(Editors' Note) On September 1, 2000, Hilde Rapp responded on the IJPA discussion list to an invitation to suggest ways of facilitating a process of translation between different psychoanalytic dialects, and made a forward of her message to the SEPI list serve. On the same day Paul Wachtel replied saying that as "an integrationist, moreover, whose initial roots and continuing strongest interests are in psychoanalysis", he had "NOT been persuaded that Lacan, or even Bion, to take a quite different example, really have something useful to contribute", and went on to ask Hilde, since she cited Bion approvingly, if she could indicate in a brief way what ideas of observations of his she thinks are really valuable. On September 2 Hilde and Tullio Carere responded to Paul's invitation, pointing up shortly what in their opinion is valuable in the thinkers quoted, and especially in Bion. Paul replied that he has nothing to object to the interesting kinship between the therapist-patient relationship and the mother-infant relationship, yet much to object to the usefulness of the image of a "container" or of "containing". This gave rise to a huge debate, in which 26 SEPI members took part. The discussion on the function of holding or containing was enriched by that on a related concept, that is projective identification, introduced into the debate by Paolo Migone. He said on September 4 that though put off by Bion's difficult language, he did appreciate several of his things, for example his re-elaboration of the concept of projective identification. He sent then the following day a long excerpt from a paper of his on this topic. The concept of projective identification met more or less with the same reception as the image of the container: those who distrusted the latter felt the same distrust toward the former. Two positions emerged in the discussion. Some thought that the metaphor of containing/holding was useful to describe a crucial therapeutic factor, connected to reparation or corrective emotional experience. Others did not deny the therapeutic factor, but took issue with the metaphor, deemed useless or misleading. A lengthy and passionate discussion brought to no rapprochement between the two positions, but we are sure that its reading will enrich many colleagues. We want to thank all 26 participants, who are the following (listed in the order in which they intervened): Paul Wachtel, Tullio Carere, Hilde Rapp, George Stricker, Windy Dryden, Jack Berkley, Paolo Migone, Rebecca Curtis, Bill Stiles, Bob Sollod, Jennifer Hillman, Robert Rosenbaum, David Allen, Luca Panseri, Nancy McWilliams, Jim Lindsley, Arthur Egendorf, Diana Fosha, Richard O'Connor, Ana M. Stingel, Elizabeth Moraes, Marvin Goldfried, Diana P. Wais, Allen Kalpin, Ava Schlesinger, Ang Wee Kiat Anthony.

 

Fri, 1 Sep 2000, Paul Wachtel

Hilde, I got your recent posting on the SEPI list serve and felt like I had come in in the middle of the movie. I gather you were forwarding something from another list to which you also belong? But there was no indication how to communicate with that list. Was there a longer history to the discussion from which you cited a piece? I was intrigued but puzzled.

I was also made aware that despite being (a) a staunch integrationist and, hence, someone who fundamentally believes that any school of thought that has attracted significant numbers of smart people must have SOMETHING useful to say that those of us of other orientations can profit from and use, and (b) an integrationist, moreover, whose initial roots and continuing strongest interests are in psychoanalysis, I nonetheless became acutely aware in reading the posting that, thus far, I have NOT been persuaded that Lacan, or even Bion to take a quite different example, really have something useful to contribute. Bion in particular has become quite strongly of interest in U.S. psychoanalytic circles (there's always a time lag across the pond), and I have frankly been put off enough by everything I have heard my Bion-citing students and colleagues say (putting feelings "into" other people, all the stuff about "containers," the view of psychic life and of groups as basically psychotic underneath, etc.) that I have not had the inclination to read his stuff for myself. That means, of course, that I speak from ignorance in a sense, so nothing I am saying here is something I would stand behind in print. (I don't believe we should spout off -- except in informal exchanges such as this, that are designed simply to draw further responses for consideration -- on matters that we have not examined seriously and carefully). On the other hand, life is short, and I barely have enough time to read the things I KNOW I will find useful, and nothing I have heard anyone say about Bion thus far has led me to think that, in the finiteness of life, reading Bion is a good investment of my limited time.

So, since you cited Bion approvingly, if you could indicate to me in a brief way what ideas of observations of his you think are really valuable (and perhaps whether you think any of them are unique enough that I couldn't come to them from other sources who use a less peculiar and off-putting linguistic style) I would be very appreciative.

I was initially going to send this just to you (along with a warm hello, which shall remain), but decided to respond instead to the SEPI list from which it came, since others on the list may also be able to help me overcome my resistance to Bion, if that be what it is. So thanks to any of you who can enlighten me (and, for that matter, to any of you who share my views about containers and putting feelings into people, and want to cure me not by enlightening me but by supporting my present inclinations). Paul.

Sat, 2 Sep 2000, Tullio Carere 

Paul, I put Bion in the same category as Jung and Lacan, for their capacity to irritate me deeply, but in the same time to intrigue me enough to get me to read further. Yet very little of Jung or Lacan has survived in my present way of working and thinking (though Jung has been a juvenile love affair of mine), while Bion's influence is still a corner stone to me.

I understand Bion's thoughts "about containers and putting feelings into people" as his way to point to the kinship between the mother/child and the therapist/patient relationships. As the mother must hold, contain, and partially work through the experience that the child cannot yet hold, contain and work through by himself, so is the therapist to do with some of her patients, in some moments, or sessions, or phases of the treatment. When a therapist relates to her patient in this way, I say that she acts from the "Maternal vertex" of the field.

But Bion's most decisive contribution is in my opinion the introduction in the therapeutic field of the Kantian polarity phenomenon/noumenon, or knowledge/unknown, or K/O. In the Freudian theory there is no Unknown (as unknowable), there is only an Unconscious (that can be made conscious). The Freudian therapist is therefore bound to make the unconscious as conscious as possible, but is not helped by his theory to trust the unknown as such.

There is a substantial difference between Freud's unconscious and Bion's unknown. The unconscious must be drained as much as possible, or reclaimed as the Zuider-Zee. The unknown is the matrix of all generative and healing powers that all therapists, from the shamans on, have always drawn upon.

The unconscious has to be conquered (which the therapist does from the "K vertex" of the field, where he acts as a scientist) while by the unknown one has to be inspired (this happens in the "O vertex", where the therapist acts as an artist). I hope, Paul, I have not succeeded in supporting your present inclinations towards Bion. Tullio.

Sat, 2 Sep 2000, Hilde Rapp 

Hello Paul, how nice to hear from you. This will be alas much briefer that I would like- I owe a chapter I must get down to- but did want to respond quickly: I think that Bion, the British Kleinians, Lacan, Kristeva and sometimes Langs, have a style which is not conducive to communicating ideas or practices.

Rather, what their writings do- I think- is to create a subjective field, an experience, into which to immerse oneself- which once one allows it to develop, recreates certain experiences and feelings which resemble how one feels when working with - usually - very disturbed clients.

Jerry (Gold) and Rebecca (Curtis), and George (Stricker), occasionally describe client work, where over a time a certain intuition about a client incubates which slowly forms into a clinical hypothesis that, say, this person has never really sepated emotionally from his mother and has , in a sense no, proper ego boundaries, but 'uses' the therapists to give some shape and stability to their sense of being a person at all...

In a way Jerry and George's their Integrative Handbook does contain chapters which draw on object relations approaches, which themselves are informed by this literature. Maybe somebody like Donald Winnicott, or among contemporaries, Christopher Bollas, or Patrick Casement has found a more accessible style for describing how they come to understand and work with these strange states.

In a way, this whole body of writing is only relevant for therapists who do a significant amount of work in long term psychotherapy with people who might be described as borderline ( but not particularly impulsive and antisocial- in which case they need something more like Marsha Lienehan's or Tony Ryle's approach or straight CBT), narcissistic, fragile self, with a particularly poor attachment history- who don't make good use of the therapeutic alliance, or of relationships in general.

Otherwise it is a body of work- Edna O'Shaughnessy falls into this category as well, which is more like literature or a curious amalgam of poetry, mysticism and philosophy- for which one has to be in the mood.

On this list, Tullio Carere is a good example of someone who writes - I think- in an accessible way about issues and themes which are centrally informed by this body of work.

On the other hand, Diana (Fosha) and Leigh ( McCullough) have a perfectly accessible, contemporary and emotionally deep and passionate way of doing this work and writing lucidly about it- so from a practitioner rather than a historian of idseas perspective, once can get the clinically insights in a whole range of styles- so why not choose the one that speaks to you and that you can relate to and enjoy reading! Maybe when I have made more progress with my chapter you might be interested to have a look - it will draw on some of these author's, or their influence. Maybe Tullio has time to do some advocacy for this body of literature meanwhile? Cordially, Hilde.

