PubMed · 9762530
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R E Malone. Caring for "difficult" patients.. https://pubmed.ncbi.nlm.nih.gov/9762530/
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A resistance to self-observation and self-reflection is discussed in which there is a perversion of the observing ego. The observing ego has been unconsciously recruited in the service of enacting an unconscious fantasy: the fantasy of being an excited observer of a primal scene who is punished for making forbidden observations. This voyeuristic observing ego is pathologically enmeshed in a love triangle with the patient's seductive superego (i.e. identification with the desired but unfaithful parent) and with the patient's punitive superego (i.e. identification with the rivalrous parent). This unconscious scenario is played out in the clinical situation as the patient unreflectively cycles through phases of denial (i.e. self-seduction) and moral masochism (i.e. self-betrayal). A case study illustrates how humor may be employed to free the observing ego from being enthralled by a perverse superego. Humor may unconsciously enable a rebellious attitude toward the omnipotent sadism of a perversely oppressive superego and thus enable the observing ego to break free from its pathological enmeshment.
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