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Projective Identification and Psychotherapeutic Technique

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An examination of projective identification and its clinical uses from a Kleinian perspective. The author puts forward the hypothesis that identification is the patient's way of mastering significant trauma.

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8 Chapters

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1. Introduction

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Projective identification is not a metapsychological concept. The phenomena it describes exist in the realm of thoughts, feelings, and behavior, not in the realm of abstract beliefs about the workings of the mind. Whether or not one uses the term or is cognizant of the concept of projective identification, clinically one continually bumps up against the phenomena to which it refers—unconscious projective fantasies in association with the evocation of congruent feelings in others. Resistance on the part of therapists and analysts to thinking about these phenomena is understandable: it is unsettling to imagine experiencing feelings and thinking thoughts that are in an important sense not entirely one’s own. And yet, the lack of a vocabulary with which to think about this class of phenomena seriously interferes with the therapist’s capacity to understand, manage, and interpret the transference. Projective identification is a concept that addresses the way in which feeling-states corresponding to the unconscious fantasies of one person (the projector) are engendered in and processed by another person (the recipient), that is, the way in which one person makes use of another person to experience and contain an aspect of himself. The projector has the primarily unconscious fantasy of getting rid of an unwanted or endangered part of himself (including internal objects) and of depositing that part in another person in a powerfully controlling way. The projected part of the self is felt to be partially lost and to be inhabiting the other person. In association with this unconscious projective fantasy there is an interpersonal interaction by means of which the recipient is pressured to think, feel, and behave in a manner congruent with the ejected feelings and the self- and object-representations embodied in the projective fantasy. In other words, the recipient is pressured to engage in an identification with a specific, disowned aspect of the projector.

 

2. The Concept of Projective Identification

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Psychoanalytic theory suffers from a paucity of concepts and language to describe the interplay between phenomena in an intrapsychic sphere and phenomena in the spheres of external reality and interpersonal relations. Since projective identification represents one such bridging formulation, it is to the detriment of psychoanalytic thinking that this concept remains one of the most loosely defined and incompletely understood of psychoanalytic conceptualizations.

PROJECTIVE IDENTIFICATION AS FANTASY AND OBJECT RELATIONSHIP

As discussed in chapter 1, through projective identification the projector has the primarily unconscious fantasy of ridding himself of unwanted aspects of the self; depositing those unwanted parts in another person; and finally, recovering a modified version of what was extruded.

Projective identification will be discussed as if it were a sequence of three phases or steps (Malin & Grotstein, 1966). However, the notion of there being three aspects of a single psychological event better conveys the sense of simultaneity and interdependence that befits the three aspects of projective identification that will be discussed. In a schematic way, one can think of projective identification as a process involving the following sequence of events. First, there is the unconscious fantasy of projecting a part of oneself into another person and of that part taking over the person from within.1 Then, there is a pressure exerted through the interpersonal interaction such that the recipient of the projection experiences pressure to think, feel, and behave in a manner congruent with the projection. Finally, after being “psychologically processed” by the recipient, the projected feelings are reinternalized by the projector.

 

3. Issues of Technique

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As with the concept of transference, projective identification provides a context for understanding clinical phenomena but does not dictate a specific technique with which the therapist communicates his understanding. Kleinian, the British Middle Group, the Modern Psychoanalytic Group, and classical analysts are in agreement on the centrality of the concept of transference to psychoanalytic work; nevertheless, the technique employed by each of these groups in the analysis of the transference varies significantly. Similarly, the concept of projective identification provides a framework for thinking about the clinical phenomena occurring in psychotherapy and psychoanalysis, but the therapist’s mode of intervention will be determined by an additional set of principles constituting this theory of technique: the clinical material that should be addressed first (conscious, preconscious, or unconscious, defense or wish, surface or depth, early or late developmental level, etc.); the timing of the intervention; the form of the intervention (verbal interpretation, confrontation, clarification, questions, silent interpretation, alteration in management of the framework of the therapy, etc.).

 

4. Contrasting Psychoanalytic Approaches

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Until recently very few therapists or analysts outside of the Kleinian group have used either the term or the concept of projective identification in their clinical thinking. However, inasmuch as the phenomena addressed by this concept (unconscious projective fantasies in interplay with congruent feelings evoked in the recipient) are an aspect of all psychotherapeutic work, each school of psychoanalytic thought has, over time, developed methods of handling this facet of the therapeutic interaction. In the present chapter, the relationship between the technical approach presented in this volume (see in particular chapters 2 and 3) and the principles of technique espoused by analysts of the classical, Kleinian, British Middle, and Modern Psychoanalytic Groups will be discussed.

