Prof. Dr. Luiz Miller de Paiva
(Member of the Sociedade Brasileira de Psicanálise de São Paulo and Professor of the Behavioral Science - Escola Paulista de Medicina - Brasil)

Address: Rua Campo Verde, 439
São Paulo - Brasil
01456-010

"Life is hollow, the soul is hollow, the world is hollow.
All of the gods die a death greater than death. All is
emptier than a vacuum. All is a chaos of nothingness".

Fernando Pessoa. Livro do Desassossego (The Book of Disquiet), pg. 46, 1931.

The pulsion of death can, from our viewpoint, reduce vital tensions to zero and reappear, reborn, as in the myth of the Phoenix. It is the analysand that symbolically kills bad internalized parents, exorcises them, and becomes redivivus to begin a new life once more, for "to bear being alive is the first duty of every living being".

Freud (1915) says: "Our unconscious is as inaccessible to the representation of our death, as avid for the murder of The Other, as divided (ambivalence), in relation to the loved person, as was man in primeval times".

Not always does non-pleasure substitute pleasure, but sometimes it is the Neutral. It is not on depression that we must dwell here, but on aphanisis, on the anorexia of living, on asceticism and on emotional indifference.

The metaphor of a return to inanimate matter is stronger than it is thought, for this petrification of the ego aims at anesthesia and at inertia of a psychic death - it is but an aporia (hesitation). It is the living death characteristic of certain schizophrenic states. To become aware of the Neutral is to be indifferent to human passions.

The Neutral is the area of this impartiality of intellect that Freud (1938) invoked when he postulated the existence of the death pulsion.

Like depression, it is more commonly found in M.D.P., the neutral is more frequent in schizophrenia, in schizomorph neuroses and in the "borderlines", but at times, it is a special disease.

Negative narcissism (Green, 1988) seems to me different from masochism; in the latter, there is a painful state that aims at pain and its maintenance as the only form of existence and, inversely, to anesthesia, to emptiness, to white (neutral). This white does not invest affection (indifference), nor representation (negative hallucination) and much less thought (white psychosis).

We know that one of the greatest obstacles to communication is narcissism. It would be untrue to say that to be born is a trauma - conditions so close to intrauterine life are soon built up outside - hence the importance of holding, that is no more than an external intrauterine fixation on the part of the child (Stone, 1988). Another birth (second birth, Green, 1988) is loss of the breast that allows for the birth of the ego. Individuals that have been subject intensely to Balint's basic lacks (Balint, 1968) may suffer from asexuality (Lacan, 1966), aphanisis or indifference.

They do not wish to have sex - a defensive position and of neutrality of fantasy built up with the aid of all of the resources of untemperate narcissism that bears the marks of absolute despotism of an ideal of a tyrannical and megalomaniacal ego: "since I cannot have all and be all, I will have, I will not be anything)" (Green, 1988).

This fantasy can be elaborated on the perception of the maternal fantasy that wishes that its child be neither sexual nor alive - the salvation of the child takes place through the existence of the neutral gender (a sign of obedience and, at the same time, vengeance against her) - is the aspiration for Nothing (Nihilism). Negative narcissism may seldom lead to suicide.

The libido is a negativity where nothing is incarnate and where desire takes place as the triumph over the death of desire - the silence of the pulsions of death! (Laplanche, 1985). The chaotic state is the primary disorder of autoregulation.
Winnicott (1960) draws our attention to very precocious traumas that affect the baby before he can become aware or elaborate what happened, as if there were emptiness, a state of expectancy of something that does not actually occur. In this fault, there remains a dead object (mother without affection, living-dead, petrify and without internal representation in the child), that may manifest itself later through the living experience of catastrophic fear.

This sense of annihilation may, when adult, be manifest by terrifying dreams about wild animals (Begoin, 1989).

They become hypersensitive, "raw flesh" or lacking in "psychic skin" in the absence, in their internal world, of a good mother. Psychic suffering must be separated from anguish because the deeper aspects of suffering remain latent and hidden through defense mechanisms. Hence, it is understood that certain negative therapeutic reactions must be reactions of survival of a desperate subject.

Absence is of the symbolic order and may be throught because it comes forth after a relationship, whereas emptiness is real disorder of the "thing in itself", equivalent to the internal space where the possibility of the appearing of a representation of the object is annulled (Malpique, 1993). According to Malpique (1993), living out emptiness may be the equivalent of an oceanic feeling to annul space-time, reaching the hallucination of immortality, to attain the anguished states of "depersonalization".

