The Psychoanalytic Quarterly

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The Structure of the Ego

Isador H. Coriat

To cite this article: Isador H. Coriat (1940) The Structure of the Ego, The Psychoanalytic
Quarterly, 9:3, 380-393, DOI: 10.1080/21674086.1940.11925433

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THE STRUCTURE OF THE EGO
BY ISADOR H. CORIAT (BOSTON)

Recent psychoanalytic literature on the multiple functions of

the ego, its defensive mechanisms, reality testing function, and
its relationship to the peripheral organs of the body is quite
abundant, but very little has been written on the structure of
the ego itself. It has been emphasized that one of the most
important tasks of psychoanalysis is a deeper investigation into
the structure and functions of the ego.-1 Anna Freud has
written a book 2 devoted to this recent development of psycho­
analysis. Its chief concern is not with instinctual drives them­
selves, but with how and why the ego deals with these instincts
either by rejection or mastery.
This paper is based on fundamental investigations in cere­
bral anatomy and physiology from which certain tentative
theoretical formulations may be postulated concerning the
structure of the ego, particularly its psychology and its relations
to the architecture and function of the cerebral cortex. The
inquiry will be limited to the ego as a perceptive apparatus
which maintains contact with reality, rather than to its repres­
sive act1v1t1es. The structure of the ego is a topographic as
well as a dynamic problem; closely related are not only the
functions of the cerebral cortex but also its cytoarchitecture.
Such a theoretical interpretation and reconstruction may be
useful to develop more practical concepts, though it is impos­
sible in our present state of knowledge to bridge the mental
and the physical. Some years ago Jacques Loeb 8 called atten-
Read by title at the Joint Session with the Section on Psychoanalysis of the
American Psychiatric Association and the American Psychoanalytic Association,
Chicago, May JO, 1939.
1 Coriat, Isador H.: Current Trends in Psychoanalysis. Psa. Rev., XXV, 1938.
2 Freud, Anna: The Ego and the Mechanisms of Defence. London: Hogarth
Press, 1937.
s Loeb, Jacques: Comparative Physiology of the Brain and Comparative Psy­
chology. New York: G. P. Putnam Sons, 1go3. The Significance of Tropisms
for Psychology. Popular Science Monthly, August, 1911.
380
 THE STRUCTURE OF THE EGO

tion to an analysis of the mechanisms ,vhich give rise to psychic

phenomena, particularly the process of associative memory
whose elements he speculated constituted the ego. He believed
the answer could be found to a certain degree in the theory
of tropisms, emphasizing the errors which could enter into any
such conception. More modern work on psychosomatic rela­
tionships has helped a little to elucidate the problem. It has
been stressed that the ego behaves actively towards the instinc­
tual life-a disposition to dominate or to incorporate it into its
organization. The ego system thus becomes a direct instrument
for regulating instincts as shown by the frequently observed
resemblances between the sensorimotor disturbances of small
cortical lesions and the disturbances of conversion hysteria. 4
It must be emphasized that the ego, or indeed any part of
the mental apparatus, has no boundaries. The concept ego is
merely a convenient designation for general dynamic processes
such as reactions to reality or the operation of a multiple syn­
thetic functioning. The term 'ego' does not in itself explain
its specific properties or its structure, because its functions are
dependent on the topography of the brain, particularly the
cerebral cortex, the most recently developed part of the brain.
Some experimental physiologists have claimed 6 that the local­
ization of function, although of considerable clinical impor­
tance, has been of little value for understanding brain
mechanisms; yet it appears that the unitary and multiple ego
functions are directly dependent on the architecture of the
cortex through the intracortical connections by means of the
systematic distribution of cells and axons.
In his discussion of the development of the neocortex, Kap­
pers 6 has pointed out that it serves as a great reservoir of
4 Waelder, Robert: The Principle of Multiple Function. This QUARTERLY, V,
1936. Stone, Leo: Concerning the Psychogenesis of Somatic Disease. Int. J. Psa.,
XIX, 1938.
6 Lashley, K. S.: Brain Mechanisms and l71telligence, Chicago: Univ. of
Chicago Press, 1929.
a Kappers, C. U. Ariens; Huber, G. Carl; Crosby, Elizabeth C.: The Compara­
tive Anatomy of the Nervous System of Vertebrates, Including Man. New York:
The Macmillan Co., 19)16.
 ISADOR H. CORIAT

