Acting up and Physical Illness: Temporal Patterns and Emerging Structure

Abstract

Many psychoanalytic writers have viewed acting out and somatization as alternate routes for the discharge of uncontained aggressive impulses in borderline patients. In order to investigate this empirically, we tracked the occurrence of two related behaviors—acting up and physical illness—over the course of one patient's long-term hospitalization. Daily scores on these variables were analyzed using a time series procedure. Results indicated that as treatment progressed, acting up and physical illness became more synchronized, and this occurred just prior to symptom remission. Material from psychotherapy suggested that these behavioral changes were associated with the patient's increased ability to verbalize aggressive impulses in the context of fantasy and memory.

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References

Atkins

(1968). Acting out and psychosomatic illness as related regressive trends. Int. J. Psychoanal., 49:221–223

Bion

(1962). Learning from Experience. London: Heinemann

Cohen

(1960). A coefficient of agreement for nominal scales. Ed. Psychol. Meas., 20:37–46

Gottman

(1981). Time Series Analysis: A Comprehensive Introduction for Social Scientists. Cambridge, Eng.: Cambridge Univ. Press

Greenacre

(1968). The psychoanalytic process, transference, and acting out. Int. J. Psychoanal., 49:211–218

Grinberg

(1968). On acting out and its role in the psychoanalytic process. Int. J. Psychoanal., 49:171–178

McDougall

(1980). Plea for a Measure of Abnormality. New York: Int. Univ. Press

Rose

(1988). The Body in Time. New York: Wiley

Schur

(1955). Comments on the metapsychology of somatization. Psychoanal. Study Child, 10:119–164

10.

Sperling

(1968). Acting out behavior and psychosomatic symptoms: clinical and theoretical aspects. Int. J. Psychoanal., 49:250–253

11.

Spitz

R. A.

(1965). The First Year of Life. New York: Int. Univ. Press

12.

Valenstein

A. F.

(1973). On attachment to painful feelings and the negative therapeutic reaction. Psychoanal. Study Child, 28:365–392