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Erard, R.E. (1983). New Wine in Old Skins: A Reappraisal of the Concept 'Acting Out'. Int. R. Psycho-Anal., 10:63-73.

(1983). International Review of Psycho-Analysis, 10:63-73

New Wine in Old Skins: A Reappraisal of the Concept 'Acting Out'

Robert E. Erard

SUMMARY

In 'Remembering, repeating, and working-through' (1914), Freud observed that when analysis was conducted by what he called the 'newer technique', in which the patient's defences were to be analysed and worked through rather than prohibited, patients tended to repeat or act out the origins of their illness rather than remember them. To the extent that such

repetitions were confined to the transference neurosis as 'an intermediate region between illness and real life' they constituted 'the patient's way of remembering' and, as such, advanced the treatment. The main technical difficulty arose when the patient's behaviour remained, in effect, a 'piece of real life' which resisted confinement to the transference neurosis and undermined the treatment process.

While only resistance in this latter sense of being antagonistic to treatment by the newer technique was still worthy of the name, Freud (evidently unprepared as yet to revise fully his abreactive theory of cure) continued to use the term 'resistance' to denote any defensive effort to avoid remembering. Further, in discussing the clinical manifestations of resistance, Freud failed to draw any clear distinction between repetition in the transference and other forms of acting out.

Since resistant behaviour in treatment may itself in principle be a form of repetition, acting out is best understood not in contrast to transference resistances but rather as a specific type of transference resistance the function of which is to undermine the requisite treatment conditions in which a transference neurosis can be established and maintained. Specifically, I am proposing that the term 'acting out' be used to denote behaviour threatening the professional relationship, the health or safety of analyst or patient, or the treatment alliance, in so far as it is used as a defence against affects or fantasies attending the development of the transference neurosis.

In contrast to resistance against remembering or insight in general, on the one hand, and simple impulsive behaviour on the other, acting out requires interpretation not only in terms of the specific fantasy or affect against which it defends but also in terms of its function of undermining the specific conditions in which effective treatment can occur.

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