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On Understanding Projective Identification in The Treatment of Psychotic States of The Mind PDF
On Understanding Projective Identification in The Treatment of Psychotic States of The Mind PDF
Joseph Aguayo
11849 West Olympic Blvd., Suite 202, Los Angeles, California 90064, USA –
joseph.aguayo@gmail.com
1
Both Rosenfeld (1952b, p. 457) and Segal (1950, p. 275) directly referred to Freud’s bleak view of the
analyzability of the psychotic disorders. While Klein’s (1946) paper certainly hypothesized that psychotic
patients could form a treatable transference in analysis, she also emphasized in the Appendix to her 1946
paper how continuous her work was with Freud’s and in many ways agreed with his analysis of the
paranoid Dr Schreber (Klein, 1946, pp. 108–10) This continuity was also a remnant of the era of the
Controversial Discussions (1941–44), during which time she took pains to show how her work was
completely consistent – indeed, extended from that of Freud (Steiner, 2000, p. 73). Klein’s (1946) paper,
however, left it open to her students to provide case material that might justify her claims to have made
an innovative contribution to the treatment of the psychoses. Their effort also addressed a central
ambiguity of Freud’s (1911) analysis of Schreber: how could Freud explicate the unconscious dynamics
of paranoid psychosis yet maintain that these types of cases were psychoanalytically untreatable?
2
I have briefly set out the importance of a textual analysis of Klein’s two versions of the Notes on some
schizoid mechanisms paper in a Letter to the Editors (Aguayo, 2008). In contrast to other works in this
area (e.g. Goretti, 2007), one clear implication of comparing these texts is that they allow us to measure
how far the Kleinian analysis of psychotic states had come between 1946 and 1952. It is also a reflection
of how the work of the Klein group had become consolidated during the post-war period into a school
of thought, complete with its own specific terminology and celebrated in a 1952 issue of the International
Journal of Psychoanalysis (1952,33, part 2). This entire issue was dedicated to a consideration of Klein’s
work on the occasion of her 70th birthday – and included a congratulatory Preface from Ernest Jones
(ibid., p. 83). It is also significant that the editor during those years (1947–1959) of the Journal (Willi
Hoffer, a Freudian) was assisted by Marjorie Brierley (an Independent) and W.C.M. Scott (a Kleinian),
which also represented the three recently established training tracks at the British Psycho-Analytical
Society.
have had ample material for psychiatric observation’’ (ibid., p. 107). In this
regard, it is of interest that Rosenfeld, Segal and Bion – all of them
psychiatrists – were all in analysis with Klein when her 1946 paper
appeared.5
In order to explicate what she regarded as one of the primary mental
mechanisms underlying the psychoses, Klein also offered a rudimentary
sketch of projective identification. In her archival research on Klein, Eliza-
beth Spillius (2007, p. 107) has noted that where Klein first mentioned the
term ‘projective identification’ (Klein, 1946, p. 104) the concept was not spe-
cifically defined; where it was described (ibid., p. 102) it was not named.
Klein’s original description:
Together with these harmful excrements, expelled in hatred, split off parts of the
ego are also projected on to the mother or, as I would rather call it, into the
mother. These excrements and bad parts of the self are meant not only to injure
the object but also to control it and take possession of it. In so far as the mother
comes to contain the bad parts of the self, she is not felt to be a separate individual
but is felt to be the bad self. Much of the hatred against parts of the self is now
directed towards the mother. This leads to a particular kind of identification which
establishes the prototype of an aggressive object relation. Also, since the projection
derives from the infant’s impulses to harm or control the mother he feels her to be
a persecutor. It is, however, not only the bad parts of the self which have expelled
and projected, but also good parts of the self. ‘‘Excrements can have the significance
of gifts.’’
