keep from seeing something we do not wish to see. Many defenses waste energy, of course, but the waste is nowhere more visible than in compulsive actions. In their efforts to maintain a sense of safety in starting the day, some compulsive people develop morning rituals of the toilet which use up several hours. I once had a patient whose eating rituals required two hours for a frugal hospital lunch. As with many such patients, he tried to conceal his compulsions from me, sensing rightly that sharing them with his therapist would be the first step in giving up those particular defensive maneuvers. The nurses noticed that, as he came down the hall in front of the nursing station, there was a particular black spot in the tile pattern which he had to touch with his foot before turning off toward his room. This created a number of problems for my youngster. Sometimes he had to wangle his way through a group of fellow patients who were standing about, managing unobtrusively to touch the black tile in some way so he could continue his walk. At other times, there might even be someone standing on his black tile, and he had no alternative but to hover around hoping that person would soon wander off, so he could get access to his safety spot.
     We discussed this operation in an interview. I had no luck in discovering why he had the need to touch his personal home base, but (as too often happens with such patients) he immediately decided he had been doing evil, and should give up the pattern. He did. My next report from the nursing station concerned an oddity in the patient's gait before their desk. Now, as he approached the spot in question, he would make a detour to avoid the offending tile. As he was a scrupulous person, this often took him as much as three feet out of his way. He had replaced his compulsion with something I could only describe as anti-compulsion compulsion. He had not resolved the original problem; rather, he ended by multiplying his expenditure of energy to pretend to himself that the problem no longer existed. The device he was using in this pretense we term a reaction formation. Had we truly succeeded in removing the conflict involved, it would not of course have mattered to him whether he stepped on the tile or missed it. Thus, we see one way in which a defense can waste energy, in the first place; we also note how the effort to keep a defense, while appearing to give it up, may increase rather than decrease the net input.
     This entire procedure was open to view. Usually, the workings of defense are submerged; they are in the "silent service" of the ego. It takes psychological SONAR to locate them, because the whole process is kept hidden from the patient's consciousness.
     A student who has conflicts about sex, for example,, may encounter a variety of unanticipated effects on his studies. Let us suppose that this conflict "began" with his hearing, as a child, that his mother did something dirty with his father in order for him to be born. Because he loved his mother very much, he was shaken and dismayed by such news. (Of course, there must already have been the germ of a problem, or he would have managed to shrug off the shock, as most children do.) He did not want to know about such things; he repressed the information, "forgot" about it. Next, we find him as a fifteen-year-old, studying biology in high school. He has done well in the course, but finally the text discusses the reproduction process. Whenever he reads about it, he finds himself unaccountably restless and bored. Were he in treatment, he would complain about difficulty in concentration. Although he can do mathematics quite well, the simplest logic concerning the entry of the sperm into the ova is hard for him to follow. He must read it and reread it. He complains that he is stupid, and cannot learn "anything." His caseworker would notice that this was not true. The worker might justifiably conclude that he preferred to term himself "stupid" in general rather than search out how and why he is stupid in this particular. In any case, our youngster does manage to pass biology, but only after expending much more energy trying to make the information sink in than he has to with most other such courses. And he is unable to know why this happened to him.
     You might say that he cannot learn because he does not want to know, but this would not be true. The fact is that he already knows! But what he knows is something he does not want to have stirred up and made conscious. As fast as he learns something about sex, it becomes associated with his childish reaction of shock and dismay and it is dragged beneath the surface and kept unconscious, joining the imagery from his childhood.
     It is as if all new information enters the mind first through the organs of perception--the eyes, the ears, and so forth. The working of these organs is of course unconscious. Therefore, the question is whether the new information will come rapidly through the unconscious, into consciousness. Preventing information from coming to consciousness takes energy; it is quite different from not caring enough to attend to it. We may allow our eyelids to droop while watching a fisherman because we are drowsy, and nothing worth watching seems to be happening. This is quite different from sitting with eyelids clenched tightly shut because we are afraid he will hook something and we feel sorry for the fish. It is because true information is constantly reaching the unconscious from the outside world that energy must be expended to keep delusions and distortions alive.
     Many a neurotic, if he is completely honest, will confess to real nostalgia over the loss of the magic that went with his illusions (Fraiberg, 1959). I have occasionally had to say, "You are giving up the thrills of your exciting daydreams; but at least you are also dropping the horrors of your nightmares." Marriage has also been described as giving up the excitements of the chaise lounge for the comfort of the double bed. There is no use in asking more out of life than there is. This, too, wastes energy.
     All these are examples of the manner in which ego strength may be depleted through the loss of energy in conflict and defense. There are other ways efficiency may be impaired.

