Identification and its vicissitudes as observed in psychosis.

I have described the mechanisms that operate in psychotic identification. One mechanism is psychotic introjection, characterized by a refusion of 'all good' self and object representations. This re-fusion threatens the destruction of the self as a consequence of the defensive blurring of these self and object representations. The second operative mechanism is projective identification, which I have defined in comparison with and in contrast to projection. Projective identification threatens the destruction of the relation with the object. The case I have described in detail illustrates these psychotic identifications, the development of psychotic transferences wherein the patient cannot differentiate herself and her thinking from the therapist and his thinking, and the struggle around a sense of personal identity at a point of resolution of the psychotic transference. This case also illustrates that an integrated self includes two types of self-representations: those centred on self differentiation and those which reflect the observing functions of the parental images internalized into the self.