You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
The author reviews classical psychoanalytic theory on the origin and development of obsessive-compulsive symptoms. The work of Freud and Abraham on the retreat from the oedipal conflict to the anal-sadistic level is contrasted with current work on pregenital developmental disturbances which prevent entry into the oedipal phase, a concept first suggested by Fenichel. On the basis of his clinical experience, Quint finds that in some cases of obsessive-compulsive organization, pregenital developmental aspects are uppermost, and the symptoms do not represent so much the regression from oedipal strivings that Freud described but rather a fixation at the anal-sadistic object level. The debate about whether regression is indispensable for the development of obsessive symptoms leads to more comprehensive questions on the function of such symptoms as addiction, perversions, and psychosomatic complaints. Quint contrasts ego strengths in neurotic and borderline patients and discusses the function of symptoms for the borderline patient. He suggests that these severe symptoms serve the important function of protecting a fragile sense of self and identity from further regression; that is, they serve the function of secondary repair of the self and defense against disintegration of the self in severely disturbed patients with fragile ego structure. Quint argues that the same function may be served by obsessive symptoms. He illustrates this with the treatment of a severely obsessional young man, showing the contrast in this case with the classical formulations concerning obsessive symptoms. He claims that the repetition compulsion in this patient was in the service of maintenance of the self, in contrast to Freud's view of it as a derivative of the death instinct with the goal of restoration to a primordial state. The author emphasizes the self-preservative and the ego preservative aspects of the repetition compulsion, in the service of maintaining a precariously achieved