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Neutrality remains a key concept underpinning the psychoanalytic attitude, but its operation in the clinical setting must be reconfigured if the countertransference is to be used as a source of data, conveyed by projective identification. Subjective responses thus mobilized in the analyst need to be processed before attention can return to the evenly suspended state, from which greater objectivity flows. Theory, internalized as part of the analyst's emotional learning, operates preconsciously in the session; in clinical work with racial matters this includes, crucially, familiarity with internal racism, of which a model is briefly described. These ideas are illustrated via two clinical vignettes in which these themes are traced.

Projective identification (PI) is a complex process that can bridge the divide between individual psychodynamics and interpersonal systemic process. Consequently, it provides a powerful lens through which to examine couple conflict and unhappiness. This paper aims to clarify and demystify the concept and to illustrate its special utility for clinicians practicing individual psychoanalysis or psychotherapy, and for therapists who treat couples conjointly. It deconstructs PI into components of transference (projection), induction, and identification of both inducers and recipients; distinguishes subtypes; and then discusses some important topics surrounding the concept, including what is meant by "identification," the importance of "containment," and how induction is often accomplished by inaction. Clinical examples illustrate how patients use PI to manage grief, shame, past traumas, and current deficits. The utility of PI for understanding partner selection and marital polarities is illustrated, and guidelines for working with PI in psychodynamic couple therapy are provided.

Ferenczi's understanding of the primitive defenses required to cope with trauma, such as introjection, identification with the aggressor, atomization and reckoning, supports the author's clinical observations of patients who introject a pain mother. Introjecting a pain mother assures that the terrorism of the original external event of a suffering mother keeps the internal suffering going, resulting in being tormented by pain. Such an introjection creates technical difficulties for the analyst. A clinical case is presented to demonstrate.

The present paper starts from the reflection that there is a curious "phenomenological gap" in psychoanalysis when it comes to processes of splitting and to describing the "life" of psychic fragments resulting from processes of splitting. In simpler terms, we are often in a position to lack a precise understanding of what is being split and how the splitting occurs. I argue that although Melanie Klein's work is often engaged when talking of splitting (particularly through discussions on identification, projection and projective identification), there are some important phenomenological opacities in her construction. I show that by orchestrating a dialogue between Melanie Klein and Sándor Ferenczi, we arrive at a fuller and more substantive conception of psychic splitting and of the psychic life of fragments which are the result of splitting. This is even more meaningful because there are some unacknowledged genealogical connections between Ferenczian concepts and Kleinian concepts, which I here explore. While with Klein we remain in the domain of "good" and "bad" objects-polarised objects which are constantly split and projected-with Ferenczi we are able to also give an account of complicated forms of imitation producing psychic fragments and with a "dark" side of identification, which he calls "identification with the aggressor". While attempting to take steps toward imagining a dialogue between Klein and Ferenczi, I note a certain silent "Ferenczian turn" in a late text by Melanie Klein, "On the Development of Mental Functioning", written in 1958. In particular, I reflect on her reference to some "terrifying figures" of the psyche, which cannot be accounted for simply as the persecutory parts of the super-ego but are instead more adequately read as more enigmatic and more primitive psychic fragments, resulting from processes of splitting.

Analysts may incorporate many of Melanie Klein's important contributions (e.g., on preoedipal dynamics, envy, and projective identification) without transforming their basic analytic approach. In this paper I argue that adopting the Kleinian notion of unconscious phantasy is transformative. While it is grounded in Freud's thinking and draws out something essential to his work, this notion of phantasy introduces a radical change that defines Kleinian thinking and practice and significantly impacts the analyst's basic clinical approach. This impact and its technical implications in the analytic situation are illustrated and discussed., (Copyright © 2017 Institute of Psychoanalysis.)

