This paper considers the interrelationship of the mechanisms of symptom-formation and the mechanisms of defense as observable in phobias and obsessive thoughts.
Displacement, which occurs in phobias, can be regarded as a mechanism of symptom-formation and at the same time as a mechanism of defense. Ego activity occurs in defense mechanisms. Displacement is regarded as a diphasic act: the first phase consists of inhibitory acts and the second of the potential release of impulses or drives. The inhibition of Oedipal impulses is not specific for displacement but is an essential precursor of displacement. Release of the impulse may follow the essential (decisive) repression only after a long time. The release is an ego activity even though the impulse may have a passive aim. Thus in animal phobias there is a high degree of condensation: there is a double identification with both parents, and the impulses are bisexual.
The essence of phobic anxiety is castrationanxiety. Under pressure of this fear many defense mechanisms besides repression are called into play against the Oedipal impulses, including especially regression. The specific content of the phobic anxiety is determined by the pregenital impulses regressively reactivated and released. Such a release activates anxiety, which in turn must be avoided, and the specific defense, phobic avoidance, results. The phobic avoidance, however, is a defense against a symptom and not against the drives directly. It appears after the symptom, the phobia, has crystallized. The distinction between defenses before and after the symptoms is important. It allows us to localize the defenses outside of the symptom and to look for the ego activity where it can be found. However, if a phobia is to develop, the impulses released in the displacement must have sufficient intensity and the ego must be weak when the displacement occurs.
In certain phobias the displacement is only partial. The danger remains internalized and related to the danger arising from the demand of the instinctual drives. The anxiety centers around overwhelming vegetative sensations. In these cases the phobic reaction originates in and remains focused on phallic conflicts, specifically infantile masturbatory activities.
Obsessive thoughts represent the perception of a highly cathected but desexualized impulse. The drive, because of desexualization, appears ego-alien. The desexualization responsible for the formal character of the symptom is accomplished through individually variable defensive activities. A reliable clinical indicator of these defenses is the fact that if at any time they are interfered with anxiety is experienced.
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(1954). Journal of the American Psychoanalytic Association. I, 1953. Psychoanal. Q., 23:294