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Spitz, R.A. (1955). The Primal Cavity—A Contribution to the Genesis of Perception and its Role for Psychoanalytic Theory. Psychoanal. St. Child, 10:215-240.
(1955). Psychoanalytic Study of the Child, 10:215-240
The Primal Cavity—A Contribution to the Genesis of Perception and its Role for Psychoanalytic Theory
René A. Spitz, M.D.
We may summarize by saying that adults, who operate on the level of the symbolic function, will regress normally to the level of visual perception and imagery in the dream; it is at this level that Lewin's dream screen becomes perceivable. When a disturbance of going to sleep occurs, as in febrile disease, or when a dissociation of the ego in waking states takes place, then a further regression to the level of the coenesthetic perception may occur in which the Isakower phenomenon becomes available.
The level of coenesthetic perception belongs to what I would call the experiential world of the primal cavity. It is the world of the deepest security which man ever experiences after birth, in which he rests encompassed and quiescent. It is to this world that man escapes when he feels threatened by pathological conditions in febrile states; also when in the waking state the ego becomes helpless through dissociation, as in toxic conditions. The method of escape has a double mechanism: the withdrawal of cathexis from the sensorium, on one hand, the hypercathexis
of the body ego, on the other. The particular sector of the body egorepresentation which seems most highly cathected is the representation of the primal cavity. This distribution of cathexis makes the experience of the Isakower phenomenon possible.
From the point of view of therapy these considerations underscore the necessity of understanding the patient in terms of earliest orality, as has been stressed repeatedly by Lewin. When we deal with the adult, however, the approach to earliest orality is not a direct one, for the mnemic traces of earliest primal cavity experiences as such are not available to the patient and cannot be communicated to him by the therapist in terms of these experiences—the terms for them do not exist in language, they can only be paraphrased. Many, but certainly not all mnemic traces of the primal cavity experiences are attached in the course of development to memory traces in the nature of images, acquired and mediated by the visual and by the auditive senses. Later still, in the course of the elaboration of the symbolic function, word representations will be attached to these images. This is the linkage between the memory traces of object representations and the memory traces of word representations. The therapist, in his therapeutic endeavor, has to travel this road in the inverse direction, from the abstractive word to the concrete representation that evoked the original affect.
A better understanding of the intraoral experience and of its ramifications into experiences of hand and skin surface suggests nonanalytical therapies in the case of the deeply regressed psychoses. Up to now such therapies have scarcely yet been attempted.
The world of the primal cavity is a strange one: indistinct, vague, pleasurable and unpleasurable at the same time, it bridges the chasm
between inside and outside, between passivity and action. The earliest sensory experiences of events taking place in the primal cavity are dealt with on the level of the primary process, yet they lead to the development of the secondary process.
In its nondifferentiation this world is the matrix of both introjection and projection, which therefore appear primarily normal phenomena, though we become really aware of their proliferation in pathological processes.
The perceptive modality of the primal cavity will also form the matrix for later developmental stages of perception in sensory organs with a very different function. The specific morphology of the particular organ will determine the mode of function—yet it will hark back to the inside-outside mode established by the intraoral experience, as for instance in the distinction between the "I" and the "non-I," the "self" and the "non-self."
We may say in conclusion that the mouth as the primal cavity is the bridge between inner reception and outer perception; it is the cradle of all external perception and its basic model; it is the place of transition for the development of intentional activity, for the emergence of volition from passivity.
When, however, the body relaxes diurnally in the passivity of sleep, the activity of the mind will retrace its way toward the primal process, and the primal cavity then becomes the cavernous home of the dreams.
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