The Invasion of Ego Functions by Neurosis
     We have just read an example of difficulty in learning new material because of its relationship to something that we do not wish to recall. Such inability to bring to mind an event that is actually still alive in memory is termed repression, in the strict meaning of the term. Freudians took no interest in the processes of memory except as they involved repression. Indeed, naive young men like me--and we were many--became so impressed with the amount of detail that came to us while free associating on the couch that we acquired a distorted picture of the nature of memory, in general. I recalled, for example, coteries of classmates from the third grade and names of teachers long forgotten. I had the fantasy that everything that had ever happened or that I had ever learned was somewhere stored within my brain on an endless reel, waiting only the release from repression to be brought to light.
     This of course is simply not true. Not everything to which we have been exposed actually impinges firmly enough to be "remembered." The laws of memory that Ebbinghaus worked out in the nineteenth century before Freud was prominent still are accepted in a general way. We know, for example, that if we are memorizing a long poem, and repeat it over and over, the parts that we first remember are the end and the beginning. We accept, too, that spaced learning is more efficient than concentrated study. Reading the poem aloud once each day for three weeks will embed it more firmly than reading it twenty-one times at a single session. In short, there is more to repression than memory; and there is more to memory than questions of repression.
     Memory, then, is an ego function useful in adapting to one's social environment. Under some conditions, it can be made to work more effectively. Similarly, some of us are blessed with a greater ability than are others to absorb information rapidly and to recall it quickly. There is reason to believe that at least some of the variation among people is due to native endowment. How, then, does repression relate to memory? Repression is present when the person is unable to recall information which, given the normal laws of memory, one would expect him to recall--e.g., his own name, to take an extreme example. We may say that the function of memory has been "invaded" or contaminated by an opposing process of defense. It is in this sense, then, that it is meaningful to talk about the invasion of ego functions by neurosis.
     Memory serves as a significant and readily understandable instance of such a process whereby the ego is weakened and psychic energy can be utilized less effectively. Perception may also be attacked. A man may look three times on his shelf for a book his wife picks out immediately, a book with which he is familiar. One of my commanding officers in the army went to see our psychiatrist when he found himself repeatedly driving ten miles down the road past the entrance to the post before realizing he had missed the turnoff. Needless to say, the CO over our CO was really something!
     The ego may be weakened, we have noted, through the leaking away of psychic energy into conflict and defense. We now see another form of difficulty. Functions that make up part of what the ego has to offer, when they are operating reasonably smoothly, may become relatively less effective when they are invaded by conflict. It is rare, by the way, that a psychological function will be totally eviscerated by such a process. Nearly all psychotic persons I have known were quite clear about how to put on their pants, however strongly they felt that we were holding them hostage. There is scarcely ever a complete loss of reality testing, and this keeps the psychotic busy in squaring his delusions with facts that keep coming to his attention. A woman may be completely illogical about her husband's unfaithfulness but shrewd in calculating the minimum rent she should get for the house after she divorces him. Still, such impairment of an ego function seldom remains confined to the content in which it first appears; it tends to spread. As the impairment becomes more general, the ego becomes weaker--thus it is important not to delay treatment of a neurosis.
     When a function like memory is operating reasonably free from the sort of invasions we have been describing, we say that it is a conflict free ego sphere. The more the adaptive functions of the personality have escaped such invasion, the less the person has been crippled by neurosis, the stronger the ego. It is evident, therefore, what one of the main goals of therapy must be. It is to free as wide an area of the ego as possible for conflict-free functioning. In this sense psychoanalytically oriented therapy holds out the same promise as do all those commercialized books about how to exploit your own "hidden reserves of talent and power." I hope this is the only sense in which the two movements are the same. But psychoanalysis ought not be held responsible for the claims made for it by some of its consumers.

The Synthetic Function of the Ego
     We have been discussing the manner in which the ego may dissipate its energies through such dynamic interferences as defense and indecisiveness. We cited J. Alfred Prufrock who must be forever held forth as exemplar of the trivialization of life. While "playing it safe," he loses all. Actually, many people have trouble coming to decisions because, to put it bluntly, they are greedy. Most important life decisions require that in order to have A, you must decide not to have B. There is a definition that states: A pessimist is a person who, given a choice between two evils, chooses both. One reason many people are indecisive is that they are trying to devise some way they can have the apple pie, for dessert, and the chocolate cream pie, too.
     One of the functions ascribed to the personality is the capacity to resolve such tremendous issues and to live with the outcome. Something must be able to convince the greedy child within us that having the chocolate pie is worth giving up the apple; or that we can have the apple pie the next time; or--and this is really a lot to ask--that the whole matter is not all that important. This ability to take two contradictory alternatives and find an acceptable way out involves a synthesis. With the possibilities that exist for random whims within the personality to ride off madly in all directions, obviously the person would be torn to shreds were he not able to find some way to integrate the parts.
