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In this chapter I want to illustrate the importance of understanding the analyst's counter-transference reaction as a central means of understanding a schizophrenic patient's communications expressed by way of powerful projective identification. Very violent emotions of love and hate, severe confusional feelings, and severely disintegrated states of mind can be transmitted through primitive forms of projective identification which are sometimes not registered in an easily understandable form by the analyst. When the emotions are particularly violent the analyst may feel overwhelmed and be unable to function as a container. At such times the patient communicates non-verbally by a primitive hypnotic force. The analyst may then develop defensive counter-transference reactions, perhaps feeling angry. Only later he may realize that what he is feeling is despair and depression related to a sense of failure. In the analysis I shall now report the analyst felt that the confusing projection was an attack on the analysis, a kind of anti-communication which could entirely destroy the analytic relationship. An analyst's depressive counter-transference is often perceived by a neurotic patient, but still more so by a psychotic one. Psychotic patients tend to exaggerate the extent of their analyst's depression and may delude themselves that the analyst is unfairly treated. Such delusions should be diagnosed early, because to protect the analyst the patient may go so far as to try to kill himself.
Dr N. presented Maria, a hebephrenic patient, at my seminar on a number of occasions. He first saw her in his clinic when she was twenty-one years old. She had become manifestly ill when she was sixteen. Until then she had been successful in school, and no