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Medical psychology.book

Unconscious. 
In addition to the conscious level, consisting of thou-
ghts and feelings of which one is aware, Freud proposed the existence of 
the unconscious, a repository for thoughts and feelings that are repressed 
because they are painful or unacceptable to the conscious mind for some 
other reason. In psychoanalytic theory, developed by Freud in the treat-
ment of normal
 
and abnormal personalities, the preconscious and uncon-
scious minds are the repositories of secret or sexual desires that threaten 
our self-esteem, or ego. Once in the unconscious, these repressed desires 
and fears give rise to anxiety and guilt, which influence conscious beha-
vior and thoughts. Freud attributed the cause of many psychological 
disorders to the conflict between conscious and unconscious urges. In 
order to understand abnormal behaviors and eliminate them, he theori-
zed, an expert was required, who, in a trusting relationship with the 
patient, would employ techniques such as dream analysis and free asso-
ciation
 
to retrieve materials buried in the unconscious mind. Thus, the 
driving forces behind behavior could be understood, and unresolved 
unconscious conflicts and anxiety could become a source of insight for 
the patient, eliminating the primary source of abnormal behavior. 
Those thoughts that are restricted to the unconscious area remain 
repressed, meaning that they are totally invisible to the conscious self, 
and can be recovered only by hypnosis, free association, or some other 
technique.
 
 
2. The Structural Model of Personality: ID, EGO, Super-EGO. 
Super-EGO. 
The 
super-ego
is one of three basic components of 
human personality, according to Sigmund Freud. The 
super-ego
judges 
actions as right or wrong based on the person’s internal value system. 
Freud believed that a child develops the 
super-ego
by storing up the 
moral standards learned from experience in society and from parents and 
other adults. When a parent scolds a child for hitting another child, for 
example, the child learns that such aggression is unacceptable. Stored in 
that child’s 
super-ego
, or conscience, is that moral judgment which will 
be used in determining future behavior. Another component of the 
super-ego
is a person’s own concept of perfect behavior, which presents 
a second standard used to govern actions. The complex interaction 


18 
among the 
id,
the 
ego,
and the 
super-ego
is what determines human 
behavior, according to Freud.
EGO. 
In psychoanalytic theory, 
ego 
is the part of human 
personality that combines innate biological impulses (
id
) or drives with 
reality to produce appropriate behavior. The 
ego
is that portion of the 
personality that imposes realistic limitations on such behavior. It decides 
whether 
id- motivated 
behavior is appropriate, given the prevailing 
social and environmental conditions. While the id operates on the 
“pleasure principle,” the ego uses the “reality principle” to determine 
whether to satisfy or delay fulfilling the id’s demands. The 
ego
considers the consequences of actions to modify the powerful drives of 
the 
id.
A person’s own concept of what is acceptable determines the 
ego’
s decisions. The ego also must “negotiate” with the 
super-ego
(conscience) in the often bitter battle between the 
id
’s drives and a 
person’s own sense of right and wrong. Repression and anxiety may 
result when the 
ego 
consistently overrides the 
id
’s extreme demands.
ID. 
In psychoanalytic theory 
id
is considered the most primitive, 
unconscious element of human personality. The
 id
 
is the part of the per-
sonality that includes such basic biological impulses or drives as eating, 
drinking, eliminating wastes, avoiding pain, attaining sexual pleasure, 
and aggression. The
 id
operates on the “pleasure principle,”
 
seeking to 
satisfy these basic urges immediately with no regard to consequences. 
Only when tempered through interaction with the 
ego
(reality) and 
super-ego
(conscience) does the 
id
conform to what is considered 
socially acceptable behavior? According to Freud, anxiety is caused by 
the conflict between the id’s powerful impulses and the modifying 
forces of the ego and 
super-ego.
The more id-driven impulses are stifled 
through physical reality or societal norms, the greater the level of 
anxiety. People express their anxiety in various ways, including 
nervousness, displaced aggression, and serious anxiety disorders. The
 id

motivated by two biological drives: sex and aggression and operates 
according to the pleasure principle, seeking satisfaction and avoiding 
pain. Guided by the reality principle, the ego’s goal is to find safe and 
socially acceptable ways of satisfying the 
id
’s desires without 
transgressing the limits imposed by the 
super-ego.
A healthy balance 
between the more instinctual demands of the id and the moral demands 
of the 
super-ego
, as negotiated by the 
ego
, results in a “normal” or 
healthy personality.

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