Sat, 2 Sep 2000, Paul Wachtel 

Dear Tullio and Hilde, thanks for your replies to my Bion inquiry. Tullio, I am indeed interested in what you have raised about Bion's less commented upon contribution (the unknown vs. the unconscious) but still have a suspicion that Carere would be a more rewarding source to read on this than Bion. But be that as it may, I wish to turn to the issue that continues to puzzle me, the one that spews forth constantly from my students and colleagues and STILL doesn't make sense to me. You state that:

<<I understand Bion's thoughts "about containers and putting feelings into people" as his way to point to the kinship between the mother/child and the therapist/patient relationships. As the mother must hold, contain, and partially work through the experience that the child cannot yet hold, contain and work through by himself, so is the therapist to do with some of her patients, in some moments, or sessions, or phases of the treatment. When a therapist relates to her patient in this way, I say that she acts from the "Maternal vertex" of the field.>>

My question is not about the interesting kinship (and, of course, lack of kinship at the same time -- something you are well aware of in your thinking dialectically) between the therapist-patient relationship and the mother-infant relationship. My question is whether -- for either -- the image of a "container" or of "containing" is useful. My guess is, apropos Hilde's interesting comment, that it is a metaphor, a poetic image for some, that resonate with SOMETHING that people observe or experience. And I agree with Hilde that basically use whatever sources, images, etc. that work for you and that different images will work for different people. But not only does "container" not work for me, it seems to me to be an image that is confusing, obtuse, and certainly not useful for any systematic understanding of the process. SOMETHING important goes on between mother and child or therapist and patient, and my guess is that what you (and others who seem to like Bion's way of speaking about it) are ACTUALLY picturing or referring to when you use the word "contain" is probably quite accurate. But why in the world describe it as "containing?" I still need enlightenment here, from the two of you or from anyone else who can help this poor, troubled soul who just doesn't get it. Paul.

Sat, 2 Sep 2000, George Stricker 

Now that Hilde has mentioned my work, which does value some of the contributions of some object relations theorists, I guess I should respond to Paul's question, and to Tullio's answer. I would not group Jung with Bion and Lacan - I don't much care for Jung, for political as well as psychological reasons, but I do understand him; I can't say the same for the other two. Over my career, I must have reviewed at least three dozen books, liked some better than others, but tried to do a fair job for all. As a result, when I was sent a Bion book to review, and after a noble effort, I sent it back without a review, feeling I could not do a fair review of a book I found incomprehensible. I should add, although this may be a different thread, that I find the concept of projective identification particularly noxious, as it often is used to exonerate the therapist from responsibility for his or her behavior and blame it on the patient. I certainly see the relationship as central, and at least some of what goes on as unconscious, but I don't find the language of Bion and Lacan useful, and the concepts either are not original or, if original, not understandable, to me at least. George.

Sun, 3 Sep 2000, Tullio Carere 

Paul, on Sep. 2 Paul Wachtel wrote:

>My question is not about the interesting kinship (and, of course, lack of

>kinship at the same time -- something you are well aware of in your thinking

>dialectically) between the therapist-patient relationship and the

>mother-infant relationship. My question is whether -- for either -- the

>image of a "container" or of "containing" is useful. My guess is, apropos

>Hilde's interesting comment, that it is a metaphor, a poetic image for some,

>that resonate with SOMETHING that people observe or experience. And I agree

>with Hilde that basically use whatever sources, images, etc. that work for

>you and that different images will work for different people. But not only

>does "container" not work for me, it seems to me to be an image that is

>confusing, obtuse, and certainly not useful for any systematic understanding

>of the process.

 

There is a pertinent paragraph in last Hilde's message of Sep. 2:

>Jerry (Gold) and Rebecca (Curtis), and George (Stricker), occasionally

>describe client work, where over a time a certain intuition about a client

>incubates which slowly forms into a clinical hypothesis that, say, this

>person has never really separated emotionally from his mother and has , in a

>sense no, proper ego boundaries, but 'uses' the therapists to give some

>shape and stability to their sense of being a person at all...

This is very important, in my experience. People who have been seriously deprived of good enough maternal care are a considerable share of our clients (or at least of mine). It is not just a metaphor, but a more or less accurate description, to say that they have no "proper ego boundaries". These are the people, if any, who badly need "corrective emotional experience". They must find some form of relational containment, if they are to let go of their defensive (and usually most expensive) self-containment.

A clinical flash: Year after year, a woman with character problems improved enough for continuing the treatment, but not enough for stopping it. At one point I felt that she had in herself so small a child, and so furious and desperate, that no talking cure would do to soothe her. I had to give her what one would give to a real child: bodily holding. It was a turning point: in less than a year I could do all the work that I had not been able to do in many years before, and the therapy could finally end.

Physical holding is absolutely necessary to children and, in my experience, also to many a patient. As I told Ellen and you in New York, I am enthusiastic of my recent discovery of EMDR because I have found that, independently of the biphasic brain stimulation, it is perceived by some as a form of physical holding (they experience the waving movement of my hand as a hug).

To some patients, especially those with depressive, obsessive-compulsive, panic attack, or eating disorders, I often give antidepressant medication for some time: it is a pharmacological containment that I find necessary when the pain is intolerable, until the person is ready for a purely relational containment (but the administration of a drug is anyway a relational event: the person feels usually contained by both the pharmacological action of the drug, and the very administration of it).

These are a few examples of most basic forms of emotional containment. For a more general view, I hope you will forgive me if I quote myself (JPI, 9, 4, 1999):

"The therapist has many ways to meet her patient's need to feel contained, from the constancy of space-time conditions to the tone and the choice of the words. Beyond the specific modes, what is decisive is the attitude that transmits to him a message of unconditional acceptance, of acknowledgment of his worth and dignity independently of any work, project, or assumption of responsibility.

One should always recall Gill's warning (though he himself, as was seen above, did not do so): nothing in the therapeutic interaction bears a universal meaning. The couch can be a comfortable cradle to one person, a Procrustean bed to another. The silence of the therapist is to some patients a room in which they feel welcome and free to move as they like, to others a sign of unbearable coldness and detachment. It follows that only an inexperienced or insensitive therapist can impose undiscriminatingly the couch, prolonged silences or whatever.

The need to find a secure base is very much variable from patient to patient, both in intensity and in quality. Some can be contained and guided in a process of change only in a definitely rigid setting, while other proceed in a softer and more flexible environment. What is reassuring to a person is intolerable to another. There is no way to know it in advance: only the careful listening to all explicit and implicit demands, and the unprejudiced observation of the reactions to any intervention can serve as a guide in a genuine relation...

In the maternal vertex the therapist receives the unstructured or chaotic signals that the patient sends to her, and gives them back to him partially elaborated, so that he can begin to integrate them in meaningful connections. This operation, compared by Bion (1962) to the maternal reverie, is different from the classic, Freudian interpretation, because its aim is not to uncover unconscious meanings (therefore it does not belong to the uncovering axis of the therapeutic relation), but to meet an actual inadequacy with the offer of an auxiliary container for the experience that the other is not yet able to keep and elaborate autonomously. This kind of interpretation does not face a resistance, but meets an incapacity: it is directed to a patient who "cannot", rather than to one who "does not want"." (pp. 379-381)

When I wrote of the different meanings of silence I had quite clear in my mind the wonderful pages in "Psychoanalysis and Behavior Therapy" where you described them. I now see that I forgot to quote you in this paragraph of the paper. So I have one more thing to apologize for, beyond the other, much more unforgivable, of imagining that I have something to teach you. But I dare do so because you taught me so many invaluable things, that may be you would accept from me a very small one in return. Tullio.

Sun, 3 Sep 2000, Tullio Carere 

George, I grouped Jung with Bion and Lacan because they have one thing in common--the special capacity to evoke in others enthusiastic allegiance or scornful refusal. If one can avoid the latter, and above all the former, that is more dangerous (because it generates followers), one can find a middle way that leads to some useful places. This was anyway my experience, as I try to convey in my response to Paul. But if what seems to me a way seems to you a blind alley, please don't hesitate to make me know. I may still be a victim of Bion's dark charm, without knowing it. In this case I am the one who need enlightenment. Tullio

Sun, 3 Sep 2000, Windy Dryden 

I have found some of the works of Lacan and Bion extremely useful in clinical practice for my clients with insomnia. They work like a dream!! Windy Dryden.

Sun, 3 Sep 2000, Jack Berkley 

Paul, I did not know Bion was catching on. Among my Bion friends, I am not as zealous. Many of my Bion friends about five years ago were reading a novel Bion wrote. As an old English major, I knew they had exceeded my devotion. But devoted they were and i was out of the loop with some good friends on that. Roger Shapiro and Elizabeth Bott Spillius (sp?) are wonderful lecturers on Bion, so are many A.K. Rice associates, which I used to be. Bion and Klein are central to that work. However, I can confirm for you that it is not necessary to take limited time to read Bion. I would not. There are too many good proponents of his theory who do a better job explaining it.

Also, you mentioned that students talk about "putting feelings into". That is a common parlance among Bion/Kleinian psychologists. It is, like many idioms, not subject to literal translation. The idiom makes it sound as if feelings are transported in some magical or psychic way. Worse, it lends itself to the misconception that the feelings have nothing to do with the recipient/container, who can be mistakenly thought of as an empty vessel filled with material not his own.

The projective identification process is a here-and-now, behavioral influencing process. It is a behavioral process. Let me say again: Its fundamental mechanism is behavior. This is not shamanism, mysticism, witchcraft, or anything arcane, though the language suggests it is. I think the language of this brand of psychology erects a boundary or shield around its proponents that makes them appear--often especially to themselves--in possession of a secret science, or mystical insight. It is very alluring, and Bion's writing and Klein's writing lends to this nether worldly professional penumbra.

