The Emergence of Projection in a Series of Dreams*

The following is a presentation of a series of dreams illustrating a particular phase in the analytic therapy of a narcissistic female patient. The phase of treatment that will be brought under discussion has to do with the transition in ego behavior from denial to projection, which seems to be a typical event in the analytic therapy of female patients presenting narcissistic maladjustments. Indeed, the writer hopes to demonstrate that a clinical and psychological evaluation of this specific combination of ego reactions is a significant guide to the therapy and prognosis of narcissistic female patients.

In a discussion of male narcissistic patients, Annie Reich remarks that while Freud used the term “narcissistic neurosis” to designate psychotic illness exclusively, the last twenty years or so have taught us to “question the usefulness of a too narrowly circumscribed nosology,” and she goes on to remind us of the ubiquitous overlapping of developmental phases and to suggest that even marked narcissistic tendencies may not entirely interrupt object cathexes.10 The narcissistic conditions to which the following presentation addresses itself are those characterized by developmental overlapping with more highly developed structures sufficient enough to preclude frank, manifest schizophrenic process. Popularly labeled “borderlines” or, even less exact, “ambulatory schizophrenics,” narcissistic patients are those who are commonly given to sudden manic-like reactions, acute, severe, though brief, depressive reactions sometimes with suicidal endeavors, promiscuous and perverse sexual patterns with