Waska RT:

struggle
Psychotherapy,
8(2):____–____
tertransference;
for understanding
Projective
Psychoanalytic;
Projective
identification,
over
Identification;
acting
Self Psychology;
out.
countertransference,
JActing
Psychother
Out
Transference/Coun-
Pract Res
and1999;
the

Projective Identification,
Countertransference, and the Struggle
for Understanding Over Acting Out
Robert T. Waska, M.S., MFCC

Projective identification is examined as an intrapsychic

and interpersonal phenomenon that draws the analyst
into various forms of acting out. The therapist struggles
I n 1946, Melanie Klein1 introduced the term projective
identification in the following way:

Much of the hatred against parts of the self is now

to use understanding and interpretation as the method directed toward the mother. This leads to a particular
of working through the mutual desire to act out the form of identification which establishes the prototype
patient’s core fantasies and feelings. Clinical material of an aggressive object-relation. I suggest for these
is used to illustrate the ways in which projective processes the term “projective identification.” (p.
102)
identification affects the analytic relationship. The
focus is on methods of using interpretation to shift from
Since then, projective identification has been rede-
mutual acting out to mutual understanding. fined by various authors and has given rise to a vast lit-
(The Journal of Psychotherapy Practice and
erature on the subject.
Research 1999; 8:155–161)
Segal2 writes:

In projective identification parts of the self and inter-

nal objects are split off and projected into the external
object, which then becomes possessed by, controlled
and identified with the projected parts. Projective
identification has manifold aims: it may be directed
toward the ideal object to avoid separation, or it may
be directed toward the bad object to gain control of
the source of danger. Various parts of the self may be
projected, with various aims: bad parts of the self may
be projected in order to get rid of them as well as to
attack and destroy the object, good parts may be
projected to avoid separation or to keep them safe
from bad things inside or to improve the external
object through a kind of primitive projective repara-
tion.” (pp. 27–28)

Received October 19, 1998; revised December 7, 1998; accepted

December 14, 1998. From the San Francisco Institute for Psychoana-
lytic Psychotherapy and Psychoanalysis, San Francisco, California.
Address correspondence to Dr. Waska, P.O. Box 2769, San Anselmo,
CA 94979.
Copyright © 1999 American Psychiatric Association