     Something there is, therefore, which helps to coordinate the disparate strivings and reactions of the personality. This we call the synthetic function of the ego. Its operations are most evident in the negotiation of a bargain between contending impulses, but the function goes beyond this. The synthetic function is invoked in conceptualizing the many processes in which the person strives to find a unifying principle in, or "make sense" out of, his experiences. Gestalt psychologists talk about the tendency to closure, by which we see at quick glance a C as if it were a complete ovoid. Such a mechanism in perception might also be ascribed to the synthetic function.
     From the standpoint of developmental psychology, such a function is a necessity for the developing organism. Development, after all, finds the child moving from a "vast buzzing confusion" as William James had it, toward more and more refined categories of experience. The child's first caretakers, for example, gradually differentiate into Mother and non-Mother. As the process of differentiation proceeds, there is the question of how the organism is going to achieve coordination among its increasingly complicated sub-parts. That it does so is evidence of the existence, in most of us, of an ability to integrate that matures hand-in-hand with the process of differentiation. The capacity to integrate, or the synthetic function, if you will, seems to be intrinsic to the warp and woof of the whole ego. As contrasted with particular dynamic interferences, this might be thought of as part of the over-all ego structure. The intactness and effectiveness of the ability to integrate are part of what we mean by ego strength.
     Just as bright people have a more highly differentiated view of the world than do unintelligent ones, so is their capacity to integrate superior, certainly in terms of the ability to think and to perceive the world. In the intellectual-cognitive sphere, the synthetic function makes its mark in the degree of abstraction one can use in relating disparate experiences. A feeble-minded or brain-damaged person might have difficulty in finding one word to cover a lamp, a desk, a chair. "Well, they are all made of wood except the lamp ... ," he would say. A normally functioning youngster would immediately respond "furniture." Integration of ideas is unquestionably facilitated by the availability of abstractions in one's vocabulary. To what extent vocabulary also helps us synthesize in the realm of action and feelings remains unclear. There is little doubt, however, that there is something like an over-all synthetic function of the ego, which varies from person to person.
     Beyond the silent workings of the synthetic function, a conscious dynamic is at work. Most people not only tend to synthesize but also have a need to appear integrated. Consistency is often considered the solitary virtue of small minds. Certainly it is true that one cannot always distinguish the man of principle from the mealy-mouthed hypocrite, especially in religious circles. The need to appear all of a piece can be exaggerated into a symptom in the obsessive-compulsive personality who, for example, may feel that once he has said something, he is "stuck" with it--whether or not he fully meant it in the first place. But the need to appear integrated can also operate to assist treatment. When a client makes a few conflicting statements, and we point this out, the effort to explain himself to himself may be part of what leads him to change internally. Self-deception about the degree to which they are unified and substantial people characterizes some neurotic characters and character disorders we shall discuss in later chapters. But the need to appear integrated seems universal, however variable its strength or closeness to reality.

Looseness of Ego Boundaries
     The client bustled into the office and brushed back a wisp of hair from her eyes. This was rather futile, because the hair soon fell back, and indeed, her whole appearance was slightly bedraggled. She was not dirty; she was not clean, either. She hunched forward in her chair, breathed a deep sigh after having hurried up the stairs three minutes late, and said:

"Well, it's the same old sixes and sevens at our house. The children are driving me wild, now that school is out, and I don't know if I really do want to go on living with him. Last night was the living end. Well, everything sooner or later comes to an end. And that reminds me. I've got to get the toes repaired on those blue shoes of mine... we were planning to go to Sylvia's wedding ... weddings are so nice. If I had only known ... What do you think? What would you advise?"
     "About what?"
     "Would you let him take me to the wedding, when I'm sure he'll just get sloppy drunk, and spill cigar ashes all over the car. And then he'll want to sleep with me. Boy, I never seem to get enough sleep. It is my aristocrasis acting up."
     "Your what?"
     "My aristocrasis. At least that's what I think it's called. They call and we fall. Tall against the wall. I should never have let him maul ... you never tell me what to do."

     By now the caseworker is a bit groggy. This lady has him on the ropes. He has been carefully schooled that one should "start with the client where she is." But where is this lady? The worker feels helpless, inadequate--if only he were more sensitive and skilled. Undoubtedly, the client is communicating something besides general restlessness and some complaints against life. It is the worker's job, of course, to pick out signals that are being passed even in a language not generally understood by laymen. But there is something else of which he should be aware. This client seems unable to formulate her thoughts into any systematic sequence of ideas. She talks, it is true, in what sounds like complete sentences. But the sentences do not follow, one from the other. There is evidence at times that her thoughts are easily distracted. Once or twice we note that the client seems to have been carried away by the sheer rhyming quality of what she said. She used a word that is not a word at all. Either she has misheard it from her doctor, or it is a word she just invented, a neologism.
