Can you explain "acting out" in Freudian psychoanalytic terms? What would cause a patient to act out?
Acting out is a Freudian psychoanalytical concept that is part of Freud's primitive defense mechanism and transference theories. Acting out is what may unconsciously occur during the process of psychoanalysis--though it is not exclusively "what occurs within, or as a consequence of, analytic work" (Alan Rowan)--when the patient's unconscious is stimulated to recognize a similarity of some sort, sometimes irrational and always unrecognizable (because unconscious and unremembered), between a past repressed experience or trauma and the person or characteristics of the therapist with whom transference has been engaged. According to Alan Rowan in "The Place of Acting Out in Psychoanalysis," the concept of acting out in Freudian theory is the most misunderstood and misrepresented by contemporary therapists:
[T]here is considerable debate in the analytic literature concerning both what acting out is essentially, and how one acts given its presence in analysis. ... In approaching the concept of acting out one is immediately faced with a problem which Sandler et al., summarize by stating: "Of all the clinical concepts considered in this book, acting out has probably suffered the greatest extension and change of meaning since it was first introduced by Freud" (Sandler et al., 1973: 94). In a similar vein, Blos goes so far as to
assert that the "expansion of the concept has reached conceptual breaking point" (Blos, 1966: 68), .... [or] most notoriously, the term is ... sometimes used simply as a general term of abuse, either as an expression of disdain and as a means of shoring up one's values .... (Alan Rowan, "The Place of Acting Out in Psychoanalysis")
In 1905, Freud first introduced the term agieren that is translated to the English term "acting out." It is significant to note that it is different from the French psychiatric term passageà l'acte used in criminology to describe impulsive and criminally violent acts. In Freudian psychology, repressed experiences may return as some part of unconscious present experience in a function called the return of the repressed. Acting out is the behavioral expression, or discharge, of the return of the repressed that cannot be expressed verbally--since it is in unconscious present experience--though it may be expressed through unconscious behavioral discharges, or acts. Consequently, acting out is the revelation of the patient's conflicted mental state that arises from repressed experience returning to present, though unconscious, experience.
What causes a patient to act out occurs wholly on the unconscious level and is the result of repressions pressing upward toward conscious recognition where they might find expression (or discharge) through memory, though the repressed experience or trauma is still below the level of conscious memory and therefore below conscious verbal expression of memory; thus the pressure for discharge of the returned repressed results in behavior, or acts, that manifest--or act out--the nature of the repressed experience or trauma.
While some therapists make a distinction between "acting out" and "acting in," with acting out occurring during treatment sessions and acting in occurring outside of treatment sessions, as in significant decision making situations, Rowan and other Freudian experts reject the concept that acting out distinguishes between intra-therapy (inside treatment) and extra-therapy (outside treatment) behaviors maintaining rather that acting out can occur either inside or outside of treatment:
"[A]cting out has probably suffered the greatest ... change of meaning since it was first introduced by Freud" (Sandler et al., 1973: 94, qtd by Rowan). ... Thus what one discovers are descriptions of acting out, ranging from those which focus exclusively on what occurs within, or as a consequence of, analytic work, to descriptions which see it as an appropriate term to designate a whole range of impulsive, anti-social or dangerous actions up to and including enduring behavioural problems such as delinquency, drug addiction and various psychosomatic illness (Abt and Weiseman, 1965, qtd by Rowan).
Freud's 1905 discussion of acting out was in relation to a case study of "Dora" in which Dora abruptly broke off her therapeutic relationship with Freud, dropping her sessions. Freud analyzed her behavior in terms of acting out by identifying key components of acting out behavior: (1) Dora perceived an unidentified similar characteristic between Freud and "Herr K.", (2) Dora retreated from therapy to enact revenge on Freud as an expression of the revenge she unconsciously desired to enact upon Herr K., (3) she acted out her return of the repressed experience or trauma in the way of recollections and "phantasies" rather than verbally "producing" these in treatment.
