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I am indebted to Dr. Aragon for his thoughtful comments on my paper. In particular his detailed description of the neurological aspects of procedural knowledge was a welcome addition.
Dr. Aragon indicated that it was his impression that I worked from an empathic vantage point. Perhaps it would help to clarify this impression if I spelled out my understanding of the case from a self psychological point of view.
Toward that end, I will review a bit of Mr. P's history. Mr. P, if you recall, had developed a paranoid system toward the end of his first year in college. He felt alienated from the world and described himself at that time as “having nothing at my center”. “My metaphor was zero. How can you organize zero?”
His history was one that included one unpredictable event after another. His was a totally unpredictable world. Eventually the very unpredictability of his life disrupted Mr. P's sense of self continuity. He had no choice but to accommodate to all the changes that took place (deaths, suicides, multiple moves, multiple caretakers) with no opportunity to assimilate the reality of those events. The absence of any validating selfobject tie, I believe is an important key to understanding how reality became lost to him. Ultimately, there was erosion of the very core of his subjective self. The special features of predictability and validation mentioned in my paper led to the establishment of a selfobject tie. In that context Mr. P. could sort out what his history had been. Over time, he began to have new expectations (procedural knowledge schemas).
It is my hope that my paper and Dr. Aragon's explanatory comments will encourage further investigation and other case reports on procedural knowledge from a clinical and a neuropsychological point of view.