The Meaningfulness of Helping Others: Loren Eiseley's “The Star Thrower”

Freud and Klein describe projective processes—projection, projective identification, and the repetition compulsion—that cause interpersonal distortions not only in the psychotherapy relationship but in adult intimate relationships as well. Winnicott's theory of the use of an object describes a way of relating that is free of the distortions of projection, opening up the possibility of differentiation between intimate partners. Two case examples illustrate how addressing projective processes assisted one patient in extricating herself from a psychologically abusive relationship and helped a couple in treatment to move from object relating to object use. It is argued that the use of these psychoanalytic theories has an important role within a modern relational social work practice.     

Everyone Must Get a Turn: From Omnipotence to Respect for Otherness: Reply to Commentary

The authors conceptualize Davies's account of the difficult session with her patient Karen as a mentalization mismatch: an expectable failure on the analyst's part to understand the mental state of the patient. In response, the patient used projective identification to re-create the link to the analyst that was temporarily severed. They argue that the therapeutic impasse produced by Karen's successful externalization of a persecuting part of her self is more than repetition of a past relationship. It is the current experience of a disorganized self: a pervasive state for the borderline patient, and a temporary but no less disorganized state in the analyst.     

The Marikana Violence in South Africa: A Brief Psychodynamic Extrapolation

This study applies psychoanalytic concepts in making sense of the individual, group and collective factors that may have contributed towards the Marikana violence. Speculatively, individual factors might include the death instinct, repetition compulsion, and intra-psychic splitting. Related group dynamics such as identification with the aggressor, group and projective identification might be relevant as would the collective psychological influences of history of oppression, severe trans-generational traumatisation, and mystical cultural interpretations in a divided society. Further public truth, reconciliation and forgiveness processes in addition to other integrative forms of healing are proposed.     

DANGEROUS LIAISONS: PSYCHOSIS AND VIOLENCE – WORKING IN A PSYCHIATRIC INTENSIVE CARE UNIT

This paper describes work with psychotic and violent patients which led to thoughts about the use of projective identification in violent enactments to communicate at physical rather than emotional levels. The excessive reliance on projective identification in these patients seems to reflect early problems in containment and to be associated with underlying fears of annihilation expressed in a dynamic oscillation between a dread of separateness and a dread of closeness. A violent enactment may attempt to resolve overwhelming anxieties about separateness by an attempt at fusion, which then may stir anxieties about engulfment. Alternatively, overwhelming anxieties about closeness may lead to violent attempts at separateness which then stir fears of fragmentation.

Moments of therapeutic contact with these patients seem to be achieved from a painful recognition of separateness but which simultaneously allows real closeness. For therapist and patient such moments seem to reflect the capacity to tolerate a third perspective, very difficult for patients whose fathers were often absent or ineffective. The therapeutic working through to achieve an integrated and separate identity is especially difficult for these patients because of problems of mourning separateness and of unravelling complex webs of projective identification which attempt to bind a fragile identity together against fears of fragmentation and death.     

Repetition compulsion and self-psychology: Towards a reconciliation

The concept of repetition compulsion, which has never been fully acknowledged by Kohut and his followers, is re-evaluated in this article within the context of self-psychology. In line with the underlying principles of defensive contact-shunning on the one hand, and non-traumatic empathic failure on the other hand, the repetition can be seen as the twofold expression both of the wish for a new benign relationship and of the dread of traumatic, repeated disappointment. Therefore, early non-traumatic disappointments are initiated by the patient, and role-responded to by significant others. This way, the risk of disillusionment of full-blown expectations is avoided. The repetition compulsion, then, is a complex mechanism: preventive in one part, it protects the vulnerable self from potentially traumatising experiences; thus, it is operated in response to the danger signal of emotional cravings, once the latter are experienced as getting out of hand. Providing novel experiences, in its other part, it can lead to opening the road for change; such curative impact relies on lengthy working through in a safe, empathic, holding environment.     

