Discussions

I will focus my discussion on the psychodynamic and therapeutic aspects to which Dr. Eckardt and Dr. Weiss have addressed themselves in their papers.

I should like to explore a point that is made both by Dr. Eckardt and Dr. Weiss. Dr. Eckardt refers to “an intended central scotoma,” and later, “the intent is not to listen, not to focus, not to be involved,” and still later, “This intent of detaching …” Dr. Weiss says, “For a long time the maintaining of the alienation appears to the patient as the only way to survive.” “Intent of detaching,” “maintaining of alienation”—these phrases infer an interpersonal goal, an interpersonal process, and definite modes of activity.

What is involved in this process of maintaining alienation? It involves denial of what one has in common with another; a nullification of empathy, a snuffing out of spontaneous impulses to reach others. This denial of common experience is, I believe, the reason why Dr. Eckardt's patients become furious when confronted with those who are a mirror image. The recognition forces upon them a bond of common experience which they seek to obliterate from all relationships.

One of my detached patients, in trying to understand his relationship with me, said, “I don't have an emotional interchange with you. I ignore your presence, talk as if you weren't there. Last year after my first session in the fall, my wife asked me what you had done on vacation. It had never occurred to me to ask. It was somehow