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The core of neuroses and psychoses can be characterized as anxiety. Symptoms themselves are expressions of anxiety and defenses against it. Psychoanalytic treatment—group or individual—by scrutinizing symptoms, structure, and dynamism constantly mobilizes anxiety. Since anxiety can hardly be tolerated, people avail themselves of preventive and counteracting defenses. We will discuss here one specific defense which is used against anxiety, stirred up by the analytical treatment itself.
This defense is called “acting out” and it designates patients' attempts to express themselves in action rather than in verbal communication during analytic sessions, or outside. These actions reflect upon the patients' relations to their therapists, as well as upon interpersonal problems at large.
Such actions carried out during or after therapy sessions show the utmost variety. In the following, I will present only some of the more frequently encountered examples of “acting out.” These examples (symptoms) will be presented in functional groups. Since, as I have mentioned, “acting out” is characteristic of a patient's relationship to his therapist, I shall apply the same terms we use in classifying transference phenomena.
“Acting Out” Suggesting Positive Transference: Giving to the therapist gifts which were bought, made, or earned by the patient; offering to the therapist services, such as secretarial, librarian, household, or “sexual” services; providing therapist with “telephone numbers”; visiting therapist in his home, or calling him on telephone; exhibiting seductively clothing, especially new clothes, or directly parts of the body; giving up symptoms too early, only for the sake of approval; starting business, social or artistic activities too soon, again only for the sake of showing co-operation.
“Acting Out” Suggesting Negative Transference: Giving to the therapist gifts which were stolen or borrowed by the patient, or gifts which can be dangerous to the thera