Projective identification is much more worldly, occurs between two or more persons, and is an identifiable process with steps. There are different definitions of it so one needs to clarify. But it is borne of behavior, not psychic vibrations or thought insertion. Sorry. Ill stop. I guess there are two ways to ruin a concept, at least. Proponents who misuse it, including beginning sophomoric users and more twisted defensive users, and those who learn of the concept from such persons and are turned off more by the misuse than the concept itself. Jack.

Sun, 3 Sep 2000, Jack Berkley 

George and others, some of my responses appear at the ends of other series of exchanges so they may have become lost for that reason and for the reason that I hit the reply button and have only on person's name listed as the recipient. George I wanted to send the response below to your attention because it may have got buried in my response to Paul. The others I just hope you will want to find. Thanks.

Response: Paul, contain yourself. Jack

P.S.: seriously, hope that is a helpful nudge. By the way, just bought your book at APA and look forward to it. Also, container = Latin continere: to hold together, hold in, to have within, hold, enclose, bound, to restrain oneself, accommodate. I think of the term in conjunction with Keats' letter on negative capability which paraphrased from memory (others may correct any literary transgression here): the capacity to be in uncertainties etc. When a therapist can calmly and genuinely listen to and perceive the distress of a client, the therapist is receiving emotional, intellectual, verbal, kinesthetic data into his or her intrapsychic system and holding it there and processing it, hopefully without reacting too precipitously, that is to say while first holding it within for a time.

Hopefully now, via email, we who find Bion's concept practical and useful, are "containing" your mix of dismay about the term which "doesn't work for me" and your yearning to understand the term in a way that we do ("I need some enlightenment here"). I think also, one must in part identify with the capacity of the most anatomically important human container, the womb to the extent possible. This is a shift in gender metaphor, and if one pauses a bit, one can remember all kinds of issues related to the psychoanalytic concepts pertaining to phallus and womb. The therapist's mind is then by metaphor quite a matrix for processing client inputs. Thomas Ogden uses the title "the Matrix of the Mind" in a book title. You can think of containing simply as "processing" in a complex human way if you like drawing from the therapist's capacities to receive constructively all kinds of difficult inputs from the client. In fact Ogden uses that synonym as do others.

In part, "Under optimal circumstances, the recipient "contains" (Bion, 1962a) or "processes" (i.e., handles maturely) the evoked feelings and ideas, and thus makes available for reinternalization by the projector, a more manageable and integrable version of that which had been projected." (p. 145 of Matrix of the Mind.)

Now that, with the womb stuff and all that may be provoked by this kind of talk should lead to plenty to contain, excuse me, process, handle maturely. Jack Berkley.

Sun, 03 Sep 2000, George Stricker 

Tullio Carere wrote:

> But if what seems to me a way

> seems to you a blind alley, please don't hesitate to make me know. I may

> still be a victim of Bion's dark charm, without knowing it. In this case I

> am the one who need enlightenment.

Dear Tullio, I often am in agreement with many of your conclusions, but I am not certain I see how Bion (or Lacan) help you to get there. I guess one person's light can be another's blind alley - I wouldn't presume to tell you not to attend to anyone you find helpful, but I for one, get very little from either. George.

Sun, 3 Sep 2000, George Stricker 

Dear Jack, having received several messages from you, some to the list and others not, I'm not quite sure what others have seen and what they have not. In any case, you thought of projective identification as a valuable concept and also thought that my concern was with some practitioners rather than the concept itself. Perhaps.

Perhaps you also can explain how anything of value in projective identification goes beyond the concept of empathy, which doesn't encourage the misuse that concerns me. George.

Mon, 4 Sep 2000, Hilde Rapp 

Hello all, most of us can probably relate to the concept of someone's being 'self contained' - in the many senses intimated by Jack. The wish for 'enlightenment' in the conceptual darkness holds some clue to the nature of the bafflement evinced by George and Paul:

The body (!) of literature spawned by Bion's work - and the predominant predicament of those to whose 'treatment' his concepts may be applied with profit - relates to a different information processing system from the visual: the kinesthetic. It is to do with feel: texture, skin sensation and contour, sensuality, shape, form, Bollas' 'first aesthetic', rythms, postures and positions, balance, temperature, equilibrium, bodily containment- hence the 'second skin formation' of Esther Bick, or Didier Anzieu's 'ego skin', Frances Tustin's 'autistic shapes': it is to do with the Harlow's deprived monkey- wire mother syndrome- no sense of being 'cradled criss cross' in a loving mother's arms, who not only coos to the child, has loving feelings towards the child but also holds the child in her mind with what Winnicott has described as 'primary maternal pre-occupation'- failure of all this, so much recent research suggests, leads to difficulties in developing a 'theory of mind'- the ability to hold the wishes, beliefs and motives of others in mind in order to develop empathic human understanding-... and of course that 'negative capability ' Keats first described in his Christmas letter to his brother George, which is actually the hallmark of all good integrative psychotherapists ( so Carlos Mirapeix agrees with me). Now, this body of literature may be the door through which you Bion skeptics may find it attractive to pass:

Peter Fonagy, Peter Hobson - good research based, elegant English, grounded in developmental psychopathology - relating to attachment and its failures, the effects of maternal depression, the effect of lack of proper empathy on the mother's part (lack of holding and containment of impulsivity in later life) etc. etc... Hilde

P.S.: There is a previous debate which struggled with what can be said in plain English and what can only be hinted at darkly: it raged between the Kabbalists and the Humanists in 14 century Italy. I think- overall SEPI-ites tend to side with the humanists- some- I am certain-are bilingual. Many analysts would side with the Kabbalists- indeed Freud's technical writings were originally excluded from publication on grounds of containing information best reserved for use by initiates...

Mon, 4 Sep 2000, Paolo Migone 

I have to say that I sympathize with Paul Wachtel's difficulty in understanding Bion (see his mail of Sept. 1, 2000). Since Bion has gained a lot of importance in the psychoanalytic community (especially in my country), in a study group that Tullio knows well years ago I invited an expert on Bion (a philosopher who wrote a book on Bion) who gave us some seminars on this author. I have to say that still I was not able to be hooked very much by Bion, also because of his difficult language, which to me is already a put-off, if not a symptom, because I have always thought that language must be clear in order to be able to contain valid ideas.

Still, I appreciated several things by Bion, for example his re-elaboration of the concept of projective identification (that I used in my article on Contemporary Psychoanalysis, 1995/4, about the bridge between projective identification and Expressed Emotion [EE] - an effort at psychotherapy integration that Paul Wachtel, if I am not mistaken, knows well and used for his students).

At any rate, I had always a difficulty in understanding Bion's peculiar leap between "mystics" and "science", but I may be simply ignorant. Also, we should not forget that Bion had four very different areas of interest in his life: groups dynamics, thought functioning, psychoanalysis as science, psychic growth in analytic treatment.

Tullio says that "In the Freudian theory there is no Unknown (as unknowable), there is only an Unconscious (that can be made conscious)", but from what I understood from Freud, he believed that reality (internal as well as external) by definition is always unknowable. What we succeed in knowing is never the reality per se, which is unreachable. But, again, I might have not understood what Bion meant to this regard. Concerning the famous dictum by Bion "Without memory and desire etc.", I find it paradoxical, on the one and, and obvious in what it tries to mean clinically, on the other. My gut feeling, for which I have no evidence of course, is that the fact that Bion has become very fashionable today in psychoanalysis is related to the crisis of psychoanalysis, I mean that it is an expression of the confusion in our field. Paolo Migone.

Mon, 4 Sep 2000, Rebecca Curtis 

I find the discussion about the idea of a therapist as a '"container" so stimulating that I'll put off my end-of-the summer (it is the "Labor Day" holiday for those of us in the US) swim and the bike ride I've been looking forward to for two months to comment. Let me say first, though, that I am upset, as is George, about the way the concept of projective identification is used to blame the patient and to allow therapists not to. take responsibility for their own feelings which very well may be simply their own. There was a paper presented at SPR last year (I'll have to check on the author's name) showing that therapists' reactions to patients (transcripts) varied enormously and revealed consistency within each therapist, but not consistent reactions to particular patients across therapists.

But back to Bion. First, his book Experiences in Groups is quite readable, unlike some of his other writings. I found it helpful knowing he was from India. The view of consciousness is very different to begin with. An undergraduate of mine newly arrived from India began a paper by stating "Before consciousness was fragmented into a million different pieces. . . " as if this were accepted fact. So there is not the beginning with an individual notion of consciousness. Still, I would like it if someone could help me appreciate Bion more. I have not assimilated anything from all of his formulas or diagrams. I think the concept of containing and holding is interesting, but I'm happy Paul has raised a question about it. Doesn't the concept refer to the therapist or parent not getting anxious? We feel safe and "held" when in the presence of someone who is not anxious, or anxious yet conveying a sense of coping.

As for Lacan, his view of unconscious processes is too language-based for me. Not being a very verbally dominated thinker, it doesn't resonate with me. But many people view the world through language more than I do. I also react very negatively to the centrality of the phallus for Lacan. Other symbols seem just as important to me. But perhaps someone could help me appreciate and use in my work his ideas about the Imaginary.

Well, my computer is being packed up to return to New York City, so I look forward to more exchange about these ideas tomorrow. Rebecca Curtis.

