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Abstract

Like any theory, the Kleinian concept of Projective Identification (PI) represents an abstract explanatory pattern for concrete phenomena. In the course of the development of the PI concept, different emphases emerged: Bion sees PI as an original, pre-linguistic way of communication-which is used, for example, in borderline disorders. Current Kleinian authors have abandoned the idea of a communicative phenomenon ubiquitous in human coexistence, in favour of a view focussing on defence mechanisms, and thus no longer make a fundamental distinction between projection and projective identification. Kernberg's object relations theory points us to possibilities of understanding phenomena in borderline disorders, and of understanding group dynamic effects also for use in the treatment process, especially with the help of the concept of projective identification. Furthermore, the concept of PI can make escalating individual, as well as group conflicts more understandable. On the other hand, the concept points to possible ways of establishing human freedom in everyday interpersonal interaction and relationships outside a therapeutic context, this by dispensing with projective identification and applying a concept of genuine response.
Projective Identication
Ulrich Rüth (München)
Like any theory, the Kleinian concept of Projective Identification (PI) represents an
abstract explanatory pattern for concrete phenomena. In the course of the develop-
ment of the PI concept, different emphases emerged: Bion sees PI as an original,
pre-linguistic way of communication – which is used, for example, in borderline dis-
orders. Current Kleinian authors have abandoned the idea of a communicative phe-
nomenon ubiquitous in human coexistence, in favour of a view focussing on defence
mechanisms, and thus no longer make a fundamental distinction between projection
and projective identification. Kernberg‘s object relations theory points us to possi-
bilities of understanding phenomena in borderline disorders, and of understanding
group dynamic effects also for use in the treatment process, especially with the help
of the concept of projective identification. Furthermore, the concept of PI can make
escalating individual, as well as group conflicts more understandable. On the other
hand, the concept points to possible ways of establishing human freedom in every-
day interpersonal interaction and relationships outside a therapeutic context, this by
dispensing with projective identification and applying a concept of genuine response.
Keywor ds: project ive id entification, Bion, Klei n, Heimann, Symington, counter t ran s-
ference, human freedom, Kleinian thinking
Projective identication is a widespread phenomenon in the clinical con-
text as well as in everyday life. Recognizing, understanding and dealing
with it can help to better orient oneself in the irrationality of human rela-
tionships. At the same time, projective identication is one of those psy-
choanalytical concepts that can be used to better understand the phenome-
non of the unconscious itself and its effects on each individual as well as
on any a social context.
Projective identification as a concept
Projective identication as a concept should serve to better understand
concrete intrapsychic and interpersonal phenomena. At the same time,
however, concepts must always be lled with content, which makes them
understandable and applicable.
According to the author‘s understanding, concepts are only justied if
they positively inuence understanding and action – and not as a theory
per se.
© 2024 Copyright Mattes Verlag, Heidelberg • Dynamische Psychiatrie • Dynamic Psychiatry
Current international development of the concept from approx. 2010 on-
wards:
From around 2010 onwards, Kleinian psychoanalysis tends not to make a
distinction between projective identication and projection itself (cf. Spil-
lius 2012).1
Valuation: according to this circumstance, the concept of projective
identication remains under psychoanalytic interpretative sovereignty.
Projective identication continues to be understood as a predominantly
pathological defence mechanism – and not as a means of human commu-
nication and/or – in the less favourable case – interpersonal manipulation
and the exercise of power.
Reception of the concept in Germany
In Germany, there was almost no reception of the concept of projective
identication until the 1990s, and thus only at the same time as the de-
velopment of specic concepts of borderline and trauma psychotherapy.2
At the end of the 1970s, considerations arose for a congress of the Inter-
national Psychoanalytical Association (IPA) in Germany in 1981; it then
became clear that a corresponding congress in Germany was impossible.
The background to this was that what Kleinians described as terrible (in-
trapsychic) fantasies had become reality in Nazi Germany (cf. Hinz 2012).
A congress of the International Psychoanalytic Association (IPA) on
projective identication was then held in Jerusalem in 1985.
Important persons and their contributions to the development of the con-
cept of projective identification
Important thinkers and their contributions to the concept development
are:3
1 Hinshelwood‘s (1993) entry on projective identication in the Dictionary of Kleinian
Psychoanalysis is considerably longer than in Spillius & O‘Shaughnessy‘s (2012)
New Dictionary of Kleinian thoughts, written some twenty years later – which may point to
the concept‘s declining importance.
