Projective identification and the therapist's use of self

This article addresses how therapists can recognize and therapeutically utilize client projective identification in therapy. Splitting and projective identification are conceptualized as occurring in sequence. Transference, countertransference, and projective identification are discussed as interrelated phenomena, which underlie the therapist's effective use of self as an instrument in therapy. A three phase intervention process, which emphasizes the importance of the timing of interventions, is introduced.     

Fantasy,defense, and the representational world

This paper discusses the manipulation of mental representations, particularly in relation to the psychoanalytic concepts of conscious or unconscious fantasy. A distinction is made between the unconscious phenomenal (experiential) aspect of representations and the nonexperiential, quasi-structural aspect. The concept of the representational world is described and elaborated, and its development is seen as a consequence of the infant's interaction with itself and the external world. Processes such as identification and projection can be seen in terms of changes in self and object representations, and the same is true for all the mechanisms of defense. The content of unconscious wishes is transformed, by use of such mechanisms, into representations that are acceptable to consciousness. Major transformations of unconscious representational content occur in the process of creating unconscious (preconscious) fantasy, and further transformations are frequently needed before such (preconscious) fantasies are permitted access to consciousness. The concept of projective identification is considered in the light of the ideas put forward in the paper.     

The borderline self and the jealous object

The purpose of this paper is to show that just as a therapist working with a borderline patient is often induced with many intense and difficult emotions, similarly, a borderline patient is induced with very intense emotions by his object, which are often experienced as foreign and ego alien to the self. As a result, these induced emotions remain repressed or dissociated from the self, but they continue to play a major role in the borderline's lifestyle. It will be demonstrated that the jealous object, and not the self, is the main factor that interferes with the borderline's growth and progress in treatment. Although a borderline patient may employ primitive defenses such as projective identification and splitting as his primary mode of coping with the bad introject as has been stated by Klein, Kernberg and other writers, I would like to suggest that a borderline patient also employs what I would call dual splittingand dual projective identificationin order to maintain a symbiotic relationship between the selfand its jealous object.     

Remembering and repeating in multiple personality

This paper is a case-history of a student in his early twenties tortured by different personalities of different ages and sexes vying for control of his body. Guilt over an incestuous relationship with his mother is uncovered and understood in the context of his whole life. Confusion between memories of fantasies, memories of sleep dreams, memories of daydreams, and memories of actual memories are described, the elucidation of which lead to clearer thinking and memory, and more tolerance for the previously distorted affectladen situations of his past. Thus his belief that he was experimented on in an alien spaceship becomes the memory of an operating-room diagnostic experience.

A hypothesis is put forward that the separate personalities in the multiple personality are not simply the products of ego splits, but are at the instant they are formed a ‘doubling’ of the personality that is being copied. Immediately thereafter, splitting mechanisms create differences between the two separate personalities, using projective and introjective mechanisms. Integration of the various personalities, the ultimate goal in treatment, is made difficult by the patient's fear of loss of self through fragmentation, when the self is felt to be in danger of being intruded upon.     

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.     

Agoraphobic and claustrophobic anxieties two problems in leaving university for some final-year students

Abstract

This article considers the way final-year students present with agoraphobic and claustrophobic symptoms which have caused them to break down academically before the end of their courses. It presents a brief theoretical discussion of these anxieties in students, and offers a way of thinking about them in terms of a particular understanding of projective identification. Fragments of casework with three students are used to show that the anxieties are brought about when the desire for invisibility for part of the self, the motive for projective identification in these cases, is more exposed by the arrival of the final months leading up to the end of the students' courses.     

‘With healing in her wings…’: Integration and repair in a self-destructive adolescent

This paper describes certain Jungian concepts related to integration and repair. Fundamental to this is Jung's concept of the self, which Fordham has made the basis of his model of development. To Jung's notion of the self as an integrator and organizer of experience, Fordham has added the idea that the self divides up, or deintegrates. Three corollaries of Fordham's model, pertaining to whole and part objects and the depressive position, are amplified through infant studies.