     When it is this difficult to understand a client, two major hypotheses are to be considered. Perhaps the client does not wish to be understood. Or, perhaps the client is unable to sustain a logical train of thought, which is then reflected in her speech. When this is true, we say that she sounds loose. This is an imprecise but descriptive term characterizing the kind of weakness in thought process we see here. It refers to a quality of illogicality and disconnectedness in thinking. It also refers to thought that seems to follow rather arbitrary associations.
     Other features are often characterized as looseness in thinking. With this client, for example, we are able pretty well to follow how one idea hooks into the next, even if the basis of association is rather primitive. That is, ideas are associated not so much in terms of a problem to be solved or a meaning to be communicated as in terms of "echoing" of verbal sounds. Other associations may be quite mysterious to us. If we had the time we might discover that the client's basis for connecting images is that they remind her of things she once saw together--her mother stooping to scrub her front stoop, or some such event.
     This kind of association by propinquity of ideas or similarity of sounds is likely to emerge in free association. It is characteristic of the mental workings of fairly young children. Another characteristic of their thought processes is an unrealistic appraisal of cause and effect relationships. For instance, the logical fallacy known as post hoc, ergo propter hoc is characteristic of children's thinking. This unsystematic, somewhat magical view of the world we call the primary process; and we refer to primary process thinking. We differentiate it from the style of the mature mind, with its ability to sustain longer chains of logic and its closer relationship to reality. Whole sentences, indeed whole paragraphs, of speech may be integrated around a single abstract idea that is being communicated. Ideas are distinguished from each other with precision. This type of thought--characteristic of the mature, conscious mind especially--we describe as secondary process thinking. Primary process thinking comes to the fore in sleep, when one is fatigued, ill, or intoxicated. Any one of us is capable of primary process thinking; it remains in the substratum of the mind.
     We have the feeling that primary process thinking predominates in this client's mental processes, most of the time. Perhaps that is partly why she seems so disorganized. She is. In a more general way, we might then say she displays looseness of ego boundaries. This refers not only to the disorderly thinking and speech but also to the inability to hold steadily to a task she has assigned herself. One can easily imagine her stopping, with one stocking on, to start the coffee, before returning to her toilet, which will be interrupted by three other activities, and never finished at all.
Loosness of ego boundaries, in more extreme forms, also permits the eruption into the conscious part of the mind of ideas and images usually kept repressed. It is hard to say whether this is pathological, although one should consider the possibility. After all, unusual ideas and images are part of the charm of poetry and painting. Important scientific problems have been solved by sudden insights brought into being by the availability, to the creative worker, of just such offbeat imagery. A famous example in the history of science is the well-known benzene ring on which so much of organic chemistry is based. Its discoverer was challenged with the problem of how six carbon atoms might be arranged, spatially, so that they had certain properties. One day he rose from a reverie with an image that, instead of the atoms sitting in a line, as he had thought of them, they had formed into a circle, like a snake who has started, to swallow his own tail. (I once got the idea of applying scale-analysis technique to a set of data while I was painting a wire gate made, as they usually are, like graph paper.) As Oppenheimer, one of the greatest physicists of our generation, remarked in a television interview, "If we do not dream by night, we shall have nothing to correct by day." But of course Oppenheimer was capable of rechecking his half-sleepy bright ideas against logic fortified by morning coffee. Persons suffering from true looseness of ego boundaries are not able to displace one style of thought with the other by an act of concentration.
     Looseness of ego boundaries refers also to the failure to sustain structure in other realms as well. We think of looseness in connection with extremely impulsive persons. They are said to be unable to bind impulses, but must give way to them immediately or else suffer extreme discomfort. An example I like to use involves a dollar bill. In an average class, I could drop the bill on my desk, leave the room, and come back to find it just where I left it. The only problem it would present to most would be whether to comment on it or to put it away for me. Hardly any student would be really conflicted about whether he wanted to steal it. His controls are well internalized, which is to say that they operate automatically and with no conscious effort. A delinquent youngster, on the other hand, might also leave the dollar bill alone, but only after some struggle with himself about whether he might get caught or whether he wanted to "treat Polansky dirty," or the like. In the realm of impulse control, his ego boundaries are not so firm as are most of ours. Or, his price is lower! The story is told that when U.S. Grant was stationed at St. Louis acting as procurement officer for the U.S. Army, he wrote to Washington asking to be relieved. Reason? "They are getting awfully close to my price!"
     To the extent that ego boundaries are firm and whole, precise thought and planful, coordinated action become the more possible. There is usually also greater capacity for dealing with abstractions. Persons whose thought processes are the more primitive usually are more concrete minded. They cannot think in complex units or even take richness of possibilities into account. I shall never forget the psychiatrist who, in reporting to the hospital staff on a new female patient, gave a colorful and hair-raising account of her escapades and harassments by her husband. As the patient seemed to the rest of us very flamboyant, someone asked, "How do you know all this really happened?" This man stared in shocked amazement and replied, "That's what she told me." It was simply not possible for him to listen to so embroidered a tale and simultaneously sift it to see whether the patient might be consciously lying or, as often happens, confusing fantasy with memory--which would be another common form of looseness.
