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History of a Childhood Neurosis and Its Relation to the Adult Superego

The purpose of this paper is to find meaning for the “presence of conscience” observable in the psychoanalytic setting and corresponding evidence for the origins of such ways of thinking, feeling, and remembering. I apply this perspective to the case study of a man who presented as constricted, inhibited, anxious, and self-critical. He was outwardly successful but internally tormented with what can best be described as an obsessional neurosis. His initial symptomatic neurosis was supplanted by a transference neurosis reflecting a childhood obsessional neurosis. In my theory of mind during this analysis, I often saw the original ideas of Freud at work—unconscious sense of guilt, ego ideal, and conscience. The analysand represented over and over the dynamics of the Oedipus stage of development. I made additional observations about character formation and guilt. The analysand terminated his work with me symptom-free. From this case study, I learned that the presence of conscience (guilt and self-denigration), or of superego structure and function in classical terms, is best approached as to origin by following the development of self in reference to the other.