Understanding Projective Identification in Psychotherapy

by Barbara O’ Connell

Projective identification is a complex and much misunderstood concept in the world of psychotherapy. The term originated of course from the work of Melanie Klein in her ground breaking work on the paranoid-schizoid and depressive phases of childhood development in the 1940s and has since been much researched and expanded upon. From the references which I have included herein you will find detailed descriptions and discussions on this topic with many case examples to assist with a more thorough understanding of this complex phenomenon. This article however is intended as a guide for newly qualified psychotherapists to highlight the importance of understanding and working with projective identification because it is according to Bion the single most important phenomenon in individual psychotherapy. (Ogden, 2005:25) Newly fledged Psychotherapists in general are ill equipped I feel for handling this phenomenon-theoretical knowledge and practical experience within training alone are inadequate in terms of understanding and managing it therapeutically. Its import will not be fully realized until the relationship between therapist and client obtains a certain level of trust and the relationship has had time to evolve and develop.

The first thing to be aware of in the relationship is that the primitive defence of projective identification involves both loving and hateful feelings affects being evacuated from the client into the therapist. Many mistakenly believe that projective identification only involves the more chaotic dysregulated emotions such as raw arousal, excitement, elation, rage, terror, disgust, shame and despair which are split off and expelled because they are felt to be unmanageable. It however occurs equally when one is unable to own and manage more positively accepted qualities because of fear of guilt or envy, retaliation, abandonment, loneliness or fear of harming someone important to them. By defensively inducing the projected experience, whatever it is, in another one is more able to avoid the reality that the projected content is part of one’s own experience. This of course occurs continually in all of our relational interactions. It is however in the therapeutic relationship that these attitudes and behaviours can be brought to the fore and explored more fully so that the projector with support can become more aware of and change these maladaptive behaviours and learn to relate in clearer, more conscious ways.

It is important to be aware that the aim of projective identification in therapy is as an affective communication to evoke empathy and understanding as well as to secure a container outside of oneself which will hold and manage the unwanted feelings. The projector, with a certain attitude and behaviour, exerts unconscious pressure on the therapist to accept and identify with the projections and has a fantasy of inhabiting not only the mind but also the body and emotions of the receiver. The projector Ogden maintains is operating in part at a developmental level wherein there is a profound blurring of boundaries between self and object representations. (Ogden, 2005: 13) Projective identification can be seen as a self fulfilling prophecy in terms of the projector whereby she may believe something about her therapist which isn’t entirely true but by the process of relating to her as if it were the therapist may succumb and identify with them in a process called introjective identification thus altering their usual behaviour to make it true. (Scharff, 1992) In this way projective identification is used to obtain control over the therapist by infiltrating their mind and body and using them as a container for the spilt off unbearable feelings. Borderline and narcissistic clients have a strong tendency to manipulate and merge with the identity of the therapist in this way. As projective identification involves the use of power and coercion as a means of attempting to control one’s undesirable and unbearable impulses through the illusion of placing them inside somebody else’s personality one may try to control the individual’s mind, in order to keep her own aspects under control. The projecting person generally seeks to be physically close to the person into whom the fantasy is projected which leads to identity connection with the other. This is evidence that whilst the projector wants to be split off from certain unpalatable bits she doesn’t want to be too far away from them either. Ogden believes that the projector doesn’t want to disown the split off bits entirely, rather she needs them to be kept alive in the receiver so she can study and decide whether they can be managed by another and whether it feels safe enough for her to take them back. Ogden believes that the client actually experiences relief when the projection has been extruded and preserved. (Ogden, 2005:15) Preserving the projections then is a crucial role for the therapist.

What is important then in working with our clients is that we are actually willing to receive, process, digest and effectively identify with our client’s projections so that we can deliver them back in manageable, bite-sizeable portions for reintegration in a safer and healthier way for growth and healing to occur. The therapist’s capacity then for toleration and containment is considered their most important therapeutic resource. We need to identify with the client and allow her to direct us and our associations both consciously and unconsciously by matching and identifying with the feelings that she projects. However when we match an inflamed feeling we may re-present in our minds our own powerful sub-symbolic representations in addition to our client’s material. Traditionally psychoanalysts focused more on the projection and what the client was doing rather than on what they as analysts were doing. The focus has since been expanded to explore what is concurrently happening for the therapist in the interaction and how their process affects the therapeutic encounter. The encounter is intersubjective and allows both to feel and re-experience troubling patterns and attitudes that constitute unconscious affective categories. The question is not what to do if countertransference is present but in what form it takes and how to use it effectively. The effects of projective identification are strong and can produce intense countertransference reactions. Our predicament involves bearing and metabolizing issues of our own personal pasts at the same time as experiencing deeply painful issues as presented by our clients. What we have difficulty tolerating in the other is unquestionably more often than not matched by what we disavow in ourselves. Our challenge at this crucial juncture is to render our own feelings and thoughts as well as those of our clients’ into empathic understanding and be able to contain both. (Greatrex, 2002:188)