Starting with Freud's discovery of unconscious phantasy as a means of accessing his patients' internal world, the author discusses the evolution of the concept in the work of Melanie Klein and some of her successors. Whereas Freud sees phantasy as a wish fulfilling imagination, dominated by primary process functioning and kept apart from reality testing, Klein understands phantasies as a structural function and organizer of mental life. From their very beginnings they involve object relations and gradually evolve from primitive body-near experiences to images and symbolic representations. With her concept of projective identification in particular, Klein anticipates the communicative function of unconscious phantasies. They are at the basis of processes of symbolization, but may also be put into the service of complex defensive operations. The author traces the further evolution of the concept from the contributions of S. Isaacs, the theories of thinking proposed by W.R. Bion and R. Money-Kyrle, Hanna Segal's ideas on symbolization and reparation all the way to the latest approaches by R. Britton, J. Steiner and others, including the understanding of transference and counter-transference as a 'total situation'. Points of contact with Freud are to be found particularly in connection with his concept of 'primal phantasies'. In the author's view, the idea of the transmission and communicative potential of unconscious phantasies enabled these authors to overcome the solipsistic origins of drive theory in favour of a notion in which unconscious phantasies both set down the coordinates of the inner world and form and reflect the matrix of inter-subjective relations., (Copyright © 2017 Institute of Psychoanalysis.)

In this paper fascination phenomenologically is described as a state of radically being captured by an imposing object. What is left of the impoverished and paralysed subject clings to the exclusive fascinating object. Fascination is the eye of the storm of extreme ambivalence towards an exclusive object: being the only remaining object it is necessary for living in an object world, but at the same time it is threatening to life by absorbing the subject totally. So the subject is sucked in by a yet frightening object. From a metapsychological point of view fascination is understood as the congealed result of excessive projective identification and a strong confusional state connected with it: the subject empties itself so much in the object that it comes to stand for the subject. The fascinating object embodies in a condensed way - as a special form of a bizarre object - split off unconscious threatening material. So fascination is linked to the Kleinian theory of anxiety. Two clinical vignettes illustrate how states of fascination can be understood as an ultimate defence against unconscious menacing material welling up. The hypothesis is developed that fascination points to a revelation of fundamental psychic truth that promptly cramps the subject because the reintegration of it is felt as annihilating. In the vignettes this takes the form of a 'transformation in hallucinosis'. Fascination is at the same time 'the moment of truth' and possibly a serious obstruction of the analytic process. This unconscious truth seems to concern primitive 'superego violence'. The challenge consists in thawing the frozen fascinating object by linking it to other material., (Copyright © 2016 Institute of Psychoanalysis.)

This paper is an attempt to deal with some questions raised by the so-called 'compulsion of destiny' constellation. In presenting the standpoints of Freud and of psychoanalysts who after him were concerned with this problematic, the author takes the view that several aspects of the configuration merit further discussion. Accordingly, the dynamics of repetition compulsion, the complexity of the projective strategy, the coexistence of passive and omnipotent trends are considered. Concerning compulsive repetitions the dimension of drive intrication is underlined, thus moderating the understanding of this clinical entity as mainly related to death drive trends. Projection is understood as serving complex psychic demands. The coexistence of passive and omnipotent trends is envisaged, as manifested in phantasies of submission / participation of patients to a force that exceeds human limitations. For certain cases the consonance of somatic and psychic experiences is noted. Finally, elements from the material of two cases are presented which pertain to the problematic of the compulsion of destiny in which random events are submitted to heavy psychic necessities., (Copyright © 2016 Institute of Psychoanalysis.)

Working to establish analytic contact (Waska, 2007) with a patient involves the verbal act of interpretation. But, how one interprets and what we try to hold in words is not the same with each patient. Each patient requires, invites, provokes and responds to a unique mixture of interpretive elements or approaches. The projective identification process that is so often the bedrock of the transference, and therefore the catalyst of the counter-transference, forms the psychological climate between patient and analyst. Case material is used to explore a Modern Kleinian interpretive approach with both a very entrenched depressive position (Klein, 1935, 1940) patient and a very primitive paranoid-schizoid (Klein, 1946) patient. Both these individuals desired relief from their symptoms of anxiety, anger, emptiness, and guilt. But, their unbearable unconscious phantasies offered pathological security that they were familiar with and therefore they preferred the known internal trauma and chaos to facing the unknown and undefined reality of self and other that change, grief, and growth would bring.

