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The development of a transference neurosis in analysis necessitates regression to a point of fixation. In this state the patient may experience narcissistic gratification and protection from narcissistic injury. He is acting out toward the analyst early patterns of behavior established in relationship to parental figures, especially mother. The analyst, serving as an ideal ego and as a tolerant externalized superego, permits the lifting of repression and direct expression of instinctual drives. The patient often resists abandoning this new found equilibrium, and thus a refractory transference resistance develops. The patient rationalizes his activity; he becomes compliant toward his image of the analyst; he may become skilful in provoking the analyst to assume attitudes that are favorable to the maintenance of the state of regression. He manages to convince himself that he is normal and at the same time dispels feelings of guilt and anxiety. In this manner a stalemate develops in the analysis. The analyst's task in such a case is to help the patient abandon his point of fixation. In order to do this it is necessary for the analyst to withhold any gratification. In such cases interpretation is often insufficient, and it may then become necessary for the analyst to employ silence as a means of withholding gratification or even to indicate a loss of interest in the case. Such a position on the part of the analyst may reverse the patient's alloplastic tendencies and arouse the feelings of guilt and anxiety that must be accessible for working through as a prerequisite to progress in the analysis.
The principal discussants of this paper included Drs. Waelder, Flumerfelt, Katan, and Marcovitz. It was the consensus that the problems to which Dr. Sloane