Mon, 4 Sep 2000, Paul Wachtel 

Tullio, I'm still confused! (and still very much in accord with George's message, which came just before Tullio's on the list serve). Yes, I understand very well the need for the kinds of clinical operations you have described, the ways in which maternal deprivation affects people and so on (though I do have some questions about whether we too readily assume maternal deprivation whenever we see severe psychopathology; clearly *something* went seriously wrong, but any notions about what happened between mother and infant in the first year or two is likely to be *very* inferential, and strongly a product of theory rather than real observation {even if it may well be good and accurate theory if we had the vantage point of God and could really know for sure}). But the main thing is: How does "containment" capture what you are describing. How does the "corrective emotional experience" become relational "containment"? It's not that I think "containment" is necessarily *wrong*. It's that it is *unclear.* What *you* mean by containment may well refer to something useful. But you can't define containment by saying containment is when you contain. You have to describe what is *meant* by containment, and when you do, I think (a) it becomes a lot clearer than saying "contain," (b) a lot less likely to be misunderstood because of it odd usage and unfortunate concreteness, and (c) less likely to be used as a cliche, as it seems to be all the time among my students and colleagues.

So I guess my response, Tullio, is that I like what you do and what you describe, but how in the world is this well described as "containment?". I await with interest the next round of our friendly debate. Paul.

Mon, 4 Sep 2000, Paul Wachtel 

Jack, perhaps I'm just not educable! I agree strongly with the idea that the therapist should not act out, should process the input, etc. But what does this have to do with the container image. The therapist doesn't "contain" it, he works on it. And he doesn't put it back into the patient in more worked through form after he has chewed on it in his own internal space. He *communicates* something, which the patient then deals with in whatever fashion he can at that point (hopefully, in a better fashion than before by virtue of that communication -- and others, and the relationship). If Bionites are saying "yes, that's what we mean" then, OK, I agree with them on such points but not on whether their language is a good way to describe it. If it's NOT what they mean, then what else is "container" adding? Paul.

Mon, 4 Sep 2000, Paul Wachtel 

Jack, here I am very much in accord with what you are describing (Paul, I did not know Bion was catching on…). My objection is not with the *clinical phenomena* that concepts such as projective identification refer to. It is precisely with the arcane way -- nicely depicted by you in your message -- that so many of the proponents talk about it.

Some ways of talking about a phenomenon promote clear thinking and lead to still further insights about the phenomenon, and some lead to cultish or superficial mouthings and DO NOT promote still further clarity. Instead, they maintain themselves by pointing again to the very phenomenon, as if the critic hasn't seen the phenomenon when in fact, much of the time, the critic (at least this critic) is not overlooking the phenomenon at all but saying instead that there are more productive ways to conceptualize and discuss it.

Maybe it's time for the container to be recycled. But at least it has had the value of filling itself up with interesting exchanges amongst us. Paul.

Mon, 4 Sep 2000, Jack Berkley 

In a message dated 9/4/00, Paul Wachtel writes:

<<Jack, perhaps I'm just not educable! I agree strongly with the idea that the therapist should not act out, should process the input, etc. But what does this have to do with the container image. The therapist doesn't "contain" it, he works on it. And he doesn't put it back into the patient in more worked thru form after he has chewed on it in his own internal space. He *communicates* something, which the patient then deals with in whatever fashion he can at that point (hopefully, in a better fashion than before by virtue of that communication -- and others, and the relationship). If Bionites are saying "yes, that's what we mean" then, OK, I agree with them on such points>>

Jack: Paul - Yes I think you are on track even though the language is not your tea. Remember to substitute 'respond maturely' or 'process' for contain and you'll be fine. You won't experience some of the poetic substance and the meanings they stimulate, but you are not looking for that. Social science language in general doesnt stimulate a lot in me, but I appreciate its value.

<<but not on whether their language is a good way to describe it. If it's NOT what they mean, then what else is "container" adding?>>

Jack: I think here you depart from your principal stance that if a language means something to an intelligent thinker then so be it. It is not a question of whether a term is "a good way to describe." It is whether the term communicates and assists practitioners. We don't have to buy and plant the same botanical species, we don't have to like the same rivers and mountains, but we're all working constructively on the environment.

I think what's frustrating to many is that the language is metaphorical and we all don't respond to the same poetry. By the way I do not count myself as a Bionite; speaking of terms I m unfamiliar with that one. It reminds me of Columbus calling Native Americans, Indians. I think of myself as a Berkley or Berkleyian, and you as a Wachtellian. Remember 'process' and 'respond maturely' for contain. Peace, Jack.

Mon, 4 Sep 2000, Jack Berkley 

Paul, this is Jack, the end of your response caused me to laugh aloud; my responses are contained by (interspersed within) yours below:

In a message dated 9/4/00, Paul Wachtel writes:

<< Jack, here I am very much in accord with what you are describing. My objection is not with the *clinical phenomena* that concepts such as projective identification refers to. It is precisely with the arcane way -- nicely depicted by you in your message -- that so many of the proponents talk about it.>>

Yes. I think it is a defensive/aggressive alliance. Many groups lean or tend to use their language both to communicate within their group and erect boundaries between their group and others' groups. I think of it as a characteristic of human groups. In this instance, I have wondered whether the language is a defense against anticipated attack from members of the empiricist religion. If you cant understand the concept, cloaked in arcane garb, you cant attack it without looking a bit dense when the defender counterattacks. Also, it does give a feeling of specialness or group belonging when one speaks a language others dont quite get, right? So it speaks to a need to have a group identity and feel special, I think. It worked that way for me to an extent. I'm just more given to the integrationist goal now, which is still special enough, n'est pas? Now, I am not attacking Bion people on this count. I think i see defensiveness in many professional languages as well as enhanced communication among its members. And the term is helpful to some. I found it helpful. I also am disturbed by the misuse.

<<Some ways of talking about a phenomenon promote clear thinking and lead to still further insights about the phenomenon, and some lead to cultish or superficial mouthings and DO NOT promote still further clarity. Instead, they maintain themselves by pointing again to the very phenomenon, as if the critic hasn't seen the phenomenon when in fact, much of the time, the critic (at least this critic) is not overlooking the phenomenon at all but saying instead that there are more productive ways to conceptualize and discuss it.>>

Well, yes to a milder form of the the idea of cultish mouthings, but i think that cult is too strong or emotionaly loaded a term. I think the people you seem to be describing are behaving arrogantly and defensively to the point of offense, like the best defense is a good offense. Language has that dual capability I think. In fact you are getting me curious. not that I expect an answer, but who are these people and why are they giving you such a difficult time? That to me is a constructive focus. Perhaps they fear your capacity to understand and translate their concepts in an integrative way; perhaps to them translation is akin to theft. Like religious groups who fear that if you take their picture you'll take their soul.

<<Maybe it's time for the container to be recycled. But at least it has had the value of filling itself up with interesting exchanges amongst us. Paul >>

This is what made me laugh aloud. the use of 'recycle' with container makes me think of a washing machine. Perhaps we should hang these clothes in the sun , let them dry and see if they got clean.

Mon, 4 Sep 2000, Jack Berkley 

George, all my posts are intended for list consumption. It has been a while since i engaged a discussion on any list and I depressed the reply button without adding the list on some messages.

Well, my question to you--before i answer you--was what about the concept itself do you feel "encourages" destructive behavior by therapists, i.e., client blaming etc. I mean, do you think the term or concept itself has an influence on otherwise well balanced practitioners? I guess in a way it could more easily lend itself to misuse than others, like empathy as you note, but I still think it is more of a problem with people rather than the idea. I concede that empathy by definition restricts the student of the concept to compassionate meanings, whereas, Projective Identification is not so restrictive. However, the term is broader.

Now to your question: "Perhaps you also can explain how anything of value in projective identification goes beyond the concept of empathy, which doesn't encourage the misuse that concerns me." First, I would say that the concept of projective identification--pardon me again--contains the concept of empathy, and includes other meanings in addition to empathy. Empathy is a form of projective identification, which as recall is fairly well described in Ogden's 1982 book "Projective Identification and Psychotherapeutic Technique."

Now you asked what does Projective Identification provide beyond the term of empathy. If you restrict the use of Projective Identification to empathy i think it is essentially the same and it could be argued that for many students it does not add anything of value. For others though, it does add something because it expands the empathy process and describes it more fully than the use of empathy usually does, usually. Essentially though, the issue is whether you or I are capable of empathy and whether we employ it to good effect. From that perspective the use of it, not the selection or promotion of a term is key. I would advocate for both terms in teaching, but only if you can empathize with those who find value in it. I'm serious. I think we have to value the people or their experience in order to respect and understand their language.

If you do not restrict the term to empathy, I think it is clear that it has many other very constructive uses. One can projectively identify good aspects as well as destructive ones for starters. One can project his own honor or integrity into another (figurative use here) for safe keeping. There are many other uses. I like Racker's "Transference and countertransference" and Ogden's 1982 book among various articles. Jack.

Mon, 4 Sep 2000, George Stricker 

Dear Jack, I'd like to insert some of my responses within yours for greater clarity. You wrote:

> Well, my question to you--before i answer you--was what about the concept

> itself do you feel "encourages" destructive behavior by therapists, i.e. client

> blaming etc. I mean, do you think the term or concept itself has an

> influence on otherwise well balanced practitioners? I guess in a way it

> could more easily lend itself to misuse than others, like empathy as you

> note, but I still think it is more of a problem with people rather than the

> idea. I concede that empathy by definition restricts the student of the

> concept to compassionate meanings, whereas, Projective Identification

> is not so restrictive. However, the term is broader.