In the Words of Hartocolles (apud Malpique), when times is experienced without affection, affection is experienced without time, hence the feeling of strangeness and emptiness (space peopled by inanimate things - living-dead mother).

Depressive emptiness would manifest itself when the elaboration of the depressive position is precarious and the self feels threatened by abandonment, becoming extremely dependent on the external object (without the capacity to be alone), hence an excessive dependence on the analyst, as occurs in the disease of the neutral (the analyst becomes, therefore, an idealized object in his absence, but when present, is devalued and depreciated - a breast filled with absence and emptiness, hollow and useless when it is offered. This is an attempt, according to Malpique (1993) to maintain the imagos in animation (living-dead, neither dead so as not to live the guilt, nor alive so as not to love them and thereby to miss them).

A feeling of depression is the place where an object (the brest for exemple) was (out goes the object, in comes depression) it is the so-called spatium (from the new theory of structuralism) (Miller Paiva, 1987). Without an object, there remains an empty space and this emptiness, thus, superposes depression - it is an existential emptiness. Mental space is like the kantean, incognizable, thing - itself, that can, nevertheless, be represented by thoughts; without thoughts (or even without good thoughts) there remains a vacuum.

Therefore, only the beta-elements should be evacuated, which explain the escape from the vacuum thought, of hallucinatory delirium, all to escape from existential emptiness. The thought which does not produce alpha elements will not even be classified as thought. We found that replacing thought would occur through somatization - a defense, therefore, in order not to succumb and to continue living, despite the frustations in life (absence of the good breast).

Emptiness is, clinically, subjective suffering, described as a deep feeling of internal emptiness, absence, basic lack, of no courage (the patient will say: "I feel dead inside"), of meaninglessness, corresponding to psychic nonelaboration. In Zen Buddhism, emptiness is sought through non-thought (as in Moslem Sufi practices) (Penalver, 1993), which renders the practice of these difficult to westerners. To these patients, the end of a session, a weekend, or holidays are experienced as abandonment, as anguish that, at times, they deny by asking for medicine, books, etc. In Freudian thought this feeling of strangeness, not recognizing his own image, etc., would be a rupture of mental thought, a type of depersonalization.

Emptiness is, therefore, of double perspective: one in the origin of thought, and the other as the center of a pathology. In the latter case, emptiness of the basic lack, the non-breast is converted "because the breast is with my father", the phantom of the primary scene whose combined figure is invariably persecutory (Botella, 1988).

According to Lopez Penalver (1993), the transitional object is the paradox of presence-absence, for it represents a magic step to substitute emptiness or absence of the mother; it is through failure of the transitional object that we can understand not only certain pathologies, but mainly this emptiness and its terrible consequences.

A person with a primitive emotional disorder may become hypersensitive to day-to-day annoyance - a deregulating of affection, producing mania, depression, panic, and shame. According to Grotstein (1991), these circumstances are the result of the onset of "noise" which is meaningless nothing. The primary nothing initiated with or without primary sense (meaninglessness) would be the rudiments of preconceptions and preperceptions expecting postnatal fulfillment and would define primary Nihilism.

Secondary nihilism would be the result of negative hallucinations (there being no breast, it would remain in the "black hole"). In this case, the discourse on the self and on meaningless objects, is distorted and bizarrely alters that which is contained with secondary meaninglessness - the chaotic state (primary disorder of self-regulation).

We had a patient, N.A.(*) who, in the absence of "reverie" of the parents (living-dead mother and indifferent father) and a strong feeling of having been rejected, could not love. He married through insistence of the bride, had little genital contact (with 2 daughters) and could never give affection to his wife. He was, nevertheless, efficient in his job as an engineer. He did his work, however, mechanically. The family lived in another town, and he saw his family only at weekends. He felt as if he were living-dead, did not enjoy himself, nor was he happy (but he did not suffer from depression); he felt inert, apathetic (four years without genital contact), with chronic fatigue. He took a discreet delight in contesting, though without much conviction and this only in dealing with emotions, with loss of apetite for food - in fact, in aphanasis, or in effect, a case of disease of the neutral or of indifference.

