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Scott relates the views of Melanie Klein's 'depressive position' to conclusions of his own arrived at in treating manic-depressive states in which were found intense, pathological types of anger, love, fear, and grief. These conclusions are illustrated by many details from the analysis of a twenty-year-old
hospitalized woman suffering from severe depression. Symptoms and a series of critical situations in the analysis are described. Scott states that as in the analysis of children he focuses on interpretations of details of behavior, the sequence of behavior, and reactions to interpretations. Some of the interpretations are based upon intuitive understanding and experience, proof of which appears in subsequent behavior and material. Fantasies connected with vomiting and vomitus are related to feelings of persecution from within and without and lead to disturbances in ability to speak about feelings. Atonia of sleep, sleep itself and fatigue are used as defenses against the effects of 'bad' internal objects. Convulsive reactions are used as an inhibitory symptom against reactions of rage.
Masturbation appeared as a defense against aggressive oral wishes. The working through of oral aggression connected with identification with the father led to a resolution of the identification and promoted feminine wishes and identification. This was followed by alternations between feminine and masculine identifications which Scott understands in terms of the swiftly changing relationships of the patient's internal objects.
When the patient ignored the analyst it was interpreted as a disturbance of the reality sense by an internal object. When the patient treated the analysis as a dream she did not wish to subject the analyst to her sadism. Writing was a projection mechanism acting as a defense against oral activities. Drawings were interpreted as the projection of memory and of fantasy material. Scott concludes that in treating psychotic patients the analyst should t