(Klein, 1946, p. 102)
5
During this time when the London Klein group treated psychotically-disturbed patients, it is important to
bear in mind the broad diagnostic distinctions within which they worked. Their diagnostic categories were
in effect ‘psychotic’ versus ‘non-psychotic’ (Bion, 1957), and did not include the diagnoses that would be of
greater interest to subsequent generations of practitioners – the so-called borderline, narcissistic and
sexually perverse disorders. While the post-war Kleinians treated and subsequently theorized about their
work with briefly hospitalized schizophrenics and non-hospitalized schizoid and paranoid disorders, their
findings and conceptual methods have been more usefully applied to patients with near-psychotic or
borderline ⁄ narcissistic diagnoses. The Klein group also did not subsequently provide much by way of
follow-up data to substantiate enduring treatment changes in the patients seen. In this sense, their overall
findings are broadly comparable to those of the American Interpersonal School: H.S. Sullivan. F. Fromm-
Reichmann and H. Searles also treated hospitalized schizophrenics, but also found that their long-term
results were more beneficial to those less disturbed than chronically hospitalized, poor pre-morbid
schizophrenics. One broad measure of this change can be seen in the shift by analysts such as Searles, who
moved from working with hospitalized chronic schizophrenics (Searles, 1965) to patients with borderline
conditions (Searles, 1986). Needless to say, the Klein group also did not factor into the treatment or
explanatory equation the effect of psychiatric medication, another variable that would take on greater
significance amongst subsequent generations of psychiatric and psychoanalytic practitioners.
6
A brief clinical illustration: in Rosenfeld’s (1947) treatment of ‘Mildred,’ who was depersonalized,
withdrawn and paranoid, she manifested confusional states, phantasizing being kept prisoner in a
dungeon by a devil. In a paranoid psychotic transference, she concretely thought her analyst needed to
keep her captive, forcing her to think his way to the point of no longer knowing what she herself thought.
In Rosenfeld’s (1947, p. 134) words, ‘‘… the central anxiety was a phantasy of the persecuting analyst
forcing himself into her to control her and rob her, not only of her inner possessions, for instance, her
babies and her feelings, but her very self.’’ For a time, she warded off persecutory fears that rendered him
not only invasive, but attacking and controlling as well. When reminded of her ‘‘… sadistic envious
attacks of the devil who in her phantasy, always attacked the good objects …’’, it then became easier to
demonstrate that she herself behaved like a sadistic devil: it was in fact the patient’s own denied intrusive
attacks that were levied against the analyst as a productive, envied and admired mother (ibid., p. 135).
In Riccardo Steiner’s (2008) analysis of this case, he also emphasized an erotized aspect of her delusional paranoid
transference, but at a primitive, part-object level, reflecting a concreteness of functioning rather than a whole
object, genital–oedipal conflict. Because of this concreteness, she often misheard the analyst’s interpretations as an
invitation to act, a seductiveness that frightened her and sometimes caused her to miss her sessions.
from 1947 to 1952, Rosenfeld stood alone in fleshing out the clinically use-
ful aspects of projective identification with psychotic patients. To cite other
examples: Rosenfeld (1949) discussed what he thought was at the basis of
projective identification – he traced its origins to what Klein had originally
termed the ‘paranoid position,’ ‘‘… to the early oral sadistic impulses of the
forcing of the self into another object’’ (ibid., p. 49).
In theorizing about some of his findings, Rosenfeld (1952a) associated the
operation of projective identification as a primary psychic operation of the
paranoid and schizoid positions, where the splitting of both the ego and its
objects into good and bad could be caused by aggression turned against the
self; and the projection of parts or the whole of the self into internal or
external objects. Whereas for Klein, this process rooted itself in the infant’s
libidinal and aggressive phantasies about entering mother’s body, Rosenfeld
refined Klein’s definition of projective identification insofar as it took on
other properties in acutely schizophrenic patients. Rosenfeld wrote:
This confusion seems to be due not only to the fantasies of oral incorporation lead-
ing to introjective identification, but at the same time to impulses and fantasies in
the patient of entering inside the object with the whole or parts of his self, leading
to projective identification.
(Rosenfeld, 1952a, p. 72)
Rosenfeld here called attention to projective identification as a develop-
mentally primitive form of object relationship – something that psychotic
patients could either regress to or simply never quite outgrow – and this fix-
ation in turn led him to postulate the existence of excessive projective identi-
fication in psychotic, confusional states. Put differently: unlike normals and
neurotics, these psychotic patients remained identified with an internally per-
secuting super-ego object – in effect, a constant attack on their own selves,
while projecting good or idealized qualities onto external objects. Rosenfeld
(1952b) also centrally linked his definition of projective identification to the
infant’s initial difficulties in distinguishing the ‘me’ from the ‘not-me,’
concluding on a somewhat optimistic note:
I suggest that the greater understanding of projective identification is beginning to
open up a new field of research and in this paper, I have attempted to show how
this made it possible to understand and interpret the transference phenomena of
this schizophrenic patient.
