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Dr Naiman has presented us with some interesting clinical material from the treatment of two cases. I shall focus my discussion on the specific affectivity in these patients that Naiman repeatedly singles out for emphasis; namely their sense of hopelessness, humiliations, and need for dependency. Corresponding to this was a specific expectancy that things should come right for them, just as the child has the compelling expectancy that its needs will be met by the average expectable environment. Naiman clearly shows us how in areas other than that of their specific 'ego-defect' related to archaic expectancy needs (expressed overtly as insecurity in the female and the need to amass wealth in the male) these patients had a shrewd sense of reality. Naiman has also stressed the attempts made by these patients 'to have the present as different from the past as possible'. What is it in the past they need to change? Naiman tells us one factor: a sense of humiliation deriving from the dependency that was not met by the parents. My feeling is that in patients, such as those reported by Naiman, it is the developmental process that has been arrested and distorted. All their superstructure of adult personality development is continuously intruded upon by the area of developmental arrest. In such patients the very archaic affective processes as well as early psychic functioning are interpolated into the most sophisticated capacities of adult living and endeavour. In this context one can all too readily misconstrue the reactive guilt and the failure of their defensive attempts at self-establishment for the deeper causes of deprivation and distress.
Naiman has discussed how in the earlier theories of acting out emphasis was on idregression. I am suggesting that in his type of case we should think in terms of a specific type of ego-regression. Here the regression is to a more archaic level of dependence on the environment. It is acted out—mobilized by and expressed thro