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DISCUSSION: Dr. Edith Jacobson spoke of the narcissistic nature of these patients. She felt that people with the problems described by Dr. Milrod are borderline patients, with more problems of ego defect than we usually see in analytic patients. The patients who feel and experience these states also manage to struggle with their environment and turn much of their aggression away
from themselves and onto their objects. She wondered about the paranoid trends in such patients, and if the libidinization of the self-representation might not help them to ward off paranoid attitudes.
Dr. Martin Stein classified states of self-pity and self-comforting into two types: 1, there is the affective state of self-pity which is a transient response and occurs in almost everyone; and 2, there is a state of self-pitying and self-comforting which is not transient but is a conspicuous character trait. The transient form is often related to the wish to elicit some sort of comforting, consideration, and pity on the part of the analyst, or may be a specific response to the analyst's lack of understanding of his patient. Where self-pity is a conspicuous character trait, self-indulgence is prominent and one gets the impression that the patient is actually enjoying it. Narcissistic attitudes are prominent and there is often frank paranoia. In this second type, one finds enormous hostility. Dr. Stein did not agree with Dr. Milrod's emphasis on the role of the superego, especially its rewarding function, in this type of behavior.