ABSTRACT
WHEN WE ATTEMPT TO UNDERSTAND psychopathology, we are confronted by two separate traditions or approaches, that of psychoanalysis and that of empirical psychiatry. The basic assumptions of the former derive from the considerations of the vicissitudes of drives, manifested in a dynamic matrix of psychical conflict between those drives and nurturing objects that become enmeshed with them. The traditional psychoanalytic conception of psychopathology seems based, consequently, on a theory of power. Empirical psychiatry, on the other hand, offers pathological conceptions which implicate defects or deficiencies in psychical functioning, some of which may be inherited, others of which may develop in infancy and childhood. More recent contributions to psychoanalysis have complicated the seeming simplicity of this duality by suggesting a developmental deficit concept of psychic structure harkening back to Freud's (1911) concept of decathexis. My contribution represents an attempt to formulate a psychoanalytic metapsychological umbrella that can integrate, not only the conflict (of power) and deficit (powerlessness) theories of psychoanalysis, but also integrate the two of them with the deficit theories which the findings of neurobiology are pressing upon psychoanalysis for integration.
