In neurotic acting out inner tension is relieved by the partial discharge of warded-off instinctual drives or guilt feelings. This becomes possible through an associative connection between present situation and repressed content.

The study of such clinical entities as 'impulse neuroses' and traumatic neuroses may help one to understand neurotic acting out. Impulse neuroses are characterized by intense, irresistible impulses like compulsive running away or cleptomaniac impulses. These irresistible impulses serve the purpose of either escaping from a (real or imaginative) danger or of denying or reassuring one against a danger. Depression must be included in the concept of 'danger'. Fenichel claims that most impulsive acts serve the purpose of avoiding depression; the basic disposition for pathological impulses and for depressions are identical in so far as both are rooted in an early phase of development in which striving for security and striving for sexual satisfaction were not yet