Projective identification and consciousness alteration: A bridge between psychoanalysis and neuroscience?

The authors claim that projective identification in the process of analysis should be considered in a circumscribed manner and seen as a very specific type of communication between the patient and the analyst, characterised through a modality that is simultaneously active, unconscious and discrete. In other words, the patient actively, though unconsciously and discretely—that is, in specific moments of the analysis—brings about particular changes in the analyst's state. From the analyst's side, the effect of this type of communication is a sudden change in his general state—a sense of passivity and coercion and a change in the state of consciousness. This altered consciousness can range from an almost automatic repetition of a relational script to a moderate or serious contraction of the field of attention to full-fledged changes in the analyst's sense of self. The authors propose the theory that this type of communication is, in fact, the expression of traumatic contents of experiences emerging from the non-declarative memory. These contents belong to a pre-symbolic and pre-representative area of the mind. They are made of inert fragments of psychic material that are felt rather than thought, which can thus be viewed as a kind of writing to be completed. These pieces of psychic material are the expression of traumatic experiences that in turn exercise a traumatic effect on the analyst, inducing an altered state of consciousness in him as well. Such material should be understood as belonging to an unrepressed unconscious. Restitution of these fragments to the patient in representable forms must take place gradually and without trying to accelerate the timing, in order to avoid the possibility that the restitution itself constitute an acting on the part of the analyst, which would thus be a traumatic response to the traumatic action of the analytic material.