Comment on Dr Ritvo's Paper

While reading Dr Ritvo's case history, I was impressed by the persistence of Frankie's problems connected with rivalry as they manifested themselves in the relationship to the father and a similar persistence of his difficulties with passivity. These impressions confirm my own analytical experience. The solution of exactly these problems determines in large part the result of our therapeutic endeavour and is of the utmost importance to our patients. The full development of the activity which they will ultimately be able to use constructively depends on it.

An interesting technical point, namely the patient's marriage during analysis, I shall not consider here, although it interests me in regard to the question how far the analysis of the preoedipal development was hampered by it.

I shall limit myself to a few clinical and theoretical remarks: These are related to

• i.the problem of rivalry and of passivity;

• ii.masochism as a defence;

• iii.the qualitative changes of the drives during analysis.

The theoretical viewpoints that I want to bring to your attention are not new but in my opinion they have often been underestimated. This results from the fact that in the development of our theory and technique one aspect is often much overstressed during a certain period. The great difficulty in our work is that we have to maintain a multidimensional approach; we must be able to work with different points of view at the same time. This multidimensional approach is of paramount importance in our technique because we have to be willing to analyse simultaneously and alternatively genital and pregenital, oedipal and preoedipal manifestations. This train of thought is characteristic of the way in which Freud himself developed his theories.

The nature of the material collected during a particular analysis together with our experience determines the extent to which the different viewpoints can be used, as well as their relationships to each other. In other words, it is necessary to r