J Psychother Pract Res, 8:2, Spring 1999 155

 Projective Identification

Besides the elements that Segal clarifies, I think of tive identification can be an acting-out process of dis-
projective identification as an unconscious fantasy of lov- charging internal “pollutants” into the object, followed
ing and hateful feelings being evacuated into the internal by a denial of any connection or familiarity with such
and external object. This process can then lead to the debris in the first place. Although this may sound like
fantasy of either re-internalizing an injured object, caus- simple projection, the ego is still responding to the fan-
ing depression and fear, or re-internalizing a now hostile tasy of some type of object and some type of relationship
and dangerous object, causing persecutory anxieties. to that object. In this case, the response is a denial of the
Projective identification also represents a very primitive relationship to the object.
means of communication that can lead to countertrans- Therapists are inevitably touched, contaminated,
ference distress and subsequent pathological interactions and seduced by these dynamics. The effects of projective
between patient and therapist. identification are strong and can produce intense coun-
Projective identification is a form of adaptation, com- tertransference reactions.
munication, defense, and creative expression that per- Certain aspects of the intrapsychic and interpersonal
meates the core of many psychotherapeutic treatments. communications between therapist and patient can con-
A gradual mutual understanding by the patient and tinue beyond the hour or even past termination. Thera-
therapist of its multiple meanings within the therapeutic pists speak among themselves of being hounded by a
relationship and its place in the patient’s unconscious session and having it follow them into their personal
functioning is crucial to the working-through process. lives. They can unwittingly bring home clinical situations
Countertransference can be quite intense in re- and even find the patient’s material invading their
sponse to projective identification experiences. Pick3 dreams. In the moment-to-moment clinical situation,
writes: countertransference anxiety can be so great that the
therapist is pushed to act out and rapidly return the pa-
To suggest that we are not affected by the destructive- tient’s unbearable projections. This can occur in many
ness of the patient or by the patient’s painful efforts ways. Some projective identification mechanisms pro-
to reach us would represent not neutrality but false-
duce intense reactions in both parties. Others produce
ness or imperviousness. It is the issue of how the
analyst allows himself to have the experience, digest more subtle effects within the analytic relationship.
it, formulate it, and communicate it as an interpreta- Pick3 writes:
tion that I address. (p. 164)
The analyst, like the patient, desires to eliminate
discomfort as well as to communicate and share
In other words, as the result of the patient’s projective
experience; ordinary human reactions. In part, the
identification dynamics and the totality of the therapeutic patient seeks an enacting response, and in part, the
relationship, countertransference will exist. The question analyst has an impulse to enact, and some of this will
is not what to do if countertransference is present in a be expressed in the interpretation. This may range
treatment, but what form it takes and how to use it effec- from an implicit indulgence, caressing the patient
tively. with words, to responses so hostile or distant or
frozen that they seem to imply that the deprivation
Therapist and patient constantly struggle to make of the experience the patient yearns for is of no
meaning and sense out of what takes place in the thera- matter; a contention that a part-object mechanical
peutic relationship. However, both parties are constantly experience is all that is necessary. (p. 158)
tempted to act out these meanings rather than verbalize
or mentalize them. There is a mutual resistance to feeling She is pointing out that both the therapist and patient
and working with the strong fantasy material in the room. are often drawn to some sort of acting out that can be
Freud4 wrote that patients remember nothing of their very secretive and subtle, yet extremely gratifying. It re-
internal conflicts but express them through action. Their moves the anxiety and threat that both may be feeling.
behavior becomes a vehicle for the conflicts they would The therapist tries to understand any residual pro-
otherwise painfully have to face. Therefore, action feels jective fragments that have been discarded, left behind,
safer or at least feels temporarily relieving. It can be an or lost by the patient through projective identification.
excitement, a stimulation, an escape, or a revenge. Nev- An image that is helpful to me is the elementary school
ertheless, it remains as an unintegrated and split-off por- teacher who, after the school day is over, finds various
tion of the mind’s urges and mobilized fantasies. Projec- notebooks, coats, and lunch pails scattered about the