various functions and for the control of the act1v1t1es of the

subcortical centers through a vast system of projections which
have reached their highest evolution in man. Thus the com­
plexity of the ego parallels the degree of development of the
cortex though it can regress from this high stage of evolution
to incomplete regression in neuroses, and in psychoses to a
more nearly total regression.
Psychoanalysis was formerly regarded almost exclusively as
the science of the unconscious, a so called 'depth psychology'.
More recently, due to the further investigations of Freud,7
interest became more definitely focussed on the integrating
functions of the ego, its contents, and boundaries. Less had
been known about the ego because its mutable structure is
more complicated than the immutable structure of the more
primitive id. 8 With the introduction of the concept of nar­
cissism, theories of ego function became widened.
The components of the psychic personality vary greatly in
their accessibility to analysis. Mental processes in the ego are
affected not only by the demands of reality but also by the
action of the superego and the id which control it� functions;
part of these processes is superficial and conscious, another part
deep and unconscious.
Psychoanalysis is an investigation of the total personality,
but there are individuals in whom the abnormal functioning
of one or more parts of the psychic apparatus predominate. In
some, it is the reality demands of the ego; in others, the instinc­
tual impulses of the id; in still others, the demands of the
superego motivate the symptomatology.
Ego domination tends to produce the realist; superego
dominance the obsessive and conscience-ridden individual; id
domination, an irresistible control by instinctual drives. All
parts of the psychic apparatus operate as a unit but one part
7 Freud: Beyond the Pleasure Principle. London: Int. Psa. Press, 1922.
Group Psychology a11d the Analysis of the Ego. London: Hogarth Press, 1922.
The Ego and the Id. London: Hogarth Press, 1927.
s See on this point, Anna Freud: loc. cit., pp. 152-3; also, Freud: New Intro­
ductory Lectures on Psycho-Analysis. London: Hogarth Press, 1933, pp. 104-5.
 THE STRUCTURE OF THE EGO

seems in each individual to predominate, often to excess; this

overdetermination produces a character type, the content of a
neurosis or the particular disposition to or choice of a neu­
rosis. Of the three, the ego is most prominent because it is
subjected to stimuli from the external world, to the frustrating
effects of the superego, and to instinctual drives of the deeply
repressed id.
The ego is changeable. It has great capacity for transforma­
tion which is mediated by the complex cytoarchitecture of the
cortex and its vast system of projection pathways. Correspond­
ing to the development of the cortex, the relatively feeble
ego of childhood becomes the relatively strong ego of puberty
and adult life. In the ego, associations of ideas are modified
and the cathectic reactions undergo a change not only because
of the demands of reality, but also through the exaction of the
superego and the incursions from the impulses of the id. This
mutability and modifiability of ego processes, that is to say
its multiple functions, are dependent on the various cortical
pathways. Sometimes the ego succeeds in repressing; some­
times it is dominated by an inner id danger or superego
demand, producing anxiety.
The ego, according to Freud, is the most superficial part of
the mental apparatus situated nearest to the external world.
It is therefore more permeable than either the id or the super­
ego. Its boundaries are fluctuating and it is continually chang­
ing its periphery through cathectic processes. For this reason
Federn 9 believes that 'since ego boundaries and their cathexis
depend upon our mental orientation and the correct distinc­
tion of the real from the unreal, ego cathexis is the most
important of all mental processes'. Of course the definition of
ego boundaries does not illuminate the fundamental essence
of consciousness.
In his various writings, Freud has given stimulating hints
on the structure of the ego. In Beyond the Pleasure Principle
( 192 2), he emphasized that consciousness cannot be the most
9 Federn, Paul: The Undirected Function in the Central Nervous System.
Int. J. Psa., XIX, 1938.
 ISADOR H. CORIAT

