Meetings of the New York Psychoanalytic Society

April 15, 1952. THEORY OF PSYCHOANALYTIC THERAPY. A FEW RARELY ASKED AND NEVER ANSWERED QUESTIONS ABOUT PSYCHOANALYTIC THERAPY, EMOTIONS, AND INSIGHT. Lawrence S. Kubie, M.D.

There is an enormous gap in psychoanalytic knowledge as to the processes of health and disease. Dr. Kubie poses the existence of a central emotional position at 'rest' around which the individual's emotional life gravitates. He describes a patient who always tended to become depressed and whose life was a desperate attempt to emerge from this state. Temper tantrums or rage, mourning, panic, hypomania, chronic disgust and loathing are also found as central emotional positions. Questions as to how to approach these positions are raised, and whether or not different approaches might be necessary for different central emotional positions is discussed. Compulsive devices are used by patients against their drives. Their breakdown causes produce an explosion of the concealed affect. Patients do not want to be freed of defenses which protect them from painful affects. There are trigger-mechanisms which release these emotions. The existence of a feed-back relationship in these states is hypothesized.

A case is presented of overt homosexuality in which the central emotional position was chronic mourning for the loss of his mother. There was a chronic hunger for love, praise, approval, and a phobic reaction to blame, hostility, or criticism. Any deviation from praise touched off panic, despair, then compulsive homosexual looking. Success threw him into a panic followed by compulsive appeasement. An alternate series of events was to lie fallow, then to become lonely, apprehensive, jealous, followed by mourning in which his response to the birth of a younger brother was relived. After this would come compulsive spending and homosexual panic. Under analysis it became possible to interrupt this, first by description and then by interpretations which led to unconscious Oedipal wishes, castratio