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By David Shapiro

Beginning with a dialogue of the matter of autonomy in dynamic psychiatry and a assessment of its improvement from infancy to youth, the writer of Neurotic Styles explores, with a variety of medical examples, the distortion of the improvement of autonomy in obsessive-compulsive stipulations, in sadism and masochism, and, ultimately, in paranoia.

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P. 111. 17Werner, Comparative Psychology [8], p. 192. 19 Such a capacity means that, out of further and more varied experience, the child has achieved a more objective view of the world. He is more clearly aware of the independent existence of things and can now imagine them even when they are out of sight. This capacity also develops gradually. Piaget demonstrates, for example, that be­ fore the acquisition of language and the conceptual-symbolic representation of external reality, the child achieves a capacity for a primitive kind of internal representation, a “feeling” of imagined reality which is a product of the sensory-motor expe­ rience of that reality— a feeling that permits a degree of imagi­ native manipulation of events and a kind of sensory-motor 18This matter bears on an important point in psychoanalytic theory.

It would be too narrow and restrictive a definition, however, to identify the achievements of this developmental phase with the overall achievement of autonomy or self-direction; for in this general sense, the achievement of individual autonomy is not a phase of child development but extends throughout that develop­ ment and itself has numerous phases. (This view seems in principle consistent with Erikson’s. ) T he general development of autonomy, as I shall try to show in this chapter, reflects the development of the mind— of “in­ telligence” in Piaget’s general sense— and the changing rela2Erik H.

It is not the existence of unconscious feelings or motivations themselves that poses the problem; it is not difficult, for example, to assume that uncon­ scious feelings or motivations may contribute to or affect the conscious aims of volitional action. But the matter, insofar as it involves neurosis, is more complicated. Neurosis confronts us with a picture of conflict and schism in the personality which is not necessarily represented in consciously articulated motiva­ tions and intentions; with behavior that may be at odds with these articulated motivations and intentions and cannot possi­ bly be explained by them; with symptomatic behavior for which no motivation at all may be consciously recognized, and which may even be contrary to consciously articulated interests and attitudes.

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