general characteristic of the psychic processes, but merely a

special function of them. Accordingly he stated that percept­
ual consciousness (ego) 'must lie on the boundary between the
outer and the inner, must face towards the outer world, and
must envelope the other psychic systems.... In this assump­
tion we have ventured nothing new, but are in agreement
with the localizing tendencies of cerebral anatomy which
places the "seat" of consciousness in the cortical layer, the
outermost enveloping layer of the central organ. Cerebral
anatomy does not need to wonder why-anatomically speak­
ing-consciousness should be accommodated on the surface of
the brain, instead of being lodged somewhere in the deepest
recesses of it.' However recent work in neurophysiology, as
will be stated below, does not seem to confirm this statement
that consciousness lies exclusively on the surface of the brain.
In the Ego and the Id (1927), Freud states that the ego
includes consciousness, and adds that 'consciousness is the
superficies of the mental apparatus; that is, we have allocated
it as a function to the system which is situated nearest to the
external world. Incidentally, on this occasion, the topograph­
ical terminology does not serve merely to describe the nature
of the function, but actually corresponds to the anatomical
facts. Our investigations, too, must take this surface organ of
perception as a starting point. ... The ego is first and foremost
a body-ego; it is not merely surface activity, but it is itself a
projection of a surface.' An authorized note to this descrip­
tion by the translator reiterates that the ego is ultimately
derived from bodily sensations; it may thus be regarded as a
mental projection of the surface of the body besides repre­
senting the superficies of the mental apparatus.
While one surface of the ego is directed towards the instincts
-what may be called its inner perception-the other surface
is exposed to sense perceptions and external reality. The
conscious ego is synthetically plastic in adjusting to inner and
external stimuli. \Vhen this plasticity is lost or diminished,
the ego is impaired in its capacity for multiple functioning and
associations of ideas are blocked, as in schizophrenia, or become
 THE STRUCTURE OF THE EGO

abnormal as in the psychoneuroses which are compromises

between instinct and ego defenses.
This concept harmonizes with Sherrington's statement 10
that the cerebrum may be regarded as the ganglion of the
distance receptors. In a later publication Sherrington 11 finds
a physiological parallelism for this concept of the body ego
derived from bodily sensations. According to this viewpoint,
the brain is a receiving station, not directly open to the outer
world but responsive to bodily events which share in activat­
ing the brain. This physiological viewpoint does not seem
to agree with Freud's statement that consciousness is on the
surface of the brain. Sherrington writes,1 2 'Mental action lies
buried in the brain, and in that part most deeply recessed from
the outside world, that is, furthest from the input and out­
put.... It may be that in those parts of the brain which may
be called mental, nerve actions exist still unknown to us and
that these may correlate with mind.' This last statement may
be interpreted to correspond to a physiological correlate of the
psychological id, or to what Freud has termed the kernel of the
ego, the unrecognizable material of imageless thought.
It seems then that what may be termed the structural psychol­
ogy of the ego is a general type of dynamic process which
would explain its specific properties and structure. Whether
or not its functions are dependent upon the topographical
arrangement of the brain, particularly the cerebral cortex,
is a question that merits serious consideration. The cortex
may be considered as a chain of neurons built on the plan
of the reflex arc. However according to Fulton, 13 there is
no basis for considering the cortex as composed of several
layers, each with specific and primordial functions such as
reception, association, projection. It is, rather, a unitary sys-
10 Sherrington, Charles: The Integrative Action of the Nervous System. New
York: Charles Scribners Sons, 1go6.
11 Sherrington, Charles: The Brain and Its Mechanism. Cambridge, England:
University Press, 1933.
12 Ibid.
1s Fulton, J. F.: Physiology of the Nervous System. New York: Oxford Univ.
Press, 1938.
 ISADOR H. CORIAT

tern formed of chains of neurons whose impulses are synchron­

ized at the level of the architectonic layers and sublayers.
Probably in certain phases of cortical activity the cells of the
various layers discharge a more or less synchronous volley of
impulses. The important subcortical levels and the pyramidal
projections arise in many parts of the cerebrum and are in
direct anatomical and physiological connection with the cortex.
This excitability of cortical elements is subject to exhaustion
as shown by the fact that they become unresponsive after a
focal epileptic seizure. Nevertheless electrical records of corti­
cal activity show that it is almost never completely absent. It
becomes so only when the brain is almost completely anemic
or in nearly lethal an.esthesia. This would agree with the
freudian hypothesis that the most promising insight into the
nature of consciousness reveals itself to us in the determina­
tions of neuron excitement.14 Therefore, according to Bleu­
ler,15 thinking may become perfectly intelligible from associa­
tion mechanisms combined with the drives which determine
the dynamics and the direction of association.
Federn 16 maintains that the extent of the state of cathexis
which constitutes the ego varies. Its boundary at any given
moment is the ego boundary and, as such, enters conscious­
ness. In psychoses and dreams the ego boundaries have either
lost their cathexis or have not had it restored; consequently,
the shifting reality testing is either defective or absent.
The viewpoint of the anatomists is somewhat similar.
According to Campion and Smith,17 consciousness has its neural
correlates in a continuity of neural impulses from thalami to
cortex and from cortex to thalami along the multitudinous
thalamo-cortical and cortico-thalamic paths in the thalamic
14 Freud: The Interpretation of Dreams. New York: The Macmillan Co.,
1913, p. 428.
15 Bleuler, Eugen: Mnemistic Biology and Psycholog;y. J. of Nerv. and Ment.
Dis., LXXXVII, 1938.
16 Federn, Paul: The Awakening of the Ego in Dreams. Int. J. Psa., XV,
1934·
17 Campion, George G. and Smith, Grafton Elliott: The Neural Basis of
Thought. New York: Harcourt, Brace & Co., 1934.
 THE STRUCTURE OF THE EGO