The idea that Projective Identification involves an unconscious communication that reaches the therapist in an irresistible way, and the therapist then responds unconsciously to this communication, is what I object to. It is part of our job, after all, to help the patient to make the unconscious conscious, and in order to do so, to be aware of our own unconscious influences on the process. To the extent that Projective Identification occurs beyond anyone's awareness, the therapist is left saying "the devil made me do it" rather than taking responsibility for his or her own lack of awareness of the process. I don't dispute that such things happen - my concern is that giving them the label serves to sanction them.

[Regarding other passages of your mail] I still am at a loss as to what those other meanings are/ I'm well aware that empathy usually is included within Projective Identification. I still don't know what else, that is of value, is.

Mon, 4 Sep 2000, Jack Berkley 

George, good idea to intersperse. I see now why you conclude that the concept itself leads you to dislike the concept for encouraging abuse. We however part ways on your definition and description of Projective Identification, and if my understanding were the same as yours, then i would of course agree. We don't seem therefore to disagree on anything, except perhaps how to define Projective Identification.

First I am not sure what you mean by an unconscious process reaching the therapist in an "irresistible way." I do not doubt that you gleaned this from someone reputable, but it does not contribute to the understanding of Projective Identification and I don't recall it from my learning about Projective Identification, at least not as an essential feature, absolute feature. At times I suppose it could be described as irresistible, but I fail to see the utility of the word irresistible. I have trouble with it and suggest it be jettisoned regardless of its source unless the context is different than the one used here.

Second, more importantly, I could not agree more with the task of making the Projective Identification process conscious. This is done via interpretation, etc. George I cannot imagine any proponent of Projective Identification taking issue with this. To employ the concept as a rationalization for irresponsibility is far out of bounds. I can't seriously think of anyone I know who employs the term as describing an unalterable preordained event. Were it employed this way, I would agree with you; in fact any time it is used this way, I agree fervently that it is a malevolent event. (yes, all kinds of things occur outside awareness, but that is an observation, not a plan, not an acceptable approach).

To me the term militates against letting it be unconscious. By identifying that it happens, and naming it, the task is to discover it in the immediacy of the therapy hour, and promote understanding, conscious processing of it. (If I need to say, no one would / should attempt to communicate this using Kleinian language). The term, as I was taught it within A.K. Rice and the Washington School family therapy program, exists to encourage its conscious processing. I do think tough one must be taught this in live moments and in supervision. I am discouraged from thinking the term can really be internalized and employed based on book learning. It is a skill to experience and identify the process, not just an idea on pages.

In sum, as you describe it, yes, I agree, it is a foul, unthinking beast. We are talking about completely different concepts and completely different users of the concept. I suggest that the concept and application you describe is very unflattering to caring, thoughtful people/therapists. It is inimical to responsible work. Why would anyone take what you describe seriously? No wonder you are upset. I hope you do not associate such practice and thinking with me. I hope no one does. Sincerely, Jack.

Mon, 4 Sep 2000, George Stricker 

Dear Jack, if the confusion about the definition of Projective Identification is now cleared up, and I believe we have come to a point of agreement in that you don't like what I don't like about it either, we still are apart on my understanding what you do like about it. What is different and more than empathy about the concept? George.

Mon, 4 Sep 2000, Jack Berkley 

George, I'm responding to your response below:

<<I still am at a loss as to what those other meanings are/ I'm well aware that empathy usually is included within Projective Identification. I still don't know what else, that is of value, is.>>

George, well I said in my last post that one could project good objects as well, such as in idealization, except that Projective Identification would invite further analysis of what in the projector is projected and the proper use would necessitate an analysis of what aspects of the recipient resonate with the idealizing behavioral influencing process. This has application in therapy obviously; it goes beyond simply saying someone idealizes their therapist. The concept and practical employment of it invites the therapist to identify his/her internal objects that are activated in response to the projector's behavior. And to analyze/understand what is occurring within the client. Now, anyone can do this without the term Projective Identification. Its not necessary. But as i have learned and employed it, the concept helps orient my thinking about such processes. The fruit is in the further actual applied analysis of the Projective Identification. The term is merely an aid to examine preconscious and unconscious interpersonal influencing, feelings, self aspects, underlying beliefs, etc. Did you read my posts to Paul?

The Projective Identification term includes so many intrapsychic-interpersonal experiences that I am hard pressed to know George how to select examples that you would find useful. Also, to be frank, since you have already called the concept "noxious" and seem fairly convinced that it is used to "blame" patients for therapist ills, I feel uncomfortable and think we may be at cross purposes here. I fear I run the risk of repeatedly offering you examples and not constructing an example that is particularly meaningful to you because I do not know you well enough to find such an example. Also, is that what you want anyway?

1. I mean if the purpose of this discussion is for me to attempt to convince you that you ought to like Projective Identification as a concept when you've already concluded it is "noxious" and is employed malevolently, I can end that here. I'm sure you have done swimmingly well without the concept and i and others have done well with it. Nothing strange there.

2. If the goal is for you to reify your objections to the term as noxious and inimical to patients with each effort to explain it, I defer to a more energetic proponent with a stronger desire to convince you. Id have to know that you wanted to meet me half way on this. I'm not sure you're interested. I lean toward thinking you're not, are you? I'm sincere, I'm not certain where you are situated attitudinally in this discussion.

3. If your goal is to learn Projective Identification from the point of view of someone who finds it useful because you want to experience its value as they do, that is, an empathic joining on the concept, then I am interested. However, i need more help from you. For instance, what other kinds of uses would be useful to you? How do you understand the term now other than the noxious meanings? Do you have any understanding of the term that is benign or constructive?

Please answer those questions so I know my audience as it were. Give me a ball park to play in, otherwise I just dont know where to begin. Do you have a case, an example, anything? I think that would be more useful than my generating a list of examples in the hopes that I luck out and become helpful to you. Also, it would help to know what you have read so far.

My task so far has been to assert that Projective Identification and Containment are useful to me and many others who are responsible therapists and perhaps clarify that the understanding of the term that some folks have would lead any reasonable person to reject it, me included. Your criticisms are well taken, but they hit the wrong concept and wrong use as my experience and training define and employ it. We're just not talking about the same concept or the same use of it based on what you've said so far.

Again, I like Racker's 1960 book "Transference and Countertransference" and Ogden's 1982 book "Projective identification and Therapeutic Technique" among various articles; have you read Ogden's book? You'd only need to read two or three chapters to revise the description of Projective Identification you have given so far. Jack.

Mon, 4 Sep 2000, George Stricker 

Dear Jack, I have read Ogden, and several others, and always have been struck by how different writers use different definitions, making it easy for any criticism to be met by "That is not what I meant at all." I appreciate how hard you are working to get across your meaning, but I'm afraid that everything that you find useful (e.g., exploring one's own contribution to an idealizing process) is something that I do without invoking the concept. If it works for you, fine, and you seem to use it in a constructive way. It doesn't work for me, and I'm not sure there is much profit to be gained in belaboring it much further. George.

Mon, 4 Sep 2000, Jack Berkley 

Dear George, my responses are interspersed: In a message dated 9/4/00, George Stricker writes:

<< Dear Jack, if the confusion about the definition of Projective Identification is now cleared up, and I believe we have come to a point of agreement in that you don't like what I don't like about it either,>>

Except George you describe a concept that contains noxious elements and these aspect that you attribute to the concept are alien to me and those from whom I have learned and with whom I communicate with the term. I agree that the noxious aspects that you add to the term are noxious. I just don't agree its part of the concept.

<<we still are apart on my understanding what you do like about it. What is different and more than empathy about the concept? George>>

I guess we'll have to leave it there, for now any way. I tried and would need more from you to go further as I said before. Sorry we couldn't work this out, for now.

Mon, 4 Sep 2000, Jack Berkley

Dear George, in a message dated 9/4/00, George Stricker writes:

<< Dear Jack, I have read Ogden, and several others, and always have been struck by how different writers use different definitions,>>

There are different definitions, and this term is not alone in having multiple definitions in psychology. Its not as bad as existentialism, but it is diverse.

<<making it easy for any criticism to be met by "That is not what I meant at all.">>

Well the way you put it, it does make efforts to differentiate the definitions sound like immature defense. Ogden does not define Projective Identification with the characteristics you attribute to it or describe its use the way you do. I still don't know who does. You haven't said.

 

<<I appreciate how hard you are working to get across your meaning, but I'm afraid that everything that you find useful (e.g., exploring one's own contribution to an idealizing process) is something that I do without invoking the concept.>>

I have been too wordy I think. but I said a few times that yes you don't need the concept. I have never said otherwise. I thought I have been very clear about that.

 

<<If it works for you, fine, and you seem to use it in a constructive way. It doesn't work for me, and I'm not sure there is much profit to be gained in belaboring it much further. George>>

Yes that is what i was questioning in my last post. I think you are resolved with you view of Projective Identification concept as noxious, and i am happy relinquishing the effort to convince you otherwise. It is just a conceptual tool. I am glad you afford me the position of someone who at least seems to use the concept to good compassionate purpose. I do. I am sorry that you have run into such misguided and destructive persons who misuse the concept they way you described: to blame patients, avoid responsibility, and avoid processing unconscious material. That's not Ogden, me, or anyone I can name who understands its use. Jack.