Clinical material from the treatment of a pigeon-phobic adolescent is presented, which attempts to demonstrate that a significant part of what the phobia represented was an infantile state of projective and introjective identification with an anxious mother. Treatment facilitated actions of the self that contributed to the integration of the experiences represented by the pigeons, so that what had been split off became a deintegrate capable of being reintegrated.

The focus of this paper is on the developmental as well as the pathological. Both are conceived in relation to the treatment.     

Projective identification: A theoretical investigation of the concept starting from ’Notes on some schizoid mechanisms’1

This paper submits passages from four papers‐‘Notes on some schizoid mechanisms’ (Klein); ‘On identification’ (Klein); ‘Analysis of a schizophrenic state with depersonalization’ (Rosenfeld); and ‘Remarks on the relation of male homosexuality to paranoia, paranoid anxiety and narcissism’ (Rosenfeld)‐to a critical reading, enabling the theoretical premises which have produced the current, differing views on projective identification to be traced. These views revolve both around the role assigned to identification in the process and around the meaning of the expression‘to identify oneself with’ which in ‘On identification’ goes from ‘to feel similar to, or identical to the other’ to ‘to take another person as a model’. This legitimizes the inclusion of very different phenomena into the concept of projective identification. The author describes some uses of the term ‘projective identification’ and proposes the hypothesis that the process constitutes a way for managing otherness and the separateness of the object (be it external or internal, real or imaginary) that can compromise its reality to a greater or lesser degree. Covering a large set of phenomena, the author poses the question of whether it is useful to retain the term ‘projective identification’. She proposes an answer in the last part of the paper.     

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。     

On Becoming Meta

This presentation will develop the concept of metapsychological capacity and describe the convergence of Systemic, Self, Intersubjective and Horneyan theory that integrates into the metapsychological construct. The traditional concepts of repetition compulsion and projective identification are expanded from their mechanistic roots towards a more real, existential, iterative force that influences the therapeutic process. Metapsychological capacity creates a therapeutic presence enabling greater emotional awareness and psychological growth for both the therapist and the patient. The foundations of repetition compulsion, Horneyan character splits and projective identification serve to frame the intersubjective space from which real self emerges. Focused on subjective/relationship-near immersion, real self emergence and resonating character splits, Horney clearly understood the metapsychological capacity required for emotional growth. Deconstruction of other more classic historical and mechanistic theoretical legacies is required to comprehend and experience this therapeutic presence.     

Limited space or space within limits

This paper has arisen out of the understandings gained following the in-patient treatment of a severely disturbed and self-damaging young woman with a borderline personality disorder. The phenomenon of projective identification is considered in terms of its capacity affectively to control apparently separate and independent professional structures within a hospital setting so that an entire institution may become mobilised into reflecting and acting out one patient's internal world. This phenomenon is illustrated using examples from the patient's own art-work and by clinical vignettes which aim to highlight the destructively regressive processes which occurred. One of the greatest difficulties was found to be the seemingly inevitable loss of boundaries between self and object; between intrapsychic and interpersonal; between staff-member and patient. Consequently some thoughts are offered concerning the need for structures, practical and theoretical, which can be utilised to help recognise and understand the enormously complex and diverse events which such a situation so often engenders.     

Clinical identification of compensatory structures on projective tests: a self psychological approach

In this article I discuss compensatory structure, a concept from Kohut's (1971, 1977) psychology of the self that is not as familiar as Kohut's other views about the self. Compensatory structures are attempts to repair selfobject failure, usually by strengthening idealization or twinship in the face of mirroring deficits. Compensatory structures, particularly their early indications, can be detected on projective tests for identifying adaptive resources and treatment potential. The clinical identification of compensatory structures on test findings is described using Rorschach and Thematic Apperception Test (Murray, 1943) content. Particular attention is devoted to the 2-part process of demonstrating first, an injury to the self, and second, how attempts to recover from such injuries can be detected on projective tests. Clinical examples are provided, and the differentiation between compensatory structures and defenses and sublimation is discussed.     

Some functions of the self personified by the father.

I have presented clinical material in order to illustrate a series of fantasies of parental intercourse which represent the self in successive stages of individuation from early projective identification to later introjective identification. From this is abstracted the idea of 'father' both as a component of the self representation and as the personification of the urge towards continuing development. Evidence is also gathered from the clinical material, supported by mythological parallels, to suggest that the whole process, including those components explicitly identified with the mother, is subsumed under an identification of the deintegrating self, its identity and integrity, with 'the father'.     

