Acting out and Ego Development

The term acting out is rather loosely applied to repetitive compulsive behavior in the service of gratification of unconscious impulses. It occurs during selective suspension of reality testing. In the genesis of habitual acting out, Fenichel (1) postulates first, a heightened constitutional motility or 'alloplastic readiness'; second, oral fixations, highly narcissistic needs, and intolerance of tensions; third, an infantile trauma which produces an abreactive repetition similar to that which characterizes traumatic neurosis. Greenacre (2) adds two more: 'a special emphasis on visual sensitization producing a bent for dramatization' and 'a largely unconscious belief in the magic of action'. She goes on to say, '… the common genetic situation which combines with or sometimes partly produces these characteristics, and the accompanying general tendency to act out, consists in a distortion in relation of action to speech and verbalized thought, arising most often from severe disturbances in the second year'. She notes that the frequently distorted speech serves the motor discharge of tension rather than the establishment of communication or any distillation of a situation into thought. 'The capacity to verbalize and to think in verbal terms seems to represent an enormous advance not only in the economy of communication, but also in a focusing of the emotions which are associated with the content thought … An incompletely developed sense of reality has appeared characteristic of many of these patients. But chronic or habitual acting out is a repetition of past events and an establishing of transference relationships with too great a burden, from the second year of life. Both are lived out and presented without the sufficient emotional equipment or the methods of communication that belong to later development. This symptom complex is intensified when, in addition, a