radiation. Rossett 18 emphasizes, as a result of extensive investi­

gations of brain anatomy with a new technique, that the syn­
thetic function of the ego is due to the intercortical pathways
and it is these intercortical systems which constitute the appa­
ratus of consciousness.
According to Kappers,1° in the higher vertebrate forms
(primates and man) certain cortical centers are so essential in
the activities of the individual that they cease functioning
when the cortical centers are destroyed. If 'ego' be substi­
tuted for 'activities of the individual', the relationship of ego
function as dependent upon cortical structure becomes more
evident.
What is the psychological meaning of this anatomical and
physiological information? What light does it shed on the
structure of the ego? And if we understand this structure
theoretically, can we hope better to appreciate the various func­
tions of the ego as they have been described in psychoanalytic
literature? It is to these questions that we direct our attention.
Ego function in the newborn child consists essentially of an
attempt to attain a state of satisfaction by wishing and by ignor­
ing reality.�0 The reality testing function of the ego has not
yet developed. The ego is weak and immature and has not
become organized. The medullation of the brain is incom­
plete. The fully developed ego is not completely controlled
as it is in the young infant by the pleasure principle but must
take into account the reality principle. This transition 1s
one of the most important advances in the development of
the ego.
The newborn child brings into the world only an ego of
narcissistic bliss continued from intrauterine existence. Soon
however, probably from the state of oral tension in nursing,
it begins to lose its narcissistic ego bliss and becomes exposed
18 Rosett, Joshua: Intercortical Systems of the Human Cerebrum. New York:
Columbia Univ. Press, 1933.
10 Kappers: Loe. cit., II, p. 1664.
20 Ferenczi, S.: Stages in the Development of the Sense of Reality. In Contribu­
tions to Psychoanalysis. Boston: Richard G. Badger, 1916. Chap. VIII.
 ISADOR H. CORIAT

to anxiety situations. The immature ego gradually becomes

the organ for testing reality and gradually increases its level
of cathexis. As Nunberg 21 points out, until the superego is
formed and acts as a monitor of brain activity, the ego has but
a single task: it acts only as an intermediary between the inner
and the outer world, between the id and reality; it lacks
repressive activities and multiple synthetic functioning.
The ego is that part of the id which has become modified
due to its relation to the external world; it represents the
external world for the id and by a dynamic force termed
repression, prevents the id to a certain extent from gratifying
its instinctual drives. Because the ego shades imperceptibly
into the id, a great deal of the ego is id. It is unconscious
and this unconscious part of the ego, as previously indicated,
is termed by Freud 'the kernel of the ego'. Only part of this
kernel becomes conscious. Part of the ego is preconscious and
latent, but capable of becoming conscious. The real uncon­
scious ego is that part which lies nearest to the id and like the
id is dynamically unconscious.
The conscious elements of the ego are formed from the
perceptive system; the preconscious from those elements just
outside the ego perception boundaries; the unconscious part
of the ego, its central nucleus, consists of elements which have
been deposited from perception; the superego, from introjec­
tion of specific experience related to the redipus complex.
The ego includes consciousness and the reactions of motil­
ity-discharges of excitations into the external world from the
body. These functions correspond to Nunberg's 22 classifica­
tion of a perceptual eg o of ideational material and affects,
and a kinetic ego which influences the motor apparatus.
These functions correspond to general cortical activity and
also to the activity of the pyramidal pathways which have their
cells of origin in the motor cortex. Freud says that a psychic
process generally takes its course from perception to motility.
This 'perception' is probably synonymous with the activity of
21 Nunberg, H.: The Synthetic Function of the Ego. Int. J. Psa., XII, 1931
22 Loe. cit.
 THE STRUCTURE OF THE EGO

