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July 1958

Experience of Perceptual Distortion as a Source of Anxiety

AMA Arch NeurPsych. 1958;80(1):98-113. doi:10.1001/archneurpsyc.1958.02340070116019

Important in psychological growth is the emergence of cognitive functions through which external events are apprehended more in terms of perceptual field characteristics and less as outward representations of inner drive processes. As Freud originally proposed,4 and Rapaport has recently developed at length,14 the trend from primary toward secondary process thinking —from chaotic, or instinct-determined, cognition to reality-oriented, logical thinking-parallels the organism's maturing ability to delay discharge and gratification. Without such ability, there could be no concern with external events mainly in their own terms. In this conception, veridical perception serves a distinctly adaptive function, summarized in the phrase "reality testing." With the accretion of experience, and the operation of memory and an extended time perspective, the individual is able to act vicariously, i. e., to fantasy the conditions and consequences of action, rather than acting directly, as in an earlier stage. Hence, the sometimes painful consequences of