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Kestenberg's view of the genesis of acting out raises a number of questions which are central also to a definition of the function of acting out, and it has bearing on the manner in which we may deal with various forms of acting out behaviour during the treatment of children and adults.
My understanding of Kestenberg's view is that there is a period in normal development,
which she refers to as the "inner genital-preoedipal phase", during which time the tension experienced by the child is such that he is unable to cope with it unless there is the availability of the mother or of an accessory object as an auxiliary ego. The child's effort during this phase to include the object, although related to what Kestenberg describes as "loss", is really an effort to avoid intolerable tension by trying to create a feeling of oneness with the object. It is the use of the object to establish narcissistic equilibrium. The action of the child revives, in fantasy, the relationship to a "lost" infantile object. She states that it is during the "inner genital-preoedipal phase", that is, at a time when the child feels that the mother's role encompasses his whole life, when "conflicting impulses are externalized and external reality is used to make up for loss of past feelings and past relationships, [that] we find the prototype for acting out". It seems to me that Kestenberg is referring to a time in development when there is not yet the physical means, that is, through genital discharge, of dealing with tension. If I represent her view correctly, it then means that the patient in analysis, during certain states of the transference, tries to get the analyst to take on the role of the mother of the "inner genital-preoedipal phase," and to become the person who protects him from intolerable tension while at the same time acting as the vehicle for tension discharge.
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