Freud summarizes his arguments in the essay thus far, noting that the complexity of the ideas requires frequent restatement of what he has already said. He describes how the superego is derived from the Oedipus complex, that is from the early ego-identification with the parents driven by the object-cathexes of the id. The superego is therefore close to the id and it mediates between the id and the ego. Like the id, it is unconscious.

He builds on this finding with evidence from clinical practice. He notes that some patients cling to their illness and seem to get worse instead of better with treatment. He concludes from this that the patient clings to their illness out of a sense of guilt; unconsciously, they feel that their mental pain and suffering is a justified punishment for their perceived wrongdoing.

A normal, conscious sense of guilt is caused by the tension between the ego and the superego. However, guilt becomes pathological when the superego is extremely cruel to the ego, resulting in “obsessional neurosis” and “melancholia.” To alleviate these conditions, the patient has to identify for themselves what the superego is doing; the analyst cannot do it for them. In cases of “hysteria,” the patient’s psyche seeks to repress the superego’s criticisms, creating an unconscious guilt. Freud hypothesizes that guilt is often unconscious because it arises from the superego, which is itself largely unconscious. Freud states that unconscious guilt can lead to criminal behavior, because people seek to affix their unconscious guilt to identifiable immoral behaviors. Like the ego, the superego can be accessed through “word-presentations,” that is through the use of language to describe what is otherwise inchoate.

Freud raises the question of why the superego is so often manifested as guilt or criticism. He argues that it is because the super-ego is closely connected to the death instinct; it seeks to destroy itself and other objects. He concludes that this is why “the melancholic” patient may attempt suicide. These death instincts can be mediated through deviation to external objects through eroticism.

Freud argues that the id is “totally non-moral,” the ego desires to be moral, the superego is “super-moral.” When a man eschews redirecting his death instinct to external objects, his superego becomes more severe towards himself.

Freud presents the hypothesis that the superego arises from identification of the father as a result of a process of sublimination and desexualization. However, this process leaves behind the death instinct that was once part of the erotic instinct for the father, resulting in the harshness and aggression of the superego.

The ego has an important role in mediating reality to the psyche. It also derives libidinal energy from the id and “transforms the object-cathexes of the id into ego-structures” (45). Along with the superego, it derives phylogenetic information from the id. The id connects to the ego through its instincts, which can either be controlled or inhabited by the ego. The superego is an instrument of this process. The ego is thus at the mercy of the external world, the instincts of the id, and the harshness of the superego. When the ego is unable to balance these three competing forces, anxieties and other mental illnesses arise. It also has to mediate the two driving instincts, Eros and the death instinct.

The ego generates fears based on the pleasure principle (since the pleasure principle is also the principle of avoiding unpleasure). It is particularly fearful of the superego because it has learned, through the Oedipus complex, to associate the superego with the fear of castration. Freud believes that the overriding fear of death derives from the ego’s dread of the superego.

Freud concludes the essay by noting that the id has no unified will. It is directed by the tension between Eros and the death instinct.