Chapter 20. Symptomatology and Diagnosis

To sum up, we learn from Freud that, clinically, regression may have four functions: (a) as a mechanism of defence, (b) as a factor in pathogenesis, (c) as a potent form of resistance, and (d) as an essential factor in analytic therapy.

In this Part, I shall discuss only a small sector of the complex field of regression, comprising the phenomena observable during analytic treatment. This limitation practically excludes regression as a mechanism of defence, since cases of serious hallucinations are rather rare in my ambulant practice. Furthermore, this will make the study of regression as a pathogenic factor somewhat limited and one-sided. This is because during analysis regression is treated as a temporary measure only; although regression is tolerated, the patient is not supposed to settle down in it and establish it as an acceptable solution. Studied in this way, regression in its pathogenic function appears hardly as an event of the past, but rather as a dynamic process of the present; one sees it coming, taking over the situation, ruling it for some time, relinquishing its hold to some other powers, for instance reality, and then disappearing. Evidently, the two functions that an analyst can observe most frequently during treatment are regression as a form of resistance, and regression as a therapeutic ally.

I intend to discuss this field under three headings. First, the symptomatology and the diagnosis of regression. The relevant questions will be: what constitutes a regression during analysis, that is, what are its differential diagnostic criteria? Does it occur only in one form or, if in several, what are these various forms? The second group of questions relates to its dynamism. What are the essential events during a phase of regression and what is the specific significance of each of these events? And, lastly, the third group of questions will be about technique and therapy. This last group will only be touched upon in this Part, for I intend to discuss it in