Finell J S
Psychoanal Rev. 1986 Summer;73(2):103-28.
This paper reviewed the merits of and problems with the concept of projective identification. On the negative side, lack of universal meaning of the term was cited. Personal countertransference receives little regard, while an isomorphic reading of patient feelings may be used to gratify omnipotent symbiotic analyst and patient fantasies. On the positive side, the concept offers a framework that can lead to deeper understanding of difficult therapeutic situations. It helps the analyst process and contain distressing feelings and eschews interpretation that can be destructive to the analytic process. Proper use of projective identification should engage the patient's ego rather than foster passivity and merger wishes. Case material was presented which illustrated problems with and merits of the concept. Personal countertransference, especially therapeutic omnipotence, was shown to receive insufficient attention. The important role of complementarity in projective identification was illustrated in the treatment of depression, a disorder which can offer difficult treatment resistances. In conclusion, the concept should not be used as a justification for analyst omnipotence and avoidance of countertransference responsibility. The concept, however, can lead to a deepening of the analytic situation if it is used with caution and respect for the patient's separateness.
本文回顾了投射性认同概念的优点和问题。消极方面,文中指出该术语缺乏普遍意义。个人的反移情很少受到关注,而对患者情感的同构解读可能被用来满足分析师和患者全能共生的幻想。积极方面,该概念提供了一个框架,有助于更深入地理解困难的治疗情境。它帮助分析师处理和容纳痛苦的情感,避免采用可能破坏分析过程的解释。正确使用投射性认同应调动患者的自我功能,而非助长被动性和融合愿望。文中呈现了案例材料,阐述了该概念的问题和优点。个人反移情,尤其是治疗性全能,被证明未得到充分关注。互补性在投射性认同中的重要作用在抑郁症治疗中得到了体现,抑郁症是一种治疗中会出现棘手阻抗的疾病。总之,该概念不应被用作分析师全能以及逃避反移情责任的借口。然而,如果谨慎使用并尊重患者的独立性,该概念能够深化分析情境。