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Dear Sirs,
I would like to raise several questions which have been of concern to me for some time, and have more recently been prompted by Cimino and Correale (2005). The authors build on the prior understanding of the concept of projective identification, more closely specifying and circumscribing its clinical meaning and application. They write:
the patient actively, though unconsciously and discretely … 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 … [which can range to include] full-fledged changes in the analyst's sense of self … this type of communication is, in fact, the expression of traumatic contents of experiences emerging from the non-declarative memory [of the patient]. These contents belong to a pre-symbolic and pre-representative area of the mind [of the patient] … These pieces of psychic material are the expression of traumatic experiences [of the patient] that in turn exercise a traumatic effect on the analyst … (p. 51, my additions in brackets, based on assumptions of the authors' meaning).
I have three questions:
How is it that one does not hear of the patient's experience in the transference being an expression of projective identification—that is, a parallel notion of the analyst ‘unconsciously bringing about particular changes in the patient's state’? If the concept of projective identification is to be viewed as having clinical validity— which may in its own right be debated—does it not follow that for such a psychic phenomenon to be meaningful its applicability would need to be understood as occurring in both directions?
If so, could not changes in the patient's state be articulated and explored, perhaps to discover their specificity evoked by a particular experience or perception of the analyst, and which in turn may be seen to recreate and indeed awaken a