intentions, however unconscious they seem.
4 The Neurotic and the Psychotic Experience of Reality
Perhaps nowhere did Freud demonstrate more persuasively his conception of reality than when he sought to distinguish between the neurotic and psychotic experience of it. After having introduced the structural model in 1923 in The Ego and the Id (1961d), Freud wrote two papers in 1924 on the nature of neurosis and psychosis from this new perspective. The first paper, simply tided, “Neurosis and Psychosis” (1961g), contained a formula for “the most important genetic difference between a neurosis and a psychosis: neurosis is the result of a conflict between the ego and its id, whereas psychosis is the analogous outcome of a similar disturbance in the relations between the ego and the external world (149; emphasis in original). Freud depicts the nature of neurosis, now described in accordance with the structural model, accordingly:
Our analyses go to show that the transference neuroses originate from the ego’s refusing to accept a powerful instinctual impulse in the id . . . or from the ego’s forbidding that impulse the object at which it is aiming. In such a case the ego defends itself against the instinctual impulse by the mechanism of repression. The repressed material struggles against this fate. It creates for itself, along paths over which the ego has no power, a substitutive representation . . . the symptom. The ego . . . threatened and impaired by this intruder, continues to struggle against the symptom, just as it fended off the original instinctual impulse. All this produces the picture of a neurosis. (1961g, 149–50)
Typically, the ego obeys and even follows the commands of its superego—its “conscience”—which, in turn, “originates from influences in the external world” (150). In its effort to accommodate reality the ego may feel compelled to “take sides” with it. When this happens, “the ego has come into conflict with the id in the service of the super-ego and of reality; and this is the state of affairs in every transference neurosis” (150). On the other hand, when it becomes psychotic “the ego creates, autocratically, a new external and internal world; and there can be no doubt of two facts—that this new world is constructed in accordance with the id’s wishful impulses, and that the motive for this dissociation from the external world is some very serious frustration by reality of a wish—a frustration which seems intolerable” (151).
Freud suggests, however, that despite these differences, neurosis and psychosis share the same aetiological factors. “The aetiology common to the onset of a psychoneurosis and of a psychosis always remain the same. It consists in a frustration, a non-fulfillment, of one of those childhood wishes which are forever undefeated and which are so deeply rooted in our phylogenetically determined organization. This frustration is in the last resort always an external one” (151; emphasis added). What, then, accounts for the divergence between a neurosis and a psychosis? According to Freud, whether “the ego remains true to its dependence on the external world and attempts to silence the id, or whether it lets itself be overcome by the id and thus torn away from reality” (151; emphasis added).
In other words, the ego’s relationship with reality governs, (a) the onset of a neurosis and a psychosis and, (b) whether we eventually succumb to a neurosis or a psychosis. Neurosis, generally speaking, is a result of complying with an unacceptable reality, whereas psychosis is a consequence of rebelling against reality by denying it. Because of the ego’s incessant “conflicts with its various ruling agencies,” it is always striving for a fragile “reconciliation between its various dependent relationships” (152).
Soon after the publication of “Neurosis and Psychosis,” Freud published another paper focusing specifically on “The Loss of Reality in Neurosis and Psychosis” (196If). Now his preoccupation with reality itself comes closer to the fore. While continuing to distinguish between neurosis and psychosis, Freud emphasizes even more emphatically their similarities, specifically their respective relationships with the “real world.” Highlighting the difference, he reiterates that “neurosis is the result of a conflict between the ego and its id,” whereas psychosis is the result of an analogous conflict “between the ego and the external world.” However, he quickly adds that “every neurosis disturbs the patient’s relation to reality in some way, that it serves him [her] as a means of withdrawing from reality, and that, in its severe forms, it actually signifies a flight from real life” (1961f, 183; emphasis added).
Freud’s distinction between these two forms of psychopathology—the neurotic’s compliance with reality on the one hand and the psychotic’s disregard for reality on the other—appears to be compromised by the observation that the neurotic, too, is capable of “taking flight from real life.” But Freud resolves this seeming contradiction by qualifying the two steps that are essential in the formation of every neurosis. Step one entails the ego’s repression of its (id’s) desire. This step, however, isn’t specifically neurotic. Neurosis, rather, consists in step two. As a consequence of repression and its failure, the ego tries to compensate for the damage to the id that resulted from its efforts to repress it in the first place. Hence, the loosening of the ego’s relationship “to reality is a consequence of this second step in the formation of a neurosis” (183).
Of course, there isn’t anything new in Freud’s characterization of neurosis “as the result of a repression that has failed” (183). That the return of the repressed—rather than the act of repression itself—constituted neurosis was noted in his correspondence to Fliess in 1896. Later, his increasing interest in the ego and its relationship with reality led him to look at this problem from a fresh angle. At the same time that he wrote these two papers, Freud wrote a third dealing with “The Dissolution of the Oedipus Complex” (1961b). In that study he distinguished between two types of repression in the context of the Oedipus complex.
After its [the Oedipus complex] dissolution takes place, it succumbs to repression, as we say, and is followed by the latency period. It has not yet become clear, however, what it is that brings about its destruction. Analyses seem to show that it is the experience of painful disappointment. (173; emphasis added)
Freud’s use of the term repression is ambiguous. It is used to characterize a total, or “successful,” repression on the one hand, as well as those acts of repression that are only partial, or unsuccessful, on the other. The expression, “dissolution of the Oedipus complex” refers to the successful type, whereas, if the complex isn’t actually “dissolved,” it is destined to return in the form of a neurotic symptom. Anticipating our objections to this ambiguity, Freud defends his use of this term as synonymous with the more radical dissolution of the original complex:
I see no reason for denying the name of a “repression” to the ego’s turning away from the Oedipus complex. . . . But the process we have described is more than a repression. It is equivalent, if it is ideally carried out, to a destruction and an abolition of the complex. We may plausibly assume that we have here come upon the borderline—never a very sharply drawn one—between the normal and the pathological. If the ego has in fact not achieved much more than a repression of the complex, the latter persists in an unconscious state in the id and will later manifest its pathogenic effect. (177; emphasis in original)
If we assume, however, that the origin of all neuroses lies in the failure to “dissolve” our (Oedipal) demands for satisfaction, surely the resolution of future, adult neuroses rests on the same principle, which is to say, the ability to “dissolve” that demand when it arises. How, then, does Freud conceptualize the difference between merely repressing libidinal urges on the one hand, and dissolving them on the other? The preconditions for onset of neurosis are determined by (a) failure of the ego to fully repress (i.e., dissolve) the id’s demands, so it displaces them instead onto symptoms, or (b) the relative strength between the id’s demands and the ego’s repressive forces though, according to Freud, an inordinately powerful id is consistent with the onset of psychosis. How does Freud imagine resolving these conflicting forces in terms other than the ego’s success at repression itself? As we shall see, this question suggests no clear answer.
Having suggested that the neurotic, like the psychotic, is capable of losing his grip on reality, Freud examines more closely the psychotic’s relationship