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I mentioned in Chapter 1 that I found Melanie Klein's (1946) concept of projective identification to be seminal for understanding the transference relationship in the treatment of very disturbed patients. The concept of projective identification has been much in vogue since 1946 and is often used very differently.1 In this chapter I want to set out my ideas about projective identification and the way a precise understanding of it can help clinical practice. In particular I want to explore the way a detailed understanding of the various projective processes (particularly in psychotic states) is essential if the analyst is to maintain his therapeutic functioning and avoid complex transference/counter-transference difficulties and therapeutic impasse. However, before discussing the role of projective identification in daily practice, some consideration of the concept itself and the processes it seeks to describe will be necessary.
As the term ‘projective identification’ has been used for a variety of similar, but not identical, processes, I shall attempt to differentiate and clarify some of the problems related to this term. Projective identification relates, first of all, to a splitting process of the early ego, where either good or bad parts of the self are expelled from the ego and, as a further step, are projected in the form of love or hatred into external objects. This process leads to a fusion of the projected parts of the self with the external objects; the individual is identical with the relevant aspect of the external object to the extent that he is it. A major consequence of such projective identification is that it gives rise to paranoid anxieties. Objects felt to possess the aggressive parts of the self become persecuting and are experienced by the patient as threatening retaliation. He feels they will try to force