Egosyntonic and egodystonic

In psychoanalysis, egosyntonic refers to the behaviors, values, and feelings that are in harmony with or acceptable to the needs and goals of the ego, or consistent with one's ideal . Egodystonic (or ego alien) is the opposite, referring to thoughts and behaviors (dreams, compulsions, desires, etc.) that are conflicting or dissonant with the needs and goals of the ego, or further, in conflict with a person's ideal self-image. Abnormal psychology has studied egosyntonic and egodystonic concepts in some detail. Many personality disorders are egosyntonic, which makes their treatment difficult as the patients may not perceive anything wrong and view their perceptions and behavior as reasonable and appropriate. For example, a person with narcissistic personality disorder has an excessively positive self-regard and rejects suggestions that challenge this viewpoint. This corresponds to the general concept in psychiatry of poor insight. Anorexia nervosa, a difficult-to-treat disorder (formerly considered an Axis I disorder before the release of the DSM-5) characterized by a distorted and fear of gaining weight, is also considered egosyntonic because many of its sufferers deny that they have a problem. Problem gambling, however, is only sometimes seen as egosyntonic, depending partly on the reactions of the individual involved and whether they know that their gambling is problematic. An illustration of the differences between an egodystonic and egosyntonic mental disorder is in comparing obsessive–compulsive disorder (OCD) and obsessive–compulsive personality disorder. OCD is considered to be egodystonic as the thoughts and compulsions experienced or expressed are not consistent with the individual's , meaning the thoughts are unwanted, distressing, and reflect the opposite of their values, desires, and self-construct. In contrast, obsessive–compulsive personality disorder is egosyntonic, as the patient generally perceives their obsession with orderliness, perfectionism, and control, as reasonable and even desirable.