Tue, 5 Sep 2000, Paolo Migone 

On 04/09/2000, Paul Wachtel wrote:

>Re Paolo Migone's recent posting on the listserve:

>I do indeed know Paolo's paper on projective identification and expressed

>emotion, and I strongly recommend it to those on this list serve who share

>both my interest in psychoanalytic ideas and my confusion/annoyance re

>Bion's language. Paolo's paper is the single most clearly articulated

>exploration of the concept of projective identification that I have come

>across. It is precisely the sort of clarifying rather than obscuring kind

>of writing that I wish were common around these issues.

Since Paul Wachtel said these nice things on my paper, in case it might be of interest I send to the list members the part of this paper (pp. 624-629) in which I talk specifically of Projective Identification (see below). I thank you for your attention and I apologize for the length of this mail:

-----------

[From: Paolo Migone, Expressed Emotion and Projective Identification: A bridge between psychiatric and psychoanalytic concepts? Contemporary Psychoanalysis, 1995, 31, 4: 617-640 (pp. 624-629)]:

The concept of Projective Identification was originally formulated by Melanie Klein in 1946, when she spoke of the projection of a part of the subject onto the object, with whom the subject remains identified, so that he exerts a "control" on him (or from "inside" of him). When M. Klein had this clinical intuition and used this term for the first time, she was somehow dissatisfied with it; subsequently the concept was refined and further explored by many analysts (who, incidentally, were working mostly with schizophrenic patients), to the point that this concept became of central importance in Kleinian thought. Currently, it is widely used also by non Kleinian analysts, and many authors have shown its usefulness also for patients with less severe forms of psychopathology. It can be regarded as a "bridge concept" between classical and interpersonal psychoanalysis, and a useful theoretical tool for understanding family dynamics (Zinner & Shapiro, 1972). An in-depth discussion of this concept does imply an adequate consideration of wider metapsychological problems (for example the use of metaphors), and of the relationship between this concept and other previous conceptualizations (such as the concept of transference and countertransference). For this reason, only a brief mention of its principal clinical aspects will be made here, while I refer to other papers for a longer discussion of the underlying theoretical problems (Migone, 1988b, 1989a, 1995a ch. 7). Since the concept of Projective identification today is used in different ways, and may encompass various clinical phenomena (Sandler, 1988), I will use the schema suggested, among others, by Ogden (1979, 1982).

Ogden divides the clinical phenomena of projective identification in three phases, which somehow overlap one another: (1) "projection," (2) "interpersonal pressure," and (3) "reinternalization." (These three phases are not to be confused with the three historical phases of the development of the concept of projective identification described by Sandler [1988], even if there are some similarities.) The three phases will be briefly described.

(1) First phase: "projection".

It is assumed that the person who uses projective identification has first of all an unconscious need to get rid of a part of himself and to project it onto someone else. Various reasons may explain why a person needs to project. Kleinian authors use a metapsychological (although concrete) jargon, and speak of bad parts of the self that could be considered dangerous for the self, or, vice-versa, good parts that could be in danger of being destroyed by the bad parts of the self. These, then, need to be put into someone else in order to be protected and kept safe. These explanations are scarcely testable, although the concept of projection is commonly accepted as an explanation of some clinical and social phenomena, such as scapegoating, for example. At any rate, such metaphors may prove to be useful in understanding complex clinical situations and overcoming some especially difficult moments encountered in the course of a therapy. What is important to know here is that this first phase alone does not yet involve the use of the term projective identification; it involves simply the concept of projection.

Projection can be conceived of as an intrapsychic phenomenon, not necessarily affecting the object (the other person), who may be unaware of being the target of projective identification. In this case, projection may have defensive functions for the subject, who does not need to concretely modify or "control" the object. For a more in-depth discussion of the concept of projection, with its metapsychological and clinical aspects, I refer to the classical discussions by authors of the "Freudian" tradition, on the one hand (Freud, 1885, 1896, 1911, 1915, 1921, etc.; A. Freud, 1936; etc.), and of the "Kleinian" tradition, on the other (M. Klein, 1930, 1931; Isaacs, 1948; Segal, 1973; etc.). The most interesting aspect of projective identification, for our present discussion, concerns the second phase.

(2) Second phase: "interpersonal pressure".

This phase is the one most directly related to the psychiatric concept of Expressed Emotion (EE) and to Greenley's concept of "High Intensity Interpersonal Social Control." There are two main differences between simple projection and projective identification. First, in the latter situation the person must be involved in an actual interpersonal relationship with another person, and not simply in a fantasized one. (In a sense, using EE terminology, we might say that the length of time spent in "face-to-face" interactions between the patient and his relatives may increase the intensity of this phenomenon.). Second, the person shows an interpersonal pressure, or control, to make sure that the other behaves in a manner consistent with the feeling that he has projected on him. Using Greenley's words, we might say that the person exerts a "High Intensity Interpersonal Social Control" because he needs the other to change his behavior.

Supposedly, if the other does not change his behavior, he comes to represent a threat for the projector; therefore the projector continuously needs, in subtle or open ways, to exert various kinds of pressure to ensure that the person who received the projection really is the person that the projector wanted him to be. In a way, we can also conceive projective identification as a projection that has not been completely successful, so that the projector needs to exert pressure on the object to reassure himself of the success of this defensive operation. It is for this reason that some authors (e.g., Kernberg, 1987) conceive projective identification as a primitive defense mechanism (present mostly in borderline and psychotics), while projection is considered to be a more mature and successful defense (present mostly in neurotics). However, other authors (e.g., Meissner, 1988) reject the distinction between projection and projective identification made on the basis that the latter induces the object of the projection to respond, claiming that "complementary pulls" are always at work in all projections occurring within an interpersonal context. Whether we accept this equation between projection and projective identification or not, the presence of an interpersonal context for phenomena such as "complementary pulls" must occur. In this article I prefer to use the term projective identification, rather than simply projection, because it is the one that has been the most widely employed by those authors who have studied these complex interpersonal phenomena.

The clinical phenomena considered as examples of this interaction usually are intimate or close relationships, such as the mother-child relationship or the patient-analyst relationship. In all these situations there is some form of dependency of one person upon another, in some cases because of physical or psychological needs of survival, similar to those relationships studied in the framework of the "double bind" concept (Bateson et al., 1956). Typically, a therapist who "receives" a projective identification from a patient may develop a new set of feelings, and only during later self-scrutiny come to understand that they, so to speak, "belonged" to the patient. Furthermore, since this process is unconscious and can be very subtle, sometimes the therapist, in a way, may "become" someone else.

Interpersonal transmission of affect is well known in psychotherapy (as well as out of psychotherapy), and this mutuality of emotional response was already illustrated long ago by the simultaneous psychophysiological recordings of patient and therapist (Greenblatt, 1959). For this phenomenon, Redl (1966) suggested the term "contagion" of mood. Luborsky (1984, pp. 137-139), discussing this issue, says that there seems to be evidence that neither extremely field-dependent therapists (who may be more apt to get caught up by such contagion) nor highly field-independent therapists (who may be too uninvolved and unable to form a warm relationship with the patient) are helpful. He argues that moderately field-dependent therapists may be more effective, and that alertness to the existence of this phenomenon helps to preserve therapist's equanimity.

We may recall that Paula Heimann (1950), in her pioneering work on countertransference, said that the feelings of the therapist are a "creation" of the patient. Actually, long before Heimann's contribution, it was Helene Deutsch who clearly anticipated the enlarged view of countertransference in a paper, published in 1927, on "Occult processes occurring during psychoanalysis." Indeed, some authors have linked the concept of projective identification to phenomena such as telepathy, folie à deux, Jung's concept of "psychic infection," "Devil's possession," "evil eye," suggestion, hypnosis, and the like, all phenomena in which there is a threat to personal identity and autonomy (Bilu, 1988; Bolko & Merini, 1988, 1991; etc.).

The interest around the concept of projective identification started with many analysts when they were working with extremely difficult or regressed psychotic patients and felt very uncomfortable with them, overly "controlled" or under pressure, or experienced a new set of feelings that were difficult to index as "countertransference." For them, it was more clinically useful (and possibly reassuring) to believe that in those moments they were not reexperiencing an old (and not well analyzed) aspect of themselves, but that a new and disturbing feeling was simply "put into them" by these very sick patients. This, in my opinion, is the origin of this concept, and it might explain the increased need to change the old terminology "transference/countertransference" into the new one, "projective identification/projective counteridentification" (a term coined by Grinberg in 1957). Furthermore, studies focusing on the concept of projective identification, which ran in parallel to those concerned with a new "enlarged" view of countertransference that started in the fifties (Heimann, 1950; etc), produced many interesting clinical intuitions, such as the use of the analyst's own feelings to know and understand the patient's unconscious, the concept of "evocation of a proxy" (Wangh, 1962), "externalization" (Brodey, 1965), role "actualization" and "role-responsiveness" in the transference (Sandler, 1976), the use of the patient's feelings on the part of the analyst to know and understand (or even "supervise" or "interpret") himself (Searles, 1975; Langs, 1978; Hoffman, 1983), etc.

