The psychoanalytic theory of psychopathology

The psychoanalytic theory of psychopathology proposes that the clinical manifestations of the symptomatic neuroses, character pathology, perversions, sexual inhibitions, and selected types of psychosomatic and psychotic illness reflect unconscious intrapsychic conflicts between drive derivatives following the pleasure principle, defensive operations reflecting the reality principle, and the unconscious motivations of the superego. Unconscious conflicts between impulse and defence are expressed in the form of structured conflicts between the agencies of the tripartite structure: there are ego defences against impulses of the id; the superego motivates inhibitions and restrictions in the ego; at times the repetitive, dissociated expression of id impulses ('repetition compulsion') constitutes an effective id defence against superego pressures. The resolution of unconscious conflicts implies the analysis of all these intersystemic conflicts.

All these conflicts are expressed clinically by three types of phenomena:

1. inhibitions of normal ego functions regarding sexuality, intimacy, social relations, and affect activation;,

2. compromise formations between repressed impulses and the defences directed against them;

3. dissociative expression of impulse and defence.

The last category implies a dominance of the splitting mechanisms referred to before; these have acquired central importance in the understanding of severe character pathology as reflected in contemporary psychoanalytic thinking.

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