現代増加している「キレる」，「引きこもる」といった顕現様態を示す，外的現実と適切な関係性を営めない，そして容易に人格障害と見なされる臨床群の中に存在する重度神経症群を，人格構造論的，発達論的に精神分析理論の観点から検討した。そして，自己愛空想概念を中核に置き，重度神経症群の人格構造の問題を，エディプス期発達における三部構造の確立はなされているものの，潜伏期前期から発達する心的空間の発達不全があるものとする仮説を構成した。また，重度神経症群の鑑別のための力動を，精神病性人格構造，境界性人格構造，高次神経症性人格構造との比較において仮説構成した。In line with the structural, developmental and dynamic theory of psychoanalysis, the author studied and theorized about two cases of severe neurotic patients, the number of which has been increasing recently. One patient showed aggressive tendencies, while the other one was withdrawn. These patients cannot fully interact with reality and are not receiving proper treatment because of the present system of diagnosis and assessment. The author, initially using the theory of narcissistic fantasy, constructed hypotheses which maintain that their personality structures are due to the failure to establish psychological space through the early-latency phase, not due to a failure to establish triadic structures through the Oedipal phase. Moreover, the dynamics for a differential assessment of severe neurosis is hypothesized in comparison with the dynamics of psychotic personality organization, borderline personality organization, and higher neurotic personality organization.