Looseness of ego boundaries is, itself, not a very precise concept, but it does prove helpful in beginning to size up a client with whom we will be dealing. All of us vary in how loose we are, depending on the situation. Nevertheless, there are some persons who unfortunately remain relatively loose under even optimal conditions. Some are psychotic, of course: all schizophrenics betray this pattern. Whether such looseness is inborn or the result of early life experiences remains unclear. There are analysts who believe that the group we call autistic children have a congenital defect in their capacity to order the world they perceive. They have looseness of ego boundaries as an inborn trait, persisting even as they mature.

External Supports Against Looseness
     We have mentioned that looseness may be an enduring characteristic of the personality, but it may also be a reaction to the immediate situation. Once, for example, I found myself in what I had always fantasied as an ideal job. I arrived for work and was led to a small but plush office (at least it was plush by the standards on which I had been reared in social agencies, prisons, children's camps, and the like). I was introduced to a pleasant woman who, I was told, was my full-time secretary available for any typing I should need. There was a rather good library on the premises and easy access to others. Naturally, I was curious about what was expected of me. The answer was, "Well, hang around a while and see what comes to mind. We want to know what you think of what we are doing." This is not an unreasonable request, actually, nor was mine so outlandish a job for an intellectual. The trouble was that I had come to it after a rather frantic period of my life in which I taught a full course load at a university, while conducting a major research project "on the side"; in addition, I undertook a variety of extra assignments, some because I felt they should be done, some because they fed my narcissism, and some because I needed the money. The sudden shift to this placid and undemanding existence was more than I could take; its major impact was an enormous feeling of inadequacy. After all, the "bright ideas" to be expected from a person so petted by society must be terrific. The price of having no demands made upon you is also that no one really needs you. Such a situation can give full play to any paranoid imaginings or anxieties to which one is prone. He may yearn for a solid assignment, any routine job, into which he can sink his teeth. Although this experience happened later in my life, it is, I believe, not far different from what occurs for many students during their first days, or even weeks, in field placement. They arrive with stars in their eyes and butterflies in their stomachs and are told, "Here are some case records from last year. Why not look them over and see what sort of thing we do here?"
     A young psychiatrist and his chief social worker decided, when they were assigned to take over a mental hospital, to see what life was like for patients in the hospital. They went to one of the back wards and proceeded to follow the patients' routines. They got up, ate a meager breakfast in the cafeteria among a group of withdrawn, somber fellow patients. Then they returned to the main hall of their ward building, where they joined the other patients in sitting in long rows of rocking chairs. There they sat, rocking. Such spasmodic efforts as the staff made were dedicated to "keeping things peaceful." From time to time, one or another patient would arise, grasp the end of a push-broom and shamble the length of the day room, clearing a few odd bits of dust from the polished floor. This routine was interrupted by two major events: meals and trips to the bathroom.
     After three days of this routine, our two professionals found themselves no longer observing. Instead, they noted that their thoughts wandered aimlessly; bits of old songs caught their attention and perseverated in their minds; indeed, one of them began to have visions which, fortunately, he could recognize were quite unreal and creatures of daydreaming with his eyes open. They emerged with this question: Was the ward designed to keep peace among a group of schizophrenic patients, or was the schizophrenia supported by the lack of structure and stimulation in the ward environment? Of the two, the second possibility seemed to them the more likely. And this was not an isolated instance. To this day, you can go to almost any state hospital, in almost any state, and you will find this universal feature. Ward personnel are sitting on their bottoms waiting for the end of their eight-hour shifts, and the patients are immersed in fantasies.
     From a variety of sources, we have reason to suppose that the absence of clear external structure in one's life makes it likelier that ego boundaries will loosen. This is one of the potent effects of isolating political prisoners from all contact with the outside world, while simultaneously keeping them in a state of uncertainty about the future. It is especially important that the prisoner have no map to guide his actions, and it is deliberately made capricious whether by his actions he can do anything to save himself. Other illustrations come from the now-familiar experiments on stimulus deprivation. Placed in a soundproof room, suspended in a bath at body temperature in the darkness, some subjects hallucinate. Content usually held unconscious breaks through and begins to dominate consciousness.
