chapter  11
13 Pages

Phantasies of dread, demand, and desire

In private practice, the contemporary analyst faces a great variety of patients in various degrees of primitive or neurotic functioning and acting out in often strong and persistent fashion. This can be taxing in the counter-transference, and enactments are common but hopefully helpful in learning about the patients’ unconscious motivations. Projective identifi cation is considered a cornerstone of the transference from the Kleinian perspective (Waska 2004, 2005, 2006) and with the more primitive, paranoid-schizoid (Klein 1946) or disorganized patient, this dynamic is often the primary vehicle for much of their inner life as opposed to more organized depressive (Klein 1935, 1940) confl icts that utilize higher level defenses.