Patient N.A. could not love anyone because he might, later, be disappointed. He could not fall in love with any woman, since he was afraid he would become overdependent. In describing childhood problems, patient N.A. showed a picture of resentment and of hostility and the perception that something that he really wanted was lacking at home. Lack of reverie or fillicide fantasy of the mother seems to have led to a feeling of disappointment. The patient’s struggle was against being dependent on the analyst and on his job, as also on his wife’s, or on his parents’ past. His wish to be completely independent was based on his fear of being disappointed and disillusioned as occurred in contact with his mother. He would say: “... pleasure ran like sand through my fingers, just as happiness did at the weekend”.

(*) Similar cases (Neutral Disease) were presented in the meating of the Soc. Brasil Psicanal. S. Paulo by Leila Cintra (Nov 20, 1993), M. La Puente (April 30, 1994) and Ricardo Pelosi (Oct, 1993, Grupanálise Congr., Portugal).

The patient said (during a session): "When I am in an extraneous state I can not belong essentially to a thing. This produces in me a feeling of insecurity (similar to dizziness, half-sleep). All objects (trees, streets, sky, etc.) seem to be gloomy with smut. Sometimes the whole of São Paulo city is in a kind of dusk; I think of death only, of buried life (but I don't think of suicide). Recently my aunt died. She was like a mother to me. I liked her very much, but I did not cry. I did not feel sad because I am "living-dead" already. In the newspaper I saw the word "seduction", which upset me a lot as it reminded me of the analytical interpretation associated to seducing and to the guilt of not having an intercourse with my wife..." The patient seemed calculated in communicating or in giving vent to despair and to a feeling of despair both concerning himself and the analyst, although, apparently, desiring comprehension. He seemed to derive satisfaction from punishing himself, from arriving late to sessions and repeatedly went over the same incidents with subtle use of derision, sneering, and contempt of the interpretation. He was attracted, however, to life and towards sanity, had no thoughts of suicide, but was fond only of complaining, both in analytical dialogue, and in family and social life. He used manic defense of negation, never suspecting there might be the possibility of unfaithfulness on the part of his wife, although there had been no sexual contact for four years. There was no evidence of infection to account for fatigue; tests of neurocirculatory asthenia were positive (increased lactic acid, decrease in blood calcium, urinary phosphate loss) with the exception of hypoglicemia, also the endogene depressive tests (dexamethasone, fenfluramine, prolactine and lactate) were negative.

The table below will better clarify the distinction between schizophrenia, depressive states and the disease of the neutral:

TABLE NUMBER 1

SCHIZOPHRENIA DISEASE OF NEUTRAL MELANCHOLIA

Introverted. Introverted (discreetly) Extroverted (periods)
.
Not doing so well at school Studious. Not doing so well at
school

Decrease in affectivity Indifference to love and to Suffers too much with
(cold) indifferent to misfortune of etc (cold) suffering of others.
misfortune and others Lack of sexual interest. Cries easily. Sexual
joys of others. Ambivalent desire diminished.
love. Diminished libido.

Wears different clothes. Discreet in dress. Wears loud clothes.

Paradoxical(ex. sudden Lack of interest in everything Unstable. Loss of
interest in philosophy). (no enthusiasm) no paradoxism. self-esteem.
Loss of self-esteem.

Opposition and hostility to Indifferent to what family thinks.Accepts or suffers
family and to all of its Quarreling without conviction. through not accepting
ideas. family adversity.

Less appetite for food and Indifferent to food (no Increase in appetite.
strange. Loss of sexual enthusiasm in tasting food). Less sexual desire.
interest.

Conflict between impulses Indifferent to conflicts. Argues Any conflict
and prohibition. Absurd with no emotion. Is not generates guilty
aggression. aggressive. feelings. Become
irritable.

Tendency towards Discusses tendency towards Indifferent to family
isolation. isolation and friends.

Unsociability. Expression Does not seelk new friendships, Difficulty being in
of fear. but receives them well. Bouts of sociable or state
insatisfaction. of periodic agitation

TABLE NUMBER 2

SCHIZOPHRENIA DISEASE OF NEUTRAL MELANCHOLIA

Taciturn and passive. Loss Passivity.Diminished Sociable in excess with
of initiative. initiative. retiring periods. Loss of
initiative is cyclic.

Neurocirculatory asthenia Neurocirculatory asthenia Asthenic depression
only in simple cases and (growing chronic fatigue).
spells of hebephrenia.