156 J Psychother Pract Res, 8:2, Spring 1999

Waska

school yard. The items have to be examined, recognized, tain difficulties. I felt that Miss A. would turn on me and get
and returned if the owner can be found. In a psychoana- rid of me. I felt as if the person I always knew and trusted
were suddenly an adversary. Dr. Jekyll was about to become
lytic psychotherapy process, we are always dealing with Mrs. Hyde. Examining these strong feelings, I started to
temporarily bequeathed psychic elements, even after the understand how she had turned the tables on me. In her
patient leaves treatment. childhood, Miss A. often was left to deal with her manic-
The therapist’s charge is to be a holding and trans- depressive father, who could dramatically shift from friendly
“dear old dad” to a selfish or frightening figure. While she
formative object. There are times when the therapist
had often spoken of this and its continuing manifestations in
must work through certain mental dynamics even after her adult life, it had not been a clear part of the transference
the patient has left the room. The therapist is often re- up to now.
quired to continue “meeting” with the patient within the She had turned passive into active by the use of projec-
context of projective identification. Long after the patient tive identification. She projected the parts of her that were
scared of being abused by a “Freudian” father object into
is gone, the therapist can still be struggling through spe-
her mental representation of me and then onto me interper-
cific internal object relations. (This is quite different from sonally. This was accomplished by the subtle teasing threat
the accidental or temporary holding function that some- of “Oh, don’t worry, ” much as the wolf had assured Little
times occurs between the end of one session and the Red Riding Hood to not worry. I then felt afraid of being re-
beginning of the next when projective identification is jected and attacked by her. Fortunately, I was able to under-
stand this as a concordant countertransference5 where I
not analyzed.)
identified with her vulnerable feelings and feared her as the
nasty father object. I was able to regain my footing by the
CLINICAL MATERIAL next hour. I introduced these ideas and we were able to ex-
plore them together.
Some of these problems are illustrated in the following
clinical material. I will present one case in which the hour Ogden,6 synthesizing many ideas including those of
ended and the therapist was left feeling alone; one case Bion7 and Rosenfeld,8 writes:
in which both patient and therapist frequently felt used,
persecuted, or controlled; and two cases where the thera- Projective identification . . . is a psychological pro-
pist began acting out the sadomasochistic, envious, and cess that is simultaneously a type of defense, a means
fearful elements of the patient’s internal object relations. of communication, a primitive form of object rela-
tionship, and a pathway for psychological change. As
a defense, projective identification serves to create a
I had seen Miss A. for two years in psychoanalytic psycho- sense of psychological distance from unwanted (often
therapy, and during that time she had positive feelings to- frightening) aspects of the self; as a mode of commu-
ward me that she never spoke about directly. She would nication, projective identification is a process by
never volunteer any transference feelings, but when I would which feelings congruent with one’s own are induced
comment on their absence she was very forthcoming. She in another person, thereby creating a sense of being
told me she felt very safe, thought of me as always “on her
understood by or of being “at one with” the other
side,” and saw my office as a “special and wonderful haven.”
person. As a type of object relationship, projective
We understood this as a fantasy in which I was a person
identification constitutes a way of being with and
with whom she could do no wrong and always felt wel-
relating to a partially separate object, and finally, as
comed. Miss A. would resist any exploration of this one-
a pathway for psychological change; projective iden-
sided idealized transference. Therefore, I always felt
tification is a process by which feelings like those that
suspicious of “what else” might be afoot.
one is struggling with are psychologically processed
One day she seemed unusually uncomfortable and anx-
by another person and made available for re-inter-
ious. After sputtering for a while, she explained that her
nalization in an altered form. Each of these functions
friend had said that given how I practiced, I must be a “Freu-
dian.” Miss A. felt very insecure and worried. To her, a Freu- of projective identification evolves in the context of
dian was one who is only interested in sex and money. She the infant’s early attempts to perceive, organize, and
was not sure if she could trust me anymore and was con- manage his internal and external experience and to
cerned that I was subjecting her to “questionable Freudian communicate with his environment. (p. 362)
techniques.” When I suggested we explore her sudden mis-
trust, try to understand how this had come about, and see With Miss A., one can see most of Ogden’s ideas
what it meant, she assured me that all was well and I had
“no need to worry.” This was said in a way that seemed omi- illustrated. Miss A. used projective identification to de-
nous or mysterious. fend herself from the fear of her internal father, to com-
After the hour and during the next two days, I had cer- municate her affective states to me, to relate to me in a