2 For example, in R. Klußmann (1993) – who taught psychotherapy as a university lecturer
at the LMU Munich – there is a page reference in his textbook on psychotherapy after consul-
ting the index under projective identication with then only two lines of text there.
3 Other people could certainly be mentioned here, such as Ogden (cf. Ogden 1979), but he
will not be discussed further here.
Projective Identication 13
2024 (57), S. / pp. 12-25
- Edoardo Weiss4, who first used the term projective identification in the
1920s;
- Melanie Klein5, who described projective identification as a defence
mechanism in “psychotic patients“ in 1945;
- Paula Heimann6, who described second-order countertransference in
1950;
- Roger Money-Kyrle7, who saw projective identification as an essential
agent of psychoanalytic work;
- Wilfred Bion8, who emphasised the communicative character of projec-
tive identification and created important preconditions for understan-
ding projective identification with the two concepts of container <->
contained and of L-, H- and K-links in thinking;
- Neville Symington, who9 saw the renunciation of projective identifica-
tion as a necessary precondition for interpersonal freedom.
Foundations for understanding projective identification on the
basis of Kleinian psychoanalysis
Melanie Klein – Projective Identification as a defence mechanism
Melanie Klein focused on the intrapsychic and described projective
identication as an inner-psychic defence mechanism (Klein 1946), with
the help of which affects and self-states are evacuated into another person
or an “object“. The aim of evacuation is to control, harm and/or possess or
even destroy the object.
Ulrich Rüth
14
Dynamische Psychiatrie • Dynamic Psychiatry
4 Edoardo Weiss (1889-1970), Italian psychoanalyst who left the Italian civil service because of
the required Italianisation of his Jewish surname and the required entry into the Fascist Party,
and then emigrated to the USA because of the Italian racial laws under Mussolini.
5 Melanie Klein (1882-1960), Austrian-British psychoanalyst who emigrated to England in the
1930s and became Anna Freud‘s main opponent.
6 Paula Heimann (1899-1982), German psychoanalyst who emigrated to England with her
child in 1933 after Switzerland granted resicence to her husband, but not her. Close collabora-
tor of Melanie Klein, but belonged to the Middle Group of British psychoanalysts from the end
of the 1950s. The reasons for the separation from Kleinians are yet mostly unknown.
7 Roger Money Kyrle (1998-1980), British psychoanalyst with a philosophical-anthropological
background.
8 Wilfred Bion (1897-1979), Indian-born British psychoanalyst who developed his own models
on the basis of Kleinian thinking.
9 Neville Symington (1937-2019), Portuguese-born, British psychoanalyst who turned to
psychoanalysis after studying Catholic theology and whose substantial work took place
in Australia.
Like all defence mechanisms, projective identication serves to regulate
the intrapsychic state.
Paula Heimann – transference and countertransference
Until the fundamental work of Heimann (Heimann 1950), the coun-
ter-transference of the analyst/therapist was primarily seen as a reaction in
the context of the therapist‘s own neurosis or biographical background. By
means of one‘s own analysis, the counter-transference was supposed to be
“puried“, so to speak.
Heimann described another form of countertransference (CT) in the the-
rapist, which could also be called 2nd order CT. This involves the thera-
pist’s perception of mental states of the patient,
- on the one hand due to empathic (outreach) ability (activity of the the-
rapist), and
- on the other hand, via preconscious messages from the patient, which
take place by means of projective identification, but can also be mani-
pulative as a preconscious action.
A perception by means of 2nd order countertransference can be iden-
tied, because one‘s own condition is experienced as “different“ and un-
usual – for instance as an affective reaction that one does not know in this
way in relation to this particular patient (cf. Behnsen o.J.).
Wilfred Bion
Container-contained
All human relationship, according to Bion, is based on the Container-Con-
tained principle (cf. Hinshelwood 1993b) which means that there is a
content that is held and received by something else – the container.
The principle of container-contained can be understood as the basis
for the phenomenon of (psychic) evacuation described by Melanie Klein
with the help of which affects and contents are “excreted“ or “handed
over“ and deposited in another person (as a container), usually the infant’s
mother on early stages of development.
L-, H-, K-links
According to Bion, all human psychic activity can be traced back to one
of the three basic forms of “thinking”: loving “L“ - hating “H“ - knowing
Projective Identication 15
2024 (57), S. / pp. 12-25
“K“, or to a differentiated connection of two or all of these “links“.10
Hating as a human activity is often denied, since hate is directly related
to revenge and destruction. In a constructive form, the “H“-activity leads
to self-efcacy, and in connection with L and K to cooperation.11
Hate as a basic psychic activity is of decisive importance for projec-
tive identication because this “link“ is essentially active in it. Projective
identication is connected with hatred, destructive fantasies, wanting to
dominate.
