Molnos, A. (1998): A psychotherapist's harvest

(33) ACTING OUT

Acting out can be looked upon as one of the defence mechanisms by which the unconscious protects itself against being uncovered by the ego. In therapy acting out can be viewed as one of the borderline defences.

There are many possible definitions of "acting out" (Bellak, 1976). A succinct one is to say that acting out is making something happen, doing something instead of experiencing the corresponding feeling (AM). In the broadest sense we talk about acting out when a patient unconsciously uses action or any non-verbal communication or psychosomatic symptom instead of getting in touch with his true feelings, instead of acknowledging to himself and putting into words what he really feels and experiences inside himself.

Acting out is a hidden manifestation of destructive anger. Perhaps the most dangerous form of destructive anger is one that is not experienced as anger or any feeling at all, but is acted out instead. The repressed, unrecognised, destructive anger can turn also against the self and appear in many different guises. The patient might suffer from psychosomatic symptoms, become accident-prone, attempt suicide, or commit unconscious acts of self-sabotage or destruction in relationships, in his work, and so on.

In BDP the danger of disruptive acting out is minimal. One reason is that due to the exclusion criteria patients with destructive acting out tendencies at the psychopathic and borderline end of the spectrum are ruled out. The other reason is that any inclination to act out will be pre-empted in BDP by the immediate and sustained confrontation of the resistance and by challenging the whole defensive pattern.

It happens fairly frequently that the patient in group therapy acts out some of his negative reactions to the conductor, or to another group member, in his relationships outside the therapeutic situation. This acting out constitutes a technical problem (Foulkes et al., 1957, p.106). It can be prevented by recognising the negative feelings in the here-and-now and working through them in the group.

See also index: ACCIDENT PRONENESS, ACTION, ANGER, BORDERLINE PERSONALITY, DEFENCE MECHANISM, DESTRUCTIVE ANGER, EXCLUSION CRITERIA, FEELING, NEGATIVE FEELINGS, NON-VERBAL COMMUNICATIONS, PSYCHOSOMATIC, REPRESSION, SELF-SABOTAGE, SUICIDE, UNCON-SCIOUS. The next pathfinder entry is: (34) PSYCHOSIS.