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In presenting this clinical paper I have had to condense and simplify the material very greatly and have attempted only to sketch it in such a way as to indicate the fundamental outlines of the work. In the last case cited, the work began with the problem of management of the anxiety laden behavior and the establishment of a better grasp of immediate reality. The education away from narcissism extended throughout the entire analysis, permitting the patient an increasingly useful self-critique. The interpretation was gradually deepened until the essential neurosis could be reached. I believe that these general principles are applicable wherever there have been many severe and early traumata, whether or not there is any possibility of antenatal and natal contributing factors in the underlying anxiety.
This is a group of patients who are coming to analysts with increasing frequency, asking and needing help. It is clear that the consideration of these cases takes us back to the need for more observation with infants, work which appears to me the source of the richest material for psychoanalysis.