Meetings of the Psychoanalytic Association of New York

DISCUSSION: Dr. Frank Berchenko does not doubt that the altered states of consciousness described are instigated for defensive purposes by the superego, but these are similar to other defenses involving a structural conflict. The sleep or trancelike states observed in the Balinese he believes to be adaptive behavioral patterns in reaction to the mother-child relationship and child rearing techniques. The universality of such a reactive behavioral pattern in a culture with a specific child rearing technique suggests that it originates from innate neurophysiological patterns. Dr. Berchenko does not think that so sharp a distinction should be made between the phenomena described by Dickes and the processes of falling asleep and sleeping.

Dr. Max Stern stressed the importance of distinguishing between the hypnotic and the hypnoid states; they are different in structure and effect. Underlying both is the state of quiescence (Spitz), a stupor reaction which is a response to overstimulation. But it leads to different results.

Dr. Melitta Sperling questioned whether the hypnoid state is a defense or a symptom in the transference which should direct the analyst to check both the transference and the countertransference. She wondered about the role of intense voyeuristic-exhibitionistic impulses in such situations, with unconscious repetition of primal scene experience. Under the guise of sleep the subject of the hypnoid state is permitted gratification of these impulses and a reliving, regressively, of childhood experiences. Dr. Sperling felt that the hypnoid state may reproduce aspects of the early nonverbal relationship to the parent.

Dr. Sandor Lorand noted that Ferenczi had characterized hypnoid states as a conversion symptom in the transference. There is a defensive aspect to sleep states on the couch, and they are a resistance in the sense that anything which interferes with the analysis is a resistance. Such patients on the couch behave like Balinese children,