The interaction between dyslexia and its secondary emotional problems, especially those arising from unproductive defenses, is illustrated in the history and successful treatment of an adult dyslexic male. At the start of treatment, the 33-year-old subject was illiterate, despite an average IQ and a history of many previous educational and therapeutic interventions. Psychological problems, including low self-esteem, alcohol abuse, temper outbursts, and poor relationships with women were seen as largely secondary to the subject's learning problem. A review of the treatment, consisting of remediation concurrent with psychodynamic psychotherapy, reveals specific ways in which these emotional problems hindered educational efforts, as well as ways in which their exploration and resolution in psychotherapy helped the remediation. Similarly, ways in which the subject's learning problem contributed to the development of his emotional problems are discussed. Finally, with reference to the psychoanalytic concept of sublimation, the relationship between improvement in the subject's reading skill and improvement in his impulse control is described.

Dyslexia and the self-control problems that frequently accompany it are viewed from an ego psychoanalytic perspective. Dyslexia is conceptualized as resulting from an ego deficit in language processing; this deficit is seen as contributing to the ADHD-type symptoms often seen in dyslexic children. Lacking certain crucial components of linguistic competence, the dyslexic child is therefore also lacking a basic tool of impulse control. As a result, this child may exhibit a type of language deficit based impulsivity that has dynamic characteristics which are diagnostically significant. In addition, the ego deficit associated with dyslexia affects and interacts with unfolding drives, especially during the oedipal phase; unlike the more normal child, whose newly ascendant language skills help to inhibit oedipal fantasies and impulses, the dyslexic youngster is prone to a marked intensification of oedipal concerns, especially as these interact with actual experiences of failure. The treatment implications of these issues are discussed.

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