Abstract
Building on my previous work (Carveth, 2013; 2015; 2016; 2023), which distinguishes persecutory from reparative guilt and the superego from the conscience, this paper explores how these distinctions can be applied in clinical practice. I argue that while we must avoid becoming “superegoish” with our patients, we are nonetheless tasked with carrying the conscience within the treatment until patients are able to internalize it themselves. Similarly, although the hostile superego cannot be simply “demolished,” it can be disempowered through ethical critique. This paper considers how that process
unfolds in the clinical encounter.
Learning Objectives
At the end of this presentation, participants will be able to:
1. Explain the difference between persecutory and reparative guilt.
2. Distinguish the superego from the conscience.
3. Explain why we need a judge to judge the judge, and how in the clinical situation we help patients to stand up to the bully superego.
Biography
Donald Carveth is an emeritus professor of sociology and social and political thought at York University in Toronto. He is also a training and supervising analyst with the Canadian Institute of Psychoanalysis, a former Director of the Toronto Institute of Psychoanalysis, and past Editor-in-Chief of the Canadian Journal of Psychoanalysis. Dr. Carveth is the author of several influential books, including The Still Small Voice: Psychoanalytic Reflections on Guilt and Conscience (Karnac, 2013), Psychoanalytic Thinking: A Dialectical Critique of Contemporary Theory and Practice (Routledge, 2018), and Guilt: A Contemporary Introduction (Routledge, 2023). Many of his publications can be found on his York University webpage and his personal website. His video lectures are available on his YouTube channel. Dr. Carveth maintains a private psychoanalytic practice in Toronto.
Reference
Carveth, D. L. (2013). The still small voice: Psychoanalytic reflections on guilt and conscience. Karnac.
Carveth, D. L. (2015). Toward a post-Kleinian theory of the superego. Psychoanalytic Review, 102(2), 147–169.
Carveth, D. L. (2016). The superego, sadism, and despair: Toward a contemporary understanding of the superego. American Journal of Psychoanalysis, 76(2), 162–182.
Carveth, D. L. (2023). Disempowering the superego: Guilt, shame and the function of the conscience. Canadian Journal of Psychoanalysis, 31(1), 72–93.
Carveth, D. L. (2024). A psychoanalyst's confrontation with illness, aging, and
death. The Psychoanalytic Review, 111(1), 47-50.
Carveth, D. (2025). The superego: Our inner authoritarian. In D. Burston & K. Jacobson (Eds.), Authoritarianism in all its guises: Perspectives on right, left, and center (pp. 24–31. Routledge.
