ABSTRACT
'Projective identification' relates first of all to a splitting process of the early ego, where either good or bad parts of the self are split off from the ego and are as a further step projected in love or hatred into external objects, which leads to fusion and identification of the projected parts of the self with the external objects. There are important paranoid anxieties related to these processes as the objects filled with aggressive parts of the self become persecuting and are experienced by the patient as threatening to retaliate by forcing themselves and the bad parts of the self which they contain back again into the ego.
In this paper I have discussed a number of processes related to projective identification which play an important part in psychotic patients. First of all, I am distinguishing between two types of projective identification: the projective identification used by psychotic patients for communication with other objects, which seems to be a distortion or intensification of the normal infantile relationship which is based on non-verbal communication between infant and mother; and secondly, the projective identification used for ridding the self of unwanted parts, which leads to a denial of psychic reality. As a third point I am discussing projective identification representing a very common transference relationship of the psychotic patient which is aimed at controlling the analyst's body and mind, which seems to be based on a very early infantile type of object relationship. My fourth point is projective identification used by the psychotic patient predominantly for defensive purposes to deal with aggressive impulses, particularly envy. The fifth point I am drawing attention to are those object relations of the psychotic patient in analysis where he maintains the belief that he is living entirely inside an object - the analyst - and behaves like a parasite using the capacities of the analyst, who is expected to function as his ego. Severe parasitism may be regarded as a state of total projective identification. I am also discussing the parasitical state which is related to living entirely in a delusional world. Sixthly, I am discussing the psychoanalytic treatment of the processes related to projective identification in the psychotic patient. Finally, I shall present case material of a schizophrenic patient in order to illustrate some aspects of projective identification and ego splitting.