The aim of this article is to present a French psychoanalytic model of how and to what extent the sequellae of sexual abuse by a male during a girl's childhood are transmitted to the next generation, as a function of the gender of the abused mother's children. The authors conducted a qualitative exploratory study based on the longitudinal follow-up of a woman who had two boys and a girl. They focused on the impact of two general sequellae: separation anxiety and negativity-disqualification of the paternal and/or male figures. From the methodological standpoint, they used a clinical interview to assess the mother, and a projective tool, a storytelling test, to assess the child's personality using content analysis. The results confirm both the merits of the theoretical framework and the relevance of the projective methodology for grasping sequellae transmitted to the child. The sequellae turned out to be markedly different for the two baby genders: rejection for the male, overprotection and ghostly encryption for the female. Avenues for using this tool and model in future quantitative, comparative studies are suggested.

Referring to Melanie Klein's unpublished views on projective identification, Bion's theory of container/contained and Money-Kyrle's understanding of countertransference as a process of transformation, the author develops a multiphase model of projective identification. He differentiates five subphases of (1) adhesion, (2) penetration, (3) linking of the projection with an internal object of the analyst, (4) transformation and (5) re-projection. In the author's view the differentiation of overlapping subphases may be helpful to better localize problems of working through the countertransference. Some technical implications are illustrated by brief clinical vignettes. To conclude, the paper discusses typical impasses and options for interpretation., (Copyright © 2014 Institute of Psychoanalysis.)

Throughout his career, a central feature of Roy Schafer's theorizing has been to highlight the role of activity and personal agency in every facet of human experience. This theme has remained at the forefront of Schafer's work, despite being embedded within different frames of reference. In this paper, the author highlights Schafer's focus on activity, notes some clinical problems to which it can give rise, and suggests the way that Schafer has attempted to deal with these difficulties., (© 2013 The Psychoanalytic Quarterly, Inc.)

This article examines pathologies in the creation of symbols and those pathologies' ensuing consequences. It relies mainly on the vertices provided by Bion and Meltzer. It studies the different forms in which these lapses occur in symbolic processes, where they may create vacuums in symbolic networks or give rise to 'lies', and even destroy or de-symbolize established symbols. Based on Bion's concept of the minus-contained (-contained), I propose that when a symbol is attacked, a particular mental structure with its own peculiar characteristics comes about. This structure not only creates a vacuum in that mental zone, it ends up damaging the entire symbolization process. This contribution aims to describe that structure from the metapsychological point of view - contained. I end by synthesizing the possible widening of what could be a Bionian negative grid., (Copyright © 2012 Institute of Psychoanalysis.)

In this article the author argues that in order to be psychoanalysis, the 'here and now' technical approach needs to be firmly grounded theoretically and technically in a practice that includes the notion of reverie or its equivalent. The author has argued previously that the analyst's theory is the essential 'third' of the two-person analytic situation. She now suggests that it is specifically the theories of temporality and the attitude of 'evenly suspended attention' or its more contemporary development, 'reverie', that are the crucial aspects of that theory. She refers to these essential aspects as the 'theory in practice' in so far as they are more than a technical approach or a theory of practice but reflect directly a particular analyst's internalisation of the whole psychoanalytic theoretical corpus. While she believes this to be an essential component in any true psychoanalysis, in developing her argument the author looks at situations in which the analyst is particularly prone to forgo this temporal aspect, as is the case when patients show an absence of symbolic thinking within the analytic situation. In fact, with those patients reverie and the visual images it produces within the analyst's mind offer perhaps the only hope of a meeting ground between the concrete and the symbolic and the possibility of avoiding an impasse. Impasse, she suggests, has at its root the absence of reverie as a third and temporal element, inevitably giving rise to concrete thinking on the part of patient and analyst and so to a situation that cannot evolve., (Copyright © 2012 Institute of Psychoanalysis.)

The author begins with an examination of two unpublished notes by Melanie Klein, written in 1953 and tracked down by Hinshelwood (2008). In these notes, the role of the study of projective identification as a tool that can permit the analyst to master countertransferential difficulties is highlighted; in 1953, this is the most advanced point of psychoanalytic investigations into unconscious object relations. The author also considers Winnicott's essays "Primitive Emotional Development" (1945) and "Hate in the Countertransference" (1947). In the former, Winnicott begins to inquire into the relationship between subjectivity and objectivity, in relation both to the birth of the mind and to the analyst's psychic functioning. Ultimately, the author demonstrates that the origins of an extraordinary transformation of psychoanalytic theory are contained in Winnicott's essay on countertransference of 1947. In fact, the Winnicottian conception of psychic functioning is founded on the radical and absolutely innovative principle by which the object's unconscious functioning, as well as its transformations caused by the subject's unconscious, must be investigated and transformed in order for the subject to be capable of beginning a psychic transformation.

