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It seems logical that any discussion on acting out, in order to be meaningful, would have to be related to the concept of 'working through'. There are few aspects of our daily analytical work which are more challenging than acting out and more directly pointing to the necessity and arduousness of working through the patient's resistances, as Freud (1914) has warned as. The problem is not only that the tendency to act out needs constant attention by the analyst but also that disturbing episodes of acting out may well occur in the course of working through anxieties and conflicts under apparently quite satisfactory circumstances. I am referring to those optimal conditions where analyst and patient work well together and, of course, where the analyst has in no way contributed to force the patient to act out as a result of his own incompetence or because of the persistence of unresolved conflicts in himself. However, it would be fair to say that there are many instances when the analyst may unwittingly play a part. The experienced analyst is not only disappointed at seeing years of insightful working through wasted but may even come to the conclusion that the patient's resistances are intractable to the point of abandoning analysis.
The trainee analyst's difficulties are even more complex. The patient with acting out propensities at the onset of treatment makes him feel out of his depth. He may go so far as not to regard some aspects of the patient's behaviour as acting out, since he feels this might be unfair to the patient and, in any case, lacks the skill to see through the patient's rationalizations. Acting out as it occurs in a transference setting inevitably creates countertransference reactions. This fact has been noted and taught to students of psycho-analysis for a number of years. In spite of this, in the course of discussions with colleagues, seminars, and in scientific writings, it is possible to see that, for many, acting out is, more than anything