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Guédeney relies on clinical material gathered over several years by a multidisciplinary team. She attempts to understand in psychoanalytic terms the first seizure in cases of essential epilepsy in which there is no evident neurological lesion. She finds that these first seizures have much in common. In general they
occur in early childhood in a context of psychic tensions for the individual and for the family, and they are most often preceded by a decisive event. Hence the economic factor is of major importance. The defenses of the ego are precarious in the face of intense drive tensions. The psychological elements in such a seizure are projection, failure of repression, and failure of symbolization. The ego is forced to resort to primitive defense mechanisms such as destructuralizing, regression, and splitting. This splitting involves the loss of consciousness and amnesia for the seizure. The epileptic is forced into a quasi-biological regression and attempts to flee from the threatened danger by this regression. A comparison with dreams and with the hysterical attack is helpful. The regression in epilepsy goes far beyond the hallucinatory wish fulfillment of the dream experience and returns to fixation points probably preceding the formation of the ego. In contrast to hysterical attacks, there is a complete failure of symbolization.