DISCUSSION: Dr. Robert C. Bak stated that in his experience with ten patients with defects, he had often found factors which mitigated against a successful result—e.g., heightened dependency with consequent fear of aggressivity. When it appears that a precariously achieved balance will be upset by analysis, he favors early termination. He sees denial of the defect as the defense of choice and as adaptational.

Dr. William G. Niederland referred to the 'recognition shock' which parents undergo when they discover the defect. Open rejection of the child is usually unthinkable and is dealt with by oversolicitousness. In his patients with defects, Niederland found an uneven distribution of body cathexis. He emphasized that what might seem unimportant to the adult patient may have been of great importance to the child.