It is the therapist’s task first of all to understand and assimilate the intrapsychic projections and through verbalisation, exploration and understanding provide a vehicle to work through the various conflicts, fears and pains associated with them. Well timed and attuned clarifications and interpretations are paramount when working with projective identification as each client will differ in terms of what they are able to retrieve and assimilate. Often it may not be wise to interpret at all depending on the capacity and psychological maturity of the client to work through their projections. This may require then of the therapist a more creative approach to working through the material presented. Therapist’s need to be open to taking an experiential approach and be unafraid to use themselves and their experience and whatever else they have at their disposal in the relationship to assist their clients in working through their projective identification difficulties. The moment of repair includes the sense that the therapist can bear what both the client and often the therapist originally found unbearable. The therapeutic action rests on the possibility that the client matches the empathic, hopeful, comforting feelings we project as they receive what Ogden considers a ‘modified version of what was extruded’ (Ogden, 1979:357)

What is projected is not only primarily a part of the client but a fantasy of an object relationship. This is often the reason why the therapist is tempted to act out and resist the pressure to be a specific object relationship that exists as part of the client’s object relational psychic structure. The projector in this instance will notice that the recipient has been thrown by the projection and the sense of these feelings or experiences as being intolerable and unmanageable will have been confirmed because of the recipient’s rejection of them. This often brings a new state of hopelessness and despair for the client which can prove detrimental for the therapy.

Casement suggests that the unconscious hopes of our clients are not always met if we remain blocked or shut off from the attempt at communication or fail altogether to recognize the interactive pressure. More harmful though in the relationship is when the therapist puts pressure on the client to receive their projections. Either through an identification with the client’s own defences, the therapist may themselves come to rely excessively on denial, splitting, projective identification or enactment in an effort to defend against the engendered feelings. There is then the potential for this resulting in therapeutic misalliances wherein both seek gratification and defensive reinforcements in their relationship. (Casement, 1991:72) This failure results in the client’s re-internalisation of the original projected feelings, combined with the therapist’s so the client’s fears and pathological defences are not only reinforced but expanded. In addition, the client may despair about the prospect of being helped by a therapist who shares significant aspects of their pathology. (Langs in Ogden, 2005:32) By not accepting the projective identification we as therapists are also repudiating the learning and psychic growth that we could gain from working with our clients.

As mentioned earlier projective identification is an infiltration of the mind and body of the therapist. It is largely seen though more as a body to body communication and represents the non-linguistic communications between mind and body. Awareness of your own body as well as of theory and practice of the body and body processes is I would say a necessity in being able to identify, understand and work with projective identification more holistically. The body after all is the therapist’s primary instrument for psychological attunement.

‘When we allow ourselves to be receptive to another person, we have the capacity to resonate with the unconscious feelings of that person like a vibrating tuning fork. And when we resonate with those feelings, our whole being is involved-both mind and body’   (Greatrex, 2002:189)

Self care of the body as well as the mind then is of the essence for the therapist who needs to be aware of outside “invasions” and “pollutions” which may prove harmful to health over a prolonged period.

Therapists then need to be willing to be effected by their clients and to embody the experience of identifying projectively with them whilst maintaining a psychological distance from them. We do not use clients for our own psychic growth. If this occurs as it invariably does from time to time we must deal with it as quickly as possible so that we are free to work with our clients’ material. We as therapists need to be constantly monitoring our own countertransference reactions and be able to also contain them in the midst of interactive affective pressures from our clients. The support that we need to do this is ongoing commitment to extensive supervision and our own personal therapy. For a long while working with projective identification can feel like a perpetual process of trial and error and can lead to a great deal of frustration and disharmony for the therapist who is already trying to get to grips with a whole plethora of other therapeutic skills. It is however crucial to every therapeutic relationship that all therapists get to grips with this phenomenon and become acutely aware of its presence in the therapy room.

Barbara O’ Connell, BA, MA, Dip in Psychotherapy, is a Psychotherapist working in private practice in Cork.

References

Casement, Patrick J. (1991) Learning from the Patient. New York: Penguin Press.

De Mello, Vera Rita. Projective identification: A theoretical discussion about some roots of power.

Gomez, Lavinia. (1997) An Introduction to Object Relations. New York: New York University Press.

Greatrex, Toni. M. D. (2002) Projective identification: How does it work? Neuro-Psychoanalysis, 4(2): 187-197.

Grotstein, J. (1985) Splitting and Projective Identification. New Jersey: Jason Aronson

Lewis, Robert. M.D. (2001) Projective identification revisited: Listening with the limbic system. www.bodymindcentral.com

Lowen, Alexander. (1994) Bioenergetics. London: Penguin

Ogden, T.H. (1979) On projective identification. International Journal of Psycho-Analysis, 60: 357373.

Ogden, Thomas H. (2005) Projective Identification & Psychotherapeutic Technique. New Jersey: Karnac.

Scharff, Jill Savage. (1992) Projective and Introjective Identification and the Use of the Therapist’s Self. New Jersey: Jason Aronson

Segal, Hanna. (1974)  Introduction to the Work of Melanie Klein. New York, Basic Books.

Smith, W.L. (2000) The Body in Psychotherapy. North Carolina: McFarland & Company Ltd.

Wallin, David J. (2007) Attachment in Psychotherapy. New York: Guilford Press