     David Rapaport (1958) said that the ego is relatively autonomous. It maintains its autonomy from the id in part by virtue of its continuing responsiveness to external reality. In psychiatric treatment, at least under inpatient conditions, we have learned this lesson well. When the inner structure of the personality is too infirm, a more stimulating external one acts as a counter. Certainly it is to this process of prodding and protecting that one must attribute those successes in some state hospitals of treatment through medical staff inaction which we used to call "spontaneous remissions." It is now possible to design a life-encompassing treatment setting which leads to a higher percentage of remissions, less haphazardly than formerly (Redl and Wineman, 1952).
     Just as the absence of external demand may fail to provide needed support to an ego in trouble, so may too much external pressure. It is as if the requirements of the environment lead to a rise in internal tension such that inner boundaries are literally flooded out. Obviously, in offering support to damaged egos through a structured environment, the art lies in imposing sufficient external demand so that ego boundaries are called into play and exercised, without so much demand that they become overwhelmed.
     Finally, I should like to comment on the seeming complementarity between the ego and its social setting. In the political sphere, for example, it is customary to blame the regressive, childlike quality found in so many people living under totalitarian regimes on the effects of their dictatorships. It is not customary to ask: Under what sort of regime would it be possible to sustain order among a people with this average level of maturity? It is difficult for me to believe that the average Russian peasant was at all ready for democracy, as we know it in the Western world, and that any effort to offer it to him would not have ended in chaos. One often hears that people get the governments they deserve. Perhaps it is more precise to note that people, and their governments, seem to set up complementary relationships such that if one will not provide necessary controls for himself, he intuitively accepts a government that will do it for him. "Where there is no character, there has to be a system."
     There are of course more limited examples of this kind of complementarity. Most mothers who love their children intuitively adapt themselves to a child's needs. It is not uncommon, therefore, to find that the mother of a child with a developmental defect in establishing inner boundaries has fallen into a pattern of providing the child's planning, synthesizing, and self-controlling from the outside. We then say, "She does his thinking for him," but this is an oversimplification. The problem, if there is a soluble problem, may be that the mother is continuing to act as this ego support when the child no longer needs so much. Even mildly retarded children develop, albeit at a slower pace. Caseworkers who meet with their parents often are in the position to help them turn the child loose, freer to find his own way through some aspects of living. In at least some cases, the child makes dramatic advances toward self-reliance out of this mode of treatment. The treatment, let us say, is simple in action, but it is derived from a sophisticated theory.
     One final example, before we move on. What is the role of work in the psychic economy? We know that through it we earn our financial living; we also know that through it we earn part of our psychological living, too. Is this not because, regardless of the internal conflicts or pangs we may be feeling, our jobs usually require that we brace ourselves, attend to external happenings, solve problems, invest ourselves in getting something done in a world that is real and impresses us with its reality? What a protection against inner devils! It is common to think that a man becomes unable to work because he is neurotic. This may be true. The neurosis may invade the work life as it has so many other functions of the personality. But, because of its outer-directed quality, the demands it makes, and, for people who have become good workmen, there is a sense of accomplishment while on the job, the work life is harder than many other areas to break down. In fact, continuing to work may provide a powerful support against collapsing under a burden of depression and conflict. It is for this reason that one finds so meaningful the psychoanalytic slogan, "Work: the last bastion of defense." This is as true for us as it is for our clients (Polansky, 1959).
     Although I have been a social worker as well as a psychologist, I must confess to having catered to my self-indulgence by spending a number of years in contact with some patients who represented great wealth. I cannot join F. Scott Fitzgerald's eternal adolescent when he commented that the very rich are not as others of us. This is not true (even though some of his other remarks may have had more pith, e.g., that Hemingway was ever ready to extend someone a helping hand on the ladder of success--from below). Neither does it seem likely to me that the presence of great wealth is a disadvantage. I have seen many young people whose psychiatric condition was such that they would have landed on the scrap heap were they not provided first-class treatment through their parents' monies. I have seen a woman whose children would have been seriously neglected during a lengthy depression were it not for the presence of competent hired help in the home. But it is true that the son of a man who does nothing in particular in this world has a harder time composing an identity by which to live. Even worse, as he struggles to find something bigger than himself, or at least outside himself, which would stir him from his inner preoccupations, he faces a problem which is vastly simplified for those of us who are poorer. If you are rich enough, it is hard to convince yourself that there is anything that needs doing. Worse, even if it needs doing, you can hire it done, so it does not need doing by you. Unfortunately, the external demands which poorer men experience as insistent acquire for the very rich a game-like, playful quality. Only the most dedicated can find "work"!

Protections Against Becoming Overwhelmed
     We have discussed a desirable complementarity between internal looseness and external supports; such that the latter can make up for the former. But it is clear that support for a weak ego by outside manipulation is likely to be at best a holding action. We are left with two significant issues: (1) What must character contain in order best to withstand life's vicissitudes? (2) How can such structure be instilled, either in a growing child, or in a patient in need of help'?
