Book
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.
Main ideas
- Klein's concepts of splitting and projective identification can be applied clinically to schizophrenia and other psychotic and borderline conditions.
- Psychotic patients develop a transference psychosis, distinct from the transference neurosis, which can be interpreted.
- Psychosis can be treated by a purely interpretative psychoanalytic method, without abandoning the analytic setting.
- The same approach is extended to hypochondriasis, drug addiction, depression and manic-depressive states, and to narcissistic object relations.
What it shows
Melanie Klein influenced Herbert Rosenfeld
Rosenfeld built his work on psychosis on Klein's account of the paranoid-schizoid position: his first paper (1947) read depersonalization through her newly published notes on schizoid mechanisms, splitting and projective identification, and he went on to extend her theory of envy to narcissism.
- 1964
Herbert Rosenfeld introduced Narcissistic object relations
Rosenfeld's 1964 paper described narcissism not as withdrawal from objects but as an omnipotent relation to them, in which the object's goodness is appropriated by introjection and the self's unwanted parts are projected into it, so that separateness, dependence and envy are denied.
Herbert Rosenfeld developed Psychotic transference
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.
Psychotic transference 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.