title: The exclusion of the other. A clinical contribution to an object-relations theory of obsessional defence.
abstract: The author begins by noting that the subject of obsessions and obsessional neurosis seems to have fallen out of favour with the analytic community in spite of the important part it played in the formation of Freud's theories, and notwithstanding the significance of its mechanisms in the maturation of the ego. He then discusses some theoretical considerations regarding the development of the taboo on touching and, by extension, contact. Attention is drawn to the parallels with autistic functioning emphasised by other authors. Particular importance is attached to the distinction between internal and external reality that arises during the anal-sadistic phase and that leads to polarisation and splitting in obsessional neurosis. Following a discussion of the transference-countertransference situation with obsessional patients and of their concretistic experience in the treatment situation, as also featured in the literature, an extensive case history exemplifies the author's contentions and shows how the patient concerned developed during the course of his analysis. After pointing out the importance of the avoidance of identifications as a mechanism of obsessional defence, the author concludes the paper with a brief comparison of obsessional and hysteriform functioning and a characterisation of the obsessional defence as the excessive recourse to perverted thought functions so as to ward off paranoid anxieties.
authors.forename: Hans
authors.initials: H
authors.lastname: Asseyer
mesh_terms: D000328:Adult; D003674:Defense Mechanisms; D005201:Fantasy; D005619:Freudian Theory; D006801:Humans; D008297:Male; D009497:Neurotic Disorders / Q000523:psychology* / Q000628:therapy*; D009769:Object Attachment; D009770:Obsessive Behavior / Q000523:psychology* / Q000628:therapy*; D011575:Psychoanalytic Therapy; D014110:Touch / Q000502:physiology; D014167:Transference, Psychology