Projective Identification and its communicative character
Bion (Bion 1959) assumes that projective identication is naturally inhe-
rent in us as a communicative, pre-linguistic process of the infant, needed
to survive.12 Projective identication is used as a recourse to this early pro-
cess, especially in severe disorders such as borderline, or can be observed
by the environment and the therapist or therapeutic team as a means to
reach psychic equilibrium by externalization.
However, projective identication can also be used as a means of com-
munication, for example when you want to „push something into some-
one“.
Pushing something into someone can be psychodynamically translated
as:
- to evacuate/externalise
- by means of projective identification
- through imposed containment.
Pushing something into someone‘s mind happens in conict situations
in order to
- relieve own affects (for instance in the form of a “reproach“),
- to bring the counterpart into an (unpleasant) state of affect, and/or
- in order to inf luence/control the other person.
The natural reaction to such a psychic move would be something like a
spontaneous “What was that now?”
10 see also Lopez-Corvo 2003, The dictionary of the work of Bion, as an important refe-
rence work to classify and understand Bion‘s sometimes confusing terminology, or
Rüth 2005a, Bion for Beginners.
11 Interestingly to some extent quite the same as Ammon’s Constructive Aggression.
12 In case projective identication fails, the infant recurs to adhesive identication as a
rescue mechanism – described by Esther Bick in infant observation.
Ulrich Rüth
16
Dynamische Psychiatrie • Dynamic Psychiatry
In intellectual “discussion“, intellectualized defences lead away from
hatred as well as direct manipulation, so that only very subtle forms of
projective identication can be identied.
Roger Money-Kyrle: Projective Identification as “communicationin the
therapeutic process
Roger Money-Kyrle describes that the analyst takes up aspects of the
patient via projective identication, then processes and transforms them
internally and returns them in a different form to the patient – but not as
retrograde projective identication, but in open communication. Other-
wise, it would be manipulation.
The following introjective identication of the patient then leads to a
change in the patient – and this in a progressive control cycle.
Case vignette:13
One youth reported that he had “got drunk“ with other youths after
school the day before. A preconscious event starts in the therapist – he
has to bring his hands to his face, lower his head, close his eyes, and
then a feeling of sadness arises in the countertransference.
The countertransference feeling is not communicated directly, but the
patient is asked what he (the therapist) might have felt now. The pa-
tient‘s answer: “I did something wrong! This is answered with a poin-
ted reaction, similar to the previous one, now a denial by a slow, clear
shaking of the head and a corresponding verbal expression.
The patient is further asked what he, the patient, had felt before getting
drunk. “Boredom“. In the sense of a psychoeducational explanation,
the therapist points out that he (the patient) would have to endure un-
pleasant sensations if he wanted to get to the bottom of his boredom and
the feelings to be located there. The patient then meanders a little in the
therapeutic dialogue and can finally refer to “loneliness“ and then also
to “sadness“. It is now revealed that this was the feeling that was felt by
the therapist during the therapist‘s pointed gesture. The patient can now
refer to his own feelings of loneliness and sadness of the last few days.
Projective Identication 17
13 It goes without saying that in the context of publications, case vignettes are anonymized
and represent a compilation of different patient encounters.
2024 (57), S. / pp. 12-25
The case study describes the use of projective identication effective in
countertransference, as well as the therapeutic reluctance to hastily eva-
cuate these pre-linguistic messages back into the patient.
Projective identification as a communicative method of
„manipulation”
Projective identication as communication wants to intervene “domi-
nantly“ in the other person.
Such a dominating intervention in the other happens under
- absence of acknowledgement and respect of the other, that means L.
- absence of understanding, that means K.
- using mastery, that means H.
Such communication aimed at mastery the other mind can be found in
gures of speech of political extremes, or also in extreme psychological
states.
Phenomenologically, this form of communication was quite often found
in society during the Covid 19 pandemic. Due to the insecurities and thre-
ats, unbearable conditions were projected in the sense of an evacuation.
Via introjective identication on the side of followers, these evacuated
contents were absorbed, and the fellow travellers then passed on these con-
tents via renewed projective identications, that means evacuations – with
the consequence of an echo chamber phenomenon.