Death with a Story

This study investigates how game playing experience changes when a story is added to a first‐person shooter game. Dependent variables include identification, presence, emotional experiences and motivations. When story was present, game players felt greater identification, sense of presence, and physiological arousal. The presence of story did not affect self‐reported arousal or dominance. This study clearly demonstrates that story is something that video game players enjoy; it helps involve them in the game play, makes them feel more immersed in the virtual environment, and keeps them aroused. The greater character identification may be especially worrisome, as past research has shown that justified media violence disinhibits actual aggression on the part of the audience.     

Meta—Realization in Horney and the Teaching of Psychoanalysis

Horney was the first psychoanalyst to develop a comprehensive framework for understanding character structure and character pathology, and the first to do so in experience-near terms. She uncovered the often hidden metapsychological assumptions of classical analysis and created a deeper meta-level thinking about psychological splits, including how splits can develop between assumed opposites. In the clinical moment, insight into meta-level process rests on an epistemological change in the relation between subjective and objective. Horney was an early pioneer in examining the dialectical unity of these presumed opposites. A specific proposal for training and teaching candidates in the science of subjectivity will be advanced. Systemic clinical insights in the assessment and treatment of patients are offered, as well as systemic uncovering of cultural assumptions of Western society which can impede analytic exploration of psychic conflict.     

A Practical Guide to the MMPI (Book)

The projective imagery, artwork, and behavior of an artistically trained psychiatric patient are presented 10 years after having committed a murder. The case is examined to see whether the Rorschach responses and the artist's choice of subject matter demonstrate the repetition compulsion familiarly associated with trauma. Additionally, does psychotherapy in which the crime is remembered serve as a stimulus to these other forms of repetition? Our case shows evidence of a continuing psychological struggle to express or deny his involvement in the murder, with phases of limited resolution.     

Dreams as portraits of self and group interaction

Dreams presented in group psychotherapy portray different aspects of the dialectic between the group and the individual. A self psychology perspective emphasizes the interplay between the current self-state of the group-as-a-whole and the selfobject needs of the individual. With this focus in mind, the therapist should help the group to deepen its awareness and capacity to reflect on emerging new abilities ("forward edge") which dream imagery conveys and the needed human responsiveness that can actualize these abilities and thus help the individual and the group to break and transform chains of repetition compulsion. We illustrate this approach with two clinical examples.     

Repetitive Maladaptive Behavior: Beyond Repetition Compulsion

Maladaptive behavior that repeats, typically known as repetition compulsion, is one of the primary reasons that people seek psychotherapy. However, even with psychotherapeutic advances it continues to be extremely difficult to treat. Despite wishes and efforts to the contrary repetition compulsion does not actually achieve mastery, as evidenced by the problem rarely resolving without therapeutic intervention, and the difficulty involved in producing treatment gains. A new framework is proposed, whereby such behavior is divided into behavior of non-traumatic origin and traumatic origin with some overlap occurring. Repetitive maladaptive behavior of non-traumatic origin arises from an evolutionary-based process whereby patterns of behavior frequently displayed by caregivers and compatible with a child's temperament are acquired and repeated. It has a familiarity and ego-syntonic aspect that strongly motivates the person to retain the behavior. Repetitive maladaptive behavior of traumatic origin is characterized by defensive dissociation of the cognitive and emotional components of trauma, making it very difficult for the person to integrate the experience. The strong resistance of repetitive maladaptive behavior to change is based on the influence of both types on personality, and also factors specific to each. Psychotherapy, although very challenging at the best of times, can achieve the mastery wished and strived for, with the aid of several suggestions provided.     

Revisiting the destiny compulsion

This paper is an attempt to deal with some questions raised by the so‐called ‘compulsion of destiny’ constellation. In presenting the standpoints of Freud and of psychoanalysts who after him were concerned with this problematic, the author takes the view that several aspects of the configuration merit further discussion. Accordingly, the dynamics of repetition compulsion, the complexity of the projective strategy, the coexistence of passive and omnipotent trends are considered. Concerning compulsive repetitions the dimension of drive intrication is underlined, thus moderating the understanding of this clinical entity as mainly related to death drive trends. Projection is understood as serving complex psychic demands. The coexistence of passive and omnipotent trends is envisaged, as manifested in phantasies of submission / participation of patients to a force that exceeds human limitations. For certain cases the consonance of somatic and psychic experiences is noted. Finally, elements from the material of two cases are presented which pertain to the problematic of the compulsion of destiny in which random events are submitted to heavy psychic necessities.     

