Meetings of the New York Psychoanalytic Society

November 16, 1954. A CONTRIBUTION TO THE PROBLEM OF PREGENITAL CHARACTER DISORDER. Isidor Silbermann, M.D.

The similarities in structure and function of two types of character disorder and their infantile prototypes, described in the literature as the autistic psychotic child and the symbiotic psychotic child, are described. Quoting Hartmann on the hereditary transmission of the autonomous part of the ego, the constituent factors—sense of perception, primordial memory, quality of primitive differentiation and synthesis, function of self-preservation, inhibitory function serving postponement of discharge, motoric and sensoric function, and the basic function of neutralization—are defined. Neutralized drives do not appear as identical neutral energies but retain specific propensities. In the ego, neutralized libido appears as the organizing force, as the synthesizing power in its various forms and as the energy responsible for the secondary process. Neutralized aggression travels in the direction of differentiation, abstraction, censorship, inhibitory function, defenses. The consequences of distorted ego functioning are multiple. The relationship of the infant and neonate to the mother is briefly reviewed. From unity with the mother the child slowly proceeds to the establishment of an ego. Symbiosis is an expression of the eros, but with advancing years it slowly recedes when aggressive drives gain priority. The mother-child bond can be pathological for such various reasons as inherent structural defects of the ego, a psychopathological mother, or other environmental damages. After discussing the autistic psychotic child (Kanner) and the symbiotic psychotic child (Mahler), Dr. Silbermann described two analogous types of adult patients encountered in psychoanalysis. Common characteristics of both types include anxiety attacks, phobias, bisexual conflicts, depressions, and marked ambivalence. They are cognizant of their brittle, fragile relationships and th