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(1954). The Psychoanalytic Review. XL, 1953: The 'Primary Constellation' in the Structure and Treatment of Psychoses. Joachim Flescher. Pp. 197-214.. Psychoanal Q., 23:461-462.
Psychoanalytic Electronic Publishing: The Psychoanalytic Review. XL, 1953: The 'Primary Constellation' in the Structure and Treatment of Psychoses. Joachim Flescher. Pp. 197-214.

(1954). Psychoanalytic Quarterly, 23:461-462

The Psychoanalytic Review. XL, 1953: The 'Primary Constellation' in the Structure and Treatment of Psychoses. Joachim Flescher. Pp. 197-214.

The favorable results of electroshock therapy result from discharge of destructive energies, pent up on a very primitive level. Only disorders in which such a dynamic need exists are benefited by this treatment. The improvement in psychotics depends on a change in the dynamic relationship between the erotic and the destructive (death) instincts, in favor of the former. The term 'primary constellation' refers to the quantitative relationship between these two instincts. The main problem in the treatment of psychotics is that the transference reaction is predominantly aggressive. This explains why manic-depressive psychosis reacts so favorably to shock: depression is the condition, par excellence, in which

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destructiveness is turned inward. The discharge of destructive energies brings improvement without dynamically influencing the interrelationships between superego and ego. Psychoses are interpreted as the result of traumas which strike the individual at such early and vulnerable developmental stages that they affect the dynamic interrelationship between the two primary instincts, augmenting the nonsexual drive.

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Article Citation

(1954). The Psychoanalytic Review. XL, 1953. Psychoanal. Q., 23:461-462

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