A common rationale for psychotherapy techniques is that the therapist enlightens the patient's ego about the nature of reality, and the ego then molds the patient's impulses to conform with that reality. But there is an inclination in a number of different theoretical quarters to deny that the ego registers reality and disciplines drives. The challenge extends to the very idea of an ego entity, and is matched by a growing reluctance to consider reality as a simple, objective mold which could stamp itself on an ego, or be unambiguously demonstrated by a therapist. At the same time, speculation and experiments in therapy suggest that if therapy does not mean teaching an ego, what it might mean is encouraging structure-making by enforcing flexibility and evading fixed roles.
Friedman L. How Real is the Realistic Ego in Psychotherapy? A One-Sided Review. Arch Gen Psychiatry. 1973;28(3):377–383. doi:10.1001/archpsyc.1973.01750330065011
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