ABSTRACT
Conflict and deficit psychopathology must be understood within a broad, multiaxial psychoanalytic context. The structural model alone cannot fruitfully be compared and contrasted with the deficit model in the psychology of the self as put forth in the works of Kohut and his followers. To attempt that comparison, one would need to assume that the structural model per se is superordinate, all-inclusive, or able to embrace all relevant other points of view. I cannot make that assumption any more than I can view a “structure” of self as superordinate to the traditionally designated structures, id, ego, and superego (see Richards, 1981, 1982). If one’s theoretical approach to psychoanalytic material is perspectival — and I believe mine is — then one must look at the value for integrating conflict and deficit models, of multiple points of view. Only then can we hear multiple themes in the clinical material we listen to and observe, themes that in the past have been obscured by unidimensional theoretical perspectives. And only then can we engage in timely shifts in technique geared to the material that emerges. New views on old and new perspectives permit new ways of grasping and of applying psychoanalytic interpretations insightfully. The position I am developing is not uniquely mine, nor is it held by all Freudian psychoanalysts. It derives from Freud’s (1915) idea that any psychical process can be described from various points of view, in which case we speak of a metapsychological presentation. Freud’s multiaxial position was expanded by Gill (1963) and is, I believe, still, to this day, the better model for understanding the complex relationships of conflict and deficit than the structural point of view alone. In its attempts at parsimoniously explaining everything, the structural point of view alone runs the risk of collapsing important distinctions that a metapsychological presentation — as Freud originally conceived it, broadly, though not so specifically as to include such anachronisms as the original ideas about cathexis and excitations—does not do.