In the context of the pandemic, it was ultimately impossible to say
anything “true“ – since information and facts were largely either missing
or uncertain. True statements were only possible when talking about one‘s
own subjective condition. All other statements were, to a varying degree,
projections or the result of projective identication. The background to
this was that the pandemic as an overall phenomenon triggered unbearable
affective states of uncertainty, unpredictability and fear that one naturally
wanted to evacuate without there being a container for this that could
meaningfully transform these contents in the sense of the bionic alpha
function.
In the political sphere, there is always a “push in“14 concerning the po-
litical opponent – a move already named identied as projective identi-
cation.
14 In German: “reindrücken”
Ulrich Rüth
18
Dynamische Psychiatrie • Dynamic Psychiatry
Donald Trump has made extensive use of lies as a tool, that is to say
“push ins“ into the mind of others, and in doing so he has engaged in a
deation of the K-link, using H through belittling and humiliating.
During the election campaign ahead of the 2021 federal election in Ger-
many, right-wing politician Alice Weidel15 said during a TV discussion in
connection with the planned energy transition and climate protection “you
can‘t let an industrialized country run on utter electricity“ meaning wind
turbines. This contribution to the discussion leaves no room for construc-
tive argumentation and empties the K-link (-K), contains snideness and
self-aggrandisement (H), the counterpart feels uncomfortable and fends
off (-K) – or identies (by means of one’s own H). It is reserved for further
investigation to show the connection between projective identication as
a mode of manipulation on the one hand and the adhesive identication
triggered in the follower on the other.
In everyday life, projective identication is found in communicative
processes within the framework of affectively charged relationships (with
projections) in
regressive situations, for example in the relationship with the baby or in
infatuation,
in the case of speech comprehension disorders, since in such cases af-
fects “without language“ predominate,16
and in the everyday exercise of power to stifle “dissent“ – with the con-
sequence of -K, -L, that means the absence and negation of knowing/
wanting to know and love/attention.
If people seem “unpleasant“, this might nd an explanation by projecti-
ve identication. Through projective identication, such people “radiate“
their own states of affect and self, which the other person “does not want to
have“. Subjectively, the recipient experiences a feeling of being controlled,
which one wants to ward off.
In conict situations, reproaches/aggression serve to evacuate one‘s own
aversive affect states into the other. Usually there is no successful solution,
besides the submission of one of the opponents, unless mechanisms of
projective identication and wanting to dominate are abandoned.
Projective Identication 19
15 Alice Weidel is one of the main gures of Germany’s right winged party “Alternative
für Deutschland”.
16 cf. Rüth 2005, Receptive Language Disorders and Wilfred R. Bion „Learning through
Experience“.
2024 (57), S. / pp. 12-25
Projective identification in the therapeutic context
Projective identication in the context of borderline functional disorders
can be explained by Kernberg‘s object relations theory (cf. Yeomanns &
Diamond 2011).
On the basis of split representations of self and object (simplied as a
model: provider - persecutor - victim), projective identication is used to
attribute roles and to induce taking over a role, which leads to merely a
reaction in the absence of understanding of what is really happening.
A way out of these malignant processes of projective identications is
possible via
• countershaping17, which means not to react but to act in an unexpected
way and with simultaneous stepping out of the imposed context, and
via
responding instead of reacting, the latter outlined especially by
Symington (Symington 1995, Rüth 2022).
Through these two means, the – usually pre-conscious – manipulations
are “rejected“, that is to say “not accepted“.
In the group context of inpatient treatment, the ward resembles a stage,
and the team – and possibly the fellow patients – mirror the patient’s dif-
ferent states of self and affect. Such phenomena of projective identication
can also be explained by Kernberg‘s object relations model: a “distribu-
tion“ of the patient‘s inner states to different team members takes place,
especially observable in the case of structural disorders, and possibly even
as an indication of the presence of such a structural disorder (at borderline
level of function).
Countertransference phenomena in a team via projective identication
should be understood as “mirroring“ of the patient’s self-states through
pre-conscious, identicatory assumption by the team’s members. In this
respect, an “image“ of the patient‘s inner world is created on the stage of
the clinic ward and/or the team via projective identication. If this brin-
ging to the stage is consciously taken up in the team in the case discussion,
made “thinkable” and fed back to the patient‘s inner world, it can lead to
an immediate change in the patient’s behavior, due to opposing projective
identications, as an unconscious communication with the patient.