Contributions of object relations theory and self psychology to relational psychology and group psychotherapy

Object relations theory and self psychology are psychoanalytic perspectives that are especially concerned with interpersonal relations and their mental representations. Object relations theory began as an intrapsychic "singleton" psychology with the work of Freud and Melanie Klein. It subsequently evolved into a multi-person psychology with the work of Bion on groups, as well as the clinical and theoretical contributions of Winnicott and Fairbairn. Kohutian self psychology, which emerged later, has been interested in the relations between the self and significant others as mirroring and idealizing "self-objects." Stolorow's "inter-subjective perspective" emerged from self psychology as a full-fledged multi-person point of view. This article considers the significance of contemporary object relations theory and self psychology as relational, multi-person perspectives in terms of their application to group psychotherapy, focusing upon the group-as-a-whole, projective identification, transitional space and object, and self/self-object relations as particularly useful constructs. A clinical vignette is provided.     

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.     

Striving Toward Useful Interpretation While Managing Countertransference Enactments: Encounters With a Thick-Skinned Narcissistic Person

Narcissistic patients tend to push the analyst to work harder than usual to contain, understand, translate, and utilize their countertransference states. This is because of the unusually extreme reliance on denial, devaluation, projective identification, and control that these individuals exhibit. Defenses against loss, envy, greed, and dependence create difficult transference states in which symbolic or creative material is flattened, stripped, and neutralized. Feelings are out of the question. This clinical paper explores the narcissistic lack of connection to self and other that endures in the transference as well as in all aspects of these patients' lives. With thick-skinned narcissistic patients, there is a subtle lack of engagement, an underbelly of control, and a complete uncoupling of feeling or link between self and object. Envy is often a cornerstone of such difficult clinical problems and is part of an internal desolation that fuels an emotional firebombing of any awareness of interest in self or other. Detailed case material is used to show how confusing, alarming, and demanding such narcissistic patients can be, trying the very essence of the analytic process. They enter treatment looking for help, wanting a quick fix to their suffering, but resist the deeper understanding, learning, and change that psychoanalytic treatment offers.     

The Symbolic Object

Abstract

The term “symbolic object” is introduced as a way to understand the moments between analyst and patient where “something” new and dynamic emerges within the dyadic relationship. The symbolic object is the bridge between the idealized, all-good object and symbolization proper. The intrapsychic atmosphere between self and object representations is in a relatively non-conflicted state during this process. By reformulating the Nirvana principle and the principle of constancy as ways in which the organism economically strives for the most organized and homoeostatic state possible, the infant or adult can be seen to be searching for the position of lowest unpleasure possible. This is the optimum balance between the libidinal and aggressive forces in the self and object representational field. These moments of “truce” between often highly conflicted phantasies usher in a more refined use of projective identification as a form of intrapsychic/interpersonal communication. This is a particular atmosphere from which both parties, within the projective/introjective, back-and-forth dyadic world, can begin to co-create and rediscover assorted amalgams of self and object functioning. This newly awakened psychic entity is the symbolic object. This outgrowth of something fresh to the dyadic orbit is a mutative moment that propels the relationship into a different direction. Within the pairing of minds, a novel and mutual understanding is produced. Both parties share this new symbolic object and each is shaped by it.     

Projection and projective identification: developmental and clinical aspects

Projective identification and projection are defined, described, and contrasted. Projective identification is seen as an early or primitive defensive operation, and projection as later or more advanced and derivative in nature. The developmental origins and adaptive functions of projective identification are examined with an emphasis on the cognitive preconditions for the operation of this defense. The varying functions of both defensive operations are described within the context of psychotic, borderline, and neurotic personality organization. Case material is presented to illustrate the diagnostic approach to and the clinical functions of projective identification, particularly its importance in contributing to complementary identification in the countertransference. Also illustrated is the technical management of severe transference regression under the impact of projective identification. Finally, alternative approaches to the diagnosis and interpretation of projective identification are discussed.     

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.