J Psychother Pract Res, 8:2, Spring 1999 157

 Projective Identification

way that paralleled early intrapsychic parental connec- I find myself getting into countless little sadomasochistic cat-
tions, and to encourage me to struggle with her internal and-mouse games with the patient. We seem to take one
step toward exploring his mental conflicts and one step side-
states in a manner that might enable her to handle them ways into acting out his internal fantasies and fears.
better herself. Another example of the patient’s use of projective iden-
In this second case, I related in sadistic and con- tification occurred in an hour where he felt very persecuted
trolling ways that the patient’s projective identification and worthless. He spent the hour telling me how “the sys-
tem” was against him. He claimed “they” were making
mechanism triggered.
countless accusations that made him appear to be a real
criminal. I interpreted that he felt ashamed of himself and
Mr. J. was a 24-year-old man whom the courts sent to me. unable to know what to do about it. He calmed down for a
He had committed a series of petty crimes over the years bit. For the rest of the hour he told me that his situation
and showed no remorse. He justified his actions as necessary would be comparable to my being accused of having sex
and felt the court system “had it in for him.” Mr. J. thought with minors and the humiliation I would feel at being falsely
the judges, parole officers, and social workers all were un- accused.
justly picking on him. I saw him in once-weekly psychoana- At the end of the hour, he walked out the door and
lytic psychotherapy for several years. He would become said, “Now watch out for those minors!” I felt he was trying
paranoid, believing that I was using him and forcing him to use projective identification to discharge his shame into
into therapy. At that point he would break off treatment un- me to escape his anxiety. I told him, “You are trying to
til he returned to fulfill a court requirement. share your shame with me so I will know what you feel
If I asked him to commit to a regular weekly hour, Mr. like.” Although his projective identification efforts were also
J. felt I was controlling him. In turn, he controlled me by defensive, I chose to interpret the communicative function.
making us have a week-by-week schedule. I noticed that we
had fallen into a routine where I asked him about the next
appointment at the end of each hour. He would then deliber- Grotstein’s9 contributions regarding projective iden-
ate about when he might be able to come, which ate into my tification specify the multiple aims, the simultaneously
time before the next patient. I started to feel controlled, like occurring states of self and object differentiation/fusion,
he was “just taking his sweet time.” I was irritated and felt un- and the intrapsychic as well as interpersonal aspects of
der his thumb. Technically, I felt that if I pointed out how projective identification. Grotstein’s idea of the ego’s dis-
he lingered at the end and stated his possible motivations,
he would feel accused, get defensive, and retaliate. So the charging unwanted aspects of itself into an object is close
next time, I inquired about scheduling at the beginning of to what my patient seemed to be doing with me in the
our hour. I was painfully aware that I was turning the tables transference. He tried to jettison the poisonous parts of
on him. As he tried to sort out when he could come in, Mr. his controlling internal objects by projecting them into
J. became more and more irritated. He said I was manipulat-
me. He then identified with me through the more con-
ing him and stealing his money. He became paranoid and
told me that he wasn’t paying me to discuss paperwork. As trolled, defeated, and enraged parts of himself that felt
he felt more trapped, he became verbally abusive. I started denied access to my emotional supplies. In regard to
to feel intimidated. setting the schedule with Mr. J., these roles were switched.
At that point, I interpreted that he was scared that I was My complementary countertransference turned into a
controlling him and he was feeling that he would do some-
concordant one. In other words, I started off feeling that
thing he would regret but felt unable to stop it. He said he
did feel controlled and felt that he might make a commit- I was being made out to be the persecutory father. This
ment to see me that he would later regret. Mr. J. said he shifted to my feeling victimized, which made me want
didn’t like to make mistakes and was very careful to avoid to turn the tables on him and victimize him back.
making a wrong move. This moved us in the direction of dis- In a brief paper delivered in 1949, Heimann10 main-
cussing his overly critical superego. He felt haunted by a su-
tained that
perego that found him lacking and weak. I showed him
how, through projective identification, he discharged this pu-
nitive part of himself into his objects for relief. Yet he then the analyst’s counter-transference is not only part and
quickly felt attacked and controlled by those now punitive parcel of the analytic relationship, but it is the pa-
objects. I told Mr. J. that he wanted me to be his helper, a tient’s creation, it is part of the patient’s personality.
person who could show him the way out of his anxieties and The emotions roused in the analyst will be of value
confusions, but that in his mind I quickly changed into a bad to his patient, if used as one more source of insight
person who would abandon him and attack him. He relaxed into the patient’s unconscious conflicts and defenses;
enough for us to discuss his feelings and thoughts a bit more. and when these are interpreted and worked through,
Fortunately, my acting out was momentary, and I re- the ensuing changes in the patient’s ego include the
gained my footing enough to comment on his anxieties. This strengthening of his reality sense so that he sees his
led to a shift in his normally defensive stance. Nevertheless, analyst as a human being, not a god or demon, and