17 German: “gegengestalten”
Ulrich Rüth
20
Dynamische Psychiatrie • Dynamic Psychiatry
In terms of team dynamics, the “counter-transference analysis in the
team“ (Rüth 2003) designed in this way leads to a relief for the individual
team member and the team as a whole through
allowing and tolerating affects and reaction formation (in the first step),
raising awareness with classification of the confusion experienced and
motivational clarification of the event (in the second step), as well as for
the
returning the team to work mode (in the third step),
analogous to a structural level-related integration work in the inner world
of the patient.
Studies pointed out that unfavorable countertransference in a team (in
the absence of sufcient processing) leads to negative outcomes (Kernhof
et al. 2012)
Projective identification in supervision and Balint work
Projective identication is used in supervision and Balint work to “com-
municate“ what was previously unconscious so that the Balint process
or the supervisory process is ultimately about “uncovering“ unconscious
messages with the help of countertransference processes (Schmolke &
Hoffmann 2014, Seiler 2014).
Elsewhere (Rüth 2005b, Rüth 2009, Rüth & Holch 2012), this process
has been described for Balint Group work as transforming bizarre beta
elements (according to Bion) into “thinkable”, that means conceivable al-
pha elements – with active use of 2nd order countertransference and pro-
jective identication.
It should be noted that in the context of “parasitic“ relationships, a massi-
ve attack is made by means of projective identication on the containment
function of the therapist (or the team) and on the ability to transform beta
into alpha elements (Rüth 2019). Special techniques are necessary here in
order to dissolve the entanglements that arise under such circumstances.
However, projective identication also takes place outside a genuinely
therapeutic context: Obholzer & Zagier Roberts (1994) have brought to-
gether various authors in their reader on psychoanalytic organizational
counselling and the unconscious at work. The authors address the pheno-
menon of projective identications in institutions from different points of
view. Halton (1994) sees projective identication and countertransference
as one of the essential aspects of the unconscious in organizations. Moylan
Projective Identication 21
2024 (57), S. / pp. 12-25
(1994) describes the phenomenon of contagion within the institution, but
also with the supervisor on the basis of projective identication. Obholzer
& Zagier Roberts (1994) devote themselves to the disruptive team member
with the same focus.
Projective identification as a counterpart to human freedom
When phenomena of projective identication are at work, messages are
made – but also our freedom to think is restricted (Symington 1995).
Projective identication leads to the fact that we (have to) “react“ to the
state evoked in us. In everyday life, projective identication is a common
means of exercising power. If we use projective identication to inuence
or control our fellow human beings, we have no real interest in their inner
world and their free decisions, but in our own exercise of power and con-
trol over our counterpart.18
Neville Symington postulates that freedom of the other and freedom
with each other are only possible through the renunciation of projective
identications. We would therefore have to actively refrain from trying to
“squeeze“ something into the other person, to control the other person or
to inuence them in our own way.
Instead, according to Symington, it is about trying to nd the “centre of
the other person“ without evacuating one‘s own emotional parts. This will
change the way we interact as human beings: instead of reacting to each
other, we will be able to respond to our counterparts and their needs.
If projective identication remains active, a succession of reactions re-
sults, possibly in the sense of escalation until one of the “opponents“
gives in (is manipulated) – or a breakdown occurs (possibly of the oppo-
nent or also of the entire communication).
If projective identication is dispensed with, it becomes possible to re-
spond freely to the needs of the other person and to the core of his or her
being.
18 It is undisputed that the need to exercise power and control can arise from deep exis-
tential fears for example, and in this respect a very powerful individual may well
have a contrary inner world.
Ulrich Rüth
22
Dynamische Psychiatrie • Dynamic Psychiatry
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Ulrich Rüth
24
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About the author:
Ulrich Rüth, M.D., Child and Adolescent Psychiatrist and Psychotherapist, working in
a private practice and at Munich Training and Research Institute, German Academy of
Psychoanalysis.
Contact: Goethestraße 54, D-80336 München, E-Mail: praxis.rueth@mnet-online.de
No conicts of interest in the author.
Projective Identication 25
2024 (57), S. / pp. 12-25
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Article
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The paper refers to Neville Symington’s concept of responding versus reacting, pub- lished in 1990, focusing on Bion’s ideas on projective identification as an inter-psychic phenomenon of nonverbal communication. Projective identification as a communica- tive mode uses the other person as a container for unwanted thoughts and feelings, thus leading to reactions which attack the freedom to think one’s own thoughts. In the mode of responding we abstain from projective identification, targeting at human freedom as we try to really answer the needs of the other person.
