The Pathogenicity of the Primal Scene

In his opening comments, Chairman Harold P. Blum noted that the primal scene has been implicated as a determinant in so many forms of psychopathology that the term has lost some of its descriptive and explanatory value, leading Esman1 to reconsider its pathogenicity. The concept is often used without an attempt to differentiate fantasy from actual experience; it is used to refer to activity at all levels of psychosexual development, as well as to single or repeated exposures and to remotely related derivatives of the fantasy. The primal-scene configuration is not only used to represent the copulating parents, but is given regressive meanings as well.2 Such expanding applications of the term have resulted in conceptual confusion and raised new questions about the meaning of the term and the relation of the primal scene to trauma and psychopathology. Because of the resultant dilution of the concept, it is advisable to restrict the scope of the term primal-scene fantasy to the derivatives of the oedipal conflict. These derivatives are far ranging, and included in the primal-scene imagery may be fantasies of castration or sadomasochistic concepts of intercourse.

While Freud had a continuing interest in the difference between and interplay of primal-scene fantasy and reality, he remained inconclusive about the issue. Today our conception of the