Countertransference and Projective Identification Revisited and Applied to the Practice of Group Analytic Supervision

Countertransference and projective identification are two concepts that are very useful when describing the dynamics of atmospheric processes and also more explicit issues in supervision groups. Researching both aspects of interpersonal relationship helps the group analyst to better identify and understand the emotional reactions in the group experience. However, it is important to see the different approaches of these two concepts. Projective identification deals with keenly involuntary and often unperceivable ego-syntonic actions and unconscious thinking related to early identificatory feelings.

While other instances of countertransference are often comparatively easy to perceive, projective identification is considerably more difficult to recognize and therefore more difficult to work through. Concrete examples of countertransference and projective identification predominating countertransference respectively, as well as to commonly occurring, mixed forms of these emotional answers to supervision groups illustrate this.     

Self psychology and projective identification—whither shall they meet? a reply to the editors (1995)

The concept of projective identification continues to be viewed as alien, even dangerous, by self psychologists. Six aspects of self‐psychology/intersubjectivity theory are explored in an attempt to understand the presumed incompatibility of self psychology and projective identification: 1) the empathic vantage point; 2) the focus on subjective reality; 3) the emphasis on the analyst's personal contribution; 4) the focus on selfobject experience; 5) the disruption—restoration process; and 6) the defining of transference and countertransference as “organizing activity.”; The self‐psychological/intersubjective concepts that come closest to describing the phenomenon of projective identification—that is, empathic immersion, affect resonance, and reciprocal mutual influence—fail to capture at least three of its essential elements 1) the patient's persistent, unconscious intent to communicate certain unformulated aspects of self through the other; 2) the analyst's sense of being “taken over”; by the patient's experience; and 3) the intensely visceral quality of the analyst's experience. It is argued that self psychology ignores this important form of patient communication to its own detriment and that the concept of projective identification needs to be reformulated in terms that are more experience near to self psychologists. It is suggested that there exists a normal, developmental need, a selfobject need, to communicate intolerable, unsymbolized affective experience through the other's experience—a need that remains more pervasive and intense in some of us than in others—and that the longed‐for selfobject response is to have one's communication received, contained, and given back in such a way that one knows the other has “gotten”; it from the inside out.     

Self objects and development: Infant states of mind in an adolescent girl

In the context of Fordham's model of the deintegrating-reintegrating self, the paper discusses the total quality of the baby's earliest deintegrations and the nature of what Fordham terms the self object. The use of the term ‘whole object’ in Klein's and Fordham's terminology is explored and the self object is placed in the context of Jung's construct of the self and the archetypes. The paper illustrates how residues of the self object permeated a rule-making defensive structure in a 14-year-old girl and how the therapy provided an opportunity for the defence to loosen and for elements that had been locked, as potentials, in a ‘bump car’ self object, to unfold and develop. These elements included the possibility of enjoying the feminine qualities of being a girl and exploration of the mother-infant couple and its confusions in her inner world. In addition, they included getting in touch with an infant, vulnerable part of her personality and modifying a habitual defence which was to take refuge in projective identification with an aggressive, omnipotent phantasied brother. Another important element unfolded through the separation of herself from the idealized, precept-daughter in her mother's mind. A fixed projective identification with a self object became more flexible as the object was explored and developed, and its archetypal absoluteness modified, in the therapeutic relationship.     

States of identity: a perspective drawing upon Fordham's model and infant studies

This paper examines the Jungian concept of identity and distinguishes it from projective identification and participation mystique which also refer to non-differentiation between self and object but involve projective mechanisms. Clinical work by Fordham and a psychoanalytic infant observation are used to illustrate early perceptual operations defined by experimental researches. These operations are understood to be expressions of the primary self which manifest themselves before the structuring necessary for normal projective identification. This paper attempts to describe an intersubjective experience between mother and baby that allows for their separate ways of relating, but does not depend on projective mechanisms that can exist only after there has been adequate development.     