(3) Third phase: "reinternalization".

This phase is related to treatment: if it does not occur, there is no change in the patient's psychological functioning and consequently he still needs to use projective identification. In this phase, through the therapeutic interaction (and in a complex and not fully understood way) the patient "reinternalizes" the part that was projected into the therapist, because he is ready now to keep it inside of himself. According to the various metaphorical explanations that have been given to this phenomenon, the therapist must "digest" or "metabolize" this dangerous part, and make it ready to be later "digested" by the patient. In other words, during the therapeutic interaction this projected part is transformed by the therapist and made more manageable by the patient. This process (with the concepts of "container," "contained," etc.) was first described by Bion (1962, 1963), who understood it in a concrete way, and conceived that the child can reinternalize the bad parts previously projected into the mother after she has transformed them with her thought activity, i.e., her "rêverie." (We can see here also an echo of the concepts of "holding" and "good enough mother" of Winnicott, 1958.)

According to a nonmetapsychological explanation, and using a learning model, the patient, in the course of the interaction with his therapist who (maybe for months) tolerates the anxieties and fears that have been projected into himself, learns how the analyst does it, learns new skills or adaptive behaviors useful to cope with emotional stressors. For example, the therapist may show the patient, often through his own behavior rather than through verbal interpretation, that it is indeed possible to tolerate stressful feelings (anxieties, fears, depression, persecutory ideas, suicidal thoughts, etc.) and to survive. Winnicott (1958), among others, said that an important therapeutic experience consists in the therapist's surviving the patient's destructive projections and provocations. The therapist may talk about these feelings, and at times eventually even look at them with the instrument of irony. The improvement may occur also because the fears or anxieties are explained or interpreted - they are changed into something less dangerous or stressful. Many authors, instead of emphasizing the cognitive change through interpretation, underline that most often the improvement occurs because the therapist simply does not "discharge" again onto the patient the projected feeling, and keeps it inside of himself. In fact, interpretation as such may often be experienced by the patient as a discharge, and it is the emotional containment on the therapist's side (silence, nondefensive attitude, etc.) that breaks the vicious circle and teaches the patient that it is indeed possible not to use projective identification as the only way of functioning. (Incidentally, it is interesting to note that, even in these recent investigations, many authors prefer to rely on concepts, such as "discharge," that remind us of the old metapsychological terminology of Freudian drive theory)...

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Tue, 5 Sep 2000, Bill Stiles 

I've enjoyed the exchanges regarding Bion, containers, and projective identification. I'm appending some excerpts from a paper, partly because they suggest another way to think about the phenomenon of projective identification and partly to call attention to a published exchange between Anthony Ryle and Mikael Leiman on this topic that helped me a great deal. My brief paper was a commentary on their exchange:

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[From: William B. Stiles, Signs and voices: Joining a conversation in progress. British Journal of Medical Psychology, 1997, 70: 169-176]:

With this paper, I am joining a conversation in this Journal between Anthony Ryle and Mikael Leiman. In two exchanges, summarized later, Ryle (1991, 1994) has proposed -- and Leiman (1992, 1994) has then elaborated and refined -- ways to reconcile Cognitive Analytic Therapy with Russian ideas about linguistics and semiotics, represented by Vygotsky and the Bakhtin circle.

The Second Exchange: Projective Identification

Projective identification refers to the process by which people induce their feelings in others, so that the others have those feelings and may act on them. Roughly, if I feel your feelings and motives because I want to, that is identification; if I feel your feelings and motives because you want me to, that is projective identification.

Projective identification appears to be a primitive and powerful process and perhaps an element of all social interaction. Of course, it is possible to stir people to feeling and action intentionally with words. But projective identification points more specifically to doing this non-verbally and without awareness by either party. Projective identification is common enough in therapy that experienced therapists often expect to understand what their clients are experiencing by attending to their own feelings.

Ryle (1994) suggested that projective identification can be understood as an example of enacting reciprocal role procedures, as construed within CAT. As part of learning to play each role in a relationship, infants learn to induce the reciprocal role in others. Leiman (1994) agreed, but took issue with the necessity for positing, as Ryle (1994) did, that "biologically programmed attachment behaviours" (Ryle apparently had Bowlby's, 1982, 1988, conceptions in mind) are a common precursor to forming reciprocal role procedures and hence to projective identification. By the same token, Leiman took issue with Klein's (1946) attributing to the infant such implausibly complex and seemingly bizarre fantasies as impulses to "suck dry, bite up, scoop out and rob the mother's body of its good contents" (p. 8). The theories' need to posit the biological programming or the complex fantasies to the infant, Leiman (1994) suggested, reflect a fallacious separation of infant from mother. The complex activity emerges from the joint mother-infant system, rather than being intrinsic to the infant. The activity simultaneously involves mother, infant, and the signs they use to communicate.

In this synthesis, projective identification looks like a normal part of interpersonal communication, or more precisely, of goal-directed activity by an interpersonal system. Whereas Klein saw this breaching of the mother-infant boundary as exceptional and pathological, Ryle and Leiman saw it as normal, if primitive. Leiman's (1994) summary was that projective identification is "a mode of primitive joint action mediated by non-verbal signs" (p. 67) . This sounds not so different from telling somebody else to do something for you, except that it is done without being verbalized or brought into awareness, so that the signs are harder to locate.

Projective Identification as Action Though Others

A complementary way of thinking about projective identification may help make this more concrete. Projective identification may be a considered as a way that voices [i.e., internal traces of previous problematic experiences] use other people as effectors for their intentions.

We do not seem to need conscious mental representations of the mechanics of action in order to act; we seem to be aware only -- at most -- of the action's anticipated sensory consequences (James, 1892).[footnote 1] When I move my hand, for example, I have no conscious awareness of how I do this, other than anticipating the proprioceptive, visual, and other effects of the movement.

We do not even seem require that the effectors be physically part of our bodies, so long as the their contributions to the sensory consequences of an action can be reliably anticipated. Thus, tools and machines easily become extensions of our bodies. For example, when we have become proficient drivers, we anticipate the effects (visual, proprioceptive, etc.) of the car turning left, and this produces the necessary physiological and mechanical adjustments in our arms and hands and in the car's steering mechanism, respectively, all equally out of awareness.

By the same token, other people may become extensions of ourselves. By inducing our feelings and motivations in them -- that is, by projective identification -- we can accomplish our purposes and give expression to our concerns. We need have no understanding or awareness of how this is done, any more than we need to understand the physiology of muscles to move our hands. Presumably, other people can be enlisted by signs, including subtle or non-verbal signs, passed without awareness. We can learn to use other people as effectors just as we learn to use our bodies or our tools. The conversants (Ryle, Leiman, Vygotsky, Klein) agree that elements of this occur very early in life, as infants induce feelings in their care-givers. (...)

Insofar as the other is a participant, projective identification is, by this account, joint action. Both parties to a dialogue simultaneously use each other as extensions of each other, and the extension involves not only physical actions, but also feelings and intentions. Each party's intentions may recursively use the other as an effector by the same means.

In such an interpersonal system, the distinction between actor and acted upon breaks down, except as a linguistic convenience. Put another way, the distinction between identification and projective identification does not remain strict or sharp under close scrutiny.

This account is congruent with the usual understanding, that projective identification is most notably a way of expressing problematic unsymbolized experiences without realizing it (and hence, from some perspectives, defensive). Put another way, projective identification describes a means of expression for otherwise suppressed voices. The use of others as effectors may not be confined to suppressed voices, but if the suppressed voices do not have words to express themselves, their projective identification seems particularly devious. They express themselves by projective identification rather than in more explicit signs because they are painful or problematic, denied a meaning bridge. At times in therapy, the therapist may consciously experience more of the client's problematic unsymbolized difficulties than does the client. The therapist may be more aware of the difficult feelings, even though neither party may know the content.

References

James W. (1892). Psychology: Briefer course. New York: Henry Holt.

Leiman, M. (1992). The concept of sign in the work of Vygotsky, Winnicott and Bakhtin: Further integration of object relations theory and activity theory. British Journal of Medical Psychology, 65, 209-221.

Leiman, M. (1994). Projective identification as early joint action sequences: A Vygotskian addendum to the Procedural Sequence Object Relations Model. British Journal of Medical Psychology, 67, 97-106.

Ryle, A. (1991). Object relations theory and activity theory: A proposed link by way of the procedural sequence model. British Journal of Medical Psychology, 64, 307-316.

Ryle, A. (1994). Projective identification: A particular form of reciprocal role procedure. British Journal of Medical Psychology, 67, 107-114.

Footnote:

1. An earlier generation of psychologists used introspection to describe the content of intention -- of the will to act. Bearing in mind the cautions and difficulties attendant upon such evidence, we can consider the result summarized by James (1892):

<<An anticipatory image, then, of the sensorial consequences of movement, plus (on some occasions) the fiat that these consequences shall become actual, is the only psychic state which introspection lets us discern as the forerunner of our voluntary acts. There is no coercive evidence of any feeling attached to the efferent discharge.>> (p. 420)

James went on to conclude that the "fiat that these consequences shall become actual" is simply the absence of a contrary or inhibitory anticipation. The result of James's introspective analysis thus appears to be that will (understood as the experiential aspect of action, reflecting what is happening in the brain as the body moves) consists of the anticipation of sensory consequences.