Dora prematurely broke off her treatment with [Freud]. He states: "because of the unknown quality in me which reminded Dora of Herr K., she took her revenge on me as she wanted to take her revenge on him, and deserted me as she believed herself to have been deceived and deserted by him. Thus she acted out an essential part of her recollection and phantasies instead of producing it in the treatment." (Freud, 1905 e : 119 qtd by Rowan and by Kitayama)
Freud did not intend for the distinction between mistaken acts arising from psychic conflict and acting out to be collapsed, which collapse would reduce acting out to being perceived as a straightforward neurotic act (Rowan). Through the introduction of "repetition compulsion"--related to repeating past repressed fixating experiences and past repressed trauma--and of "working through," he defines acting out:
the patient does not remember anything of what he has forgotten and repressed but acts it out. He reproduces it not as a memory but as an action; he repeats it, without, of course, knowing that he is repeating it." (Freud, 1914g: 150 qtd by Rowan)
Rowan goes so far as to say that, for Freud, transference and acting out were manifestations of the same psychological phenomena in that both are repetition that stands in the place of conscious remembering and conscious verbal production of memory in treatment. Instead of conscious verbalization, "[s]omething gets played out in the analytic encounter, the analysand acts, and behind these acts are particular beliefs and desires which may be nonsensical, odd or strange, but which are, ultimately, what the analyst aims at" (Rowan). These acts are manifestations of unconscious repetition of repressed experience or trauma that had elicited certain feelings, which were repressed along with the experience or trauma, and that return as unconscious impulses in present experience. It is critical to understand here that Freud did not interpret acting out (or transference) as signs of resistance but as communicative aspects of treatment and as the aim of treatment.
Freud is highlighting here is the communicative aspect of acting out and the requirement this places on the analyst, which is not one of either curtailing such phenomena or pointing them up as resistances, but of allowing the patient, "to work through it, to overcome it, by continuing in defiance of it, the analytic work .... (Rowan)
Freud recognized that acting out resulted from the ego's directed refusal--through the defense mechanism of repression--of verbal representations of the repressed resulting in repetition, for the repressed is not itself manifest resistance--it does not itself resist--because it, to the contrary, continually "presses for discharge," or expression (Rowan). Freud also specifies the importance linked to the patient behaving "as normally as possible outside the treatment and express[ing] his abnormal reactions only in the treatment" Freud, 1940a : 176, qtd by Rowan) since acting out outside of treatment presents a clinically more difficult situation to deal with, especially since acting out outside of treatment may lead to compounding issues such as poor professional or family choices.
Alan Rowan. "The Place of Acting Out in Psychoanalysis." Psychoanalytische Perspectieven, 2000.
Osamu Kitayama. "Psychoanalysis in the 'Shame Culture' of Japan: A 'Dramatic' Point of View." Freud and the Far East: Psychoanalytic Perspectives on the People. Editor Salman Akhtar.
Sophie de Mijolla-Mellor. "Acting out/Acting in." International Dictionary of Psychoanalysis. Ed. Alain de Mijolla. Vol. 1. Gale Cengage, 2005.
Under Freudian/psychoanalytic terms "acting out" is seen as a dichotomy between the conscious and the unconscious wanting to both send out a repressed message.
In psychoanalysis, the term "acting out" has misconceptions related to it. People have given the term the broader meaning of someone throwing a tantrum, or verbally expressing pent up emotion. In reality, Freudian psychoanalysis specifies that acting out is much more subtle than that: the client who acts out clearly unconsciously expresses a repressed, unremembered something with actions rather than with inaccessible words, and such actions are intrinsically woven within the psychoanalytical situation. In psychoanalysis, acting out has a lot of communicative potential because it sends signs that will indicate to a therapist the client's repressed, unrecallable memories.
Freud first used the term in 1914 in "Remembering, Repeating, and Working-Through". As Freud defines it, acting out is when patients cannot access repressed memories that motivate unconscious behaviors that "symbolically dramatize the past in order not to remember it". Acting out during therapy, as described by Freud, includes such things as behaving toward the therapist as they behaved toward parents, having disturbing dreams and associations, complaining of lack of success because of a childhood "deadlock" in the Oedipal stage, etc. Therapists might also, perhaps simplistically and erroneously, suggest acting out pertains to all the changes in affect and gesture that the patient goes through as he or she talks about themselves. These include:
- intonation changes
- facial expressions
- eye movement
- change in tone of voice (volume)
- imitation (remembering a mother's shrieking voice and repeating it)
- body language-use of hands and excited speech, or withdrawn
Acting out is different from "acting in," which occurs outside the bounds of therapy sessions, for example in work or love decisions. Acting out it consists of unconscious messages expressed through behavior in the therapy transference relationship, which is why the therapist must be an observant psychotherapist.