Obsessive characteristics Correct,is not miserly, enjoys a Tendency towards
(rigid, ironic oppositional discussion, but without much alcoholism.
dogmatics). conviction. No tendency towards .
alcoholism.

Suicidal raptus. No(makes an effort to live). Frequent ideas of suicide

Deliria (paranoid, feeling No. Rarely.
of strangeness and
hallucination).

No dementia but blocked No (difficulty in accepting the No.
thought. interpretation of the analyst,
without hope, although apparently
desirous of being understood).

Mutism. Answers No (compulsive repetition No (only in
“sideways” of conflicts). depressive stupor).

Word salad. Neologisms. No. No.
Neologisms.

Strange writing. No. No.

Negativism. Catatonia No. No. (psychotic
and cenestopathies. negativism).

Depersonalization. Some times. Rarely.
Mental automatism.

A child is born into a world of hereditary credit inherent to preconceptions and according to the attachment that will lend him support for development and maturity. The task of the parents consists in being not only good nutritioners but in the ability to enable the child to adjust to life, with the forming of a precocious and primitive somatopsychic alter ego (second self). Should the child fail or be incapable of receiving help, he will suffer a flaw in self-authorization with foreclosure, where the corporal ego disappears, there being only what remains of the abandonment a total victim of self-abnegation, with the death of the soul as a whole (schizoid fate - the pact of Faustus, a terrible alliance of "beta primary elements"). This condition originates a satanic superego or super-superego.

Hulak and Lederman (1992) refer to patients with a special profile: a fantasy of not inhabiting their own body, carrying a false existence that was imposed on them, with a lack of creativity, severe somatization, although desiring treatment and being alive; brought up by a mother that was little affective, begotten unwillingly or by accident. One of his patients says: "the greatest pain there is, is the pain of knowing that I lost what I never had".

These patients present a false self that these authors classify as: 1) supposed false self, that must keep up this situation through secondary gains and with somatization to a lesser extent; 2) imposed false ego, that lives the tragedy of not being himself and struggles to be another person whose somatizations are severe (in the sense of expelling bad objects), entering into chaos, but may, if well treated, lay hold of regenesis, that is, to try and restore the libido once more to the id, in order to obtain a chance for yet another rebirth.

The internal "noise" of a newborn is digested by the capacity for reverie on the part of the mother. Should there be no reverie, there will be splitting, that is, there will be no internal representation of "noise" to keep up a good structure. If the projective identification is dealt with malignantly, there will be permanence of the beta element, impoverishing mental life and exacerbating the psychotic personality. Failure to connect experiences with corresponding emotions to reach meaning is a sign of failure of the alpha function (bizarre object, product of the inversion of the alpha function). The individual seems prepared, phylogenetically, to receive information and be responsible for preconceptions (Bick, 1970). We are, in this way, prepared to receive experiences. There is, in the newborn, a series of disruptive psycho-physiological states of conscience that demands harmonic interaction on the part of the mother.

In the narcissistic personality, there is a deficiency of self-esteem that the individual overcompensates by using grandiosity. Loss of self-assurance may be seen in the following light: Example: a 2-year-old child with a temperature dreams that there are snakes in his bed, goes to his mother's room and cuddles close to her belly. This is the need for contact (skin identification) (Bick, 1970). Anzieu (1989) refers to the skin of the ego of a person without self-assurance who eventually experiences the plunge into the black hole of nihilism - a state of chronic panic as is the case in hebephrenia and as we demonstrated though a biochemical alteration (Miller Paiva, 1991). In all of these cases, filicidal feelings, sadness of the mother and her diminishing interest in the child are first and foremost. The fact is that, at that moment, the individual experienced a catastrophic change, a real mutative change in the behaviour of the maternal imago, that is experienced by the child as a catastrophe (lost love - narcissistic trauma - loss of meaning), mainly when the child feels lost between a dead mother and an inaccessible father, engendering a depressive state or disease of the neutral or of indifference.
This is deinvesting in the maternal object and unconsciously identifying with a dead filicidal mother. This person will experience a great deal of difficulty in atoning to the maternal figure; at most, there may be mimicry, for not being able to possess the object, but in continuing to possess it, becoming not like it but actually becoming it itself. These persons show a tendency towards obsessive neurosis with an intense capacity for compulsion towards repetition, repeating former defenses. What is wholly unconscious is an identification with the living-dead mother hence the anancastic ceremonials or somatizations such as neurocirculatory asthenia or chronic fatigue, characteristic of the disease of the neutral. This condition gives rise to consequences such as hate, maniac sadism, where the purpose is to overpower the object, to defile and exact revenge from it, leading personal relationships to desperate levels.

