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Holzman, P.S. (1971). Follow-Up. J. Amer. Psychoanal. Assn., 19:110-121.

(1971). Journal of the American Psychoanalytic Association, 19:110-121

Follow-Up

Philip S. Holzman, Ph.D.

In her opening remarks, Henriette Klein, as chairman of the panel, noted an increasing interest in the testing of psychoanalytic hypotheses as these emerge from the psychoanalytic situation. Such scientific endeavors include the use of longitudinal methods to supplement or complement the retrospective method of the therapeutic psychoanalysis. Two examples of such research were presented at this panel.

George E. Vaillant reported some results of an extensive study of 240 persons who were examined by interview and questionnaire methods at two-year intervals over a period of 30 years. The subjects were chosen in 1940 while they were college sophomores, and were presumed to have been psychologically and physically healthy, and to be more intelligent, more verbal, in better physical health, and to have better motivation for achievement than the average college student. Over the 30-year period of the study, there has been virtually no attrition rate in the sample. Although the probes have been gross in comparison with the fine details that can emerge from a psychoanalysis, from periodic depth interviews, or from projective testing, gross observations can become an asset for formulating a case structure over this long period of time. The principal focus of the research was on the continuity of defensive behavior. Behavior shifts unfold in linear fashion and can be observed only as fast as they occur; Vaillant's periodic interviews may be compared, then, with time lapse photography, in that they present in a short interval the major shifts in style of defense which took place over 30 years.

The conceptual scheme in which Vaillant's group viewed defenses takes the form of a hierarchy. The first level, containing psychotic denial, distortion, and delusion, is labeled narcissistic. These defenses are discernible in healthy persons prior to the age of five, and in adults they continue to appear in primary-process formations such as dreams and fantasies.

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