You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
On the question of the constitutional propensity for anxiety, it does seem to me that one can't rule that out. It is one of those matters about which one can never be sure, but as Hansi Kennedy says, the family history may be relevant. But I think there is also a general impairment in the developing organization of her psyche that takes a number of forms. One result is that the oral-phase concerns which Hansi Kennedy mentioned have carried through unduly into the next phase, and when we look at the enormous variety of forms that, say, the castration anxiety takes, we can see the different levels of development all intermixed in the presenting picture.
There are some indications of delays in development over and beyond the failure to move forward to signal anxiety, although the pervasiveness of the anxiety seems very important. The defensive organization remains fairly primitive. It rests on externalization and projection, and it has some of the classical pictures, of ego arrests in the anal organization: the use of undoing, for instance, that gets into obsessional doubting. I was also struck by the continuing preoccupation with numbers, which I think has important roots in that phase, because it is seen in terms of quantity, of bits and pieces, of subtraction and addition, and so on. I do not think it is just a matter of symbolic meaning: I think it is actually a prolongation of a particular type of thinking. I feel that a lot of the interference with the thinking process comes about because part of the thoughts themselves are too closely attached to their bodily roots. I think that comes over clearly in terms of the kinds of preoccupation about the body taken up in the symptoms. There is still a tendency to think at times of body processes as if they were thoughts. It is as if, in cases