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EGO FUNCTIONS ASSESSMENT

THE EGO-FUNCTIONS’ ASSESSMENT DESCRIBES ONE’S CONDITION IN FUNCTIONAL TERMS, AND WITHIN THE PARAMETERS OF EGO FUNCTIONS.

Rather than presenting a DSM Diagnostic Label that might have little, if any, relevance to Tx-Planning and Delivery, it is suggested that Ego-Functions be used for a multi-variant view of the patient’s status.

This is based on the thesis that the Ego, as the Executor of one’s personality, has a variety of functions that in synergy assist towards growth and adaptation. Failure, or impairment of any one, of these, may result in dysfunction at worse, or in limited progress during the treatment phase.

Care, therefore, is taken to assess each one, and to commence with a methodically planned treatment process that addresses these functions within a hierarchy.

AUTONOMOUS EGO FUNCTIONS
The capacities to breathe, walk, eat, sleep, perceive, remember, etc. … within normative standards. Autonomous Ego functions may be impaired via illness, inhibitions, anxiety, and physical handicaps, or limitations due to age.
SENSE OF REALITY
The capacity to be cognizant and aware of everything within proximity of my senses; be it external, or internal. Impairment in this function may result, aside from other sequela, in cognitive distortions, feelings of depersonalization, derealization, fugue, psychotic process, etc. States of oblivion, aloofness, autism, etc., may give us a hint of an impairment within this area, … A remarkable Sensorium, … The sense of Reality in someone with strong autistic tendencies is limited to certain elements of the internal world of subjective experience.
REALITY TESTING
The capacity to assess all that I am cognizant and aware of, against established external, or normative standards, leading to needed corrections, or modifications of my observations. Though I may have an unremarkable Sense of Reality, my capacity to test what I perceive against a set of normative standards, may be impaired. That is, am able to look at a thermostat and accept that the recorded temperature is 68 degrees, in spite of the fact that I am personally feeling hot. … To accomplish this, it is imperative that my Analytic Functions are unremarkable.
ANALYTIC EGO FUNCTIONS
The capacity of the Ego to break down complex elements in individual components, recognizing both gross, as well as subtle differences in the sources of input. Efficiency and functionality is dependent on intellect, previous exposure, etc.
INSIGHT
Insight is similar to the Sense of Reality. Where the Sense of reality represents a conscious awareness, Insight represents the capacity to unconsciously integrate all of the conceivable elements within a given situation, regardless of their relevance, or significance. That is, sounds, colors, weather, weight of objects, shape of objects, etc, etc.
SYNTHETIC EGO FUNCTIONS
The capacity of the Ego to reconstitute the results of the analytical, and/or Insight process, in a comprehensive and coherent fashion that will allow for a more in depth view of a given situation. This function is dependent on aptitude, experience, attitudes, and the presence, or absence of illness. It is most essential to Reality Testing, and the foundation of Judgment.
JUDGEMENT
The capacity to unconsciously, and automatically, arrange all of the elements in a given situation. … in order of their relative significance to a given situation, and/or to a prospective action. E.g.; The air turbulence of a ceiling fan, will have relevance to an attempt of placing a ‘tissue paper’ on a table; but little if any significance to placing a pencil, … though the degree of the table’s incline will take precedence. Most impairments in judgment owe to a poorly developed Impulse Control Function, or to a state of Impulse Discontrol (Mania, OCD, Panic, PTSD, etc.)
SELF OBSERVING EGO
The capacity of the person to view the self as an object, and to monitor all thoughts, feelings, or actions a split second prior, during, and a split second following all thoughts, feelings, and actions. This function is operative on the conscious level in order to assist in needed corrections, or modifications of overt expression, while also … operative on an unconscious level aiming at the employment of Defense mechanisms, such as suppression, repression, etc.
IMPULSE CONTROL
That part of the Ego which prevents the expression of primitive drives. Though all of the above functions may be well developed and fully functional, impairment in Impulse Control may prevent their manifest expression. To the extent that a self-observing ego is functional, but co-opted by the Impulse Control, shame, embarrassment, guilt, self-reproach, etc. may follow.
OBJECT RELATIONS
Refers to the state of one’s capacity to distinguish between Realistic vs Narcissistic cathexes.

This Function is comprised of three elements.

  • Self and Object Representations Function : The capacity to accurately assess one’s self as viewed by others, as well as the capacity to accurately assess others as others see them. Leading to the capacity of the Ego to establish and observe boundaries between self and others.
  • Part Object Function : A proclivity, or diathesis to relate to only parts of others, with only a part of one’s self. E.g; If I am hungry, the only part of me that will relate to you is the hunger part, and that will only relate to that part of you that is capable of gratifying that need, while excluding other parts of you, such as your being tired, or sick, or hungry yourself.
  • In Depth, or Whole Object Relations Function: A proclivity, or diathesis to relate to others as whole objects. That is, taking into consideration their state of being, intellect, needs, etc., … while allowing others to enjoy immediate and spontaneous access to you, and to every part of you –be it internal, or external – when appropriate and always circumscribed by the nature of the relationship.
OBJECT CONSTANCY / PERMANENCE
The capacity of the Ego to sustain a mental image of a removed or lost object, so that despair is avoided. A variety of personality disorders are underscored with an impairment in this function.
THOUGHT PROCESS
It includes, but it is not limited by: Analysis, Synthesis, Expression, Organization, Communication, … and all towards drive discharge through suppression, repression, modification, and adaptation.
CONSCIOUSNESS
The quantity of a highly mobile neutralized energy that serves as an attention cathexis. In plain English : How much of my brain is available to focus and tend to, what any given situation calls for. If I have anxiety, a burden, depression, etc., then a great deal of consciousness is taken up by these, leaving increasingly lesser amounts for functioning. The Ego-Function of Consciousness is responsible to :
  • A. Withdraw energy from drive-cathected ideas in order to block emergence into conscious. (it accomplishes this through Mature Defense Mechanisms)
  • B. Increase neutralized energy in the attention cathexes as a defensive resistance to the proclivity towards autistic preoccupations, …
  • C. Direct energy towards constriction of attention and redirection towards acceptable …
ADAPTIVE REGRESSION

A psychoanalytic concept that is rarely used, or appreciated is "Adaptive Regression In the Service of the Ego"

Though "regression" is often viewed as a negative dynamic event, by signaling a return to an earlier state of being and functioning, it fails to differentiate between adaptive and malaptive use.

Considering that maby resort to fantasy, or daydreaming, or art, music, sleep; sexual fulfillment, in order to cope/deal with ego-dystonic states, it may be highly adaptive so long as it does not consume the individual, or coapts the functions of a sense of reality, self-observibg ego, and reality testing.

adaptive regression can allow someone to think "outside the box"

DEFENSE MECHANISMS
Configurations of countercathexes aligned to protect the Ego. ... Divided into Primitive, Immature, Neurotic, Mature, and Healthy. Examples are the utilization of Denial, Projection, and Splitting (Primitive) by Borderlines, or Rationalization, Intellectualization, Avoidance, .. by Passive Aggressive, or … Here, we highly recommend review and familiarization with Defense Mechanisms as described by Kaplan and Sadock.
DYNAMIC CONSTELLATION
The particular configuration and interplay of forces present in an individual's Psychic Structure... Deriving from, as an example, problems of Non-neutralized Aggression following Object Loss, or Non-neutralized libido... or Fear of Oedipal Success, or Guilt following denial of Oedipal attachment, etc.