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It is worthy of note that, as this Panel discussion proceeded, there emerged similar trends of thought concerning its subject matter; these had been germinating independently in the minds not only of the panelists, but in all likelihood of analysts in various parts of the country. This furnished the justification for the formation of such a panel and uniquely reveals its timeliness.
With one exception, the participants expressed dissatisfaction with our current nosological pattern, while at the same time they evinced no disposition to discard it entirely. (The latter alternative is not without its protagonists.) For a long time it has been apparent that a classificatory scheme, based phenomonologically on symptom clusters, and dynamically on levels of psychosexual development, is not adequate. There was no inclination to underestimate the complexity of the task of revising and modifying traditional nosological concepts in accordance with the now-recognized intricate interplay between instinctual and ego developmental levels, but the necessity of doing so was repeatedly emphasized. As for a possible framework upon which to construct a revised nosology, Leo Rangell, Eugene Pumpian-Mindlin, and Elizabeth Zetzel proposed, as a beginning, an examination of the epigenetic scheme of Erik Erikson.
The subject matter of the panel falls naturally into two categories—general considerations and specific ones. In the papers on specific problems, by Zetzel, John Frosch and Ross, considerations of an ego-psychological nature occupied a central role.
In his "Introductory Remarks on Problems of Nosology from the Psychoanalytic Standpoint, " Leo Rangell expressed the general dissatisfaction with the ambiguities, inconsistencies, inaccuracies, and exceptions which beset the traditional scheme of nosology. Upon close inspection, syndromes and individual symptoms invariably turn out to cover wider fields than originally conceived. Earlier panel discussions, such as on conversion an