Meetings of the Psychoanalytic Association of New York

March 20, 1967. ANALYSIS OF THE ISAKOWER PHENOMENON. Geraldine Fink, M.D.

After reviewing Isakower's formulation of the phenomenon that bears his name, Dr. Fink described ten possible features that may combine to produce an Isakower phenomenon. Isakower explained the phenomenon as a regressive solution of the conflict between an incestuous fantasy and the superego by substituting an earlier gratification for the disturbing genital instinctual wish, to which screen memories contribute. Dr. Fink makes more specific the source of the screen memories and the disturbing genital stimulation with associated prohibition. She hypothesizes that the Isakower phenomenon is a regressive phenomenon: the re-creation of solace at the mother's breast, brought on solely or chiefly as a defense against the memory of the primal scene and particularly the view of the female genitals.

Dr. Fink then presented a clinical example of a man in his early thirties who was born with severe keratoconus. He suffered from impotence and had many character problems. Following development of an intense, highly libidinized transference, he made a good symptomatic and characterological recovery. The key memory in treatment was seeing his mother sitting on the toilet. This turned out to be a masturbatory fantasy, a screen memory, and a transference fantasy. In his last year of analysis, in twelve sessions he recalled or experienced the Isakower phenomenon. After describing it in some detail, he began to refer to the experience as the 'checkerboard fantasy'. The visual component was to him its most essential feature, which no doubt had to do with visual sensitization due to his congenital impairment. It was also accompanied by disturbances of equilibrium and with noises, and he reported blurring of boundaries between his body and the external world. It occurred five times in the analytic sessions. Dr. Fink then described his associations to the Isakower phenomenon and presented two typical i