Two Psychoanalyses or One?*

A central focus of our work7 has been the distinction between psychopathology that is the product of intrapsychic conflicts and psychopathology that is the remnant of developmental deficits in the formation of psychological structure. At the heart of this distinction is the difference between defenses that ward off conflictual wishes and developmental arrests at prestages of defense which occur prior to the structuralization of self and object representations. Our distinction has been shown to shed new light on such clinical phenomena as narcissistic disorder, masochism and sadism, sexual fantasy and perverse activity, and symptoms such as death anxiety, hypochondriasis, and depersonalization. In addition, we have spelled out the important implications of the distinction for the specific framing of analytic interventions and for conceptualizing the psychoanalytic situation and the course and therapeutic action of psychoanalytic therapy.

Encountering the distinction between intrapsychic conflict and developmental arrest has led some analysts to ask: Do we now need two entirely separate psychoanalytic systems, one for patients with intrapsychic conflicts and the other for patients with developmental arrests? This question is grounded in two fundamental sources of conceptual error, one pertaining to the nature of psychoanalytic theorizing and the other to the meaning of the term “developmental arrest.” With regard to the former, the question of the need for two separate psychoanalytic systems is symptomatic of the tendency in psychoanalytic theorizing to pass beyond the domain of the clinical situation into the experience-distant realm of metapsychological postulates