Chapter 5 Contribution to the Psychopathology of Psychotic States: The Importance of Projective Identification in the Ego Structure and the Object Relations of the Psychotic Patient29

Following the suggestion of the organizers of the Symposium that I should discuss the importance of projective identification and ego splitting in the psychopathology of the psychotic patient, I shall attempt to give you a survey of the processes described under the term: ‘projective identification’.

I shall first define the meaning of the term ‘projective identification’ and quote from the work of Melanie Klein, as it was she who developed the concept. Then I shall go on to discuss very briefly the work of two other writers whose use appeared to be related to, but not identical with, Melanie Klein's use of the 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 split off from the ego and are as a further step projected in love or hatred into external objects which leads to fusion and identification of the projected parts of the self with the external objects. There are important paranoid anxieties related to these processes as the objects filled with aggressive parts of the self become persecuting and are experienced by

the patient as threatening to retaliate by forcing themselves and the bad parts of the self which they contain back again into the ego.

In her paper on schizoid mechanisms Melanie Klein (1946) considers first of all the importance of the processes of splitting and denial and omnipotence which during the early phase of development play a role similar to that of repression at a later stage of ego development. She then discusses the early infantile instinctual impulses and suggests that while the ‘oral libido still has the lead, libidinal and aggressive impulses and phantasies from other sources come to the fore and lead to a confluence of oral, urethral and anal desires, both libidinal and aggressive’. After discussing the