Psychic structure and function. Some concepts useful in dealing with patients.

Abstract

Human behavior, "healthy" or "sick," is enormously complex. It is influenced by a great number of variables. The brain is the ultimate organ of psychic structure, and increasing knowledge of the brain should eventually clarify the manner in which various factors do affect our behavior. As yet, however, we do not have an adequate scheme of brain structure and function which we know how to use effectively in the formulation of behavior. For theoretical and clinical purposes the psychoanalytic concept of psychic structure and function has been highly useful in interpreting the complex data of behavior and in guiding therapeutic effort. It covers in a comprehensive way the multiple determinants of behavior... deriving from biological heritage, states and drives (id), the influences of past experience, especially those reflecting the demanding and prohibitive attitudes of parental figures (superego), the pressures of external reality and those processes integrating these various influences into adaptive and defensive behavior (ego). The psychic structure goes through a long and arduous process of development. Uneven development with weakness, rigidity and lack of integration is manifest in psychopathologic states. Psychological health is present to the extent that there is balanced development of the psychic structures favorable to growth, development and stability. In the presence of psychopathologic change, the therapeutic task is to restore or develop strength, flexibility and coordination of the psychic structures to a level at which they are capable of dealing with reality.