投射性认同的三次转向：内涵演变与概念比较

投射性认同发端自Freud的投射概念, 后由Klein正式提出, 经过Bion, Resenfeld, Grotstein等人的发展, 已经成为精神分析的核心概念之一。其内涵演变经历了从单向投射到双向互动, 从内心幻想到现实交流, 从母婴关系到咨访关系的三次重要转向。投射性认同较投射而言是一种更成熟复杂的防御机制, 与移情的差异则体现在起因、内容和结果等方面。近年来, 神经精神分析的兴起与镜像神经元的发现为理解投射性认同的发生机制提供了神经生物学的基础。     

Danger or Opportunity

SUMMARY

Countertransference is the sine qua non of all human relationships. The manner in which the couples therapist deals with countertransferential feelings can have a powerful impact as either a force for healing or a force for destruction. Based on the tenets of Integrity Therapy, this paper offers a philosophical and clinical examination of countertransference in couples therapy. Focusing on the areas of rigid adherence to therapeutic dogma, emotional expression at all costs, negative countertransference and projective identification, teaching unauthentic ways of interacting, and co-therapy issues, this paper explores the ways in which traditional dynamic, humanistic and emotionally centered couple therapies can both therapist and patient into a betrayed of self and of the couple relationship.     

Self-Disclosure and Vulnerability

Abstract

Based on the theoretical assumption and clinical observation that projective identification is a natural, constant element in human psychology, clinical material is used to illustrate how projective identification centered transference states create situations where acting out of the patient's phantasies and conflicts by both patient and therapist is both common and unavoidable. Because they are more obvious, some forms of projective identification encountered in clinical practice are easier for the analyst to notice and interpret. Other forms are more subtle and therefore difficult to figure out. Finally, some forms, whether subtle or obvious, seem to create a stronger pull on the analyst to blindly act out.

In some psychoanalytic treatments, one form of projective identification might embody the core transference. In other cases, the patient might shift or evolve from one level of this mechanism to another. Some patients attempt to permanently discharge their projective anxiety, phantasy, or conflict into the analyst. There is a patent resistance to re-own, examine, or recognize this projection. Some of these patients are narcissistic in functioning, others are borderline, and many attempt to find refuge behind a psychic barricade or retreat (Steiner 1993). In other forms of projective identification, the patient enlists the analyst to master their internal struggles for them. This occurs through the combination of interpersonal and intra-psychic object relational dynamics. This “do my dirty work for me” approach within the transference can evoke various degrees of counter-transference enactments and transference/counter-transference acting out.

Another form of projective identification, common in the clinical setting, is when a patient wants to expand the way of relating internally, but is convinced the analyst needs to validate or coach the patient along. This is why such a patient may stimulate transference/counter-transference tests and conduct practice runs of new object relational phantasies within the therapeutic relationship. Over and over, the patient may gently engage the analyst in a test, to see if it is ok to change their core view of reality. Depending on how the analyst reacts or interprets, the patient may feel encouraged to or discouraged from continuing the new method of relating to self and object. The patient's view of the analyst's reactions is, of course, distorted by transference phantasies, so the analyst must be careful to investigate the patient's reasoning and feelings about the so-called encouragement or discouragement. This does not negate the possible counter-transference by the analyst in which he or she may indeed be seduced into becoming a discouraging or encouraging parental figure who actually voices suggestions and judgment.

All these forms of projective identification surface with patients across the diagnostic spectrum, from higher functioning depressive persons to those who are more disturbed paranoid-schizoid cases. Whether immediately obvious or more submerged in the therapeutic relationship, projective identification almost always leads to some degree of acting out on the part of the analyst. Therefore, it is critical to monitor or use the analyst's counter-transference as a map towards understanding the patient's phantasies and conflicts that push them to engage in a particular form of projective identification.     

Why Do People Stay in Hateful Relationships? The Concept of Malignant Vindictiveness

Why do couples remain in hateful relationships? This article defines theoretically rigorous ways of viewing partners who stay together despite severe strife. A case presentation shows how a relationship of two people, each with his or her character structure and idealized image, creates interpersonal conflict because of opposing demands each makes on self and other. Such conflict requires radical defensive measures including alienation, idealization, and externalization that increase tensions. A vicious circle of malignant vindictiveness cements the relationship. Increasing implacability in the relationship is understood through Horneyan categories of interlocking idealized images, hurt pride reactions, and the externalizing process.