Projective identification: an alternative hypothesis

The concept of projective identification as a primitive defense mechanism is reassessed. An alternative hypothesis is offered: that projective identification can best be understood as a compromise formation which includes as its major component an "identification with the aggressor" or a "turning of passive into active." This reversal is demonstrated within a two-tiered transference/countertransference of the analyst as powerful parent and the patient as the helpless child. On the deeper level the patient enacts the role of dominant parent and the analyst experiences the feelings which the patient had felt as a child.     

An interruption in unconscious communication in the analytic couple

The authors describe an interruption in communication in the analyses of two patients, which gradually brings the analytic process to a halt/standstill. They propose several hypotheses for understanding this situation. One explanation is mutual identification of primitive superegos in the analytic couple which generates a moralizing effect thereby hindering investigation and discovery. They emphasize the importance of countertransference involvement which partly provokes this particular type of impasse. They also suggest the idea of shared acting out, with complementary participations of analyst and patient. In this way the analytic couple supports a 'bastion' which protects against the risk of breaking the omnipotence of patient and analyst or contributes to this omnipotence. Their shared unconscious phantasy feeds collusion linked to unconscious persecutory guilt. The authors also describe movements to break free from this impasse. The enclave created by the analytic couple is detected and subsequently worked through by way of the patient's contribution of dream material and the analyst's work with her countertransference.     

Countertransference and changes in the conception of the psychoanalytic relationship

Abstract

The concept of countertransference has a long history in psychoanalysis. This paper sketches the phenomenon referred to by countertransference and the development of the concept, from being signs of disturbance in the analyst to an important road to knowledge about the patient's inner life. The complexity of the questions discussed today – how to understand the concepts of neutrality, abstinence, and empathy; the relative subjective mutuality and symmetry of the analytic situation; the analyst's enactments and self-disclosure of feelings – reflects the complexity of the contemporary view of the patient–analyst relationship. In conclusion, the author presents a model illustrating the disturbing and informative aspects of countertransference together with the conceptual relationship between countertransference on the one hand and empathy and projective identification on the other. Finally, by differentiating between intuitive and irrational levels of functioning, an integrated model for countertransference is presented, synthesising the essence of the concept as it is used today.     

THE CONCEPT OF OBJECTIVE COUNTERTRANSFERENCE AND ITS ROLE IN A TWO-PERSON PSYCHOLOGY

Objective countertransference comprises those feelings the analyst experiences with the patient that are repetitions of feelings from the patient's life outside the analysis. It is viewed as being induced by the patient and is understood in the context of the patient's life, not the analyst's. The concept is used to understand the relationship of some of the analyst's feelings to recurrent interpersonal patterns in the patient's life. It has often been viewed as being incompatible with a two-person psychology. Here, in contrast, it is argued that objective countertransference is only one current within the analyst's total emotional response to the patient, and that it should be conceptualized as a component of a broader two-person psychology. However, the use of objective countertransference as a conceptual tool highlights aspects of the analytic relationship that differ from those emphasized in current two-person models. A case example is analyzed from both perspectives to illustrate their similarities and differences. Although the concept of objective countertransference can enrich the analyst's understanding of certain dimensions of the analytic relationship, it is not a theory of technique and it is not wedded to any particular style of psychoanalytic intervention.     

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.     

The animating body: psychoid substance as a mutual experience of psychosomatic disorder

Starting from Jung's hypothesis of 'the psychoid', the author suggests that the concept can be extended and understood as a dynamic, relational and interpersonal experience-especially in regressed analytic relations. The author then defines his use of the term 'animating body' as having to do with primitive animal imagery and with psychosomatic symptoms stemming from disturbed pre-verbal and pre-whole-object stages of development. A case of a borderline patient is presented, whose projective identifications into the analyst infected him with her psychosomatic disorder, with her internalized Oedipal confusion and necessarily induced a mutually similar animal dream symbolism. If these embodied countertransference experiences (of desperate merging and sickening identification) can be lived through (tolerated and survived), thought through and interpreted, then they can actually become enlivening and lead to a therapeutic psychosomatic co-ordination.     

A Picture Book of Internal Events: The Colours of Rage and Love

The views on countertransference in psychoanalytic theory and practice have undergone a change within the last fifty years. From being considered an impediment to analysis, countertransference is today looked upon as an important potential for a tentative understanding of what is unconsciously communicated from the analysand to the analyst. This implies that the analyst is susceptible to the unconscious interaction in the transference and the countertransference, and that he/she becomes conscious as quickly as possible of what is taking place. This applies especially to erotic feelings which are often intensified in analyses with patients with a serious psychopathology, as well as in analyses with patients in regressive phases where projective identification is the dominant factor used as a defence and a communication. Opinions differ as regards the question of how to deal with such a situation, especially whether it is right to be candid about the analyst's countertransference feelings towards the analysand, something most would caution against. In an example from an analysis, the analyst describes how he was influenced by an unconscious erotic countertransference. After three years of therapy with a patient with a serious psychopathology, he developed ?motherly” feelings, which he interpreted as reflecting a child's longing for closeness and physical contact. The result was that a few times, he ?forgot” to indicate the end of the session, which was then prolonged, and also that he embraced her on several occasions before she left the session. One year later, he had intense sexual fantasies and dreams about the analysand, which he experienced as both enticing and alarming, and as an impediment to the analysis. He soon became aware of the element of projective identification in the interaction, and by interpreting the analysand's unconscious communication, he regained his ability to maintain an analytic attitude and clear boundaries.     