The author takes up a number of Bion's musings posthumously published as Cogitations (1992) and attempts to demonstrate the clinical usefulness of Bion's thoughts. She offers some new models and some points of technique that might be derived from following the trail of these selected fragments of Bion's thinking. Several detailed clinical examples are offered for clarification and illustration.

Limit setting has an important role in psychotherapeutic treatment. Despite this, the psychodynamics of limit setting have been a largely neglected topic in the literature. This article will present a theoretical discussion on the psychodynamics of limit setting particularly as it relates to the parent-child and the therapist-patient relationship. The central roles of aggression and impulse containment will be reviewed along with an overview of the relationship between limit setting and projective identification. Potential enactments that occur during the treatment of limit testing patients will be examined. Case material of the treatment of a child with a disruptive behavior disorder will be used to elaborate the discussion.

The concept of projective identification has, since its introduction by Melanie Klein over half a century ago, caused much controversy amongst psychoanalysts and psychotherapists. In this paper the author traces some of the key theoretical developments of the concept since its introduction in 1946, including: normal and pathological projective identification, aspects of symbolisation and projective identification as an intrapsychic mechanism. An extended case report of a patient in weekly psychoanalytic psychotherapy is offered in order to expand upon some of the theoretical ideas previously considered. Emphasis is placed on the patient's use of intrapsychic projective mechanisms and the emergence and mutation of such mechanisms in the therapeutic relationship.

A publishing cohort of Kleinian analysts - Rosenfeld, Segal and Bion - implemented Klein's (1946) notions of projective identification and the 'paranoid ' and 'schizoid ' positions in the understanding of a group of psychotic disorders. The author differentiates Klein's (1946)Notes on some schizoid mechanisms paper from its revised version of 1952, maintaining that it was Rosenfeld's clinical work during this period that helped to centralize Klein's redefinition of projective identification. The stage was set for Segal 's contribution in terms of 'symbolic equations,' where the psychotic's attack on the breast left him incarcerated in internal torment and persecution, where things-in-themselves were confused with what they symbolically represented. Segal in turn linked psychotic to normal, paranoid-schizoid to depressive positions, where by means of projective identification and symbolic imagination, the patient could arouse feelings in the analyst related to sadness, guilt and loss. Bion assumed that psychotic pathology reflected disordered thinking, when the severely disturbed used language as a mode of action. The psychotic was profoundly confused between the use of thought and action in the natural world - where thought was required, he preferred action and vice versa. Bion also drew upon projective identification in a new, broader way, so that analysis could now become more of an intersubjective, bi-directional field of projective and communicational influence between patient and analyst. The paper concludes with the impact of the work of Rosenfeld, Segal and Bion and variations on the technique of analyzing psychotic states in terms of the patient's early history, transference and countertransference.

The meaning of the concept of projective identification (PI) is examined in an effort to determine the mechanisms involved in its operation. Formulations of the concept are reviewed conceiving of the process of PI as a form of unconscious affective communication. Difficulties and ambiguities of the concept are discussed, including the lack of a satisfactory explanation for unconscious communication. Possible mechanisms and processes that might contribute to the process are explored, including on one hand nonconscious and automatic neurophysiological, physiological, neuromuscular, and autonomic processes, along with mechanisms of emotional simulation, and on the other unconscious and conflictual defensive psychological processes involving aspects of projection and introjection. An attempt is made to integrate these findings in a coherent theoretical model of PI that is comprehensible in psychoanalytically meaningful and cogent terms.

