Basic Considerations in the Application of Therapy and Education to Parent Groups

This article presents a couples group therapy treatment approach that uses analytic object relations concepts such as transference/countertransference, projective identification, containment, and the holding environment. Object relations theory is seen as the most useful theory with which to view couple interaction because it is based on a two-person psychology and focuses on the impact of relational systems on the development of the person. This includes the idea that the person grows within the attachment to another person. Group therapy is seen as a more effective treatment approach because the group is a resilient holding environment that provides an avenue in which projective identifications can be understood and contained, power can be redefined, isolation of the couple can be decreased, and the couple's responses can become more versatile. The model described is illustrated with clinical vignettes from an open-ended couples group.     

Countertransference as Projective Identification

SUMMARY

While all countertransference reactions call upon the therapist to examine his/her internal family and unresolved issues, many instances of countertransference can best be understood as originating from and replicating and clients' internalized object relations. In this way, countertransference can be likened to projective identification. By processing countertransference as a form of projective identification the couples therapist can more effectively comprehend and work with important relationship problems. This article outlines the process of analyzing and responding to these kinds of countertransference reactions.     

Interpersonal conflict in group therapy: An object relations perspective

The aim of this paper is to demonstrate how object relations theory can be used to understand and regulate interpersonal conflict in group psychotherapy. Such concepts as projective identification, intersubjectivity and the analytic third are used to describe how conflict emerges in group psychotherapy and how it can be worked through. Case material is also provided to illustrate concepts and techniques in promoting a group's transition from a paranoid/schizoid to a depressive position. Positive aspects of the concept of projective identification are discussed including its use as a form of communication, a method of reducing anxiety and reintegrating previously dangerous and threatening aspects of the self.The paper was funded by Evan F. Lilly Memorial Trust Grant PV 13,067.     

Group Therapy with Sexually Abused Boys: Leadership,Projective Identification,and Countertransference Issues

Group therapy is an essential component of the treatment of sexually abused children. Since the painful affects associated with the abuse are often dissociated or acted out, the group leaders learn of the affective experience of the abuse through the process of projective identification. The leaders must be aware of this process, set limits on the abusive acting out in the group, and help moderate, label, and empathize with the affect. It is through this difficult process that the children have a chance to reintegrate and work through their abuse experiences so they no longer feel compelled to act them out through repetitive abusive relationships. Specific leadership, countertransference, and projective identification issues in group therapy with sexually abused boys are discussed.     

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.     

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.     

Making Sense of Walt: A Psychoanalytic Understanding of Racism

This paper explores Klein's concepts of the depressive position, paranoid position, envy, projective identification and reparation, and their application to understanding overt racism. An extensive case example from the movie Gran Torino and its protagonist Walt Kowalski are the foci of this theoretical speculation. Implications for antiracist practice are discussed.     

Exploration of a Marital Typology: Implications for Marital Functioning in a Multi-Ethnic Sample

Marital conflict is associated with multiple negative outcomes for couples, including marital dissatisfaction and divorce. Little research, however, has examined conflict in Hispanic/Latino couples or its association with marital satisfaction, which creates an unfortunate knowledge gap for clinicians working with diverse client groups. The present study sought to examine both marital conflict and satisfaction using a sample of 231 European American (EA; n = 108) and Hispanic/Latino (H/L; n = 123) couples. Through observational coding, couples were placed into four groups based on their type of conflict management strategies: Harmonious, Withdrawn, Conflictual-Expressive, or Conflictual-Hostile. For both ethnic groups, couples in the Harmonious group were nondistressed and couples in the Conflictual-Hostile group were in the distressed range of marital satisfaction. Cross-ethnic differences emerged. EA couples experienced distress when both hostile (Conflictual-Hostile) and nonhostile conflict (Conflictual-Expressive) communication types were observed, while only hostile conflict was associated with distress for the H/L group. H/L couples reported similar levels of satisfaction in both the Harmonious and Conflictual-Expressive groups. H/L couples also fell within the distressed range when withdrawn communication patterns were observed; however, this was not the case for EA couples. These differences suggest that both types of conflict are associated with marital distress for EA couples, whereas hostile conflict and withdrawn behavior appear to be more negatively associated with marital satisfaction in H/L couples. Results provide support for the use of an observational coding system with H/L and EA couples and also suggest the importance of understanding how differences in expressions of conflict across ethnicities may relate to marital satisfaction.     

A Kleinian analysis of group development

Various theoretical models have been used to study stages of group development. This paper analyzes the early phases of a therapy group using Melanie Klein's theory of developmental positions. In discussing the underlying forces that contribute to the evolution of the group, a special emphasis is placed on Klein's concept of projective identification and Bion's containment model.     

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.     

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.     

Toward Development of a Projective Set

An exploration of the possibility of developing a projective set in a client that will allow for lowering of his defenses and thus possibly eliciting “richer projective materials.” A “anxious tension” set was produced in one group of Ss by means of an intelligence type test and “playful tension” was produced in another group by means of a fantasy task. A projective technique (Part A of the Rosenzweig F-Battery) was then given to both groups. The results indicate that this projective technique was taken at a more implicit (or deeper) level following the “playful tension” than following the “anxious tension.” Implications for the pre-test environment of projective techniques are given.     

