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Silber, A. (1989). Panic Attacks Facilitating Recall and Mastery: Implications for Psychoanalytic Technique. J. Amer. Psychoanal. Assn., 37:337-364.

(1989). Journal of the American Psychoanalytic Association, 37:337-364

Panic Attacks Facilitating Recall and Mastery: Implications for Psychoanalytic Technique

Austin Silber, M.D.


A patient, during the course of a lengthy analysis, experienced several panic attacks. These regressive episodes, occurring only in the analytic setting, provided her with her special means for recalling and eventually mastering repressed elements of her life. This facilitating aspect of her disorganization, when identified and analyzed as such, helped deepen the patient's analytic experience.

It was necessary for the analyst to define verbally and clarify her reconstructed past as it emerged as part of her panic state, transferentially, so that the patient could finally recognize, acknowledge, and understand hitherto hidden aspects of her life.

The psychiatric literature in regard to panic states is briefly noted, as is the relevance of comparing the present almost exclusively organic, pharmacological orientation, with Freud's discussion of the "actual" or current neuroses of his day, almost a century ago. On the basis of this case report, the importance of understanding the content and meaning of the panic attack, by analytic means, is once again emphasized.

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