(Rosenfeld, 1952b, p. 116)
totaling 30 lines; and seven new, rather full footnotes) added to the 1952
paper. Two of these new paragraphs were particularly significant insofar as
they reflected Klein’s revised and more formal definition of ‘projective iden-
tification’ (ibid., pp. 304, 305).
Indeed, for all the minor revisions of word usage, sentence clarity, there
are other more substantive issues – for instance, the term ‘paranoid–schi-
zoid’ (hereafter, P ⁄ S), so often associated with the 1946 paper, is never once
mentioned as such in that paper, but appears in at least a half dozen places
in the 1952 version (cf. Klein, 1946, pp. 99–100; Klein, 1952, p. 294). In the
1946 version, the terms ‘paranoid’ and ‘schizoid’ position appeared separate
from one another, not amalgamated as they did in 1952, reflecting its more
complete conceptual consolidation.
While the earlier paper was a talk given at the British Psycho-Analytical
Society on 4 December 1946, the tone of the later paper is at once more for-
mal, with copious amounts of scholarly regalia added, such as footnotes
and citations of the psychoanalytic literature (Klein, 1952). The seven new
footnotes, some quite extensive, add much to our appreciation of Klein’s
new formulations in 1952: these new footnotes themselves also read like a
who’s who of colleagues who had once been close to Klein (Ferenczi, p. 297,
n. 1) or who were still on the closest professional terms with her (P. Hei-
mann, p. 292, n. 2; W.C.M. Scott, p. 298, n. 1, p. 301, n. 1; H. Rosenfeld,
p. 303, n. 1, p. 305, n.1; and J. Riviere, p. 305, n. 2).7 The 1952 paper also
marked the consolidation of the ‘Kleinian’ school, a point of view identified
with the work of Klein and her students that had become firmly established
as a training track at the British Society.
In the 1952 paper, Klein implicated the work of Herbert Rosenfeld as cru-
cial insofar as she drew on his work in two new defining paragraphs and
footnotes to fill out what she now meant by ‘projective identification.’
Here then, is what Klein added about projective identification in 1952:
Projective identification is the basis of many anxiety-situations, of which I shall
mention a few. The phantasy of forcefully entering the object gives rise to anxieties
relating to the dangers threatening the subject from within the object. For instance,
the impulses to control an object from within it stir up the fear of being controlled
and persecuted inside it. By introjecting and re-introjecting the forcefully entered
object, the subject’s feelings of inner persecution are strongly reinforced; all the
more since the re-introjected object is felt to contain the dangerous aspects of the
self. The accumulation of anxieties of this nature, in which the ego is, as it were,
caught between a variety of external and internal persecutions situations, is a basic
element in paranoia.
(Klein, 1952, pp. 304–5)
In another new paragraph immediately following the previously cited one,
Klein continued:
7
When the names of these contributors are added to existing footnotes, which included the work of D.W.
Winnicott and M.G. Evans, there is only one exception, W.D. Fairbairn, who was not a close
collaborator of Mrs. Klein. This coterie of colleagues is vividly represented in photographic form – as all
the above-mentioned analysts were present at a dinner party celebrating Melanie Klein’s 70th birthday
on 30 March 1952 at Kettner’s Restaurant in London (Grosskurth, 1986, photograph between p. 372
and p. 373; also, cf. p. 392).
to distinguish between the spoken word and the actual reality severely con-
stricted the experiencing universe of the schizophrenic more so than the cre-
ative artist. Whereas the neurotic could symbolize their conflicts in dreams,
the schizophrenic tended to enact their phantasies, leading to the experience
of a ‘pseudo-certain’ identity,’ an ‘I do know who I am’ attitude, only inac-
curately with a pseudo-certainty. This false conflation of self and other
incarcerated the patient in an internal world that was largely unintelligible
to others.
