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Mancia, M. (2005). On: Projective identification and consciousness alteration. Int. J. Psycho-Anal., 86(2):553-554.

(2005). International Journal of Psycho-Analysis, 86(2):553-554

On: Projective identification and consciousness alteration Related Papers

Mauro Mancia

Dear Sirs,

I read Cimino and Correale (2005) with great interest. The authors describe the process of projective identification (PI) on the part of the patient as well as on the part of the therapist. The patient's PI is described as an expression of unconscious early traumatic experiences which had no access to representability but which can have emotional effects on the analyst and alter his states of consciousness (or even his physical state). They then divide these changes in the analyst into three levels: the first regards ‘the partial or total loss of the imaginative or metacognitive function of the ego capable of conversing with itself. In this case, the analyst feels forced into a role and trapped in a symmetry of positions not of his choosing, which he experiences as imposed from without’ (p. 54). The second involves a contraction of the analyst's field of perception and the third the loss of his sense of self with depersonalising anxiety and a state of confusion.

I believe that at least this third level of the response to the patient's PI is due to serious difficulties on the part of the analyst to contain and elaborate what the patient projects on to him. This brings the analyst to a point of possible projective counteridentification, as described by Grinberg (1962). This important countertransference deserves to be discussed in the light of recent neuroscientific contributions which point to activation of the affective structures of the observer's brain (anterior cingulate and anterior insula areas) in response to extra-verbal (Singer et al.

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