What Is... Psychology Series

What Is… Ego-Dystonic & Ego-Syntonic

Insights into psychology: Ego syntonic vs. dystonic

In this series, I dig a little deeper into the meaning of psychology-related terms.  This week’s terms are ego-dystonic and ego-sytonic.

The terms ego-syntonic/dystonic come from the field of psychoanalysis, and were coined by Sigmund Freud in 1914.  Ego-syntonic ideas match up with the ego’s needs, view of the self, and personality.  Ego-dystonic beliefs do not match up with personal values, feelings, and self-image.

The Ego-Dystonicity Questionnaire, a measure used in research, considers four dimensions of ego-dystonicity:

  • consistency with morals, beliefs, values, and attitudes
  • consistency with preferences and past behaviour
  • consistency with one’s sense of what is rational
  • emotional reaction and resistance

OCD

Much of the research literature around ego-dystonicity relates to obsessive compulsive disorder (OCD). In obsessive compulsive disorder (OCD), the obsessions are often ego-dystonic; they’re experienced as distressing and unwanted.

Contamination-focused OCD, for example, doesn’t arise from a natural desire for neatness/cleanliness, and the person with OCD will often recognize that their obsessions and compulsions are not reasonable.

This ego-dystonic element is very much missing from pop culture’s understanding of OCD. I might be called “a little OCD” because I’m very organized, but that’s ego-syntonic and has nothing at all to do with OCD.

Personality disorders

Personality disorders, on the other hand, often involve ego-syntonic beliefs. Even if these beliefs and the behaviours that arise from them cause distress, they’re still seen as an inherent part of the self. Ego-syntonic ideas and beliefs that fuel problematic behaviours can be challenging to treat, as the individual holding these beliefs often won’t see them as problematic. 

Obsessive compulsive personality disorder (OCPD) provides an interesting contrast to OCD, with OCPD typically being driven by ego-syntonic perfectionism.

While delusional grandiosity may be ego-syntonic or dystonic, grandiosity in narcissistic personality disorder tends to be ego-syntonic, and viewed as desirable.

Addictions

Both substance and behavioural addictions tend to start out as ego-syntonic, in the sense that the individual is actively seeking out a pleasure response. Compare this to OCD, where compulsive behaviours don’t serve as a source of pleasure, but rather as a way of suppressing obsession-related distress. As addictions develop and progress, however, they become increasingly ego-dystonic.

Eating disorders

Disordered eating in anorexia nervosa may relate to ego-syntonic beliefs around the need for control and a desire to be thin, which can translate into strong resistance to treatment. Resisting the pull of hunger may be framed as a sign of virtue. Over time, though, an ego-dystonic element may develop, with a commanding inner voice driving the disordered eating behaviours. 

Bulimia nervosa and binge eating disorder, on the other hand, are more likely to revolve around ego-dystonic beliefs.

Psychosis

Hallucinations may be experienced as ego-syntonic, i.e. part of the self, or as ego-dystonic, i.e. coming from an external source. Similarly, delusions may be ego-dystonic or ego-syntonic, and this may influence the relationships a person experiencing psychosis has with their beliefs.

Sex-related beliefs

A Google search for the term ego-dystonic yields a number of hits that relate to sexual orientation or sexual practices.  These unwanted sexual thoughts don’t fit with the individual’s conception of the self, and cause feelings of and shame.

A study published in Sexual Medicine looked at ego-dystonic masturbation, calling it “a clinically relevant cause of disability, given the high level of psychological distress reported by subjects with this condition and the severe impact on quality of life in interpersonal relationships.”

I also discovered a page on Conservapedia devoted to ego-dystonic homosexuality.  Regarding the American Psychiatric Association’s decision to do away with homosexuality as a mental disorder, it says “The APA made their 1973 decision, only after active, practicing homosexuals gained a majority in the APA through totalitarian zapping the shrinks method and took over the editorship of the DSM.”  Um, okay then.  Presumably, so-called conversion therapy is wrapped up in this nonsense too.

What about suicidal thoughts?

It would be interesting to consider suicidal ideation in terms of being ego-syntonic or dystonic.  One factor would be whether you consider the ego to be the intact, well ego, or if you consider the depression version of the self.  When I’ve had thoughts of suicide, they’re distressing, but I don’t experience them as unwanted.  They are highly compatible with my depressed self, but not compatible with my well self.

Do you have elements of your illness that you would consider ego-syntonic or dystonic?

Sources

Psychology resources: What is... Insights into Psychology series and Psychological Tests collection

The What Is… Insights Into Psychology series directory contains all of the terms that have been covered in the series thus far.

You can also find a collection of scientifically validated psychological tests here.

10 thoughts on “What Is… Ego-Dystonic & Ego-Syntonic”

  1. That is so interesting. Yes, I tend to judge people based on a lot of “surface” issues; i.e., I make snap judgments about people on the spot. It’s something I think is wrong, so that would make it ego dystonic. I also have ego dystonic issues with my paranoia, when people (like at the grocery store) insist I interact with them, and I don’t want to speak, I always feel sort of guilty about it afterward. Like, gee, it’s not that person’s fault that I can’t cope with on-the-spot conversing.

    With suicide, I guess it would be ego dystonic for me…? I get terrified of myself and start trying to talk myself out of it; or I’ll try to latch onto anything that will protect me from myself.

    I wonder if there’s a correlation between the proportion of syntonic (versus dystonic) beliefs with a person and their level of self-esteem? Huh.

  2. Conservapedia is funny (they used to have an article on fat atheists implying atheism leads to obesity), but I wouldn’t take it too seriously. I got the impression there are only a couple of people actually editing it. I’m not even sure that the whole thing isn’t a satire.

  3. Excellent post. Ive only recently discovered the Ego dystonic/syntonic paradigm and it has made a lot of things clearer in my life when it comes to understanding my OCD.

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