Segal made another contribution by linking the symbolization process
to both the paranoid–schizoid and depressive positions. In spite of per-
verse confusions in P ⁄ S, Segal (1956) appreciated that severely disturbed
schizophrenics could on occasion approach the depressive position. A very
poignant example occurred with Segal’s (1956) patient, who enacted the
sadness of a girl by gathering up threads from the carpet and scattering
them about the room like so many flowers, reminding Segal of Shake-
speare’s ‘Ophelia,’ someone who could induce genuine sadness in the on-
looker by means of projective identification. Amidst psychosis itself, there
could be islands of depressive sanity, both a diagnostic and redemptive
sign. Symbolic equations could potentially become symbolic formations,
where the schizophrenic could learn to feel ambivalently towards his
whole objects, experiencing sadness and loss. Klein (1960) herself recog-
nized Segal’s achievement, adding how schizophrenics by means of projec-
tive identification could project guilt into the analyst. However, since
re-introjection follows projective identification, in Klein’s (1960, p. 266)
words, ‘‘… the attempt towards a lasting projection of depression does
not succeed’’. Klein here appeared to be thinking of Segal’s ‘Ophelia’ epi-
sode as she specifically referenced Segal’s (1956) paper – and here I quote
Klein:
In that [1956] paper the author exemplifies the process of improvement in schizo-
phrenics by helping them, by the analysis of deep layers, to diminish the splitting
and projection and therefore to come nearer to experiencing the depressive position,
with ensuing guilt and urge for reparation.
(Klein, 1960, p. 266)
his patient who then levied strong annihilatory attacks on the mind and san-
ity of the analyst. In other words, since the analyst’s integrated verbal
thought reflected in his interpretations could be and was subjected to the
psychotic’s violent splitting and attacks that were often experienced in a
very concrete way by the analyst, it was left to the analyst to survive these
violent jolts and remain the repository of sane, integrative depressive posi-
tion thinking (Bion, 1954, p. 113).
Bion hypothesized that the schizophrenic attacked his own mind and thus
his capacity to communicate, one where the patient split himself up into
many fragmented pieces and then violently projected them into his objects.
This destroyed capacity allowed the patient to evacuate concretely his dis-
tress into the sane part of the analyst’s mind.
Yet on the other hand, once the splits and fragmented insane-making
communications were interpreted and somewhat successfully introjected by
the patient, there was another round of fragmenting realizations to be dealt
with: the patient could only be catastrophically depressed at the realization
that he had been acting and thinking insanely (ibid., p. 117). Put differ-
ently, violent disintegration could also occur at the cusp of the depressive
position. As a result, the recovering patient in the throes of encountering
the infantile depressive position could and did return to the paranoid–
schizoid position and ‘‘… turn destructively on his embryonic capacity
for verbal thought as one of the elements which have led to his pain’’
(ibid., p. 118).
Bion (1956) further differentiated the non-psychotic from psychotic mind
– whereas the non-psychotic surmounted his phantasies of attacks on the
breast, the psychotic augmented these attacks by attacking his own mind
and its sense organs – yet because of so much internally generated destruc-
tiveness born of a hatred of reality, he could only fear annihilation as a
result of massive projective identification.
Since the psychotic characteristically shattered his objects into tiny frag-
ments – then violently projected into its objects – the patient strove for
a state that was neither dead nor alive. Little else was possible in a subjective
experience where the ‘‘… expelled particles of the ego lead an independent
and uncontrolled existence outside of the personality’’ (ibid., p. 345). Thus,
not only was the breast mutilated, but also the mind as the ‘apparatus of
perception’ as well, leaving the patient imprisoned in a fragmented world,
one where he could also be, in Bion’s words, ‘‘… in the grip of extremely
painful, tactile, auditory or visual hallucinations’’ (ibid., p. 346).
Bion (1957) reiterated many of these themes and now summarized his
findings, integrating them more fully with the work of Freud and Klein
as well as Rosenfeld and Segal. Comparing the findings of the Klein
group with those of Freud, whereas Freud (1923) regarded the psychotic’s
ego as withdrawing from reality in the service of the id, Bion added two
points: (1) the ego is never completely withdrawn from reality; but some-
times, contact with reality can be masked by the ‘‘… operation of omnip-
otent phantasy that is intended to destroy either reality or the awareness
of it;’’ (2) also stressed was ‘‘… that the withdrawal from reality is an
illusion, not a fact, and arises out of the deployment of projective identi-
fication against the mental apparatus listed by Freud. Such is the domi-
nance of this phantasy that it is evident that it is no phantasy, but a
fact, to the patient, who acts as if his perceptual apparatus could be split
into minute fragments and projected back into its objects’’ (Bion, 1957,
p. 268). Bion now named these expelled particles ‘bizarre objects,’ where
the particle projected becomes suffused with aspects of the natural object
with which it is identified.
