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In his introductory remarks, John Frosch, Chairman of the panel, pointed out that concepts about acting out and impulse disorders had acquired a variety of meanings and were frequently used interchangeably. This had an important bearing not only on theory but on technical procedures. The goal of the panel was to explore the possibility of establishing greater clarity in these matters.
After referring to some of the earlier contributions to this subject, and the confusion of terminology, Frosch proposed Fenichel's description as a starting point for discussion. Today, acting out is a term variously used to describe action rather than recollection during treatment, or any action tending toward alloplastic rather than autoplastic modifications, or especially actions with an antisocial bias. Frosch felt that, genetically speaking, disorders of impulse contribute in various degrees to the phenomena of acting out, but that these two are by no means synonymous.
The first panelist, Joseph J. Michaels, had previously made contributions to the subject of the relation between enuresis and certain types of juvenile delinquency and psychopathic personalities. In his paper, "Character Disorder and Acting upon Impulse," he distinguished between acting out and acting upon impulse. The latter would be more primary, more malignant and closer to the psychosomatic pattern than the traditional acting out, which is linked rather to highly evolved neurotic conflicts. Acting upon impulse, or primary acting out, is associated with narcissism and the primary process and is more generalized than secondary acting out, which tends to be specific and localized. However, a continuum between the two exists.
He then sketched a picture of the impulsive psychopathic character with primary acting out as endowed with the following characteristics: a disproportion between motor activity and verbalization, an emphasis on the sensory and concrete rather than the abstract, and a minimum capacity for