Acting Out: Some Notes on Work with an Adolescent Girl and a Boy in the Latency Period

When in the opening years of the century a young woman, referred to as Dora, prematurely broke off her analysis, Freud wrote that his patient had taken her revenge on him, deserting him, as she believed herself to have been deserted and betrayed by her friend, Herr K. In his paper, “A Case of Hysteria” published in 1905 we find the sentence “Thus she acted out an essential part of her recollections and phantasies instead of reproducing it in her treatment”. Later, in the paper entitled “Remembering, Repeating, and Working Through” (1914) this idea was further developed, and acting out was equated with the compulsion to repeat. “We soon perceive”, he wrote, “that the transference is itself only a piece of repetition, and that the repetition is a transference of the forgotten past not only on to the doctor, but also on to all the other aspects of the current situation. We must be prepared to find, therefore, that the patient yields to the compulsion to repeat, which now replaces the impulsion to remember ……not only in his personal attitude to his doctor but also in every other activity.” He adds that: “The greater the resistance, the more extensively will acting out (repetition) replace remembering”, and concludes that in drawing attention to the compulsion to repeat, “we have only made it clear that the patient's state of being ill cannot cease with the beginning of his analysis”.

In his original formulations, therefore, Freud's concept included the ideas of (1) a necessary and inevitable element in the transference, but (2) a phenomenon which served the resistance. (3) He regarded it as taking place within the session, and (4) also outside, where he linked it with the fact that “in the course of treatment new and deeper-lying instinctual impulses, which had not hitherto made themselves felt”, might come to be repeated.

Finally he considered the dangers to the patient which might follow, and while stressing that it was mainly through the handling of the tra