     My intention is not to try now to encapsulate all the literature of child guidance and child development. Much of what is needed for a resilient, reality-oriented, and flexible ego organization is implicit in what has been said above. Let me just mention a few points that have seemed outstanding to me and are not always discussed.
     The presence of a strong set of internal standards is not just admirable, it serves as a protection against falling apart. By such internal standards I am of course referring to what in sociology we call values and might also call the conscience. Life and happenstance in it are not intrinsically meaningful. We impose meaning on it. For a person to "make sense" out of life disasters, and to manage to ride them out, it is helpful if there are at least some principles to which he can cling, some bulwarks he can use to strengthen ego boundaries, if you will, when he threatens to collapse into a sodden heap.
     I have observed that, among people doing casework or therapy, those who were working in terms of a theory were usually more successful than those who were eclectic, provided the theory was not too far removed from reality. The theory seemed to lend their efforts a purposefulness, a directedness which itself strengthened the client's ego. And only if you have a theory can you calculate the direction of errors you seem to be making and correct them.
     The same might be said for a person caught in the grip of neurosis. If there is something he stands for, and something he is willing to stand by, then he has a chance of surviving the vicissitudes he will experience. But how is such a system of values instilled? Obviously, it can do its work well only if it is truly part of the person, not something he lives by in order to accommodate to external pressures. The country has always been full of young men who learned to conform either in our boys' industrial and training schools or in our prisons long enough to be discharged. External conformity, going through the motions, does not lend the strength of character which affords resilience.
     We went through a long period when many psychologists believed it would be best if children were given maximum opportunities to find their own ways. Rather than imposing values and controls on them, we should let them gradually see the point, themselves. This would be more effective in the long run. It is also easier on the parents, by the way, some of whom are avid for this approach because they do not have enough character to fight the child for his own good. The generation of young Americans who are out of control is not a result of their rearing according to the tenets of Dr. Spock ; they are the victims of weak-kneed parents who have distorted the content of Spock because they were too busy "making it."
     Therefore, we must add a few points relevant to both child development and treatment. First, controls become internalized only after they have been externally imposed. The child cleans himself first to escape mama's spanking or disapproval; next, he washes up because he can anticipate that mama will disapprove, but she does not have to remind him each time; finally, he washes up because he wants to be clean. It is not necessary to brutalize a child or force him beyond his age-relevant capacities to promote this sequence. But it is necessary that mama be clear in her mind what she wants accomplished and be both realistic and consistent with the child. A high percentage of children who show difficulties with control systems have parents who were inconsistent, or who literally never gave a bit of thought to how one "trains" a child, and usually both.
     Second, and this is related to the first point, people seem better able to withstand external pressure if they have strong values that are internally held. Although the wording of this statement is practically circular, it has some interesting derivations. For instance, many progressive educators assumed that the way to foster a self-determined young man or young woman was to provide a permissive environment in which he might find his own set of values, his own vision of truth. This is good to think about, but it is not true to my observations of people. The people best able to stand up against pressures from their neighbors, from their community, to fight for justice and truth usually came from surprisingly rigid backgrounds. Persons from deeply religious backgrounds often made up the hard and fearless core of those willing to stand against McCarthyism or the peculiar group-think which periodically sweeps the South. As Bruno Bettelheim (1943) pointed out in a classic report, it was the Zionists, not the assimilated among the Jews, who were able to survive in the Nazi concentration camp with least deterioration to their personalities.
     Finally, and we have made this point before the presence of firm ego boundaries within the person makes life easier rather than harder. Temptations are more easily withstood if one is certain what he will and won't do. It is the difference between simply turning a faucet as opposed to plugging a pipe with one's thumb. From the standpoint of psychoanalysis, the conscience plays a definite function in one's life. It is not there as a decoration, on which one can solicit and receive congratulations; neither is it a hairshirt one can conceal beneath his coat to feel secretly superior to those who "make it" less encumbered. The purpose of a healthy conscience is to keep you out of trouble, and that is what it does, and with relatively little effort on your part.
     In reviewing sources of ego strength we find a somewhat surprising note. It appears that another aspect of ego strength is to have a realistic and effective superego.
     I was once visiting the home of a famous psychoanalyst who had adolescent children. While I was there, a radio in the lower part of the house began blaring some excresence of rock and roll music grating even to the nerves of a lifelong devotee of jazz. To the analyst, it was unbearable. He left the room and "roared" that they should turn that radio down to a dull whisper. As he was well known for his writing on adolescent behavior, I teased him a bit, asking whether he did not want to be thought an old fogy. His reply was memorable: "I would rather my children thought me an old fogy than that they had a father with no opinions!"

Coping Mechanisms
     A strong ego has been described as one which makes it possible for a person to absorb life's punishments and emergencies, to reconstitute himself and go on. Very broadly, we may think of this as an ability the person has as part of his enduring personality, his character structure. In practice, none of us deals with LIFE, but rather with a long series of happenings. In this more specific way, we ask not only how generally resilient the person is, but how he copes with stresses and crises.
