I was supervising a therapy case the other day of a college student who was not reporting clinically significant levels of depression or anxiety, but she was frequently engaging in significant alcohol consumption (occasionally leading to black outs) and indiscriminate sexual encounters with men she barely knew. A part of “Megan” (name changed) felt this was wrong, but she really couldn’t say why or stay with what was wrong with it for any length of time. Megan also was not sure who she was, where she was headed in life, and bounced around from topic to topic and situation to situation with no real sense of direction or purpose. I conceptualized this case in large part in identity development terms, and I explained to my supervisee that she had “poor ego functioning” and the conversation that ensued resulted in this blog.  

To understand what I meant, let’s start with defining the term “ego”. Although in everyday language, ego means the extent to which one thinks highly of one's self, in psychology is means something different. It is an old term, being most popularly coined by Sigmund Freud in his tripartite model of the mind (id, ego, superego, as “it”, “I” and “above I”). Freud conceived of the ego as the psychological apparatus that regulated sexual and aggressive impulses and navigated the tension between those impulses and the demands and values of society.

A more modern conception that is certainly related to Freud’s is to consider the ego as the self-consciousness system. The self-consciousness system is the narrating portion of human consciousness that reflects on one’s thoughts, feelings and actions and inhibits or legitimizes them to one’s self and to others. In this sense, ego is very similar to what is meant by the term identity, and ego functioning refers to the components of the self-consciousness system that relate directly to mental health.

So, what are the elements that go into ego functioning? This is a complicated question with no hard and fast answers, but here are six basic features that I consider crucial, especially as a clinician.

1. The degree of insight. Freud’s famous dictum for psychotherapy was “Where id was, let ego be.” What he meant by that was the key to mental health was awareness of one’s defenses, motives, and conflicts. Although history has shown Freud over-estimated the power of insight, it nevertheless is the case that the most basic function of the self-consciousness system is awareness of the processes that are influencing the individual. Individuals with high levels of insight know how they feel, what makes them tick, when and why they have conflicts, and what they need to feel fulfilled. Individuals with poor insight engage in more primitive psychological defenses like denial, and either are clueless about who they are or try to convince themselves they are something they are not.

2. The degree of agency and self-directedness. Agentic individuals see themselves as able to control key aspects of their environment and guide their behavior with purpose. They are able to engage in self-directed behavior effectively guiding their actions toward goals across time, can manage impulses, and are resilient in the face of setbacks. In contrast, low agentic people have an external locus of control, experience life as happening to them rather than the reverse, have no direction, and often feel dependent on the whims of fate or the environment in terms of what happens to them. They also are impulsive responding to the needs of the moment rather than inhibiting their immediate desires for longer term goals.

3. The degree of self-esteem, acceptance, and compassion. Closely related to agency is the theme of esteem, which is the extent to which an individual respects and values themselves. Although self-esteem became an overblown construct in the 80s, it certainly is the case that feeling good about one’s self, being able to accept one’s faults or limitations, and having basic compassionate feelings toward one’s self as a complicated being is extremely important. In contrast to self-discipline, although many with low self-esteem have poor self-directedness, it is possible that an individual might exhibit much self-directness but may also be extremely self-critical, and lacking in acceptance and compassion, which is why the two are conceptually separated. Recent research has, appropriately in my view, emphasized self-compassion as a better way of fostering mental health than trying to directly raise self-esteem.  

 4.  The degree of empathy with others. As James Mark Baldwin aptly stated, “Ego and alter are born together”. What he meant by that is our sense of self emerges in close relationship to our sense of others (and how they treat us). Indeed, because our “selves” exist within interdependent networks of other people, because we initially understand ourselves through the lens of mirrored others, and because our identity is very much about narrating and legitimizing our actions to others, a key aspect of ego functioning is the capacity to understand others in a complex manner. Whereas insight refers to the capacity to understand one’s self, empathy refers to the capacity to understand others. So central is this ability that a recent, modern psychodynamic treatment is called mentalizing, which teaches individuals steps for developing more complex, richer, less judgmental and reactive narratives for describing and explaining the actions of others.

  5. The degree of integration, purpose and thematic coherence. A part of Megan, in the case referred to above, had the desire to party and hook up and another part of her felt irresponsible for engaging in such risky behavior. We all have different parts, alternating self-states and various social roles that we fill. The question here is the extent to which the ego has a meta-narrative position that links the parts together into a coherent story. Megan completely lacked a basic story line for what made her life meaningful and what values she wanted to uphold. As such, she behaved in erratic and inconsistent ways, and felt vaguely conflicted as a consequence. Her conflict was vague because she did not have an even basic sense of an over-arching narrative that placed her life in context in a coherent way.

  6. The degree of philosophical and moral development. To develop a complicated narrative of the self, one that has purpose and coherence, one must place that in the context of a worldview. As such, to assess ego functioning, one must assess the extent to which an individual has developed a philosophical point of view. The degree of sophistication of that perspective, its complexity and breadth, and the extent to which it provides the individual with a sense of direction toward what is good and virtuous (or not) is a crucial component of ego functioning.

  Whether in the therapy room or not, ego functioning (or identity) is one of the most important elements to consider in understanding an individual’s personality and the ways they operate in the world. 

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