Again, Bion quoted the work of Segal:
Since these particles are what the patient depends on for use as the prototypes of
ideas – later to form the matrix from which words should spring – this suffusion of
the piece of personality by the contained but controlling object leads the patient to
feel that words are the actual things they name and so adds to the confusions,
described by Segal, that arise because the patient equates, but does not symbolize.
(Bion, 1957, p. 268)
Persecuted by the re-introjected ‘bizarre objects’ and denied access to what
might be more connected and integrated, the psychotic patient then
achieved an attack on reality by severing his link to it and by launching ‘‘…
destructive attacks on the link, whatever it is, that connects sense impres-
sions with consciousness’’ (ibid., p. 268). So in going back to the earliest
phases of P ⁄ S, Bion claimed that true early pre-verbal thought was bound
up with awareness of psychic reality. Consequently, if the psychotic infant
attacked both internal and external reality via massive projective identifica-
tion, he would be left only with bizarre objects. One other effect of the over-
arching attack by the psychotic on his own mind was also an attack on the
links between ideographs, so that two objects could not be brought together,
a later manifestation of which is the difficulty in the combining of words.
The patient was thus stuck in a world where the mental was hopelessly con-
fused with the physical; he could not escape it because ‘‘… he lacks the
apparatus of awareness of reality which is both the key to escape and the
freedom to which he would escape’’ (ibid., p. 269).
To put the psychotic patient back on a firmer psychic footing, the pro-
cesses of massive projective identification had to be reversed, so that the
bizarre objects could be metabolized by the analyst and re-introjected
more successfully by the patient. In these efforts, Bion felt encouraged by
the improved functioning of the psychotic patients seen by Rosenfeld,
Segal and himself. He concluded modestly: ‘‘I believe that the improve-
ments I have seen deserve psychoanalytic investigation’’ (ibid., p. 266).
On treatment
To differentiate the technique of this Kleinian trio with psychotic
patients, we must first establish how Klein herself contemporaneously
defined her own approach along the dimensions of transference, counter-
transference and the role of early history or the patient’s past. Elizabeth
Spillius’s archival research has examined Klein’s unpublished and pub-
lished thoughts on these matters, most especially on technique seminars
that are likely from either 1936 or 1945 ⁄ 46 (Spillius, 2007). What will
appear familiar is Klein’s emphasis on the analyst’s maintaining an ‘ana-
lytic attitude,’ respecting whatever comes out of the human mind, e.g.
positive and negative transference reactions, evident from the initial inter-
view.
Less well known is how Klein was more like Freud with respect to matters
such as the countertransference, regarding it as ‘personal interference’ of
which the analyst needed to remain mindful. Nowhere in her published work
did Klein regard countertransference as ‘‘… useful source of information
about the patient’’ (Spillius, 2007, p. 72).
Also, in terms of the role of the patient’s view of the past, Spillius has
pointed out that Klein saw two processes ‘transferred’ from the past to pres-
ent: (1) the patient’s ‘remembered’ past, or the patient’s own unique and
mainly conscious view of their past (e.g. their parents, siblings and major
traumas); (2) also what Spillius terms ‘the ideal–typical’ model of infant
development (herein termed the ‘unconscious past’), or what Klein thought
of as the typical pattern of infantile phantasies, emotions and object rela-
tions, such as the ‘primal relation deux’ or mother–infant relationship.
Klein kept these ‘general childhood situations’ in mind, by which she meant
love and hate of the breast; an epistemophilic instinct directed at mother’s
body and its contents; reparative attempts for having attacked mother and
father; the primal scene; the Oedipus complex; and the fragmenting splits of
P ⁄ S as well as the development of the depressive position (Spillius, 2007, p.
76). While the ‘transfer’ of these past situations occurred in analysis, the
interpretations themselves were also what Klein termed ‘‘… feelers towards
early situations’’ (ibid., p. 89). In her own clinical work, Klein interpreta-
tively linked the patient’s present and early life, urging analysts to make
explicit transference links between past and present (ibid., pp. 67–76).