the ego. Freud 23 therefore concludes that the psychic appara­

tus must be constructed like a reflex apparatus.
Because it is superficial, the ego is exposed to three poten­
tial sources of danger: from the external world, from the
primitive id, and from the severity of the superego. It is
only when the ego has sublimated the instinctual forces of
the id that creative activity can take place. The ego not only
creates but binds itself to the id and the superego; it has a
synthetic function. When this synthetic activity disinte­
grates, mental illness results, notably in the schizophrenic
psychoses and paresis, the latter being the direct result of physi­
cal changes in the cortex, the central organ of the ego. For
this reason, Ferenczi terms paresis a cerebral pathoneurosis.
It is the anticipation of tension or danger from the instinct­
ual drives or from external reality ,vhich produces that change
in ego functioning which is termed anxiety. This anxiety in
turn acting as a danger sign al leads to body reactions to mini­
mize or avoid the danger, for instance, by flight as a protective
measure. Therefore one of the ego functions is a purposeful
biological activity. The functions of the ego are regulated by
several trends which proceed from the outside world, from
inhibitions of gratification and from prohibitions of its monitor,
the superego. One of the aspects of this ego function is to keep
the amount of excitation or danger signal at as low a level as
possible because the ego is more completely controlled by the
reality principle than by the pleasure principle. The pleasure
principle however does participate as shown by the fact that
neurotic symptoms are maintained and supported by the ego
because the ego gains advantages through neurotic illness. It
is this attempt of the ego to maintain its supreme omnipotence
which in analysis produces resistance.
However the kernel of the ego is unconscious; only a part
of it is conscious or preconscious. The more the ego is pushed
by analytic interference from its position, the more strongly
it attempts to maintain and entrench itself. Repetition of these
23 Freud: The Interpretation of Dreams. New York: The Macmillan Co.,
1913, p. 426.
 ISADOR H. CORIAT

attempts at entrenchment gives the ego a gTeater sense of

security; it is threatened with a loss of security when repressed
elements bombard it.
According to Freud, analysis gives the ego freedom to choose
one path or another. It is the ego which masters the instincts,
replaces the pleasure principle by the reality principle. This
power has evolved parallel with the development of the cortex.
The structural psychology of the ego is a dynamic process,
dependent upon the topogTaphy of the brain, particularly its
cytoarchitecture. It is suggested that the volleys of neuronic
impulses arising from the cortical layers and sublayers are
responsible for the multiple function of the ego, for the ego
must be considered as having multiple functions, rather than
a static structure.
The ego organization is a complex of brain functions, of
repeated connections of conceptions, associations and memories
gained through experience. Anatomical pathways within the
nervous system point clearly to relationships whose connections
are synchronized. The complicated association apparatus of
the cerebral cortex is of relatively recent evolution. It func­
tions through the inter.cortical pathways which are the reposi­
tories of associated neurons. All nerve impulses are very much
amplified by spreading through these complicated association
pathways. It is the activity of the association systems of the
cerebral cortex that produces the subjective phenomena of
thought.
How does analysis affect the cortex in terms of ego struc­
tural psychology? Probably the ego becomes modified through
the forcing of free association, through the introjection of
the analytic situation. As a result, it can be postulated that
thereby the ego is not only strengthened in its reality testing
function and its safety margin raised, but possibly also the ego
boundaries are increased in the positive transference, decreased
and weakened in the negative transference. It is these modifi­
cations which contribute to therapeutic success or failure.
We would thus have not only a 'topogTaphic' effect of the
analytic process but a 'functional' one as well. Finally, these
 THE STRUCTURE OF THE EGO 39 1

so called topographic and functional elements are responsible

for the transference, in that the increase of ego boundaries
and the strengthening of the ego function tend to permit a
freer expression and flowing of those energies which are resi­
dent in the cerebral cortex, a literal 'working through' of the
ego resistances.
Analytic introjections prevent the ego to a limited extent
from manufacturing defenses. The effect on the ego is to
increase its boundaries, unite, assimilate, in what may be called
multiple synthetic functioning. The ego becomes stronger,
assimilates the id impulses, becomes less inimical and less alien
to the superego, so that its reality function is expanded and
increased in strength. When a person with a weak ego in the
course of analysis becomes more aggressive and dominating,
it can be surmised that the analytic introjection has strength­
ened the ego function through the formation of new associa­
tion pathways.
In anxiety situations where the ego is overwhelmed by
instinctual drives, the effect of analysis is so to strengthen the
ego that it can master these drives even though the instinctual
energy remains unchanged. This strengthening is the result
of new cathexes resulting from free associations and manifest­
ing itself in a clinical improvement.
Benedek 24 finds that mental processes are correlated with
different ego cathexes. The greater the anxiety and aggres­
sion, the weaker the ego, whereas a more strongly cathected
ego maintains a better relationship with environment and
objects; hence therapy fortifies the ego by diminishing aggres­
sion and anxiety and increasing its libidinal cathexis.
The process of free associations forms new and controlled
association pathways which strengthen the ego and expand its
functions. The inroads of the id into the ego give place to
a counterattack of the ego upon the id. 25 In this double
attack however, the instinctual forces remain unchanged. In
24 Benedek, Therese: Mental Processes in Thyrotoxic States. This QUAR­
TERLY, III, 1934.
25 Freud, Anna: Loe. cit.
39 2 ISADOR H. CORIAT

