It is too easy to see a patient only as a group of symptoms. Rather, according to Erik Erikson, the main issue is to determine whether it is a question of a person having a neurosis, or of the neurosis "having" the person. He insisted on the need to see fears and anxieties as two very different things: The former apprehensions focus on realistic responses to dangers, whereas the latter, provoked by dysfunction in the internal controls, magnify obstacles without providing the means to surmount them.

Adaptive responses that are appropriate to reality are all too likely to be discounted if one understands the ego as being essentially a collection of defenses against the internal drives. The key, according to Erikson, is to seek in the ego the organizational capacities that create the strength necessary for reconciling discontinuities and ambiguities.

Like Sigmund Freud, Erikson envisioned an unconscious ego. But like other...