Meetings of the New York Psychoanalytic Society

DISCUSSION: Dr. Robert Dickes discussed a variety of altered states of consciousness, including the hypnoid state. He stressed their function as a defense against unacceptable sexual and aggressive impulses, especially when repression fails. Dr. Richard Drooz called attention to the complication of the mother transference in this situation by noting the "antitransference" role of the analyst, providing the negative of the blissful state which the patient achieved in his sexual experience with his mother. This conception of the opposition of the analyst to the union of patient and mother led to a complete ignoring of the analyst by the use of this defensive and hostile maneuver. Dr. Daniel Papernik related an instance of the use of the hypnoid state for defensive purposes, which was abetted by the conflicted patient's removal of her eyeglasses, thereby reducing the clarity of visual stimuli. Combining this with a diminishing of alertness and a monotonous tone of voice, she effectively "tuned out," repeating a maneuver that harked back to her reaction to a tonsillectomy at two and a half and to instances of the aborting of hostility toward her father. Dr. Jerome Silverman spoke of the technical problems occasioned by the degree to which identification with the aggressor interfered with the ability to use the analysis, something he felt could possibly have warranted treating the patient sitting up, more wakeful and more directly oriented toward reality. In general, the discussants referred to the ubiquitousness of the use of hypnoid states as a defense, although several different meanings and contexts were shown to warrant consideration in a number of illustrative clinical vignettes. Dr. Silber, in his summary, focused on the combination of defensive and gratifying functions served by this symptom and on the damage done by so primitive a parent-child interaction.