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Khan, M.R. (1964). Ego Distortion, Cumulative Trauma, and the Role of Reconstruction in the Analytic Situation. Int. J. Psycho-Anal., 45:272-279.

(1964). International Journal of Psycho-Analysis, 45:272-279

Ego Distortion, Cumulative Trauma, and the Role of Reconstruction in the Analytic Situation

M. Masud R. Khan


Reconstruction of the genetic data has been the prime concern of the clinical analytic situation. That historic and fateful patient, Anna O., when she compelled Breuer to listen to her 'chimney sweeping' narrative, had launched the process of reconstruction (Breuer and Freud, 1895). It remained for Freud to discover and establish the complexity of its dynamic therapeutic implications and to transmute it into a clinical instrument (Breuer and Freud, 1895, chap. IV); (Freud, 1911–15). The vicissitudes of Freud's attempts to establish the reconstructive process in the analytic situation are vividly described by him (Freud, 1897, letter 69); (1914). He was dismayed at first to realize that all the stories his patients had been telling him of seductions at the hands of their relatives were mere fantasies and not the truth. He recovered from this to discover that what mattered was not the actuality of the environmental factor but the affective reality of the repressed and dissociated unconscious fantasies relating to these persons. Since then a great deal has been argued about the environmental versus the endopsychic factors (cf. Glover and Brierley, 1940); (Kris, 1950). In the past two decades researches in ego psychology and infant-care techniques have enabled us to re-evaluate the role of the environmental factor in a truer perspective vis-à-vis early ego formation and character structure (cf. Coleman, Kris and Provence, 1953); (Winnicott, 1948).

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