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Dieses Werk ist urheberrechtIich geschiitzt. Die dadurch begriindeten Rechte, insbesondere die der Ubersetzung, des Nachdrucks, des Vortrags, der Entnahme von Abbildungen und Tabellen, der Funksendung, der Mikroverfilrnung oder der Vervielfiiltigung auf anderen Wegen und der Speicherung in Datenverarbeitungsanlagen, bleiben, auch bei nur auszugsweiser Verwertung vorbehalten. Eine Vervielfiitigung dieses Werkes oder von Teilen dieses werkes ist auch im Einzelfall nur in den Grenzen der gesetzlichen Bestimmungen des Urheberrechtsgesetzes der Bundesrepublik Deutschland vom 9. September 1965 in der jeweils geltenden Fassung zuliissig. Sie ist grundsatzlich vergiitungspflichtig. Zuwiederhandlungen unterleigen den Strafbestimmungen des Urheberrechts.

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Many find the concept of a superego not relevant anymore. Yet, there is much evidence for the cardinal relevance of what is meant with this theoretical construct. This is particularly true for the treatment of severely disturbed patientsespecially those with severe forms of character perversion and addictions. The archaic superego serves in its absoluteness as primitive affect regulation. The more we assume a stance of authority, the more we tend to get enmeshed in very important regressive transference-countertransference enactments of these superego figures, functions, and affects. The working alliance breaks apart because the regression can merely be experienced, not reflected upon. This is particularly true for cases of character perversion, especially those of a severe sadomasochistic nature.There are many today who find the concept of a superego and much of what it refers to in clinical observation not very relevant anymore, outdated, and its systematic study and use not worthwhile (e.g., Brenner, 2002; Lichtenberg, in press;Lichtenberg, Lachmann, & Fosshage, 1996; Milch & Orange, in press). Yet, there is much evidence for the cardinal and ongoing relevance of what is meant with this theoretical construct, or, as we might use it clinically in the metaphor coined by Kant (1797Kant ( -1798Kant ( /1983, with "the inner judge." There would be no objection to replacing it by alternate metaphors, like "normative system of the self" (Fabricius, in press) or "ethical-moral ego" (Roth, 2001), provided that they cover the panoply of meanings now usefully associated with the term. Some concept like this is crucially important for the task of developing a differentiated approach to the intricate dynamics involved, yet it is often amazing in supervisory work or in the readings to what extent these problems still seem strangely overlooked and neglected, no matter how strikingly helpful their understanding and tackling would be and, in fact, how obvious their presence is. All this is true with particular poignancy in the treatment of severely

Invited to contribute some thoughts on recent developments in psychoanalytic thinking about shame, the author starts off with Aristotle's prescient analysis of shame and then focuses on accumulating experiences in the psychoanalytic treatment of patients with severe neuroses, in particular the close relationship of severe traumatization and chronic states of shame, and how this is reflected in shelfdestructive repetitions. Reminiscent of what we know from tragedy and the tragic dimension of human existence, this repetition compulsion shows a built-in circularity. These circular dynamics have at their core struggles with deep woundedness that can variably be conceived of as primary pain, primary shame and primary anxiety. Consequently, throughout the experiences with these patients goes the absoluteness both of their conscience and of their ideal, what we know as the "archaic superego:".