'General Problems of Acting Out.': Phyllis Greenacre.

The Psychoanalytic Quarterly, 1950, Vol. XIX, No. 4, pp. 455–467.

The paper deals with habitual or frequent acting out. Agreeing with Fenichel as to the oral fixation and poor tolerance of frustrations, the heightened constitutional motility and the presence of severe early traumata (producing a repetitive abreactive acting out somewhat similar to that of the traumatic neurosis), the author considers in addition (1) a special emphasis on visual sensitization producing a bent for dramatization (derived naturally from the increased scoptophilia and exhibitionism) and (2) a largely unconscious belief in the magic of action, especially repetitive or imitative action. These factors are important in giving the cohesiveness to the fabric of phantasy and memory which is characteristic of neurotic acting out as distinguished from neurotic action. It is suggested that a common genetic situation in habitual actors-out lies in the very early disturbance in the developmental relation between speech and action, i.e. a condition of degradation of the functional utility value of speech, whether this be through speech being impaired or delayed in early childhood or to speech being encouraged for exhibitionistic and other narcissistic purposes rather than for communication, and especially for expression of emotion. Subsequently then these children act in order to communicate and talk to conceal rather than express their needs.

The latter part of the paper presents suggestions for management of habitual acting out in the analysis. Special emphasis is laid on early work with the patient's narcissism and with giving some understanding of the disturbed speech functioning, together with the (generally very difficult) analysis of those pieces of acting out which are reported in the analysis fairly early in the treatment. There are many cases which cannot be treated successfully.

Author's Abstract.