Severe Regressive States During Analysis

In his introductory remarks John Frosch, rather than systematically reviewing the pertinent literature, offered instead a brief working definition of "severe regressive states" and then submitted a series of questions which he hoped would serve as a framework for the ensuing discussion. In fact, however, Frosch's questionnaire provided a topical survey of the areas of both our knowledge and our relative ignorance in regard to these perplexing phenomena.

Frosch conceptualized the severe regressive states as those regressions which "seriously affect the usual patient-analyst relationship in the usual course of psychoanalytic treatment for a longer or shorter period." The pathology observed in these situations is similar to that encountered in psychotic and allied conditions. There are disturbances in the ego's relations with reality; not infrequently object relationships are impaired to the point of dedifferentiation and disruption in the boundaries of the various psychic structures; more archaic ego states, functions, and defense mechanisms can be observed, and the nature of the anxiety seems related to problems of the preservation of self and identity, not unlike that seen in psychotic states.

Frosch raised numerous issues and problems which can be consolidated into six groups of questions:

• 1Are severe regressive states to the point of regressive disorganization inherent in all analytic cases in varying degrees or are we dealing with a special phenomenon occurring only in certain kinds of cases?

• 2Do we have any criteria for anticipating such reactions in the history and initial contact, or must we await developments during the treatment situation?

• 3Do we have any indications as to what type of analytic situations may precipitate such reactions?

• 4Are such reactions a necessary development in order to facilitate the improvement in patients, or are they to be considered as intrusions into