ABSTRACT
This chapter describes the specific effects of certain psychiatric illnesses on ego function, and on psychotic or near psychotic ego structure. Psychiatric illnesses have characteristic effects on the ego: delusions or hallucinations. Because most accessory ego functions may be badly damaged in schizophrenia, observing ego tends to be limited at best. Schizophrenia has profound effects on the relationship of emotional experience to reality experience. Personality defenses are quite disorganized in schizophrenia. Schizophrenia is frequently misdiagnosed when a dyslexic with boundary problems also has an affective illness and becomes psychotic. Severe character disorders are also common psychiatric illnesses in psychotic and near psychotic structures. Traditionally, the organic mental syndrome category was composed of illnesses causing macrocellular disruptions of brain tissue, such as strokes, bleeds, tumors, and infections. Symbolic dramas are played out, either in behavior or on the mental stage, as part of the organization of quality and content of object relations.