On dreaming one's patient: reflections on an aspect of countertransference dreams

This paper explores the phenomenon of the countertransference dream. Until very recently, such dreams have tended to be seen as reflecting either unanalyzed difficulties in the analyst or unexamined conflicts in the analytic relationship. While the analyst's dream of his/her patient may represent such problems, the author argues that such dreams may also indicate the ways in which the analyst comes to know the patient on a deep, unconscious level by processing the patient's communicative projective identifications. Two extended clinical examples of the author's countertransference dreams are offered. The author also discusses the use of countertransference dreams in psychoanalytic supervision.     

Some technical problems of countertransference

There are several aspects of the psychoanalytic interaction that foster the emergence of countertransference. First is a persistent identification with the patient, based primarily on the sharing of unconscious fantasies. Then there is the evocative power the patient's material may have upon latent unresolved conflicts in the analyst. Finally, the analytic setting itself may evoke a broad range of countertransference responses. Particular attention must be paid to those interventions of the analyst which represent attempts to divert his own and the patient's attention from emerging derivatives of the conflicts. There are many clues that should alert the analyst to the possibility of interfering countertransference.     

Encounters with Omnipotence in the Psychoanalysis of Substance Users

An assumption made in this paper and explored for its clinical implications is that an act of chronic drug use often marks or serves to implement an underlying omnipotent self-state. Psychoanalytic work with substance users, as compared with other approaches, trains attention on these omnipotent states and makes use of the transferential exchange as a therapeutic tool. States of omnipotence are particularly examined here in the context of recent attention to dissociation as an organizing force in the personality, and in the configuration of the transference—countertransference of the treatment relationship. A case illustration is used to apply current thinking on dissociative and projective processes, and their role in enactment in the therapeutic exchange, to illuminate the frequent interplay of omnipotence and helplessness in analytic work with substance-using and other patients.     

On understanding projective identification in the treatment of psychotic states of mind: The publishing cohort of H. Rosenfeld, H. Segal and W. Bion (1946–1957)

A publishing cohort of Kleinian analysts – Rosenfeld, Segal and Bion – implemented Klein's (1946) notions of projective identification and the 'paranoid ' and 'schizoid ' positions in the understanding of a group of psychotic disorders. The author differentiates Klein's (1946) Notes on some schizoid mechanisms paper from its revised version of 1952, maintaining that it was Rosenfeld's clinical work during this period that helped to centralize Klein's redefinition of projective identification. The stage was set for Segal 's contribution in terms of 'symbolic equations,' where the psychotic's attack on the breast left him incarcerated in internal torment and persecution, where things-in-themselves were confused with what they symbolically represented. Segal in turn linked psychotic to normal, paranoid–schizoid to depressive positions, where by means of projective identification and symbolic imagination, the patient could arouse feelings in the analyst related to sadness, guilt and loss. Bion assumed that psychotic pathology reflected disordered thinking, when the severely disturbed used language as a mode of action. The psychotic was profoundly confused between the use of thought and action in the natural world – where thought was required, he preferred action and vice versa. Bion also drew upon projective identification in a new, broader way, so that analysis could now become more of an intersubjective, bi-directional field of projective and communicational influence between patient and analyst. The paper concludes with the impact of the work of Rosenfeld, Segal and Bion and variations on the technique of analyzing psychotic states in terms of the patient's early history, transference and countertransference.     

CONTAINING,TRANSLATING, AND INTERPRETIVE ACTING OUT

In analytic treatment, when patients project unspoken aspects of their internal self and object world, the analyst has to find ways to understand and communicate those expelled phantasies without the patient feeling accused, seduced, or persecuted; even when we do our best at interpreting such inner conflicts, the patient may experience our interpretations as assaults, forcing them to give up themselves or their hope for reconnecting with an object. The patient will resist or fight our efforts through the use of projective identification. Caught up in patient's projections, the analyst in turn may enact some of these phantasies by becoming the object rather than translating its presence in the transference, by overemphasizing one side over another of the patient's conflict, or by interpreting accurately but prematurely. These issues are illustrated in two case presentations and discussed in relation to the views of contemporary Kleinian writers on transference and countertransference.     

Miscarriages of psychoanalytic treatment with suicidal patients2

The author describes a particularly perilous frontier on the psychoanalytic landscape‐ namely, the treatment of suicidal patients with serious personality disorders. Using a clinical example of egregious boundary violations by an analyst, he describes specific countertransference pitfalls that lead to mishandling the patients' expressions of suicidal despair. These include disidentification with the aggressor, failure of mentalization, collapse of the analytic play space, reactions to loss in the analyst's personal life, omnipotence, envy of the patient and masochistic surrender. The author emphasizes the unique vulnerabilities that accompany analytic treatment of such patients.     

