By David Shapiro

Beginning with a dialogue of the matter of autonomy in dynamic psychiatry and a evaluate of its improvement from infancy to formative years, the writer of Neurotic Styles explores, with quite a few medical examples, the distortion of the improvement of autonomy in obsessive-compulsive stipulations, in sadism and masochism, and, eventually, in paranoia.

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Infancy and th e D e v e lo p m e n t o f In tentionality T he newborn infant neither makes choices nor even takes action in the proper sense of the word. 8 Werner describes the immediacy of this earliest kind of action as follows: There are no genuinely personal motives in primitive action. Primi­ tive action is set in motion by vital drives on the one hand and by the concrete signals of the milieu on the other. . [The infant] moves, not because he is experiencing any form of aspiration, but rather because vital needs force him to move.

Such recognitions are bound to create new interests, new expectan­ cies and anticipations, even if these are as yet not associated with any internal or imagined representation of the goal. The recognition of the rattle creates an interest in the rattle as an object out of what had been only an interest in a sensory experience. T he rattle has become an attractive object, an object to be grasped. These beginnings of objectification do not so much change the infant’s attitude toward the external world as create an attitude; it is not so much that his point of view is altered as that he begins to have a point of view.

Pose or attitude. Probably most of our behavior is of this sort, relatively spon­ taneous, often without articulated purpose, but ultimately guided by interests and attitudes that become articulated and self-conscious only from time to time, and then perhaps incom­ pletely. There are, of course, striking and characteristic individ­ ual differences in the style of this kind of hierarchical selfdirection and in the degree and the kind of permissible spontaneity. Neurosis and th e Problem o f U n con sciou sly M otiva ted A ction The most difficult problem to be accounted for by a theory of consciously directed, volitional, action is that of unconscious motivation as it appears in neurosis.

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