The establishment of primal repression and its consequences in contemporary clinical practice.

Freud himself never clearly and unequivocally defined his concept of primal repression, which has been considered mythical, obscure, mysterious, incomplete, enigmatic or controversial. This paper revisits the concept with the support of the hypothetical conceptual clarity provided by the heard word (soundimage) and the visual image discussed in Freud's book On Aphasia: A critical Study (1953[1891]). The heard word allows for affective change and reorganisation according to Oedipal law, which is postulated as the essence of primal repression. Thing-presentation takes place prior to word-presentation. The word would retrospectively generate two elements that the author calls the Ding- and the Sach- elements of the thing-presentation. An everyday scene is used to illustrate the theoretical approach. Three vignettes are subsequently examined: a neurotic patient's dream to illustrate how primal repression works when it has been adequately established; a contrasting clinical experience with a schizophrenic patient in which the opposite is true; and finally, an intermediate situation is presented, in which the analyst's primal repression of filicide is fundamental to resolve an enactment. The latter two situations also illustrate the role of supporting the generation of primal repression in contemporary analytical work.