158 J Psychother Pract Res, 8:2, Spring 1999

Waska

the “human” relationship in the analytic situation another. It alerted me to the blurring of boundaries so often
follows without the analyst’s having recourse to extra- produced with projective identification mechanisms.
analytic means. (pp. 77–78)
Looking back on the session, I believe I enacted the
As Heimann notes, the therapist continually tries to smothering, controlling object by telling Miss B. that I
understand how the emotions the patient arouses in him needed time to treat her. Pick3 writes:
or her can be of value to the treatment. In the case of my
patient Miss A., I was successful in gaining such an un- The contention that the analyst is not affected by
derstanding. In the case of Mr. J., I went back and forth these experiences is both false and would convey to
the patient that his plight, pain and behavior are
between interpreting the projective identification pro-
emotionally ignored by the analyst. [I am suggesting]
cess and throwing his struggles back at him to get relief that if we keep emotions out, we are in danger of
from his unconscious and interpersonal pressures. keeping out the love which mitigates the hatred,
As Sandler11 has clarified, the therapist is always in- allowing the so-called pursuit of truth to be governed
volved in some sort of acting out that is best understood by hatred. What appears as dispassionate may con-
as a specific measure of “role responsiveness.” Projective tain the murder of love and concern. (p. 165)
identification is the most basic mental mechanism that
invites such a dynamic. The therapist serves a containing I would add that by ignoring the countertransference
and translating function in the projective identification we would be not only mitigating the love, but also deny-
processwhether the patient is still in treatment or not. ing the aggression, pain, and confusion we feel that has
Perhaps it is best to say that neither patient nor therapist been projected into us. With Miss B., I felt the urge to
is ever out of treatment. pursue her and convince her of the importance of mul-
tiple visits. I was forcing her to commit and to submit to
Miss B. told me, in the first hour, a tale about dating a man a relationship with me. This was an acting out on my
who could not commit to her and was “wishy-washy.” Miss part based on her projections of a greedy, needy, and
B. portrayed herself as solidly interested in him and clear forceful part of herself. She then sided with the part of
about what she wanted: a commitment. When I introduced herself that felt victimized, dominated, and manipulated.
the idea of a regular appointment hour and the possibility of
Only over the course of many months of treatment did
multiple weekly visits, she immediately felt it was something
that she would find “overwhelming,” “way too much,” and the particulars of these feelings and fantasies come to
something she “couldn’t possibly commit to.” We suddenly light and a working-through begin.
seemed to get into a debate and a tug-of-war. I tried to use
logic and explained that I needed to see her regularly and at Miss M. was a patient who entered treatment for help with
least once a week so that I might be able to help her. She re- job troubles. She felt that she always worked extremely hard
sponded by becoming more anxious and repeated that she for others but never got recognized for her efforts. In fact,
couldn’t commit to anything right now and that commit- she felt that others took advantage of her generous nature
ment just “wasn’t her style.” and piled on more work because of it. After the first few
Thrown off by this abrupt switch in how she was pre- hours of treatment, my impression was that she related to
senting herself, I was not able to interpret her projection of her objects, including myself, in a masochistic manner that
her own fear of commitment into the “date” she now felt she was based on fear and tightly managed rage.
had with me. We left it that we would meet again, but The patient’s father had left the family when she was an
clearly she was now in charge, with appointments happen- infant, and her mother seemed to collect and discard boy-
ing “whenever” and “maybe once a week at the most.” This friends at will. She treated people as though they were ex-
was very much like the ongoing dynamic with Mr. J. and his pendable. Miss M. told me she “got the message” early on to
reluctance to commit to regular hours. However, the under- be good or risk her mother’s total rejection.
lying fantasies were different. I felt that if I had made spe- After the patient’s health insurance ran out, we began
cific interpretations about this fear of commitment, Miss B. discussing what fee she could afford. She said she wanted to
would not have been able to take them in. I felt she would “simply know” what my fee was, and if she couldn’t pay it
have taken them as a more concrete pressure to submit to then she would stop attending. When I told her my fee was
me. In fact, later on this is what some of her fears turned out somewhat negotiable depending on her income and how
to be. often she attended, she became tense and silent. The more
What I did say to Miss B. was, “You are fearful of an in- we tried to discuss the fee, the greater her anxiety grew. I
volvement with me, which may be a clue to some of your asked her what she would like to pay, based on her current
difficulties. Let’s take it up next time.” As we ended, I no- income. She was visibly sweating and sprang to her feet and
ticed that I had gone over by 10 minutes. This felt as if we demanded to know my fee so she could decide to remain in
had become too close on one level and not close enough on the room or leave for good because she couldn’t afford it. I

