On Patient's Sleep During the Psychoanalytic Session

THE PATIENT WHO DEVELOPS STUPOR and sleep during the analytic session has been a subject of interest to psychoanalytic investigators over many years. As early as 1914, Ferenzi (1950) recognized this condition as an important resistance problem. Freud, in the Metapsychological Supplement to the Theory of Dreams (1916) likened the withdrawal of interest which results in sleep to the womb-like, prenatal state, and wrote of two forms of temporal regression—primary narcissism and hallucinatory wish fulfillment. Later, in the General Introduction to Psychoanalysis of the Ego (1921), he drew attention to sleep as a way of avoiding the pain of reality brought to bear on the infant following birth.

Among those contributing in more recent times, Gabe (1951) has related the patient's sleep to a wish to be united with the good mother and to hallucinatory wish fulfillment. Lewin (1954), Parkin (1955), and Scott (1956) have stressed the importance of narcissistic elements and the blissful escape from external reality through sleep. Dousuzkov (1952) has made reference to hostile urethral impulses expressed against the analyst via sleep, and Stone (1947) has related the patient's sleep to a rivalrous, hostile refusal or inability on the part of the infant to nurse and receive from the breast. This latter paper expands our understanding in that the sleep in question is no longer considered to express only a regressive wish, i.e., for the good breast of mother, but draws attention to a form of hostility which expresses a rejection of and denial of the existence of a good object.

This view is consistent with the findings I have gleaned from analytic work with a certain type of patient, treated during the past few years. In particular, I have found that these patients will tend to fall asleep following the analyst's interpretation or confrontation, even at times during their own recounting. This is indicative