In this paper, I wish to illustrate how working with a patient who had a certain kind of narcissistic difficulty led me to develop particular clinical strategies to facilitate the development of a sturdier sense of self, greater affect tolerance and modulation, the diminution of harshness of her superego, and the ownership of projected parts of herself, and to decrease paranoid ideation. I call upon concepts from various theoretical schools of psychoanalysis to make sense of the dynamic intricacies of the patient's psychological organization as they revealed themselves in the analytic process. These conceptualizations of the patient's difficulties and of clinical interventions to address them result in a hybrid theory of both theory and technique. What transpired in the clinical work also led me to propose an additional way to understand this kind of patient's difficulties with accepting interpretations or any view that differed from the patient's subjectivity. I am proposing that 'otherness' itself, rather than only specific conflictual aspects of the self, is disowned. It is the analyst's empathic stance toward all that is repudiated--the specific disowned aspects of the self and 'otherness' itself--along with empathy for the patient's conscious state that will enable reinternalization and ultimately healing.

This paper presents a comparison of two psychoanalytic models of how human beings learn to use their mental capacities to know meaningfully about the world. The first, Fonagy's model of mentalization, is concerned with the development of a self capable of reflecting upon its own and others' mental states, based on feelings, thoughts, intentions, and desires. The other, Bion's model of thinking, is about the way thoughts are dealt with by babies, facilitating the construction of a thinking apparatus within a framework of primitive ways of communication between mother and baby. The theories are compared along three axes: (a) an axis of the theoretical and philosophical backgrounds of the models; (b) an axis of the kind of evidence that supports them; and (c) the third axis of the technical implications of the ideas of each model. It is concluded that, although the models belong to different theoretical and epistemological traditions and are supported by different sorts of evidence, they may be located along the same developmental line using an intersubjective framework that maintains tension between the intersubjective and the intrapsychic domains of the mind.

This paper submits passages from four papers--'Notes on some schizoid mechanisms' (Klein); 'On identification' (Klein); 'Analysis of a schizophrenic state with depersonalization' (Rosenfeld); and 'Remarks on the relation of male homosexuality to paranoia, paranoid anxiety and narcissism' (Rosenfeld)-to a critical reading, enabling the theoretical premises which have produced the current, differing views on projective identification to be traced. These views revolve both around the role assigned to identification in the process and around the meaning of the expression 'to identify oneself with' which in 'On identification' goes from 'to feel similar to, or identical to the other' to 'to take another person as a model'. This legitimizes the inclusion of very different phenomena into the concept of projective identification. The author describes some uses of the term 'projective identification' and proposes the hypothesis that the process constitutes a way for managing otherness and the separateness of the object (be it external or internal, real or imaginary) that can compromise its reality to a greater or lesser degree. Covering a large set of phenomena, the author poses the question of whether it is useful to retain the term 'projective identification'. She proposes an answer in the last part of the paper.

This paper explores the concept of delineation in light of the dialectical process as currently defined in the relational or intersubjective literature. Although this concept is also based on projective identification processes, we see it as a broader concept. Using the modern dialectic model we propose two modes of delineation. One mode involves an interaction between the subjective organizing principles of the family and its members, on the one hand, and the child's own subjective organizing principles, on the other hand, in a mutual process of construction, destruction, and reconstruction of self-definition. We term this concept mutual intersubjective delineation. The second mode of delineation is the individual experience of selfhood or "me"-ness as a monadic entity removed from all contextual interaction with other and thus termed the self-determined delineation. These two modes of delineation are seen as inherent, mutually defining processes of personality development. The manner in which the adolescent negotiates the dialectic tension between these two modes of delineation is seen as an essential process in the development of a dynamic, vital, and integrated self.

The author looks at definitions of racism from the viewpoints of various theoretical frameworks, addressing the role of projection and other phenomena. Racism is then examined according to principles of psychoanalytic relational theory, attachment theory, and radical group analytic theory. Power relationships, the psychosocial process, a sense of us versus them, and the universal importance of a feeling of belonging are also taken into consideration. In examining the meaning of race, the author addresses the notions of black and white and their evolution over time, as well as the phenomenon of othering.

