ABSTRACT
Freud's (1923) decision to fold conscience and the ego-ideal into the superego restricted our attention to conflicts among and within only three of the five major mental structures, obscuring conflicts such as those between the superego and the conscience, the conscience and the ego-ideal, the ego and the ego-ideal, and the ego and the conscience. Whereas the superego is an identification with the aggressor turning aggression against the self, conscience is an identification with the nurturer, mediating love and concern for others and the true self. Whereas the superego generates persecutory anxiety and punitive guilt, the conscience generates depressive anxiety, concern (not depression), and the need to make reparation. Unlike the superego the conscience is not sadistic and tyrannical, but its “still small voice” is insistent. It is essential to distinguish guilt grounded in one’s own wrongdoing from that induced by people unwilling to acknowledge faults and failings in themselves. Analysts who conflate neutrality vis-à-vis the superego with neutrality vis-à-vis the conscience are in clinical error, for while analysts must refrain from normative judgment, they must also carry the conscience in the treatment until such time as their analysands are able to embrace it themselves. A case vignette.
