A Point of View on Acting Out1

Menninger (1958) has described the history of nosologies as consisting of successive waves of differentiation, followed by contractions, and then by differentation again. Similar alternation has been the case with the phenomenon of acting out. After an initial specific coinage and use, there followed a phase of diffuse expansion of our understanding and usage of the term, from which our challenge today, I believe, is to contract it again to a more narrow and precise form. Hopefully however, this should be on the basis of our increased refinement of theory and the continuous amassing of clinical experience.

While some authors limit acting out to actions designed to avoid memories or which take the place of remembering (Freud, 1905, (1914); (H. Fenichel, 1956; (Greenacre, 1966), others apply the term much more liberally and include almost all irrational, impulsive, or inappropriate actions, in life situations as well as in the analytic process, (see Abt and Weissman, 1965).

There is hardly a syndrome or clinical phenomenon which has been subjected to such widespread proliferation, resulting in a clinical potpourri with a lack of boundaries and absence of internal theoretical definition or consistency. From an original meaning limited to actions which defend against the therapeutic process there has been a progression to include

any action tending towards alloplastic rather than autoplastic modifications, or especially actions with an anti-social bias (Frosch, 1957),

or

a concept—so broad as to include every human impulsive act of whatever nature (Rexford, 1966b).

After one of the most rewarding recent symposia on this subject (Rexford, 1966a), Blos (1966) concluded by observing that the

expansion of the concept has reached a conceptual breaking point.

There is no doubt that clarification and a movement towards precision and semantic consensus are much overdue. A major service would be rendered by the present symposium if it would reverse this spiralling effect by which a