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Loose, tight, and free associations

Loose, tight, and free associations Theodore Isaac Rubin I first heard of"loose" associations during my first year of residency train- ing about thirty-five years ago. Loose associations included hebephrenic, garbled, or "silly" speech; primary process thinking; predicate thinking; obsessive ruminating; flight of ideas; ego syntonic garble; rambling disasso- ciations; ecolalia; clang formations; compulsive rhyming; confabulations; magical incantations; invented languages; pressured productions; thought disorder; language disorder; neologistic speech; and still more. Some of these, especially compulsive rhyming, eventually inspired me to write a story called Lisa and David. Many of these forms of thought and speech and feelings they represent overlap and coexist. They crisscross nearly all diagnostic categories established at that time as well as those designed and organized by the current DSM 3. We were warned at that time to absolutely avoid free associative therapy of any kind with patients demonstrating significant "looseness." The "couch," with implications therein contained, was seen as highly danger- ous to these patients. We were told that lying on the couch and associating freely would exacerbate already damaged reality contact and contribute to further autistic flights from reality. The real danger was seen as getting lost in what I can describe as an autistic web of ever more http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png The American Journal of Psychoanalysis Springer Journals

Loose, tight, and free associations

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Publisher
Springer Journals
Copyright
1987 Association for the Advancement of Psychoanalysis
ISSN
0002-9548
eISSN
1573-6741
DOI
10.1007/BF01255228
Publisher site
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Abstract

Theodore Isaac Rubin I first heard of"loose" associations during my first year of residency train- ing about thirty-five years ago. Loose associations included hebephrenic, garbled, or "silly" speech; primary process thinking; predicate thinking; obsessive ruminating; flight of ideas; ego syntonic garble; rambling disasso- ciations; ecolalia; clang formations; compulsive rhyming; confabulations; magical incantations; invented languages; pressured productions; thought disorder; language disorder; neologistic speech; and still more. Some of these, especially compulsive rhyming, eventually inspired me to write a story called Lisa and David. Many of these forms of thought and speech and feelings they represent overlap and coexist. They crisscross nearly all diagnostic categories established at that time as well as those designed and organized by the current DSM 3. We were warned at that time to absolutely avoid free associative therapy of any kind with patients demonstrating significant "looseness." The "couch," with implications therein contained, was seen as highly danger- ous to these patients. We were told that lying on the couch and associating freely would exacerbate already damaged reality contact and contribute to further autistic flights from reality. The real danger was seen as getting lost in what I can describe as an autistic web of ever more

Journal

The American Journal of Psychoanalysis – Springer Journals

Published: Dec 1, 1987

Keywords: Clinical Psychology; Psychotherapy; Psychoanalysis

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