THE KLEINIAN APPROACH

Because projective identification was first described by Melanie Klein (1946), it is commonly, though erroneously, assumed that it is inextricably linked with Kleinian theory (see, for example, Meissner, 1980).1 Projective identification has no inherent connection with any aspect of specifically Kleinian meta-psychology or clinical theory (for example, the Kleinian notion of the primacy of the death instinct, its assumptions concerning the infant’s capacity for fantasy activity from the earliest days and weeks of life, and the idea that the Oedipus complex and superego develop in the first year of life).

 

5. The Developmental Impact of Excessive Maternal Projective Identification

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The concept of identification has historically served as a vehicle for conceptualizing the interface between object relations and individual psychological organization. This has involved therapists and analysts in the task of coming to terms with their views about the ways in which the psychological attributes of one person are “taken in by” or “made a part of” another person (Fairbairn, 1952; Fraiberg et al., 1975; Freud, 1905, 1915b; Guntrip, 1961; Hartmann, 1939; Kernberg, 1966, 1976; Knight, 1940; Loewald, 1962; Schafer, 1968).

In this tradition the present chapter examines a form of identification demonstrated by a specific group of patients. This form of internalization will be explored to further refine the concept of identification and contribute to our thinking about the interplay of maternal pressures and the psychological processes of the infant.1

The clinical focus will be on one of this group of patients who demonstrate a form of identification with their mother and in particular with the conflicted aspects of the mother. These patients seem to take the mother’s pathology, and especially the mother’s view of the patient as colored by her pathology, as a model for identification which is reflected in their self-representations, in their object relations, and in many of the characteristics of their ego organization. The early history of these patients is dominated by a picture of a mother deeply involved in her own problems—problems from which she failed to shield the infant.2Among the group of patients studied, examples of such maternal preoccupations include: one mother who was consumed by wishes for the child to be an embodiment of an aspect of herself which was both intensely hated and highly idealized; another mother who was filled with the need for the baby to restore her relationship with her mother, who had died when she was 10 years old; and finally, a mother consumed by wishes and fears concerning the sex of the child because of her own wishes, fears, and disappointments about her own sex.

 

6. Psychiatric Hospital Treatment

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THE INPATIENT SETTING

The clinical usefulness of the concept of projective identification has been studied primarily in the context of outpatient individual psychotherapy. In this chapter we will examine projective identifications as it occurs in inpatient treatment. Inpatient psychiatric work entails a broadened and less well defined framework of treatment and is powerfully influenced by the social system of the psychiatric hospital within which the treatment takes place.

In this chapter, several complementary lines of thought concerning analytic inpatient work are discussed. Case material will be presented which demonstrates the value of the concept of projective identification as a framework for organizing and dynamically formulating the complex interplay between the intrapsychic and the interpersonal sphere. Finally, there will be a discussion of two additional facets of projective identification as they relate to hospital treatment: projective identification occur-ing in a group setting and the accessibility to action in inpatient treatment.

 

7. The Nature of Schizophrenic Conflict

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HISTORICAL AND CONCEPTUAL FRAMEWORK

Beginning with Freud, analysts have been torn about whether schizophrenia can be understood in terms of conflicted psychological meanings or whether schizophrenia represents a disturbance on the level of the capacity to generate psychological meanings. The theory proposed in this chapter holds that an exclusive focus on either of these alternative levels is inadequate and that it is necessary to generate conceptualizations addressing the interplay between these levels, i.e., the level of psychological meanings and the level of the capacities generating these meanings, in order to develop a comprehensive psychoanalytic theory of schizophrenia.

This chapter discusses a psychoanalytic formulation in which schizophrenia is viewed as a form of psychopathology involving conflict between wishes to maintain a psychological state in which meaning can exist, and wishes to destroy meaning and thought and the capacity to think and to create experience. Moreover, the theory holds that not only are there wishes to destroy meaning, but that these wishes are enacted in the form of the schizophrenic’s actual attack on his own capacities for attaching meaning to perception and his capacity to think about that which he perceives.

 

8. Treatment of the Schizophrenic State of Nonexperience

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The ability of schizophrenic patients to manage feelings within the psychological sphere of representations is frequently exhausted and these patients then resort to psychological methods of dealing with their thoughts and feelings in primitive and pathological modes that reach beyond the sphere of psychological representation. It is these psychological modes, to be referred to as types of actualization of warded off emotional content, that will be the focus of the present chapter. Case material will be presented in order to explore the way in which psychological representations are actualized, both interpersonally and intraper-sonally—that is, the way such events are played out, enacted, and made actual, both in relation to other people and in relation to the patient’s own mental capacities. As the clinical material is presented, the rationale for both the content and the timing of interpretations and other forms of the therapist’s processing of the clinical data will be formulated in terms of the framework of interpersonal and intrapersonal actualization. Also, within this framework, the concepts of transference and resistance will be expanded and formulated.

 

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