Meeting of the Psychoanalytic Association of New York

March 17, 1975. PANEL DISCUSSION: RECONSTRUCTION IN CHILD AND ADULT PSYCHOANALYSIS. Jules Glenn, M.D., Moderator; William G. Niederland, M.D.; Peter B. Neubauer, M.D.; Henry Rosner, M.D.

Dr. Jules Glenn opened the discussion with a general description of reconstruction. The analyst observes with the patient current urges and defenses, and uses the past to put these into perspective and to trace their origins. Reconstructions are used by the analyst and the patient to fill gaps in memory and to correct distortions. A reconstruction may be of a memory of an external event, of an internal event, of a reaction to an event, or of connections between events. The analyst uses the reconstruction to aid his own understanding, and at the appropriate time he may present the reconstruction to the patient. The analyst and patient can then further refine and correct the reconstruction. The panel was asked to consider whether reconstruction is the same in child analysis as in adult analysis, and to discuss the scientific and therapeutic values of reconstruction.

Dr. William Niederland presented two clinical vignettes. The first was a report of the psychotherapy of a twenty-year-old man, diagnosed as having hebephrenic schizophrenia. He repetitively sang advertising jingles, made grimaces, removed pencils from the analyst's desk and threw them on the floor. The patient always dressed warmly—even on hot summer days he wore woolen sweaters, scarves, etc. because he felt "warmer with them." After several months, the family was told that no progress was being made, but they requested Dr. Niederland to continue treatment as they sensed some change in the patient. One day the patient told Dr. Niederland, "You look like Mr. Magoo." Since Mr. Magoo is very nearsighted, Dr. Niederland thought the patient might be telling him he was blind to something. After two years, the patient reported a dream. He was at the North Pole on a dark, cold night, lying on a big block of ice "th