Mobilizing ego strengths

In certain special situations in psychoanalytic treatment there is a need to mobilize ego strength: (1) those patients who are "so infantile" that they need ego strengthening to mature sufficiently to cope with their lives; (2) patients who regress partially during psychoanalysis and cannot progress without analytic intervention to help strengthen their ego; (3) those patients with a strong tendency toward regression whose egos need immediate strengthening in analysis to prevent an immobilizing regression; (4) those patients for whom a stressful reality situation so undermines their confidence that they fall into a severe regression and need to be helped out of this as an emergency to avoid permanent trouble, such as flunking out of school or getting fired from their jobs. All attempts to mobilize ego strengths require an especially thorough understanding of the psychodynamics and especially of the transference and countertransference. In addition, the patient's ego must be assessed as having the potential for more effective functioning. Usually the patient has been unable to realize this potential because of the various degrees of regression, and the analyst has already made exhaustive analytic interpretation of the unconscious material, including the transference and resistance. He may then shift to a more direct approach, pointing out the patient's ego strengths and giving him an accurate picture of the way he can use these strengths toward his own goals. The aim is to help the patient use his own willpower and ego functions gradually to work on and finally resolve some of his neurotic problems. Accurately and honestly mirroring the patient's ego potentials, encouraging him to use his ego, and providing examples of how others have used their own willpower in comparable situations are usually helpful. The analyst must not impose his own values or goals on the patient but must work with the goals, problems, and strengths the patient has. Seven analytic cases are presented to illustrate different ways of helping the patient to mobilize and utilize his own ego strength. We are not suggesting any new "technique," but only that there is something, which can be recognized as willpower, that can be mobilized for therapeutic effect; the appeal is make primarily by the usual procedure of pointing out reality but with encouragement to the patient in coping with both external and internal stresses, these latter being most often regressive tendencies.