On technique
Rosenfeld (1952a; 1952b) borrowed from both Klein’s general understanding
of psychosis as well as her technical approach and refined it in his treatment
of psychosis. In my view, these Kleinians were too busy treating the psychot-
ically-disturbed and writing up their results to have time to make program-
matic statements about technique – that would have to wait for another
time. Rosenfeld interpreted positive and negative transference, relying on
neither reassurance nor suggestion, but centered his interventions on the
transference psychosis, which reflected what he thought was a regression to
the earliest P ⁄ S levels of the first few months of life (Rosenfeld, 1952a, pp.
111–12; 1952bb, p. 458).
Taking the Kleinian trio’s work on psychosis as a whole, in my view,
they made a structural assumption that the patient’s internal psychological
situation was the primary and enduring focus of analysis. In understand-
ing, clarifying and working through the patient’s confused and distorted
experiences, the stage was set for teasing out the effects of the environ-
ment as a distorted and perhaps ‘secondary’ phenomenon. Put differently:
these Kleinians held the external or environmental factor constant while
examining the myriad fluctuations in the patient’s intrapsychic subjective
existence. Rosenfeld’s views were representative of this view, insofar as he
On countertransference
These Kleinians wrote very little about the countertransference during this
time, but their views are of some interest. Rosenfeld briefly broached the
subject in 1952 and acknowledged the work of Paula Heimann (1950). He
wrote: ‘‘In my opinion the unconscious intuitive understanding by the
psycho-analyst of what a patient is conveying to him is an essential factor
in all analyses, and depends on the analyst’s capacity to use his counter-
transference as a kind of sensitive ‘receiving set’’’ (Rosenfeld, 1952b, p.
116). Bion made an even briefer comment on countertransference at the
9
In his reconsideration of countertransference, I conjecture that Bion also had in mind his 1950
membership paper for the British Society and his new view made it possible to publish it later on as the
first paper in a collection of papers from this period (Bion, 1950). In effect, Bion’s 1950 case of a
middle-aged schoolteacher who had lived an unacknowledged ‘pretend’ existence in and out of analysis
had unwittingly created a fetid and stale atmosphere in his analysis. It was only with Bion’s belated
understanding of the existence of the patient’s ‘counterfeit’ self that helped to enliven the analysis. Yet it
was based on his comprehending a maddening psychic quadrille, where there was a stale-making
potential for meaninglessness at the juncture where the pseudo-patient encountered a pseudo-analyst.
This folie deux finally became clear to the analyst: he was in fact experienced by his patient as an
‘imaginary twin.’ In different terms, I think Bion recognized the importance of the patient’s role as an
unreliable and self-subverting narrator. Once this was understood, Bion could in turn grasp more clearly
his own unconscious collusion with the patient, thus giving impetus to the importance of the active
consideration of the countertransference later on. It was from this countertransferential web that the
analyst had to extricate himself. By 1955, Bion came to the fuller realization of the broader importance
of the countertransference, and he indicated as such in a much revised version of his 1952 paper on
Group dynamics (Bion, 1952): ‘‘The experience of countertransference appears to me to have quite a
distinct quality that should enable the analyst to differentiate the occasion when he is the object of a
projective identification from the occasion when he is not. The analyst feels he is being manipulated so
as to be playing a part, no matter how difficult to recognize, in someone else’s phantasy’’ (Bion, 1955b,
p. 446).
While Segal (1956) herself did not explicitly write about induced counter-
transference during this period, her clinical work ran parallel to Klein’s
views. In the clinical example of Segal’s ‘Ophelia’ patient, this incident poi-
gnantly reflected how Segal made use of her countertransference, as induced
by this very disturbed patient. Like Klein in this instance, Segal did not
explicitly write about her countertransference. When the patient danced
about the consulting room, Segal wrote:
… it struck me that she must have been imagining that she was dancing in a mea-
dow, picking flowers and scattering them. And it occurred to me that she was
behaving exactly like an actress playing the part of Shakespeare’s Ophelia. The like-
ness to Ophelia was all the more remarkable in that in some peculiar way, the more
gaily and irresponsibly she was behaving, the sadder was the effect, as though her
gaiety itself was designed to produce sadness in the audience, just as Ophelia’s
pseudo-gay dancing and singing is designed to make the audience in the theater
sad.