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Tue, 5 Sep 2000, Bob Sollod 

I know very little about Bion except for some reading I did many years ago and have largely forgotten. A couple of years ago we were having a retreat to sort out some departmental issues. One faculty member said that she did not feel she could bring up certain issues because we did not have a large enough "container" for them. Some of my colleagues and I chatted and joked later about this metaphor: Perhaps we could benefit from a trash can, toilet or garbage disposal, or maybe we needed a stronger pressure cooker. We wondered aloud how large a suitable container would be, where it would come from, etc, etc, etc.

Now I know - thanks to the SEPI list, that this metaphor is associated with an actual theory and theorist. Is anything more meant by the container allusion than one's adequacy or ability to handle a given topic? Best wishes, Bob Sollod.

Tue, 5 Sep 2000, Jennifer Hillman 

Hello. I am new to the list serve, and hope that you will humor my comments as a relatively new member of SEPI. I have found it helpful to view projective identification through the lens of neuropsychology. Recent research has suggested we can glean important information about others through non-verbal communication, and that the right hemisphere collects and culls this information. Because the left hemisphere, rather than the left, is typically responsible for language, the right hemisphere often has a difficult time relaying this collected information, and sends it to the left hemisphere via sensations and "feelings" which have been referred to as "gut feelings," and more recently as intuition. In other words, I think projective identification exists, but that it is based in reality (i.e., derived from observable, non-verbal communication), and that it can be useful if examined and processed, rather than acted upon. It also has been my experience that projective identification occurs when a patient has experienced a trauma, and is not sure whether they want to reveal the extent of their pain or suffering. In a way, I think it represents an initial test to see if the therapist can handle the patient's strong emotions, and the therapist's own likely strong, countertransference. Hence, I think of the ability of a therapist to manage strong affect in the therapeutic relationship as the more literal version of Bion's "container." With Regards, Jennifer Hillman.

Tue, 5 Sep 2000, Jack Berkley 

Paul and Paolo, thanks for the paper; I did not have the energy to locate and post one. I notice you cite Zinner and Shapiro. They were two who taught me Projective Identification among others. I am convinced by this exchange and previously, that Projective Identification has to be taught in supervision during and immediately after live sessions preferably with two way mirror work. It is best if the supervisor conducts the sessions and allows the student to observe and then analyzes the Projective Identification that occur during the session that the student has observed. The supervisor can report his/her feelings, perceptions, experience. There is the one-body two-body dichotomy of Projective Identification, Klein representing the former. I think Ogden offers a nice explanation, which you cite; I like your choice. Jack.

Wed, 6 Sep 2000, Tullio Carere 

Paul, firstly, I strongly agree on relying as much as possible on real observation and not on theories. The concept of containment or holding is useful to me not because I *assume* early maternal deprivation (even if I do assume it), but because I *observe* in the session precise signs of breaches in the "ego boundaries"--i.e., a prevalence of evacuative versus elaborative behaviors (which can also be observed in dreams: Grinberg, 1987), incapacity of tolerating minimal levels of conflict and frustration, presence of stiff armors to protect a tender core, and similar phenomena.

Secondly, I also agree that one cannot "define containment by saying containment is when you contain". As a basic definition I would give the following: The holding function of psychotherapy (the maternal vertex of the field) is a set of actions and attitudes inspired or derived by the bio-psychological prototypical container--the womb. (Remember Freud, 1926: "between intrauterine life and first childhood there is much more continuity than one would suspect, after the striking cut of birth"). The womb has basically two functions: it offers a protected environment where the child grows *by herself*, and provides essential nutrients.

You ask why in the world we should use "container" and related words to refer to operations better described in terms of ordinary communication. My answer is that there are people who cannot properly function outside a psychological container. Either they evacuate thoughts and emotions, or they are closed in their shells. In the first case the containing function of the therapist is well described by Paolo in his excerpt: "Many authors, instead of emphasizing the cognitive change through interpretation, underline that most often the improvement occurs because the therapist simply does not "discharge" again onto the patient the projected feeling, and keeps it inside of himself. In fact, interpretation as such may often be experienced by the patient as a discharge, and it is the emotional containment on the therapist's side (silence, nondefensive attitude, etc.) that breaks the vicious circle and teaches the patient that it is indeed possible not to use projective identification as the only way of functioning." In the second case, the patient is implicitly or explicitly invited to substitute the relation for his/her shell. Sometimes I find it necessary to offer, as I said in my previous message, a bodily holding, more often a mental holding is enough.

Many times I have the experience that I "pass the test" if I can show them that I can accommodate them inside the space of the relation. I don't have to do much: just be a "good enough" container, i.e. strong enough as not to be damaged or seduced by them, and patient enough as to respect the times of their self-healing, without intruding or pressing them.

Paul, I agree with you that all I have said could be rephrased avoiding the words you dislike. But why? George wrote (20 May):

>for character problems... I do think that we have a parenting role 

>to play - I prefer the term reparenting, as that acknowledges 

>that the patient already has had a parenting experience, and that may even 

>serve as an obstacle to our success. This reparenting often takes the form of a 

>corrective emotional experience, which I see often as being at the heart of good treatment.

Let me ask you a couple of questions. Do you agree with George that many times we have a reparenting (maternal plus paternal) role to play? Do you agree with Freud that the maternal role is very much in continuity with the first container? If you have answered "yes" to both questions, what is the problem in accepting that many times we have to play the role of a container? Tullio.

Wed, 6 Sep 2000, Paul Wachtel 

Jennifer, welcome to SEPI and to the list serve. Glad to have your contribution. I was struck that your description of Sep 5, 2000:

"It also has been my experience that projective identification occurs when a patient has experienced a trauma, and is not sure whether they want to reveal the extent of their pain or suffering. In a way, I think it represents an initial test to see if the therapist can handle the patient's strong emotions, and the therapist's own likely strong, countertransference.

Hence, I think of the ability of a therapist to manage strong affect in the therapeutic relationship as the more literal version of Bion's "container."

is very reminiscent of Weiss & Sampson's views about the therapist passing tests. Have you thought about it in those terms? And if so, do you see Bion's notions as adding something additional? It's good to have a neuropsychological perspective added to our mix. Paul.

Wed, 6 Sep 2000, Paul Wachtel 

Tullio, I know we won't be able to REALLY talk this thru together until we are once again sitting together on the same continent, with the luxury to talk (and talk, and talk). But for now, let me respond only to the final questions you posed. (I will print out Tullio's entire message at the bottom for those who may be coming in in the middle of this discussion. (I also made sure to write "containing" in the subject section so that those of you who have had enough of this topic could delete my message without reading it!)

You asked: Let me ask you a couple of questions. Do you agree with George that many times we have a reparenting (maternal plus paternal) role to play? Do you agree with Freud that the maternal role is very much in continuity with the first container? If you have answered "yes" to both questions, what is the problem in accepting that many times we have to play the role of a container?

My answers: (a) I do think something LIKE reparenting is often an important part of therapy, but therapy is also in crucial ways rather different from parenting as well; (b) No, I actually don't think there is much about psychotherapy that has any resemblances to being in (or being) the womb, which may be part of why the container metaphor continues to be one I personally do not find useful. It has had one useful function for me, however -- to get me into interesting conversations with a number of SEPI colleagues. Paul.

Wed, 6 Sep 2000, Hilde Rapp 

Dear Bob, it is not so much that 'more' is meant by 'containment', but rather that the term has a more technical meaning. It has become used loosely in the sense you indicate, and, as this discussion shows, this does not seem to be helpful. In the more technical sense, 'containment' refers specifically to the ability of the mother of a very young infant- and by extension and analogy- of ( usually) the psychoanalyst of a very disturbed 'patient' -to remain calm and self contained in the face of the baby's or the patient's extreme anxiety ( terror), ( murderous) hate, ( extreme) frustration, and (violent) aggressive feelings and behavioral intentions.

In the case of actual 'acting out' of these feelings, physical restraint will become necessary- although- especially in work with disturbed children- analysts and child therapists will often tolerate a certain amount of physical violence without themselves exercising physical restraint, but rather putting words to what they think is going on for the child at the time, restating verbally what the therapeutic boundaries are.

The predicament of the baby/patient is that they do not at this point in time have the resources to tolerate their own feelings. They do not have the resources to remain in touch with what they feel without needing to defend themselves against the psychic pain via either physical violence, or emotional shut down. The therapeutic task is to help them to find ways of tolerating frustration without hitting out or damaging themselves, etc. and without shutting off their feelings.

The notion of 'container' is meant to indicate that the mother ( caretaker) / analyst will allow the baby/patient to 'project' some or all of these intolerable feelings into them. This means simply that they initially accepting in a non defensive manner the baby's/ patient's sincere but erroneous conviction that it is the mother/analyst, and not themselves who are angry, hateful or violent. Otto Kernberg has written much about all this and how to work with such situations clinically- especially if the distortion in the patient's perception of reality is of a nature which would commonly be labeled as 'clinical paranoia'. In this act of acceptance the mother/analyst helps to 'contain' ( keep in, rather than 'act out') some of the extreme feeling states. I this way they help to contain the baby/ patient, emotionally, rather in