Ego Strength

The concept of ego strength derives from psychoanalytic theory and refers to the healthy, adaptive functioning of the ego (i.e., the capacity for effective personal functioning). Sigmund Freud conceptualized the ego as an intrapsychic substructure that serves the essential organizing and synthesizing functions that are necessary for an individual to adapt to the external world. When the ego performs these functions adequately, individuals experience themselves as coherent, functional human beings with an enduring sense of personal identity. They are said to possess ego strength.

Intrapsychic and Interpersonal Dimensions

Ego strength has both intrapsychic and interpersonal dimensions. It implies a composite of internal psychological capacities—both cognitive and affective—that individuals bring to their interactions with others and with the social environment. Ego strength reflects a person’s capacities for adaptability, cohesive identity, personal resourcefulness, self-efficacy, and self-esteem. Ego strength also connotes mental health as encapsulated in Freud’s well-known phrase “to love and to work.” Indicators of ego strength include interpersonal competence, a sense of purpose, life satisfaction, and the capacity for meaningful activity. Like the solid foundation of a well-built house, ego strength supports the individual across developmental stages in the pursuit of life goals, dreams, and ambitions, especially under stressful conditions or during turbulent times. Ego strength provides an individual with a cohesive sense of self, ensures coping abilities, increases as individuals grow in maturity, and is recognizable during initial clinical assessment and throughout psychotherapy.

Utility and Relevance

The importance of ego strength as an area for clinical assessment derives from the notion that the significant problems in living for which people seek therapeutic assistance often express themselves as ego deficits (i.e., a lack of ego strength). Deficits in ego strength can manifest as poor judgment, difficulties with reality testing, and problems with interpersonal relationships or intimacy. A lack of ego strength can also show in extreme defensiveness, lack of self-control, and the inability to regulate emotions or self-soothe when distressed. Ego deficits are also apparent in the individual with poor self-esteem, no cohesive identity, unrealistic or inconsistent life goals, and issues with mastery and competence.

Psychotherapists pay special attention to ego strength when assessing a client’s current capacities and potential to benefit from therapy. Their ability to support a client’s current and developing ego strength depends on their ability to identify and assess ego functions in the clinical situation. In psychoanalytic theory, a client can grow in ego strength over time by identifying with and incorporating the therapist’s own ego strength. Across mental health practice disciplines, clinicians assess ego strength to locate a client on a developmental continuum. That allows them to identify a suitable place to begin therapeutic work, provides data to develop therapeutic goals, and constitutes a baseline against which to measure psychotherapeutic progress.

Historical Perspective

Structural Theory

Freud’s conceptualization of the ego took shape around the turn of the 19th century. Freud was deeply pessimistic about human nature and impressed with the archaic drives and primitive passions that seemed to shape human behavior. He came to understand civilized, adult behavior as the end result of the ego’s struggle to mediate between the powerful, infantile, even bestial forces of the id and the punitive requirements of the superego for social conformity. The ego of Freud’s structural theory lacked strength relative to the id. His metaphor for the ego was a person on horseback who can barely hold in check the superior strength of the horse. Freud did not recognize the fullness of an ego that, in addition to its job of holding id impulses in check, performs other vital functions, including perception, cognition, judgment, reality testing, and affect regulation.

Ego Psychology

Colleagues who carried Freud’s structural theory forward in the first decades of the 20th century did so in the context of a devastating First World War, the deadly flu pandemic of 1918, and the destruction of the Austro-Hungarian empire. That historical era was followed by the Great Depression, the rise of Nazism, the earliest days of the Holocaust, and the burgeoning militarism that culminated in World War II. In contrast, ego psychology was elaborated during the more optimistic post-World War II era by European expatriates who emigrated to the United States to escape Nazi persecution. They shared Freudian beliefs about the power of the id and its biological drives but, buoyed by the political freedom and optimism of American society, they were far more interested in the ego and its functions. In particular they focused on how ego functions contributed to the unfolding of human capacities in response to the interaction between environmental factors and innate potentials. The psychoanalyst Heinz Hartmann was the first to suggest that some ego functions are independent of, and autonomous from, the drives (id). Since this seminal contribution, many others have elaborated ego psychology, most notably Erik Erikson, who proposed an enduring stage theory of ego development over the life span.

Assessing Ego Strength

Ego Function Assessment

The most comprehensive and systematic effort to describe and study ego functions, whose healthy adaptations essentially constitute ego strength, has been undertaken by Leopold Bellak and colleagues. Beginning in 1958, Bellak began to study the nature of the psychoanalytic process in a controlled, experimental way. His National Institute of Mental Health (NIMH) research study resulted in a list of 12 ego functions considered necessary and sufficient to describe the personality of the individual. The list is a useful outline for assessing a person’s strengths or evaluating therapeutic gains.

Other Approaches to Ego Strength Assessment

An alternative approach to assessing ego strength involves ego-oriented assessment as a process of data collection over several interviews on a client’s current and past functioning and on his or her inner capacities and external circumstances. Questions that guide the overall assessment of ego strength include:

To what extent is the client’s problem a function of

stressors imposed by his or her current life roles or developmental tasks?
situational stress or a traumatic event?
impairments in his or her ego capacities?
developmental difficulties or dynamics?
the lack of environmental resources or supports?
a lack of fit between his or her inner capacities and external circumstances?

What inner capacities and environmental resources does the client have that can be mobilized to improve his or her functioning?

Ego strength assessment is not essential to all forms of help giving, but it can help determine where to direct interventions. For example, in some cases it is important to maintain, enhance, or modify inner capacities. At other times intervention is designed to mobilize, improve, or change environmental conditions. Sometimes intervention is necessary to improve the fit between inner capacities and external circumstances. When a client is overwhelmed by current stressors but evidences some ego strength and has at least some environmental supports, the practitioner will use a supportive approach aimed at stress reduction and more effective problem solving. In contrast, clients who have limited ego strength and developmental deficits that interfere with their ability to cope with current life roles need interventions targeted at building ego strength.

References:

Bellak, L. (1989). The broad role of ego function assessment. In S. Wetzler & M. Katz (Eds.), Contemporary approaches to psychological assessment (pp. 270-295). New York: Brunner/Mazel.
Bellak, L., Hurvich, M., & Gediman, H. (1973). Ego functions in schizophrenics, neurotics, and normals. New York: Wiley.
Bjorklund, P. (2000). Assessing ego strength: Spinning straw into gold. Perspectives in Psychiatric Care, 36(1), 14-23.
Erikson, E. (1959). Identity and the life cycle. Psychological Issues, 1(1), 50-100.
Freud, A. (1936). The ego and the mechanisms of defense. New York: International Universities Press.
Freud, S. (1961). The ego and the id. In J. Strachey (Ed. & Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 19, pp. 3-66). New York: Norton. (Original work published 1923)
Goldstein, E. (1984). Ego psychology and social work practice. New York: Free Press.
Hartmann, H. (1939). Ego psychology and the problem of adaptation. New York: International Universities Press.
Schamess, G. (2004). Ego psychology. In J. Berzoff, L. M. Flanagan, & P. Hertz (Eds.), Inside out and outside in: Psychodynamic clinical theory and practice in contemporary multicultural contexts (pp. 67-101). Lanham: Rowman & Littlefield.
Vaillant, G. E. (1993). The wisdom of the ego. Cambridge, MA: Harvard University Press.