Concept
Psychotic transference
The transference formed by psychotic patients, and the psychotic parts of other patients, in analysis. Freud had held that in the narcissistic neuroses the libido is withdrawn from objects, so that no analysable transference arises. From the 1940s Kleinian analysts, Herbert Rosenfeld foremost among them, with Hanna Segal and Wilfred Bion, showed that such patients do form an intense transference, but a concrete and delusional one: through massive projection, and projective identification, of phantasies and parts of the self, the analyst is experienced as actually being the persecuting or idealized figure rather than as standing for it. They held that this transference could be understood and interpreted, which opened the way to analysing schizophrenic patients without changing the method.
Development
Undated
developed by Herbert Rosenfeld
Against the view that psychotic patients form no transference, Rosenfeld analysed schizophrenic patients without changing the classical setting and showed that they form an intense transference, in which the analyst is treated as the bearer of the patient's projected parts; he called it the transference psychosis and made its interpretation the core of his technique.
In Analysis of a Schizophrenic State with Depersonalization (1947);Psychotic States: A Psycho-Analytical Approach (1965)
Relations
- developed by Herbert Rosenfeld
Against the view that psychotic patients form no transference, Rosenfeld analysed schizophrenic patients without changing the classical setting and showed that they form an intense transference, in which the analyst is treated as the bearer of the patient's projected parts; he called it the transference psychosis and made its interpretation the core of his technique.
- derives from Projective identification
In Rosenfeld's account the psychotic transference is carried by projective identification: the patient puts split-off parts of the self into the analyst, who is then experienced as those parts rather than as a separate person.
Works
- 1947
Analysis of a Schizophrenic State with Depersonalization
Rosenfeld's first paper, drawn from his first training case at the British Psycho-Analytical Society, reports the analysis of an adult schizophrenic patient suffering from depersonalization, treated by interpretation alone, without changing the analytic setting. It is often described as the first adult psychotic case treated successfully by a purely interpretative psychoanalytic method. Drawing on Melanie Klein's newly published account of schizoid mechanisms, it was the first clinical paper to use her concept of projective identification. Rosenfeld traces the fragmentation of the patient's ego and the feeling of depersonalization to excessive splitting and to the projection of parts of the self into objects, and he describes the patient's psychotic transference to the analyst. The paper was reprinted in Psychotic States (1965) and again in Rosenfeld in Retrospect (2008).
- 1965
Psychotic States: A Psycho-Analytical Approach
Rosenfeld's first book collects the papers he wrote between 1946 and 1964, from his first case report of a schizophrenic patient with depersonalization (1947) to his clinical paper on the psychopathology of narcissism (1964). Together they apply Melanie Klein's account of early anxieties and defences, above all splitting and projective identification, to the analysis of schizophrenia and to hypochondriasis, drug addiction, depression and manic-depressive states. The book argues that psychotic patients can be treated by interpretation within the analytic setting, because they form a transference of their own, a transference psychosis marked by massive projection onto the analyst. It also contains his account of confusional states (1950) and his first statement on narcissistic object relations. It was published in London by the Hogarth Press and the Institute of Psycho-Analysis, and in New York by International Universities Press.
See also
Linked from
People
References
- Analysis of a Schizophrenic State with Depersonalization1947Evidence for a relation
- Psychotic States: A Psycho-Analytical Approach1965Evidence for a relation