(Segal, 1956, p. 341)
When other students of Klein, such as Money-Kyrle (1956) wrote more
explicitly and enthusiastically about Heimann’s views, Klein finally made
her views on the subject more public by way of a seminar given to younger
colleagues in 1958 (Klein Archives, PP ⁄ KLE ⁄ C72; Spillius, 2007, pp.
78–81). Recorded on audiotape, an otherwise amiable discussion became
somewhat heated on the topic of countertransference, when Klein said:
‘‘I have never found that the countertransference has helped me to under-
stand my patient better. If I may put it like this, I have found that it helped
me to understand myself better.’’ By this late point in her career, Klein was
aware of the enthusiasm for the ‘patient-induced’ view of countertransfer-
ence, but regarded it more as an error to be corrected. Klein apparently did
not want analysts getting carried away (in Spillius’s words), ‘‘… by their
transference to the patient and to regard this aspect of their character as
valid data about the patient’’ (Spillius, 2007, p. 80). Like Hinshelwood, Spil-
lius also conjectures, however, that Klein did draw implicitly on her counter-
transference in working with patients.
Bion’s absorption with what we today would regard as ‘enactments’ left him
little room or interest in reconstructing the hypothetical ‘early’ life of the
patient. Given his postulations about the psychotic’s propensity to attack his
own mind, which included memory, it implied a view of a self-subverting and
unreliable narrator, one whom would leave the analyst ‘in the dark’ (as Bion
wrote) about what actually happened in the patient’s early life (ibid.). Bion
moved away from early developmental models of a ‘there and then’ infantile
history – perhaps they too could be used defensively as a way of projecting
Conclusions
After 1957, the members of this particular ‘publishing cohort’ more or less
went in separate directions, continuing to refine, re-think and reformulate
the leads opened by their analytic experience with psychotic patients. Rosen-
feld, for instance, took his work in the direction of summarizing the results
with treating schizophrenics, but now also included work with drug addicts,
alcoholics, hypochondriacs and narcissistic characters (Rosenfeld, 1965). He
concluded that Klein’s approach had helped him deepen his understanding
of the psychotic process and at times would lead to a diminishment of the
patient’s schizophrenia. His work had received an endorsement from Ernest
Jones, who approved of the emphasis on the exploratory and research
aspects of Rosenfeld’s work (rather than the curative outcome process)
(ibid., p. 11).
On the other hand, Hanna Segal by and large moved away from publish-
ing on schizophrenia per se, but continued with her work on aesthetics and
literature, artistic creativity and freedom of thought. Her best-known work
that came just a few years after Melanie Klein’s death in 1960 was An Intro-
duction to the Work of Melanie Klein, a collection of lectures that she had
given for years to the candidates in training at the British Psycho-Analytical
Institute (Segal, 1964). This widely known work has had a tremendous
impact over succeeding generations on the international community, often
serving as the primary orienting text for those interested in learning more
about Melanie Klein’s theories and techniques.
It remained Wilfred Bion’s task to continue treating and writing about his
results with schizophrenic patients. In his extremely well-known writings on
hallucination, arrogance, attacks on linking, he gathered his work together
now in a more general direction of an over-arching theory of thinking
(Bion, 1967).
Yet what remained as a legacy to psychoanalysis were their collective
efforts to map out the complicated and hazardous terrain of schizophrenic
disorders, something that would not only make possible the psychoanalytic
treatment of psychosis, but also make more apparent the psychotic islands
that existed in neurotic and normal individuals.
Although the conclusions I now propose are schematic and preliminary,
I offer them as a departure point for further consideration. With respect to
Klein’s legacy, Rosenfeld’s post-war work secured Klein’s connection to the
past, demonstrating at a number of different levels how continuous her work
was with that of Sigmund Freud. Historically speaking, since Rosenfeld’s
analysis came during the time of the Controversial Discussions, one might
say that he was more purely an analytic child of that time – as demon-
strated with his interest in articulating the continuity between Klein and
Freud’s clinical thought (e.g. his 1949 paper that tied together paranoia,
homosexuality and narcissistic object relations). More so than the others, in
his numerous bibliographic references that demonstrated a rich and keen
awareness of Freudian and neo-Freudian literature, his interest in recon-
struction and attempts to get at ‘what really happened’ in the first years of
life made him eager to make explicit and detailed linkages in the transfer-
ence between past and present. Bion, of course, added to this with his inte-
gration of Freud and Klein’s conceptualizations of psychotic thinking.
