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Joseph, B. (1966). Persecutory Anxiety in a Four–year–old Boy. Int. J. Psycho-Anal., 47:184-188.

(1966). International Journal of Psycho-Analysis, 47:184-188

Persecutory Anxiety in a Four–year–old Boy

Betty Joseph

Child analysis presents us with a unique opportunity to observe primitive and fluctuating anxieties being expressed directly, and with this to see shifting defensive processes being mobilized vividly in the play room. This gives to our work a special research value. One of the purposes of this paper is to show how the analysis of a small child reveals the economic factors which determine the emergence of an obsessional neurosis. In this way child analysis can demonstrate that the problem of 'choice of neurosis' is really a question of 'defensive preference' going back to the earliest times of life. These preferred defences can be used with varying rigidity against any anxiety constellation, giving a different clinical picture according to the underlying anxieties.

In the case to be discussed I aim to show how this little boy using, primarily defences of splitting, projective identification, and omnipotent control over his objects, progressed from a paranoid organization to an obsessional one during the first two years of his analysis.

It is interesting to note that Abraham, writing in 1924, connecting up his own work with that of Freud, could already state

We may now regard as definitely established the psychological affinity between melancholia and obsessional neuroses,

but the understanding of the relationship between obsessional neurosis and paranoia was not clarified until 1932. In that year Melanie Klein, working with extremely disturbed children, began to discuss how, as she put it

It seems to me that obsessional neurosis is an attempt to cure the psychotic conditions which underlie it and that in infantile neuroses both obsessional mechanisms and mechanisms belonging to a previous stage of development are already operative.

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