Discussion of Peter L. Giovacchini's Article, Regressed States, Timelessness, and Ego Synthesis

I find much in Dr. Giovacchini's paper that I agree with. I concur with his contention that character neurosis springs from pathology in earliest infancy and that it may be amenable to psychoanalytic treatment, provided that sufficiently primitive layers of the personality are reached.

I agree with him also in what he says about interpretation, in terms of its structuring role as well as in terms of object relation (the introjection of the analysis via the interpretation). I would add to this that the interpretation provides a link, through symbolization between parts of the patient's self which are split off from one another.

Certainly, I agree with the contention that even the most regressed patient understands speech. I think that the only patients

unable to understand speech would be those who never developed the capacity for verbalization. In all others, including catatonic schizophrenics, the capacity to understand speech may be repressed or split off, but can be mobilized in psychoanalysis.

I am in accord with his technical procedure, believing as he does that the psychoanalytic treatment depends on the analyst's capacity to maintain a psychoanalytic attitude toward understanding and conveying his understanding to the patient, and that any actual attempt “to help” is, in fact, an interference in the psychoanalytic process.

Where I part company with Dr. Giovacchini is in some of his theoretical formulations. He says that the patient regresses to an original narcissistic stage, yet all his own clinical material shows clearly primitive object relations. Thus, he describes that his patient, at the height of his regression, has fantasies of being inside an ideal analyst. He also says, “the projection of archaic imagos characteristic of transference occurs in analysis when the ego or parts of the ego have undergone repression.” His description of his patient coming out of the state of fear of void and disintegration and “floating,” as it were, inside the ideal analy