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In the discussion I made two separate comments, the one to do with the nature of obsessional neurosis and the other to do with the case under discussion.
In regard to the theory of obsessional neurosis I attempted to formulate a concept of a split-off intellectual functioning which I believe to be an essential feature of a thorough-going obsessional neurosis case. The conflicts belonging to the personality have become localized into this split-off intellectual area. It is because of the fact of this split that there can never be any outcome in the obsessional neurotic's efforts and activities. The best that can happen is that for the time being the obsessional person has arranged a kind of order in the place of the idea of confusion. This is a never-ending alternation and has to be contrasted with the universal attempt of human beings to arrange for the experience of some kind of structurization of the personality or of society in defence against the experience of chaos. Here there is a possibility of an outcome because the work is not being done in the split-off area of the personality.
In regard to the case, I limited my observations to a study of the beginning of the treatment of Frankie as reported with faithful detail by his child analyst. I prefaced my remarks by a reminder that if we are able to discuss this case in detail we are indebted to her report and indeed the description of this analytic treatment has rightly been used for more than a decade in the teaching of the psycho-analytic technique. I made an attempt to look critically at her handling of the first interview.
Frankie started his first session by building a hospital which was separated into a 'lady department', a 'baby department', and a 'men's department'. In the lobby, a lonely boy of 4 was seated all by himself, on a chair placed in an elevated position.
The further details of the game showed that this was a place where babies are born and the game, the analyst reports, was repeated in th