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Grotstein forecasts that in the history of psychoanalysis the emphasis will shift from the mechanisms of repression and displacement, which have been the theoretical focus of its first hundred years, to those of splitting and projective identification.
His book is divided into two sections, one dealing with splitting, the other with projective identification; each section follows a similar pattern, the earlier chapters tracing the history of the concepts, and the later ones illustrating the theory with clinical material. He links the pioneering work of Melanie Klein back to ideas in Freud's earlier writings, which were abandoned in favour of instinct theory, and forward to the work of Klein's successors including Fairbairn, Winnicott and Rosenfeld, but above all Bion to whom Grotstein acknowledges a special debt. He also places within the total context the work of Kernberg and of Kohut, whose influence is clearly recognisable in the book. These theoretical portions of the book provide a clear and comprehensive overview of the historical development of the concepts.
Following Hanna Segal's work in elucidating Kleinian theory, Grotstein shows how splitting and projective identification which arises from it, are evident in a vast range of psychological phenomena from the healthy and everyday to the bizarre and severely pathological. The primary experience of splitting occurs at birth and upon the ego's capacity to tolerate this, combined with the quality of post-natal experiences, depends its ability to use splitting positively in perception, cognition and the formation of object relations. Projective identification, as the basis of empathy, is an important ingredient in social interaction; it is also operative in states of confusion and disorientation, in phobic states, and in relationships characterised by coercion or seduction, and, when excessive, it seriously weakens the ego. Grotstein makes no distinction between projection and projective identification, arguing th