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A second case, illustrating the difficulty of treating projective identification, concerns Charles, a hypochondriacal patient treated by Dr A., a psychoanalyst, who attended one of my seminars over a two-year period. Dr A. had helped Charles improve during his analysis but at the time his case was presented was having great difficulty. During the two years before 1983, with the help of presenting in my seminar, the analyst felt better about Charles because he began to understand the projective process in the analysis. The patient made remarkably good progress in his life situation. Only occasionally did Charles complain again about his disturbing pressure inside him.
The seminar in which the analyst had participated for two years prior to the time of the two sessions I will report had considered the development of impasses such as this. After presenting some basic information about Charles, in which I shall interpose reports from Dr A. given to the seminar (in italic type), with my own thoughts (in roman type) to describe the development of the case, I will describe some of the discussion in the seminar.
Charles started his analysis with Dr A. when he was twenty-four He stammered so much that he often distorted his face into grimaces. He was disturbed in contact with other people and had difficulties in studying medicine, because he felt he could not speak. He had no sensation in his mouth when he was eating; nothing had any taste, and he had to use a great deal of salt and pepper to establish any sensation at all. He also complained about pressure and pain in his abdomen. He had attacks of crying and screaming and he sometimes felt relieved after he screamed at his father. When the pressure in his