A clinical syndrome of exposure to early massive stimulation via primal scene involvement or the threat of abandonment is described as frequently being associated with acting out. This acting out, in turn, is seen as a later repetitive defensive effort to master or bind the anxiety by repeating in an active role aspects of the stimulating experiences that were passively imposed originally. This defensive ego activity, tentatively called an identification with the doer, uses the repetition compulsion to help achieve mastery over stimuli originating from within or without and is in keeping with the findings of Freud, Hartmann, and Waelder.

Clinical material is cited to illustrate these points. It is stressed that this identification with the doer could be used as a specific transference resistance to being flooded by stimuli from within in the process of recall, and hence must be handled by making repeated interpretations of its origin and genesis.