J Psychother Pract Res, 8:2, Spring 1999 159

 Projective Identification

interpreted that she felt very worried about hurting me if she used case material to show the frequent and usually un-
revealed her own thoughts and desires on the matter. I avoidable acting out of countertransference feelings. Ide-
added that she worried she could cause trouble between us.
She started to cry and said, “Yes. I also think you would get ally the result of this process is that, sooner rather than
rid of me if I opened my mouth!” later, either the therapist or the patient will gain a full
This was the beginning of a complex and rich therapeu- enough understanding to allow the making of a mutative
tic process. We gradually explored her fears of me being interpretation.
like her mother and possibly rejecting her for what Miss M.
Feldman12 writes:
felt to be unacceptable aggressive needs and toxic thoughts.
In the transference, she projected her easy-to-ruffle, rejecting-
mother part of herself into me and she sided with the threat- The patient’s use of projective identification exerts
ened-little-girl part of herself. In that early hour, I had subtle and powerful pressure on the analyst to fulfill
experienced a complementary countertransference11 in the patient’s unconscious expectations that are em-
which I began to act out some of the characteristics of her in- bodied in these fantasies. Thus the impingement
ternal objects. I sensed that she was anxious about the fee- upon the analyst’s thinking, feelings and actions is not
setting, but I kept plowing ahead with it in a somewhat an incidental side-effect of the patient’s projections,
sadistic and stubborn manner, almost forcing her to have an nor necessarily a manifestation of the analyst’s own
opinion. In these ways, I was pushing her into a place that conflicts and anxieties, but seems often to be an
felt dangerous and sure to lead to pain for somebody. Her essential component in the effective use of projective
fantasy of her own destructiveness, which would push me identification by the patient. (p. 228)
into being rejecting and attacking, was to become known
later in the analysis. However, this projective identification Therefore, a patient’s projective identification efforts
and countertransference acting out helped us start to see her
are most likely to bring about some type of result if they
fear of me as a rejecting persecutor.
affect the therapist. Often, if a patient feels that the thera-
pist ignores these efforts, the patient may redouble them
It was important to Miss M.’s sense of internal safety
or may give up and try elsewhere, acting out in other
that she keep me matched with her fantasies. Even
relationships.
though this meant I was an attacking or non-under-
Feldman writes, “What is projected is not primarily
standing figure, that was better than facing the pain of
a part of the patient, but a fantasy of an object relation-
not having a caring object. The sense of loss would be
ship” (p. 234). This is the reason the therapist is often
overwhelming. Regarding patients who try to keep the
tempted to act out. The projective identification mecha-
analyst matched with their internal expectations, Feld-
nism brings the therapist in touch with core fantasies of
man12 writes:
a particular type of relationship that lives within the pa-
The lack of this identity between internal and exter- tient’s mental structure. The urge for the therapist is to
nal reality may not only stir up envy, or doubts about become an active participant and act out the according
the object’s receptivity, but create an alarming space feelings and behaviors. In psychoanalytic psychotherapy
in which thought and new knowledge and under- treatment, first the therapist and later the patient strives
standing might take place, but which patients find to understand these intrapsychic projections and what
intolerable. (p. 232)
the elements of that fantasy relationship are. Verbaliza-
tion, exploration, and understanding then provide a ve-
SUMMARY
hicle to work through the various conflicts, fears, and
pains associated with those fantasies.
I have used clinical material to examine the patient’s use
of projective identification and its effect on the therapist
and the analytic dyad. Therapists struggle to understand
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anal 1985; 66:157–166
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