ABSTRACT
When we considered Conran's description of an admission to a mental hospital, we summarised the process of projection into the hospital staff (Essay 1, ‘Responsibility and professional identity’, p. 12). In that paper, interestingly, Conran compared the psychotic's admission with that of a quite normal person admitted as an emergency to a surgical ward with acute appendicitis. In the latter case too, Conran described a process whereby the patient in pain and feeling extremely unwell gave up his own initiative and agency. His capacity for self-care was lost as he took himself to bed and asked his wife to call the doctor. In subsequent steps, his self-care was passed to the wife, then the doctor, and then the hospital and the surgeon. Finally, as he recovered after the operation, his body healed and the split in his personality also healed. He could ‘take back these projected parts of himself, resume the government of himself and take his discharge’ (Conran 1985, p. 35): a fluent process of splitting and projective identification, followed by a return of the projected parts and restoration of his initiative and agency for himself. The processes that we have seen as fundamental to the psychotic condition - splitting and projective identification - are therefore to be seen as occurring in quite significant and painful form in the ordinary person. This patient too became alienated from himself for a while.
