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(1960). Journal of the American Psychoanalytic Association. V, 1957: On the Oral Nature of Acting Out. A Case of Acting Out Between Parent and Child. Leon L. Altman. Pp. 648-662.. Psychoanal Q., 29:287-288.
Psychoanalytic Electronic Publishing: Journal of the American Psychoanalytic Association. V, 1957: On the Oral Nature of Acting Out. A Case of Acting Out Between Parent and Child. Leon L. Altman. Pp. 648-662.

(1960). Psychoanalytic Quarterly, 29:287-288

Journal of the American Psychoanalytic Association. V, 1957: On the Oral Nature of Acting Out. A Case of Acting Out Between Parent and Child. Leon L. Altman. Pp. 648-662.

The observation that both oral cravings and acting out need a satisfying object, demand immediate gratification, and have urgent incorporating tendencies without regard for the object leads Altman to view oral impulses and acting out as identical. When instinctual urges of both child and parent coincide there is a summation of effect. The child is threatened from within and without and has no chance of conflict-free fulfilment. Because of the partial instinctual gratification occurring in such acting out between parent and child the only course open is an effort to master and bind the excitation through repeated acting out, which produces a specific by-passing of the ego with a reversion to oral activity with further impairment of ego function.

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A detailed case report of a thirty-year-old man demonstrates these mechanisms and the summation effect when the instinctual urges of child and mother coincided. Everything the patient did had an oral imprint. The patient never had any real satisfaction with gratification of his repressed wishes because there was 'nothing in it for the ego'. The mother's acting out was frequently indiscernible from the patient's who had a great struggle in distinguishing that which belonged to his mother and that which was his. Derivatives of his interacting relation with his mother appeared in all of the patient's relations outside the analysis as well as in it. After much struggle in the analysis he was extricated from this trap through the experience of transference in which his conflicts came to the fore and in which he relived his infantile experiences without the bilateral acting out which had paralyzed his attempts to find a solution. Altman states that without taking into account and validating for the patient the real fact of his mother's actions no progress would have been possible. Acting out outside of the treatment became converted into acting out in the analysis, and thought replaced action. The patient must act out until he develops some tolerant observing ego which is able to defer immediate action, reflect, and find an adaptive solution to conflicts.

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Article Citation

(1960). Journal of the American Psychoanalytic Association. V, 1957. Psychoanal. Q., 29:287-288

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