title: [Deviations from the "fictive normal ego": on the dilemma of the diagnosis of structural ego disorders].
abstract: The functional aspect in psychoanalytic ego therapy seems to be especially useful with regard to obtaining diagnostic criteria for the decision of whether and to what extent the patient's ego deviates from a "fictitious normal ego" and whether or not modifications must, therefore, be introduced into the therapeutical procedure. Such criteria are required in particular when psychoanalysis and psychotherapy are concerned with patients suffering from severe structural ego deficiencies. It seems, moreover, that such patients, in obviously increasing numbers, are hospitalized in psychotherapeutic clinics and, even more frequently, taken care of in psychiatric institutions. In the diagnosis of structural ego deficiencies, however, a certain dilemma is observed which has an impact on both single and group therapy with the patients concerned: when, on the one hand, the diagnosis of an 'ego alteration' is inevitable, the diagnosis of functional ego deficiency, because of its so to say impartial mode of reasoning, on the other hand, offers to pronounce as an ego deficiency in the patient much of what has its origins more or less in the counter-transference reactions and the limits of adaptability in the therapist, both qualities being especially in demand when dealing with patients suffering from structural ego deficiencies, as e.g. in psychiatric institutions. It is suggested that the functions of the ego be interpreted as consistent symbolic capacities of the ego which constitute reality. Their diagnosis in each case remains tied to an interpersonal process in the course of which the parties concerned alternate in typefying and interpreting one another.
mesh_terms: D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000523:psychology; D004532:Ego; D005619:Freudian Theory; D006801:Humans; D010554:Personality Disorders / Q000175:diagnosis*; D011369:Professional-Patient Relations; D011575:Psychoanalytic Therapy; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000523:psychology; D011615:Psychotherapy, Group
vernacular_title: Abweichungen vom "fiktiven Normal-Ich": Zum Dilemma der Diagnostik struktureller Ich-Störungen.