Our patient N.A. had a sudden thought: "I should like to murder 783 people. I'll be damned! How crazy can you get". Later, reflecting on the cabala of this number, he came to the conclusion that: "I want to kill myself, for that was my number at military school". This insight showed how former murderous hate was now directed towards himself".

These cases also experience subsequent autoerotic excitation not necessarily accompanied by sadic fantasies, but rather by reticence in love for the object - blocking love, aphanisis. Finally, this person brought up by a living-dead filicidal mother is frantically engaged in a game within the obligation to win - to win the mother-good-breast, mainly because he has no love for his professional life. He may also have an intellectual obligation, that is an obligation to think so as not to feel the living-dead mother or in the search for a means of resurrecting from the living-dead mother and thus putting an end to the curse of the living-dead and of psychic pain.

This type of patient cannot tolerate a lasting relationship, tends to destroy the good work - nursing at the breast - as also the analyst representing the mother - his envy, giving rise to damaging rivalry.
The pulse of life does not predominate to the extent that the patient may trust in his love. The patient who does not suffer pain is incapable of “suffering” pleasure, according to Bion (1970). Pain is not only anxiety: it is associated to a greater perception of the self, and is therefore associated to a feeling of existing separately. Some artists could transmit anxiety and death in sublime forms of art. If these patients suffer from neutral disease, they are more profoundly analyzed, make progress, and experience changes anxiety into “pain”. The slow rupture of this mode of internal relationship leads to very deep feelings of pain in the periods of absence of the analyst and of friends. It seems to involve a fantasied project of the self to within the mind or the body of the analyst; proximity is of this type and not of a relationship and of contact. They do not realize this and believe they have a very positive attitude and admiration for the analyst - that proves far from true. The feeling of fetalization (Miller de Paiva, 1971) is, at times, intense, mainly if it is profoundly identified with the foetus, that feels it is being pulled or torn from the body of the mother, thereby giving rise to claustrophobia.

There is a type of very malignant self-destruction, addicted to the quasideath in the words of Beti Joseph (1992). From our view-point, living-death dominates life for these patients. The internal object is felt and maintained as an object paralysed (full of lethargy) neither dead, nor live, a state of suspension of the vital functions - the living dead, the disease of the neutral.

The commitment between life and death can be seen in the condition of paralysis, of suspension of vital functions. Its object is paralysed just as he himself is, to a great extent, emotionally paralysed. What makes the problem insoluble is that there is no real integration or any real mitigation of hate for love, so there is no progress, but only compulsive repetition.

These patients with the neural disease can not face the ambivalence and guilt and, therefore, can not attain and elaborate the depressive position; they withdraw from it by the use of defenses pertaining to the schizoparanoid position.
Their particular method of cision and fusion with the idealized object offers protection from psychosis; however, their incapacity to tolerate ambivalence, conflict and, therefore, integration, prevents the possibility of normality.

The death pulsion as a trend to reestablishing a former state of existence, as a last instance, of an inorganic state. Patients with neutral disease feel more free from anxiety when they are close to the inorganic, that is, free of emotion.

Neutral disease is able to tolerate a good external object that it requires, owing to hate and envy, while it is part of the self and is fused with it, the object can be kept alive and not be lost. Narcissism, therefore, protects him from psychosis. The object has to be kept paralised internally, hence the be neutral. By means of much cision and projective identification, the patient keeps himself as emotionally lifeless as possible, even if he does not lose contact with the parts that are more alive and that were hidden, he remains frozen, since he does not have sufficient confidence in his love to be able to tolerate ambivalence that integration would imply.

These patients are more and more absorbed in despair, involved in activities that seem destined to destroy them physically and mentally, as, work that is considerably in excess, almost no sleep, deficient or excessive diet and hidden, when it is necessary to lose weight, more and more drink and, eventually, to cut relationship. It seems calculated to communicate or to give rise to despair and a feeling of despair in themselves and in the analyst, although apparently desirous of understanding. Just to die, although attractive enough, would have nothing of good; in these patients, there is no idea of suicide. What is felt is a need to know the feeling and to have the satisfaction of seeing himself being destroyed. This is the attraction for the death pulsions, the attraction for the living-dead, a type of mental or physical acrobatics of which one essential aspect is to see the self in a dilemma, without any possibility of being helped. However, it is important also to consider where the attraction for life and for sanity is. I believe that this part of the patient is placed on the analyst.

