Action, Acting out and the Symptomatic Act

In her introductory remarks, Elizabeth Zetzel quoted Leo Rangell's suggestion in his presentation "On Acting Out" at the Copenhagen Congress: "We need to establish the role of acting out within the major realm of human action and to distinguish it particularly from neurotic action." The present panel was an attempt to answer this need. Since the primary source of our detailed understanding derives from the treatment of disturbed patients, our approach to a theory of healthy action is necessarily indirect. She hoped for some consensus with respect to acting out and the symptomatic act.

The use of the term "acting out" in analysis has almost invariably had a pejorative implication. This may be appropriate to the acting-out character or to the patient who habitually reverts to previously ego-syntonic repetitive neurotic actions as an overdetermined and possibly unanalyzable defense against analytic progress. Such pejorative implications are not only inappropriate but incorrect with respect to certain symptomatic actions. These might rather be regarded as communications to the analyst serving the analytic process, comparable to the reported dream. Such symptomatic acts should be contrasted with those forms of acting out which represent organized resistance to recollection. Symptomatic acts often can lead to new insights and analytic progress, particularly among action-oriented people. A forgotten appointment, a confusion about time, forgetting to sign the check for the analyst's bill, a minor accident which prevents an analytic hour from taking place provides an "a ha!" reaction, almost always related to dependent aspects of the analytic situation. Such symptomatic acts, like vivid and convincing dreams, are far less attributable to the defense (resistance) than they are to genuine re-emergence of long defended-against infantile wishes.

Although the title of the panel did not include neurotic action, it was impossible to present case material illustrative of ac