Projective identification: the container and reverie as concepts in applied psychoanalysis.
This paper discusses theoretical and clinical problems experienced in the assessment and treatment of two borderline patients admitted to a psychotherapeutic community. It is proposed that difficulties encountered were related first to the inability of the therapeutic couple (therapist and nurse) to develop a capacity for reverie and containment essential if pathological projections were to be detoxified and made available for reintrojection by the patient. Second, it is proposed that failure relates to the patients' difficulties in developing normal symbol formation with respect either to thought or behaviour, related retrospectively to excessive splitting and pathological projective identification and prospectively to an inability to experience whole object relationships. This in turn is linked to the patients' attack on those capacities which are present in the therapeutic couple.
D000328:Adult; D001883:Borderline Personality Disorder / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D007062:Identification, Psychological; D009034:Mother-Child Relations; D011369:Professional-Patient Relations; D011385:Projection; D011575:Psychoanalytic Therapy / Q000379:methods*; D012059:Rejection, Psychology; D013561:Symbolism; D013808:Therapeutic Community