Discussion of Herbert A. Rosenfeld's Article, The Need of Patients to Act Out During Analysis

Dr. Rosenfeld has attempted to clarify the process of “acting out” in analysis by tracing it back to its genesis in the splitting process in the paranoid-schizoid position of early infancy, and he has gone one step further in elaborating the crucial differences in the origins of schizophrenic and non-schizophrenic “acting out.”

Essentially, he states that, in non-schizophrenic “acting out” excessive splitting between the “good” and the “bad” breast, due to

excessive hostility, causes a violent turning away from the primal object (breast-mother) and an equally intense need to idealize the secondary object. The “acting out” would, therefore, be a defense against intolerable guilt which would emerge if “good” things were remembered about the unequivocally “bad” objects. “Acting out” is, therefore, a manic defense against this unacceptable feeling. In the analytic transference situation, it is shown by excessive “acting out” behavior, which is resistant to insight and parallels an excessive idealization or contempt of the analyst without mitigating ambivalence.

In schizophrenics, “acting out” is a defense against a confusional state caused by insufficient splitting, owing to the operation of excessive envy, which does not allow for sufficient development of the good object and, thus, does not permit clear distinction between “good” and “bad”; hence, the confusional state.

I feel Dr. Rosenfeld has greatly added to our understanding of this vexing and recalcitrant problem and has given “acting out” a new dimension which has hitherto been lacking. We always understood “acting out” as a defense against memory, and we knew it was oral in origin. Beyond that, we were at sea. Now we have a guide to follow, namely, the relative degree to which the patient is fixated in the paranoid-schizoid position, with its attendant splitting between excessively “good” and “bad” objects, and the violence of the turning away from the primal object. The degree to which the patient can be brough