With child psychotherapy as the point of departure, meaning making in therapy may be described in light of the patient's relationship to the psychotherapist as "a meaning bearing other"-that is, someone who allows the possibility of meaningful thoughts and feelings, either through his or her actual communicative presence or as an unconsciously imagined communication partner. Within the theoretical framework of this article, being with a meaning bearing other is regarded as a prerequisite for development of both immediate, playful and reflective understanding of needs, wishes, and affect in self and other. The term meaning bearing other refers to three distinct but often synchronic modes of relatedness. These may be seen as developmental imperatives in both parenting and psychotherapy. The present article is a theoretical and clinical inquiry into the prerequisites for change in relationally oriented psychoanalytic psychotherapy. The article discusses what might be seen as basic forms of relatedness and interaction in light of Winnicott's developmental approach, relational and neo-Kleinian approaches within psychoanalysis, and also Heidegger and Gadamer's philosophy of meaning and interaction. The theoretical points of view are illuminated and illustrated through an excerpt from the first session from a twice-a-week psychotherapy with a 5-year old boy.

The aim is to understand the meaning and significance of the symptoms by means of psychoanalytical theoretical models and to give an insight into the functioning of analytical therapy, using the example of an adolescent bulimia patient. In this therapy, the cause of the bulimic illness is seen as being a failure to build an intrapsychic space, and it is shown how triangulation can be achieved via the three-dimensional analytical relationship. Particular attention is given to the theories of M. Klein and W. R. Bion. The theory of S. Freud is based upon the portrayal of bulimic symptoms as the expression of an intrapsychic conflict. The two models complement each other, leading to a more profound understanding of eating disorders.

The author discusses the experience of 'being invaded' that is sometimes communicated by certain severely disturbed patients. The complaint can sometimes be couched in terms of bodily suffering and such patients may state that they have the experience of a 'foreign body' inside. It is suggested that these patients have suffered severe early failure of containment of their projections, while at the same time they have incorporated primitive characteristics of the object that have been powerfully projected into them. An object that invades in this way, it is suggested, experiences a compulsive need to expel unbearable states of mind using others as a repository. The infant incorporates these violent projections as part of his own mental representational system, and normal identification processes are disrupted. There follows impairment of the development of the sense of self. Clinical examples of how the invasive experience manifests itself in the analytic setting and in the transference and countertransference are presented. It is argued that this highly complex form of early subject-object interaction (prior to the differentiation of psyche-soma) is more likely to be found in severely narcissistically disturbed individuals. Some reflections on the origins of invasive phenomena are given.

The processes of identification between adolescent cocaine addicts and their parents were studied in 402 subjects, in total 134 familial triads (father-mother-son), subdivided into two groups of 67 triads, one of these groups having as the child an adolescent of masculine sex dependent on cocaine and the other, equal in number, being a control group, duly matched for age and socio-economic status. The instrument employed was the Rorschach test (1922), limited to the application of the Lerner Defense Scale (LDS; Lerner & Lerner, 1980). The findings in the affected triads showed up as consistent statistically for the presence of intense processes of pathological identification, especially between father and son, a sign of the importance of the presence of disturbances of paternal function in the development of this addiction. The utilisation of very regressive defence mechanisms, above all of projective identification, was the predominant mode of procedure in triads with a dependent child. In comparisons between the fathers the odds ratio (OR) for projective identification was 8.66 to 1, which points to the association between cocaine addiction and the primitive mental functioning of the fathers. With empirical methodology these findings serve to corroborate the psychoanalytical conclusions based on studies of single case studies, testifying that the dysfunctions of identificatory phenomena in familial functioning are predominant in the mental organisation of cocaine addicts.

To clarify the concepts of critical realism, subjectivity, and subjectivism, distinctions are drawn among ontological subjectivism, moral subjectivity, psychological subjectivity, and epistemological subjectivism. Psychological subjectivity, including the ongoing affective life of the analyst, is an essential aspect of the analyst's response to the patient, and may either facilitate or distort an adequate observation of transference and countertransference dynamics and of the psychic reality of the patient. Subjectivism in current psychoanalytic literature involves an argument that there is an "irreducible" subjectivity in the analyst, who is bound to see things from an incorrigibly personal point of view, such that there is no substantial subject-object differentiation between analyst and patient. Issues of authoritarianism in the analyst, or of pathological certainty, should not be confused with the issues of epistemological objectivism. The concept of critical realism or scientific objectivism includes the essential idea that there is no pure knowledge, no complete knowledge, that often evidence is insufficient for knowledge of some aspect of nature, and that care must be to taken understand what is sufficient knowledge in a given area, in this case clinical psychoanalysis. The question is raised whether "projective identification" makes the sorting out of "what comes from whom" impossible. It is argued that when free association is sufficiently facilitated, when there are enough corrections of the distortions wrought by transference and countertransference, when defenses are analyzed, and when sufficient subject-object differentiation is recovered, the analyst can get to know enough of the patient's psychic reality for the therapeutic and scientific purposes of psychoanalysis.

