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Dr. Ingram: As I understand it, we are being presented with the thing-in-itself, the diary of Professor M. in sagittal section, so to speak. The purpose of this is to demonstrate the compulsion to repeat. Now are you not doing the very thing that Freud does in the Schreber case? Are you not using the data to make a metapsychological theoretical point?
Dr. Chessick: The compulsion to repeat is not a metapsychological concept; if you say that this compulsion is “beyond the pleasure principle,” or due to a death instinct, or (with Ives Hendricks) a drive toward mastery, that is metapsychology. The compulsion to repeat is a phenomenon that stands by itself, as you can see: the fellow in the diary keeps going over the same ground again and again, as shown every five years. By the way, “thing-in-itself” is noumenal, not phenomenal, a Kantian term referring to a speculative idea that there is a reality we cannot know “out there”; it is the opposite of phenomenology as used here.
Dr. Ingram: I can recognize a deteriorating clinical condition in this narcissistic neurosis. The relatively hopeful and enthusiastic presentation we find early cedes in the 1970s and 1980s to storms of narcissistic rage, frustrated claims, dashed expectations. And in the 1990s, this pattern cedes again to resignation, boredom, withdrawal, and increasing somatic preoccupation.
Dr. Chessick: You are correct that these other phenomena manifest themselves! However, the diagnosis “narcissistic neurosis” is not phenomenology; at this point a nomenclature and DSM-IV are introduced. The point of the illustration is that this person's agony can be demonstrated, as he spins about over and over on the same issues like a needle stuck in a groove of a record. Please understand that the phenomenological approach is not meant to supplant other approaches but to add to them, to complement them, to help the therapist get a direct grasp of who the patient is, rather
than to label the patient or make him or her a cre