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During seminars in Rome in the Spring of 1982, students of the Rome Course in Child Psychotherapy (related to the Tavistock Clinic, London) presented several cases which Mrs. Harris and I had periodically monitored over the previous three years. Two of them, Mario (G.M.) and Francesco (D.P.) were clearly approaching the termination of therapy, while the third, Antonio (S.M.), a child who had had many autistic features, seemed to be in crisis regarding depressive anxieties and the capacity for thought. Not only were the three boys of similar age (nine years, plus or minus a few months) but also the form of the material was strikingly similar. Resentment of dependence upon a thinking object, hatred of being small and weak, envy of the mother's richness and fertility and jealousy of prospective siblings were all gloriously displayed in the sessions presented to the seminar. But the strategic significance of the material was quite different in the three children and offered a background for the investigation of this important conceptual problem, concerning which there has been much confusion: how do these two concepts, projective identification and container-contained, relate to one another? What are the clinical indicators and how may the distinction be utilised in the clinical situation?
Before describing the clinical material, a brief theoretical preamble may help to focus the problem. In her 1946 paper on schizoid mechanisms, Melanie Klein described the operation of an omnipotent phantasy of intrusion inside the body and mind of another (external) person, producing a form of narcissistic identification and a corresponding alienation from one's true identity. Work in the following years by her followers traced a wide range of pathological phenomena to this mechanism, including claustrophobia, agoraphobia, hypochondria, manic-depressive states, disturbances of thought and judgment, certain psychotic confusional states; as well as demonstrating that the mech