“One patient described by Beti Joseph (1992) reports a dream in which he is in a deep cave, having been captured by bandits. There reigned a feeling of confusion. The man clung to him and to his genitals, as if he were a homosexual, and was about to knife him and felt tremendous pain”. The dream was interpreted that the man must be in some way related to himself. This long dark cavern represented the place where he felt that he was too far deep in ever to be hauled out. But to have gone too deep seemed associated to the notion that he was completely captured and captive.

This his despair or his description of the session contained real masochistic excitement.

These patients feel like slaves of one part of the self that dominates them, imprisons them, and does not allow them to escape, however much they may see life beckoning from outside. No usual pleasure - genital, sexual or any other - offers so much delight as this kind of terrible and exciting autoannihilation.

Circular mental activity is the antithesis of thought. This phenomenon is obviously important in the analytical situation. To “grumble” in a complaining fashion, is lived in the analytical dialog, as also in the lives of these patients. Patients with neutral disease take up a great deal of time in the analysis apparently bringing material to be analyzed and understood, but, unconsciously, they use it for other purposes.

The neutral patient will do anything to provoke the analyst and to feel disturbed and show himself repetitive, besides adopting a recriminating attitude.

It is not “understanding” that the patient wants, even if the words should make it seem so. Patients with neutral disease often seem to be passive in their lives; however, a very important step is taken when they can see how active they are - through projective identification - as, for example, by means of the type of provocation. The despair is so effectively deposited within the analyst, that he feels overpowered by this and sees no way out. The analyst is then internalized in this way by the patient.

The prime objective was to create a masochistic situation through arrogance. Masochistic excitation is, very often, to cover with deep anxiety aroused by his situation at work associated to feelings of rejection, of being unwanted, of failure and of guilt. The interpretation is heard, but some part of the personality of the patient views the analyst with disdain, sarcasm and ridicule, even if the ridicule and the disdain are silent. He is not “melancholic” - his guilt and self-reproval are avoided or swallowed up by his masochism.

As a baby, because of his pathology, he did not merely draw away from frustration, jealousy or envy, into a state of withdrawal, nor was he able to get angry and to shout with his objects. I believe they drew into a secret world of violence, in which one part of the self turned towards another part, in which parts of the body were identified as parts of the offending object and that this violence was extremely sexualized.
Another type of behavior found in the neutral disease is the compulsion to repetition that may lead to mental paralysis (regression to the inorganic).

Compulsion towards repetition is a lethal mechanism that leads psychic life to paralysis (regression to the inorganic).

A compulsion towards repetition, as instinctive manifestation, is broached differently when Freud (1913) describes the function of undoing traumatic experiences. The Kleinian school (Joseph, 1992) refers to the compulsion of repetition, as part of the effort to find an answer to greater anxiety, substituting it for others less fearful.

As an example:

This patient N.A. whose extremely repressed homosexual feelings when face to face with the analyst-father, defended himself with hate, projected himself with subsequent paranoic ideas; these would be resistance to transference and the homosexual feelings, that resisted him. For this patient to be cured, it was necessary for him to relive (and not to repeat) his homosexual feelings towards the father, in the person of the analyst.

The myth of eternal abandonment (Miller Paiva, 1992) only becomes reality in the measure in which it repeats an archetype; thus reality is only attained by repetition. The neutral patient has to repeat a feeling of abandonment, he must attack the analyst.

The patients therefore develop beligerent attitudes towards the analyst, to protect themselves from feelings of love and tenderness, that is, from the painful outcome of sexual and aggressive infantile desire.

Besides the reference in the capacity to love, the deficiency in dealing with the truth, which may result in self-destruction, also coexists.

A patient wished to have sexual relations with the analyst, so that on repeating this desire, not to remember her incestuous desire but rather, to repeat, even in place of remembering, certain situations from childhood in which she felt marginalized, excluded from the amorous triangle; she would now like to be the first and to belong to this triangle, in the figure of the analyst. The element resisted was the living-out of the primary scene, with paranoid anguish.