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Es werden Widerspiegelungsphänomene innerhalb der Supervisor-Supervisand-Beziehung untersucht sowie die Frage, wie sich der Transfer von der Supervisionssitzung zur nächsten Sitzung mit dem Patienten zeigt. Theoretische Aspekte der Widerspiegelungsphänomen werden zunächst in Anlehnung an verschiedene Autoren und deren Verständnis diskutiert. Danach werden Ergebnisse einer Befragung von Ausbildungskandidaten im Münchner Lehr- und Forschungsinstitut und von praktizierenden Psychotherapeuten aus der Ambulanz der dynamisch-psychiatrischen Klinik in Menterschwaige vorgestellt. Sechs Befragte kamen der Aufforderung nach, ein Fallbeispiel darzustellen, bei dem Widerspiegelungsaspekte im Rahmen der Supervision erlebt wurden. Zwei Fallbeispiele werden hier vorgestellt, das sie die intensiven Gefühle des Therapeuten, wie sie häufig bei Widerspiegelungsphänomenen auftreten, illustrieren. Es wird deutlich, dass nur durch eine vertrauensvolle Beziehung zwischen Supervisor und Supervisand diese intensiven Gefühle im geschützten Raum der Supervison verarbeitet werden können. Dies führt zu einer tieferen Kenntnis von sich selbst, den eigenen Fähigkeiten und inneren Konflikten, etwa persönliche Gegenübertragungsneigungen. Diese nachholende Identitätsentwicklung, die auch in der Supervisionsarbeit zum Tragen kommen kann, ist ein zentrales Konzept in der Psychotherapie.
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Anhand eines komplexen Fallberichts aus der Balintgruppe wird das Konzept der parasitären Beziehung nach Bion aufgegriffen, bei welcher Denken und Entwicklung zerstört werden und eine Alpha-Funktion zur Transformation gemachter Erfahrungen nicht mehr zur Verfügung steht. Ausgehend von der Überlegung, dass eine parasitäre Beziehung gar keine übliche Arzt-Patienten-Beziehung mehr darstellt, wird ein aktives Leiterverhalten beschrieben, um die über Spiegelungsphänomene in der Gruppe verloren gegangene Alpha-Funktion zu ersetzen und die parasitäre Verstrickung aufzulösen. Abstract: Referring to a complex Balint case, the parasitic container-contained relationship is discussed, where thinking is destroyed and the Alpha-function is no longer available. On the basis that a parasitic relationship isn`t a patient-doctor-relationship any more, an active leadership behaviour is described, aiming at reinstalling the lost Alpha-function, targeting at the resolution of the parasitic entanglement.
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Light is thrown on psychoanalytic and organizational aspects of senior physicians leadership as worked cut in the Tavistock model of psychodynamic consultancy for institutions. There is a special focus on group processes, the task of leadership and the problems of external versus internal supervision. Counter transference is discussed as a crucial point in internal supervision. Psychodynamic aspects of assessing structure, process and results by senior physicians are discussed. The "team" as a multiprofessional work group oscillating from a hierarchic to a heterarchic state of function is elucidated.
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Psychic distress in the patient leads to defence models and to projective identification which transfer emotional distress from a patient into the doctor's mind. Balint Group work can serve as a container for the doctor's psychic distress and emotional trouble with the patient. The special Balint Group setting aims at digesting bizarre β-elements into something more thinkable, according to ideas of W. R. BION. The Balint Group process helps the doctor to change from a reactive into a response model. Vignettes illustrate the process of containing, digesting and emotional growth.
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Content & Focus: H.G. Well’s novel The Time Machine shows how art imitates reality and brings to life Klein’s concept of projective identification. Using a composite example of sessions from a Humanistically-oriented addiction service and subsequent psychoanalytic training, supports how the process of projective identification can be understood as a communication. The concept of projective identification is developed from an intrapsychic to an inter-psychic process. In this reciprocal relationship projective identification is the therapy. How the philosophical underpinnings of each service and their competing approaches can lead to very difference outcomes, is also explored. Conclusions: Klein’s theories have multidimensional implications and the concept of projective identification is easily misused. Rather than conceptualising projective identification as a psychotic or malign defense, the emotional tugs of intersubjectivity are a key to effective therapy. Patient and practitioner essentially become co-operating parts of the whole, and so develop together by working thorough the symbiotic dance that is projective identification.