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Alexander, F. (1956). Two Forms of Regression and their Therapeutic Implications. Psychoanal Q., 25:178-196.

(1956). Psychoanalytic Quarterly, 25:178-196

Two Forms of Regression and their Therapeutic Implications

Franz Alexander, M.D.

SUMMARY

Originally Freud described regression as a trend to return from a later acquired, more advanced form of ego and instinct organization to a more primitive phase. This occurs when the ego is confronted with a conflict situation it cannot master and returns to a phase of its development which was still successful: it returns to a preconflictual state ('fixation points'). The greater the cathexis of the fixation point, the more likely will be a regression to it if later conflicts arise. Later Freud described another type of regression and fixation: fixation to an unresolved traumatic conflict. Traumatic dreams are common examples. The return to such unsettled traumatic situations does not serve any gratification. They are painful and cannot be explained by the assumption that the organism is always motivated by avoiding the unpleasant tensions caused by the pressure of unsatisfied instinctual needs which it tries to eliminate by seeking gratification which in itself is pleasurable. Freud's explanation for this type of phenomena was that the ego's fundamental task is to maintain a stable equilibrium within the mental apparatus; if it fails to fulfil this task, it retains a tendency to achieve a belated mastery. It again and again returns to the traumatic event in order to resolve the tension.

Fenichel has pointed out that the concept of repetition compulsion should be revised in the light of these new formulations. He showed that the term repetition compulsion refers to quite different phenomena. He describes three of these: first, repetition compulsion which is based on periodicity of instinct; second, repetitions due to the tendency of the repressed to find an outlet; and finally, repetitions of traumatic events for the purpose of achieving a belated mastery. In spite of its theoretical significance this principle of mastery has not yet been applied for the understanding of the therapeutic process.

The transference manifestations of the patient are the best known examples of the repetition compulsion. In this paper it is demonstrated that the regression in the transference can follow

both types of regression described by Freud: a regressive evasion of an unsettled conflict by returning to a preconflictual adaptation or a return to an unresolved conflict in the past. The significance of these two types of transference mechanisms is quite different from the point of view of therapy. Evasive retreat to preconflictual adaptations is in the service of resistance, while return to an unsettled conflict for its belated mastery runs parallel with our therapeutic effort. A differentiation between these two kinds of transference manifestations is important from the point of view of our interpretations. It has been known and repeatedly described in psychoanalytic literature that patients often dwell upon a type of material for which the analyst shows interest. If the analyst interprets evasive regressive material as pathogenically significant, this gives the patient opportunity to use such material as resistance: by dwelling on it he will procrastinate, turning to chronologically later but pathogenically more important material. In other words, our interpretation should express our judgment concerning the nature of a transference manifestation: whether it is regressive evasion or an attempt at belated mastery.

Pregenital material is often evasive regression from the Oedipal conflict. In some cases, however, it may signify a return to early unsettled pregenital conflicts, but in most cases this is not an 'either-or' situation. A patient seldom returns to a completely conflict-free period but regresses to a relatively conflict-free period. In other words, he chooses the lesser evil. In these situations the analysis of such defensive material contributes to our therapeutic goal: it gives opportunity to resolve earlier conflicts of pathogenic significance which contributed to the central conflict of later origin. In this paper it is demonstrated that the two types of regression are mostly mixed and the therapist's task consists in estimating their relative significance in the transference manifestations of the patient.

Two general conclusions are made: 1, chronological depth is not always equivalent to pathogenic depth; 2, it is fallacious to attempt to find one general formula valid for all cases.

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