chapter  11
Intractable Character Pathology as the Convergence of Repetition and Apraxia
Pages 16

In this chapter, I propose to differentiate one group of personality disturbances from the heterogeneous welter of archaic problems en­ countered in our consulting rooms -a group best characterized by its typical therapeutic course rather than phenomenologically. I shall also describe one successful approach to the psychoanalytic management of this group of patients. This method depends on persevering with painstaking reconstructive efforts to pinpoint the specifics of the devel­ opmental distortions that characterized the patient's early childhood. To this end, certain largely nonverbal enactments may have to be understood as crucial communications, like the play activities of young children in analysis (M. Klein, 1932j see also ch. 7, this volume). In a later phase of treatment, when the patient's deficits resulting from early developmental distortions have been identified, therapeutic inter­ ventions that transcend our usual interpretive technique may have to be employed.