In the context of the treatment of eating disorders, the author describes a specific failure in the container/contained relationship (Bion, 1962) that goes beyond the experience of having projections rejected. She addresses the predicament of those patients who have not only lacked containment, but also perceived themselves as receptacles of unmetabolised phantasies and experiences projected into them by their parents. The author briefly refers to those patients who succeed in protecting themselves from this predicament by developing a 'no entry system of defences' that often includes anorexia. The main focus of the clinical exploration in this paper is the predicament of 'porous' patients, those who remain open to parental projections. The author suggests that in such cases the introjection of an object performing a function opposite to organising 'alpha function' can be hypothesised. She suggests the term 'omega function' to describe a disorganising, disrupting agent in the patient's internal world. The author makes reference to the type of countertransference experienced by the clinician working with the disorganised 'porous' patients, which is different from the type experienced in the treatment of patients prone to envious attacks and, in particular, to attacks on linking.

The challenges of chronic fatigue syndrome (often called myalgic encephalomyelitis, especially in the UK) (CFS/ME) to analytical and medical approaches are connected with our inability to understand its distressing somatic symptoms in terms of a single identifiable and understandable disease entity. The evidence for the roles of viral aetiologies remains inconclusive, as does our understanding of the involvement of the immune system. The history and social context of CFS/ME, and its relation to neurasthenia and psychasthenia are sketched. A symbolic attitude to the condition may need to be rooted in an awareness of psychoid levels of operation, and the expression and spread of CFS/ME may sometimes be aided by the ravages of projective identification. Psychic denial, sometimes violent, in sufferers (especially children and adolescents) and their families may be important in the aetiology of CFS/ME. We draw out common threads from psychodynamic work with five cases, four showing some symptomatic improvement, analytic discussions of three cases being presented elsewhere in this issue of JAP.

The aims of psychoanalysis are reviewed in terms of theories of mental function and structure. The theory of mental conflict remains the central theory of classical psychoanalysis but has been deepened and supplemented by newer theories. In particular the theory of projective identification has radically altered our view of mental structure and function and has allowed us to reformulate the aims of psychoanalysis in terms of the re-acquisition and re-integration of projected parts of the self. The central role of mourning in this process is discussed, and some of the obstacles to progress are reviewed. It is suggested that oedipal resentments may play a central role in the creation of impasse.

This article presents clinical material from a group that is now in its seventh year. The clinical material illustrates an aspect of the working through of depressive anxieties. The theoretical framework for understanding the material and my interventions is Bion's application of Klein's ideas. The clinical vignettes show how a group struggles with the split between good and bad characteristic of the paranoid-schizoid position (Ps) and the more integrated view of objects as both good and bad, characteristic of the depressive position (D). This more integrated view carries with it the capacity for both love and hate. One member's early memory of cruelty mobilizes other members' guilt toward their objects as well as their reparative wishes.

This paper points to problematic tendencies in psychoanalytic thinking about women and suggests approaches that might address these problems. Psychoanalytic theories about women tend to overgeneralize, universalize, and essentialize. Furthermore, they do not sufficiently explicate the inextricable cultural aspects in anyone's gender psychology, and they are often permeated with unreflected-upon cultural assumptions. I suggest that paying attention to clinical individuality and assuming that subjective gender has multiple components for everyone gives us better understanding of our patients and points us toward more accurate and complete gender theories. There are many psychologies of women. Each woman creates her own psychological gender through emotionally and conflictually charged unconscious fantasies that help construct her inner world, that projectively imbue cultural conceptions, and that interpret her sexual anatomy. By making some unconscious fantasies and interpretations more salient than others, each woman creates her own prevalent animation of gender.