Meetings of the Psychoanalytic Association of New York

October 20, 1969. SECONDARY REVISION, SECONDARY ELABORATION AND EGO SYNTHESIS. Austin Silber, M.D.

Secondary revision in dreams is a complex function which serves the ego, superego, and other structures, and uses primary and secondary processes. Secondary revision proper employs defenses within the ego to obscure from the dreamer the meaning of his dream. It is autonomous and relatively stable, affected only by drives and external stimulation. Embedded within it is the synthetic function, which is unique to the secondary process and independent of the demands of instinctual drives and of reality. Silber suggests that secondary elaboration be reserved for functions that pertain to the dream and to the maintenance of its disguise. It is less autonomous than 'secondary revision'. It is affected more by 'experience', such as the analytic situation.

The manner of operation of secondary elaboration and its synthetic function drastically affect the efficacy of treatment because the synthetic functions embodied in it are bound up with the oscillations in the state of the relationship with the analyst, and with the intensity of the resistance encountered in the treatment. The synthetic function which forms part of secondary elaboration can probably be altered by 'experience' and can be put to a defensive use by the patient. It would be an interesting observation. Integration of interpretations and acquisition of insight may thus be affected by the state of the patient's relationship with the analyst as much as by the cogency of his remarks. Intense resistance manifested during recitation of a dream brought about changes in function that permitted observation of the process. The energy of synthetic function in secondary elaboration (or its correlate during analytic work) perhaps continually varies according to the relationship with the therapist and the intensity of resistance.