Meetings of the New York Psychoanalytic Society

DISCUSSION: Dr. Milton Horowitz agreed with Dr. Willick's hypotheses and noted that current discussions of primitive defenses often confuse the dynamic and the genetic considerations of psychoanalysis. Defenses are to be understood, as are all other analytic data, in terms of structure, function, and developmental history. The distinction between the dynamic and the genetic viewpoints may be crucial to the deeper understanding of the "here and now" phenomena of the analysis. "The course of development is so complex … that we can no longer conceive of development as having a straight line continuity or an onion skin layering. What may be labeled primitive or more developed in one patient may have a completely different functional, structural, and genetic history in another … a fixation in one patient may be the result of a complex regressive automatism in another." Dr. Horowitz felt that Dr. Willick's views have far-ranging implications for psychoanalytic technique. He stated that "focus upon the primitive often leads to technical prescriptions emphasizing affective and empathic responses from the analyst and minimizing the role of interpretation and insight. It tends to offer replacement therapy in a mother-child context and to view the adult patient as an undeveloped child rather than as an adult with a specific, complex developmental history." Dr. Theodore Jacobs suggested some modification of Dr. Willick's views. He stated that the changing clinical picture, when