title: The merits and problems with the concept of projective identification.
abstract: This paper reviewed the merits of and problems with the concept of projective identification. On the negative side, lack of universal meaning of the term was cited. Personal countertransference receives little regard, while an isomorphic reading of patient feelings may be used to gratify omnipotent symbiotic analyst and patient fantasies. On the positive side, the concept offers a framework that can lead to deeper understanding of difficult therapeutic situations. It helps the analyst process and contain distressing feelings and eschews interpretation that can be destructive to the analytic process. Proper use of projective identification should engage the patient's ego rather than foster passivity and merger wishes. Case material was presented which illustrated problems with and merits of the concept. Personal countertransference, especially therapeutic omnipotence, was shown to receive insufficient attention. The important role of complementarity in projective identification was illustrated in the treatment of depression, a disorder which can offer difficult treatment resistances. In conclusion, the concept should not be used as a justification for analyst omnipotence and avoidance of countertransference responsibility. The concept, however, can lead to a deepening of the analytic situation if it is used with caution and respect for the patient's separateness.
mesh_terms: D003379:Countertransference; D003866:Depressive Disorder / Q000628:therapy; D004645:Empathy; D005260:Female; D006801:Humans; D007062:Identification, Psychological; D008297:Male; D011385:Projection; D011573:Psychoanalytic Interpretation; D011575:Psychoanalytic Therapy; D013406:Suicide, Attempted / Q000523:psychology; D013559:Symbiosis