Case Discussion and Position Statement

Any separation of the intrapsychic from the interactional or interpersonal is arbitrary. Those who think that the patient is replicating, in the present, interactional patterns of his childhood of the past, neglect the fact that these patterns are transformed and structuralized intrapsychically. There is no simple blind repetition of the past in the present. The past is organized within the subjectivity of the individual into structures. It is this internalized structure which is replayed. Escalona (1968) used the phrase “pattern of concrete experience” to delineate an intermediate domain where individual endowment and stimuli from the environment blend in subjective experience, which in turn affects and influences further interactions with the environment. Thus, the intrapsychic and the interpersonal are in ongoing interchange through projection or introjection, or, in other terms, through assimilation or accommodation.

The more severe the psychopathology, the wider the gap between actual and intrapsychic experience, and the less direct is the relation between present and past experience, as well as the influence of the past on the present. It is important that those who think everything is intrapsychic see the past only in terms of its