fact, many abnormal ego reactions are not pathological prod­

ucts but in reality are attempts at recovery, a process of
cathectic reconstruction as Freud so well demonstrated in the
Schreber case.
In a recent paper by Freud, 26 it is emphasized that analysis
produces a state in the ego which never occurs spontaneously.
Analysis enables the mature ego to review old repressions with
the result that some are lifted and others reconstructed from
more solid material. In the analytic situation, certain parts
of the id are subdued and included in the synthesis of the
ego. The task of analysis is to secure the best possible psycho­
logical conditions for ego functioning.
Whatever the ultimate nature of the energy of the cortex,
electrical or otherwise, it absorbs it, so to speak, not only from
surroundings but also from the various receptors. It utilizes
this energy in the form of memory and symbolic thought, but
how or why or through what channels it is impossible to state.
Probably the thalamic organization plays a preponderating role.
The cerebral cortex exerts a controlling influence over the
functions of the thalamus and the thalamus itself, as shown
by the accumulating evidence of clinical and pathological
observation, is the anatomical equivalent of the very threshold
of consciousness (Rosett 21). From the thalamus, nerve im­
pulses proceed to the cerebral cortex, are there amplified by
an innumerable number of association pathways, and it is
these association pathways which form the neural basis of the
ego. One of the ego's chief attributes is purposeful activity
which is as well regulated psychically as the systematic organi­
zation and distribution of cells in the brain.
These correlations of ego function with brain topography
can be supplemented and, to a certain extent, illuminated by
recent investigations in psychosomatic interrelations. 28 The
2a Freud: Analysis Terminable and Interminable. Int. J. Psa., XVIII, 1937.
21 Rosell, Joshua: The Mechanism of Thought. New York: Columbia Univ.
Press, 1939.
28 See on these points, Leo Stone: Loe. cit. Also, Grinker, Roy R.: Hypo­
thalamic Functions in Psychosomatic Relations. Psychosomatic Med., I, 1939.
 THE STRUCTURE OF THE EGO 393

ego is not only a function of the cerebral cortex, but also may
become a direct instrument of instinctual levels, that is, the
hypothalamic. It is suggested that this level corresponds to the
id and is the main source of the adult unconscious. The hypo­
thalamic drives are synonymous with id demands: its tension
produces a conditioned danger signal within the ego. If the
ego is unable to handle the situation, there results either
anxiety or a visceral expression of organ dysfunction, pro­
ducing an organ neurosis.
It is realized that this mass of psychological and physio­
logical material is difficult to correlate, and until we know the
exact nature of thought processes whether ego, superego or
id, it is impossible to prove any exact dependence of the ego,
for instance, upon cortical structure and function. Of course,
it is generally admitted that there must be a dependence, but
how or why or through what pathways, is a problem for the
future to investigate.
In the paralyses of the conversion hysterias, it is well known
that ideas or complexes of ideas and emotions condition these
paralyses. But how an idea can be transformed into a physical
symptom is a matter which up to the present has remained
unsolved although it has been suggested that it is the result of
the effect of the action of instinctual levels upon the ego system.
Possibly the electroencephalograph may throw some light
u·pon the subject. In one such investigation 29 applying the
technical procedure to analysis, no significant correlation
appeared between the changes in the Alpha index and the
clinical changes. There was, however, some correlation be­
tween the Alpha index and the instinctual trends as revealed
by psychoanalysis. Of course such a procedure would have
its difficulties, principally because the patient's knowledge
that such a technique was being used might affect the results.
29 Saul, Leon J.; Davis, Hallowell; Davis, Pauline A.: Correlations between
Electro-encephalograms and the Psychological Organization of the Individual.
Trans. Am. Neurol. Assn., 1937.