ABSTRACT
In this chapter, the author explores the implications of experiences with autistic and primitive mental states for our understanding of obsessional mechanisms and the suffering of some of so-called 'neurotic patients'. The author refers to obsessionality rather than obsessive neurosis, since he would like to highlight the role played by primal psychotic and autistic aspects of the personality in obsessional patients, hence reiterating the imperative of working with more primal, unmentalized layers of the mind. The need to meet the patient at a more primal level of psychic functioning has been highlighted by several authors, yet the obsessional patient seems to present the analyst with a further difficulty. These patients, whose verbal capacity is often highly developed, stimulate in the analyst an overreliance on verbal content, distracting him from the nonverbal and unverbalizable elements of the total transference situation.