Critical realism: distinguishing the psychological subjectivity of the analyst from epistemological subjectivism

To clarify the concepts of critical realism, subjectivity, and subjectivism, distinctions are drawn among ontological subjectivism, moral subjectivity, psychological subjectivity, and epistemological subjectivism. Psychological subjectivity, including the ongoing affective life of the analyst, is an essential aspect of the analyst's response to the patient, and may either facilitate or distort an adequate observation of transference and countertransference dynamics and of the psychic reality of the patient. Subjectivism in current psychoanalytic literature involves an argument that there is an "irreducible" subjectivity in the analyst, who is bound to see things from an incorrigibly personal point of view, such that there is no substantial subject-object differentiation between analyst and patient. Issues of authoritarianism in the analyst, or of pathological certainty, should not be confused with the issues of epistemological objectivism. The concept of critical realism or scientific objectivism includes the essential idea that there is no pure knowledge, no complete knowledge, that often evidence is insufficient for knowledge of some aspect of nature, and that care must be to taken understand what is sufficient knowledge in a given area, in this case clinical psychoanalysis. The question is raised whether "projective identification" makes the sorting out of "what comes from whom" impossible. It is argued that when free association is sufficiently facilitated, when there are enough corrections of the distortions wrought by transference and countertransference, when defenses are analyzed, and when sufficient subject-object differentiation is recovered, the analyst can get to know enough of the patient's psychic reality for the therapeutic and scientific purposes of psychoanalysis.     

Body talk: somatic countertransference

This article focuses on a clinically observed event: the impact of the analytic session on the corporeality of the psychotherapist. The author sees this as an example of countertransference, in this instance ‘somatic countertransference’. Short and long clinical extracts are used to detail these events. The author touches on some early ideas on somatizing. The Kleinian concept of projective identification is itself explored and then used to explore further the idea of somatic countertransference.     

Imaginary hide and seek - A technique for opening up a psychic space in child psychotherapy

Working with concrete states of mind confronts the analyst with major countertransference problems: faced with the emptiness of the patient's psychic functioning, the analyst is threatened with the deadening of his own psychic capacities and the crumbling of the analytic process. This paper examines two cases of children who presented in very different ways, one featuring deeprooted depression and empty behaviour, the other featuring mastery and destructive omnipotence. It proposes a specific technique to enable the reconstruction of representational functioning through play. In the context of the transference/countertransference relationship and the analytic process, the introduction of a game of imaginary hide and seek, whose rules are defined and analysed, may represent an instrument of choice for opening up an undeveloped psychic space in these pathologies.     

The Development of an Analytic Perspective in the Group Leader: Some Basic Thoughts

Previous experience working with individuals on a one-to-one basis along with previous analytic therapy are important prerequisites for analytic group training. Training must emphasize understanding of group-as-a-whole processes, such as basic assumption life, complex transference manifestations, as well as awareness of one's countertransference toward individuals, subgroups and the group-as-a-whole. Specific concepts derived from object-relations theory such as projective identification are crucial to master. Personal analytic group therapy is recommended.     

“You Must Remember This”

The question of a theory of analytic change is approached through a consideration of analytic impasse. Impasse is considered in relation to impasse in the analyst, linked to an impasse in some forms of mourning in the analyst. The analyst's impasse is considered in the light of character formation, the relation of analytic vocations to early attachment, and object ties in the analyst leading to problems with omnipotence. Impasse then is tied to various processes and defenses that shape and contribute to the analyst's countertransference. Analytic change is considered then in the context of theories of nonlinear development, models of speech practice, and mutative action. These ideas are explored through case material.     

Projective identification and working through of the countertransference: A multiphase model

Referring to Melanie Klein's unpublished views on projective identification, Bion's theory of container/contained and Money‐Kyrle's understanding of countertransference as a process of transformation, the author develops a multiphase model of projective identification. He differentiates five subphases of (1) adhesion, (2) penetration, (3) linking of the projection with an internal object of the analyst, (4) transformation and (5) re‐projection. In the author's view the differentiation of overlapping subphases may be helpful to better localize problems of working through the countertransference. Some technical implications are illustrated by brief clinical vignettes. To conclude, the paper discusses typical impasses and options for interpretation.     

Analyst Envy in Working With an Artist: Four Scenes

The paper describes a rich analytic relationship with an artist patient in which countertransference feelings of envy surfaced. The analyst's examination of her envy led to a review and reassessment of the concept of envy in psychoanalysis. I propose here that envy is a complex affect that moves on a continuum from a fairly benign combination of admiration and desire to more malignant emotional states, described by Melanie Klein and her followers. Malignant envy may lead to anger, fury, and murderous rage. A more benign form of envy, which emerged for the analyst in the treatment, resulted in psychic support for and validation of the patient as well as a shift in personal identifications and new motivational directions for the analyst.