Parallel Identification: A Shield Against the Assault of Traumatic Jealousy

This paper draws a connection between the clinical emergence of a primitive form of identification, termed parallel identification, and a temporary stasis in the transference. Parallel identification is defined as a manic defence that blocks the acute suffering brought on by consciously experienced jealousy arising from the loss of a beloved yet sadistic object. It occurs as follows: the identifying subject merges with his object of desire through compulsive imitation. This merger holds the subject in a developmental cocoon of non-being that negates his perception of any rivals for the object's love. Parallel identification, illustrated in two case examples, inhibits conscious jealousy, subsequently blocking the subject's capacity to evolve through empathy and fantasy.

For theoretical context I introduce a framework that classifies established forms of identification dually, as either penetrating or nonpenetrating, with parallel identification offered as one example of the latter. Nonpenetrating identifications are merger fantasies that occur one-sidedly, within the subject only, protecting the subject from the trials of forging a more fully elaborated, three-dimensional internal world based upon spontaneous relatedness and empathy with another. Penetrating identifications occur bilaterally, impacting both self and other, allowing for an internal world of empathy and fantasy to be co-created within a two-person relationship. The paper asserts that nonpenetrating identification, though serving a protective purpose, may temporarily serve to blunt the power the therapist normally finds through internally tracking projective/introjective processes. In the first case example, the discovery and articulation of parallel identification brought a new sense of dynamism to a stalemate in the transference, while in the second case, the stasis-inducing presence of undetected parallel identification temporarily dulled the sharp edge of projective identification within an erotic transference. In both cases, parallel identification was a defensive response to unbearable jealousy that, until made conscious, inhibited relatedness in subtle but extreme ways within each treatment.     

The Id and the Regulatory Principles of Mental Functioning by Max Schur

The authors draw on their experience as male and female cotherapists with a group of adults having a history of incest. These patients repeat in therapy numerous roles learned in childhood. These roles influence countertransference through projective identification, inducing role suction and/or role reversals. Acknowledging the pressure to assume these roles facilitates treatment. The role fluctuations may cause additional confusion.

Countertransference experiences are described, ranging from disbelief, revulsion, and rage, to fantasies of rescue, feelings of attraction, and defensive fears. The authors were, on and off, deskilled by their extraordinarily intense countertransference responses when treating the emotional scars of incest.     

Leadership in the Therapist-Centered Group-as-a-Whole Psychotherapy Approach

Psychodynamic group therapy, by definition, offers group members an opportunity to revisit some of the earliest developmental stages. The authors argue that conflicts around separation and individuation are stimulated with each beginning and ending of an intimate group. The leader of that group is similarly challenged around these primary conflicts. The question of group contagion, difficulties around the capacity to be alone, and the problems of projective identification are explored as they have an impact on leaders in a group. Case examples are offered to illustrate leadership problems along these dimensions.     

The Patient-Staff Community Meeting: A Tea Party with the Mad Hatter

The author shows how object relations group therapy focuses on primitive defense mechanisms that shape the group-entity image or “basic assumptions group.” Such primitive defense mechanisms as splitting, projective identification, omnipotent denial, projection, and introjection are the mental resources to protect the endangered self and the threatened objects from the fantasized imminent destruction. Object relations group psychotherapy addresses those defenses and the underlying psychotic anxieties, offering members opportunities to search for other ways to respond to their primitive fears. The author introduces two extensive clinical vignettes to illustrate how object relations group methods are different from other group-centered psychoanalytic techniques. He concludes by commenting on future theoretical refinements and on the problems in the professional practice of this modality.     

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.     

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.     

Containment and the threat of catastrophic change in psychotherapy groups

Wilfred Bion's seminal work with treatment and training groups is considered by many group therapists to be a classic study of group behavior. Despite the influence of his early work on groups, practitioners frequently find his later writings difficult to apply to group settings. The purpose of this paper is to illustrate the potential usefulness of Bion's later psychoanalytic writings to our understanding of the complex dynamics active in therapy groups. This paper examines the relationship among four concepts that Bion emphasized in his later writings: projective identification, containercontained, (Ps<---->D), and catastrophic change. Two clinical vignettes are presented to demonstrate how these concepts can aid the therapist in understanding the complicated dynamics active in therapeutic group settings.     

Conflict management: A premarital training program in mutual problem solving

Abstract

The purpose of this study was to evaluate the effectiveness of a structured educational program designed to train premarital couples in communication and mutual problem-solving skills. Twenty-six couples participated in an eight-week, 24-hour problem-solving training program, while 28 similar couples participated in an eight-week, 24-hour relationship discussion group. Results indicated that the problem-solving group, as compared to the relationship-discussion group, showed a significant increase in communication and mutual problem-solving skills. Discussion focused on the benefits for premarital couples of learning effective problemsolving procedures as well as the need for follow-up assessments of both behavioral skill level and relationship satisfaction and adjustment.