      Interest in mechanisms for coping has grown in recent years as clinicians have moved out of their traditional role of dealing only with curative processes in long-term treatment. During World War II, for example, we learned that if a man were evacuated from the immediate vicinity of combat in order to treat his so-called "battle fatigue," it was nearly impossible to restore him to duty. Therefore, the pattern grew up of offering psychiatric first-aid practically on the battlefield, as it were, before the neurotic reaction had become so set--and so overlain with not wanting to get well--that restoration to duty was impossible.
     Such on-the-spot treatment was much emphasized in Lindemann's germinal work on handling acute grief (1944). From detailed observations of persons who had just lost someone they loved, it became possible to analyze not only the various ways people spontaneously cope with such a tragedy but also which methods of coping seemed more successful. Of course, no form of responding can bring back the one we have lost and restore life to how it had been. But there are ways of responding that seem to make us less susceptible to enduring damage to our personalities. It was found, for example, that persons who express their grief at once and with open display of emotions are less likely to present severe personality difficulties to themselves and their families than do those who delay and show no immediate response.
     From such observations it is possible not only to identify what appear to be the potentially "healthier" forms of grief reaction (which tend of course to occur in people who were healthier to begin with) but also to use the insights gained from such observations to encourage clients experiencing a loss to handle it in such a way that it will be least destructive to them. These efforts to help our clients and patients handle such stressful experiences are called crisis intervention (Parad, 1965). Much of what we know about how to help people in crisis has been gleaned from studying the automatic processes of self-healing that have worked well for others. Here, as always, therapy follows the pattern of trying to cooperate with nature.
     The function of the coping mechanisms is to restore equilibrium, to get the person back on his feet, and to permit further growth if that is in order. It is nearly impossible to list all the coping mechanisms. For one thing, they are only now being identified and collated. In general, like the defenses, they involve thinking, feeling, and acting--singly or in combination. A simple form of coping with a problem, for example, is to delay action while detouring into thought. Rather than act impulsively, we think about possible solutions, we conduct trial-and-error experimentation in our minds at low cost in energy and for the moment without commitment. When we have finally imagined a course that seems likely to achieve what we want, we are able to act. Obviously, this kind of thinking-as-detour-behavior is not at the disposal of impulse-ridden people. By the same token, casework viewed as a problem-solving process is pitched beyond their grasp (Perlman, 1957).
     Coping mechanisms are likely to come to mind especially when we have a patient faced with a sudden external trauma like accidental loss of a limb or desertion by a mate. But there are also universally experienced stress points in the life cycle deriving from maturational processes. Every adolescent has to "cope" with his developing sexuality in his early teens, and so do his parents. How well he does so is determined by the kind of support he is given at that stage of his life, and perhaps more, by the ego strength he had already built up in resolving previous developmental crises (Erikson, 1950). Similarly, each of us must come to terms with aging, and the prospect not only of physical decline but of ceasing to be (Cath, 1965).
     Sometimes what needs to be handled is within the person. Each of us who is at all active sooner or later does something about which he feels guilty, and the guilt is completely realistic and appropriate. Whether we are able to learn from the experience and change our way of treating others depends on the coping mechanisms we employ. Some patients, for instance, are overcome with remorse, but only in a general way that does not lead them to examine what they did or seek to prevent its recurrence. Some go into depressive reactions which are well deserved but evidently overdone and perhaps histrionic. Some simply refuse to experience the guilt consciously at all, claiming that what they did was right. For them, the method of coping is to undermine the superego. The absorption of deserved guilt is one of the hallmarks of maturity, and it can be encouraged by proper counseling at the time it occurs.
     Finally, we must recognize that it is not easy to distinguish coping from defense mechanisms which may, or may not, prove pathological. A person with a long-term illness that will eventually prove fatal can cope with it best by partially denying it, living as if he had a longer future than he really does. On the other hand, there are well-known instances in which flagrant, primitive denial has led to unnecessary risk-taking and suffering--like the man who climbed a mountain immediately after release from the hospital after a heart attack, and died at the summit. None of us could survive in our part of the twentieth century without some capacity for denial of the military postures under which we do our work, so it is hard to see this defense mechanism as purely pathological. Persons with an exquisite sense of reality and a need for truth-telling often lead markedly uncomfortable lives. It is because there are defenses, then, which aid in coping that we teach the student early to "respect defenses." Just as earlier we reminded the reader of the difficulty in labeling categorically any group of defenses as "symptoms," so now we emphasize that there are softenings of reality-perception which we refer to as coping. Evidently, a judgment of what is evasion and what is adaptive perception must be made with tenderness of spirit on the part of the practitioner.

References
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