chapter  10
17 Pages

Keeping the faith when working with turbulent patients

Our more diffi cult patients have typically spent their lives cultivating, maintaining, and then enduring intense internal and interpersonal turbulence through excessive reliance on destructive projective identifi cation processes. As a result, the analyst must be constantly aware of these shifting and complex dynamics. Turbulent patients, by defi nition, create a vicious internal cycle of projecting toxic mental confl ict, reacting to it as if it is an outside force threatening them, and then creating more defensive projections to protect themselves.