On the other hand, Hanna Segal seemed to most attune her clinical work
to Klein in the present. Since her analysis came at a time when the tumultu-
ous issues of the Controversial Discussions had been institutionally resolved
with the three-tiered training system, Segal proceeded (as relayed in a pri-
vate communication) in her analysis with Klein almost as if the Controver-
sial Discussions had never happened. In her analysis with Klein, Segal never
recalled it ever being a topic of conversation. I suggest that this temporal
factor essentially made Segal a ‘post-Controversial Discussions’ analytic off-
spring. Segal focused on Klein’s contemporary work, something that formed
her orienting point of departure and led her in the direction of reconciling
her own work on symbol formation and aesthetics with the corpus of
Klein’s published work. Thus in spirit of a new ‘Klein’ group that had
secured its own legitimate training track at the British Psycho-Analytical
Society in the post-war years – and perhaps here, the ease facilitated by a
young female analyst’s identification with someone she experienced as a
sound mother figure – also led Segal at that time to analyze most in the
spirit and technique of her analyst. It was equally as clear that both Rosen-
feld’s and Bion’s clinical work took their orienting focus from the work of
Klein.
While Segal, for instance, focused on linking past with present, her expli-
cations about the past were made with economy, not detailed elaboration as
one would have found in the work of her colleague, Herbert Rosenfeld. This
is neither criticism nor praise: it is more a matter of degree rather than a
qualitative difference. Likewise, Segal’s attitude about countertransference at
that time was aligned with Klein’s view of it as ‘personal interference.’ Like
Klein herself, Segal also drew upon her countertransference, but did not
explicitly write about it until later (Segal, 1981).
Turning to the third member: Bion was the last of the trio to be analyzed
by Klein and his work on psychotic thinking eventually opened up his
Acknowledgments
An earlier version of this paper was delivered at the ‘Hanna Segal Today’
Conference at University College London on 1 December 2007 (Mary
Target, Chair). The author also here gratefully acknowledges the support of
the International Psychoanalytical Association’s Research Advisory Board –
through its fellowships granted in the area of the history of psychoanalysis,
a number of publications (Aguayo, 1997, 2000, 2002, 2008; Spielman, 2006)
as well as research trips to the Melanie Klein Archives housed at the Well-
come Institute in London and to the archives of the British Psycho-Analyti-
cal Society have been made possible. The author also recognizes the helpful
support of a number of colleagues: Robert Hinshelwood, Riccardo Steiner,
Robert Westman, James Grotstein and Jon Tabakin. The responsibility for
the final paper is, of course, the author’s own.
Translations of summary
Zum Verständnis der projektiven Identifizierung in der Behandlung psychotischer psychischer
Zustände: die Publikationsgruppe H. Rosenfeld, H. Segal und W. Bion (1946-1957). Eine Publi-
kationsgruppe kleinianischer Psychoanalytiker – Rosenfeld, Segal und Bion – fhrte Kleins (1946) Kon-
zepte der projektiven Identifizierung und der ‘‘paranoiden’’ und ‘‘schizoiden’’ Position in das Verstndnis
einer Gruppe psychotischer Stçrungen ein. Der Autor unterscheidet Kleins Beitrag von 1946 von seiner
revidierten, 1952 erschienenen Fassung und behauptet, dass die klinische Arbeit, die Rosenfeld in dieser
Phase leistete, die Formulierung von Kleins Neudefinition der projektiven Identifizierung ermçglichte.
Damit war die Bhne bereit fr Segals berlegungen zur ‘‘symbolischen Gleichsetzung’’. Infolge des
Angriffs, den der Psychotiker auf die Brust vorgenommen hat, ist er innerer Qual und Verfolgung ausge-
setzt. In diesem Zustand werden die Dinge an sich mit dem, was sie symbolisch reprsentieren, verwech-
selt. Segal wiederum brachte die psychotische mit der normalen, die paranoid-schizoide mit der
depressiven Position in Verbindung und zeigte, wie der Patient durch projektive Identifizierung und sym-
bolische Imagination Traurigkeit, Schuld- und Verlustgefhle im Analytiker hervorrufen kann. Bion
nahm an, dass die psychotische Pathologie ein gestçrtes Denken widerspiegele und der schwergestçrte
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