Responses to Dr. Baudry and Jeng Chen

It is our privilege to respond to two thoughtful readers.

For Dr. Baudry, we will respond on two of his points: the research and cultural aspects of this paper.

We agree with Dr. Baudry that Deutsch's 1942 As-If paper was predominately descriptive with minimal genetic or psychodynamic aspects. Fortunately for us, the journal published it nevertheless. While we also value psychodynamic and genetic viewpoints, these can be heavily theoretically tilted. For instance, today, psychodynamic may mean to account for the “field” aspects of an interaction (which often is presented with little or no genetic component). Some prominent Italian field theorists argue that no one, neither analysand nor analyst, takes responsibility for a parapraxis, as it is something that happens in the “field.” The latter stance, in our opinion, profoundly changes the understanding of countertransference and transference. It abrogates responsibility, particularly from the analyst.

Dr. Baudry raises the issue of age of emergence of “as-if,” citing the analysand's memory of tricking both her parents by placing her father's shoes on mother's new scale (when she was a child). This genetic question we hope will be clarified with further inquiry. Our hypothesis is that given that character (about which Dr. Baudry has written three classical papers) crystalizes in later adolescence, we would expect the as-if to arise then.

Dr. Baudry states that free association is useless in cases such as this. Yet, Winnicott in his Squiggle book, points out that for this kind of patient, the free association manifests itself defensively as a form of imitation or echoing of the analyst. In Winnicott's case, the boy copied or imitated

Winnicott's squiggles. The analyst was able to interpret this as a form of defensive keeping the same as the analyst in order to not reveal one's inner life. This is a way of describing the False Self as presenting in order to protect the True Self from discovery. We suggest that understanding the nature of the transference as a form of “echoing” in order to protect oneself might be technically helpful.

Finally, Dr Baudry recommends in similar cases that one focus on sensory manifestations and psychic surface. We agree. Giovacchini suggested that by doing the latter, and by the analyst incorporating the analysand's projections, the analyst can metabolize these and re-present them to the analysand in a manner he or she will find useful .1

For the cultural implications of this paper (raised by Dr Baudry), we turn to Dr. Jeng Chen's comments. Ironically, she mentions this in one of her emails to us, but not directly in her comments. She remarked that she and her staff have seen many such cases in their clinic, including forme fruste manifestations. These have resulted in clinical consternation. She found our paper useful in clarifying the nature of the diagnosis and possible paths to clinical treatment.

While Dr. Baudry correctly states that the as-ifness as an “adaptive” response to living in an authoritarian or totalitarian state may be a conscious decision, we want to suggest that it may have preconscious elements. Dr. Wu recalls a childhood education (at school, but also at home) of quiet compliance to protect oneself (and one's family). Her point is that such as-ifness or false-self, becomes almost a form of “muscle memory” (like turning the key in your lock at home), not necessarily fully conscious.

In any case, if this is true, the elements of this forme fruste cultural version of as-ifness may have at least preconscious qualities.

We thank both Dr Baudry and Dr. Jeng for their comments.