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May 1961

Simulation of a Previous Psychotic StateA Particular Defense of a Previously Psychotic Ego

Arch Gen Psychiatry. 1961;4(5):452-458. doi:10.1001/archpsyc.1961.01710110022003

Introduction  The purpose of this paper is to demonstrate the existence of a previously not too clearly defined defense occurring in patients who have had or have been close to a prior psychotic episode. Specifically, this consists of varying degrees of conscious simulation of the previous psychotic state by and under the control of the patient's ego when a subsequent situation of stress occurs.As the result of a chance comparison of simultaneous experiences with 2 different patients, we felt we had each observed a defense mechanism with which we had not been previously familiar. Observations on subsequent patients and retrospective reexamination of the case histories and clinical courses of earlier patients seemed to confirm the initial observations.Our premise might be restated as follows: A patient who has had a previous psychotic episode with ego disintegration, regression, and various symptoms manifest thereof may, under

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