To be enamoured with the analyst would be the resistance to not recollecting exclusion from the triangle of the parents (Miller de Paiva, 1987 e 1991).

It is not this repetition that is resistance, but impulse, forming exteriorization. Pines (1974 & 1992) finds it, more often, in narcissistic borderlines.

Experiments have shown us how animals and, also, drug addicts, need to maintain homeostasis and well-being, through a certain count of dopamine.

Lagache's (1953) idea does not accept that compulsive repetition is primary, that is, that it is at the service of the death instinct, on the contrary, he accepts it as secondary, for the conflict would be between need, the principle of pleasure and reality. It would be primary if there were a repetition of need. Zeigarnik's experience shows us that once the task is interrupted, there is a tendency or need to complete it - the frustration resulting from interruption, intensifies the need to complete the task satisfactorily (Junqueira, 1993).

Olds' (1993) experiments show that the rat with an electrode on the anterior hypothalamus, continues to turn on the electrodes to have continuous orgasm, on the contrary, the stimulus of the posterior hypothalamus causes displeasure; in the experiment of Justice (1988): cocaine is injected at intervals of 2', 5', 15'. Dopamine increased at 15' intervals. On choosing the intervals, the rat preferred those of 5', for in these, the rates of dopamine were low.

To some analysis, transference is resistance, predominantly so. The important fact is to utilize and to remember forbidden childhood, and transference is an instrument for this, although to remember may cover over living (at times, memories serve to disguise present conflicts with the analyst) and that it may serve also to avoid the danger of dissociating past from present, for example:

In patient N.A., the bad father from the past, superimposed on the analyst of the present, was a repetition of former dichotomizations that the analyst should not reinforce. The danger lies in not perceiving the nature of resistance in certain transferential situations.

The regulating function is instinctive, constitutional, automatic, non-symbolic and non-intuitive, as can be seen in the myelinization of the corpus calosum that begins only in the third or fourth month of life and coincides with a depressive Kleinian position; the individual seems to live with two separate consciences, as also with two brains to process data from experiences, one objective hemisphere and the other for fantasy. In human psychism, there may or may not be specificity (thisness)(Miller Paiva, 1991), but it is psychosomatic in its sphere of action, with its own signs and laws. It is separate from the symbolic function and is governed by Cannon's homeostasis (Cannon, 1939). We believe, therefore, that compulsive repetition in neutral patients (similar to the impulse of the obsessive individual or of a drug addict) is primary as a consequence of the pathological structure of the nervous system (ontological insecurity or holed ego) (Ammon, 1974) owing to a genetic factor and exacerbated in the molding periods, as is often the case in the foreclosure of Lacan (Lacan, 1964); hence the difficulty of carrying out psychoanalysis in psychoses. In fact, Patterson (1985) discovered, by means of the "high-speed digital electronic", that the tomographic image of the thought of a schizophrenic is different from that of a normal individual. It is thus possible to explain thought disorder and foreclosure, rendering psychoanalysis difficult. Grotstein (1991) states: "the mind has a greater scope than Freud's neurophysiological mind", and Junqueira (1993) writes: "unconscious as a continent of infinite preconception". These are concepts that are useful for understanding the multiple facets of the pathogeny of mental and psychosomatic diseases.

The compulsive repetition is primary, then the psychopharmaceuticals could improve the situation. Hypomaniacs must be controlled in their exaggerated interaction. Cases of depression or of neutral disease, on the other hand, seek out the object in order to aggravate their disphoria. In panic, because he is in a "black hole", the patient is inhibited.

In an aggressive attack, a person has sparse control over his impulses (amygdaloid nucleus), so that on becoming impulsive, he is attempting to regulate his state of impotence and vulnerability. His neurotransmissors (cephalin, endorphin, norepinephrine, etc.) are stimulated to cause the patient to react and to face the weakness of the ego.

His traits of character are psychodynamic (symbolic) and by the mere alteration in the neurotransmissors, they lead to low ambition, shortening pleasure and exacerbating ill humor.

According to Lagache (1953), the human mind strives in the search for a certain degree of integration. That is right. Please see under Homeostasis and the concept of auto-regulating of interaction set forth by Grotstein (1991). In the domains of regulating (or better, of deregulating), a psychosomatic or (somatopsychic) extraterritorial alterego persists for the symbolic irresponsibility and the discourse on itself persists.