Egosyntonic and egodystonic
Egodystonic (or ego alien) is the opposite of egosyntonic and refers to thoughts and behaviors (e.g., dreams, impulses, compulsions, desires, etc.) that are in conflict, or dissonant, with the needs and goals of the ego, or, further, in conflict with a person's ideal self-image.
Many personality disorders are considered to be egosyntonic and are, therefore, difficult to treat. Anorexia nervosa, a difficult-to-treat Axis I disorder, is also considered egosyntonic because many of its sufferers deny that they have a problem.
Obsessive compulsive disorder is considered to be egodystonic as the thoughts and compulsions experienced or expressed are not consistent with the individual's self-perception, meaning the patient realizes the obsessions are not reasonable.
The Freudian heritage
"Ego syntonic" was a taken-for-granted aspect of Freud's conceptual armoury, as in his formulation of 'the aim of psychoanalytic therapy, which is "to replace repressions which are insecure by reliable ego-syntonic controls"'. He saw psychic conflict arising when 'the original lagging instincts...come into conflict with the ego (or ego-syntonic instincts)'.
His daughter, Anna Freud, would point out that 'the defences are harder to get at than the impulses, because...defenses against them are familiar, comfortable, unobjectionable, "ego-syntonic" ways of being, and are thus difficult to see as transference rather than as "real"'.
Otto Fenichel's grand summary of the first psychoanalytic half-century 'differentiated sharply between ego-syntonic morbid impulses and the ego-alien symptoms of compulsion neurotics'. He saw 'impulsive actions, which are ego syntonic' as driven by 'the ego-syntonic impulses'; and conversely regarded neurotic symptoms 'as both painful and ego alien' - while still recognising the possibility of 'a reaction formation against a symptom, namely, the denial of the ego-dystonic character of the symptom'.
Later writers, exploring the gradual emergence of unconscious material, would note how 'the direct, unmitigated expression of a repressed semantic element would be highly "ego-dystonic", and it is considered more "ego-syntonic" for the repressed element to be only indirectly expressed'.
A dispute arose over whether gambling was ego syntonic or ego dystonic, one viewpoint arguing that 'at no time is the compulsion egosyntonic, that is, a thing which the gambler wants to do and in which he takes pleasure: it is always ego-alien or dystonic'. Others disputed the universality of the displeasure; and pointed out that 'the reason that the gambler does not always experience the form of the gambling ritual as an ego-alien action resides partly in the fact that...gambling is not widely regarded as an abnormality'. In general, it must be conceded that 'what is egosyntonic and what is ego-dystonic must be determined in a historical, cultural, and social context'.
- Howard Rosenthal, Human Services Dictionary (2003) p. 102
- Aardema, F. & O'Connor. (2007). The menace within: obsessions and the self. International Journal of Cognitive Therapy, 21, 182-197.
- Aardema, F. & O'Connor. (2003). Seeing white bears that are not there: Inference processes in obsessions. Journal of Cognitive Psychotherapy, 17, 23-37.
- Ernest Federn, "Ego-Syntonic"
- Freud, quoted in Teresa Brennan, The Interpretation of the Flesh (1992) p. 82
- Sigmund Freud, Case Studies II (PFL 9) p. 206
- Janet Malcolm, Psychoanalysis: The Impossible Profession (London 1988) p. 36
- Otto Fenichel, The Psychoanalytic Theory of Neurosis 9London 1946) p. 382
- Fenichel, p. 367-8
- Fenichel, p. 453 and p. 458
- Daniel Rancour-Laferriere, Sign and Subject (1978) p. 52
- Robert M. Lindner, in Jon Halliday/Peter Fuller eds., The Psychology of Gambling (London 1974) p. 236
- Peter Fuller, in Halliday/Fuller eds., p. 31