Meeting of the Psychoanalytic Association of New York

DISCUSSION: Dr. Eugene Halpert raised the question of how the patients described by Dr. Silverman can be differentiated from other patients with the same psychic and behavioral constellations who do not have underlying phobic or claustrophobic dynamics. He provided a case example of an obsessive-compulsive man who took pride in his independence, was an entrepreneur, and was controlling and competitive. Wishes to nurtured and fed were also prominent. The behavior and underlying dynamics of this obsessive-compulsive character matched very well the profile given by Dr. Silverman of the claustrophobic character. Therefore, "the question of what is unique to the development of the phobic character as opposed to, for example, the obsessive-compulsive character is a complex one… Issues of ego and superego development in the various character types would have to be addressed." Another question is: Why don't the characters described by Dr. Silverman end up as overtly symptomatic claustrophobes? Dr. Halpert speculated that this has to do with the nature of their identifications, particularly those inherent in the formation of the ego ideal. In Dr. Silverman's case history, the patient's father had been very phobic, and the patient had recalled phobic attitudes of his own during childhood. But he had been so troubled by his father's "weaknesses" that he forced himself to overcome his own. Dr. Halpert suggested that this patient had "both identified with his father's phobia (which equaled weakness) and competed with him; he would be stronger … and less feminine than father by not being phobic." Being overtly phobic would be a "blow to aspects of his masculine ego ideal"; therefore, his own phobia had to be hidden. Dr. Halpert's obsessional patient had different sorts of identifications but a similar need to hide these identifications from himself. Dr. Halpert than indicated that he had other questions but had decided, in keeping with the topic, "to avoid them."

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