From the author: The most commonly used communication mechanism in psychotic patients is projective identification. Patients try to evoke in the analyst feelings that they cannot bear. It should be noted that unbearable realities are not necessarily catastrophic events in life, such as death or divorce. These are ordinary realities of life. For example, everyone has a moment of realization that mom is separate, that mom is not omnipotent, that parents have their own lives. During the session, the patient talked about how tired she was of waiting, waiting for “the arrival of a new world, the arrival of a loved one.” She asked when the psychosis would end. My interpretations were mainly that the patient was angry with me, and that I was not doing my job and could not help her. To which she replied: “no, it’s me who can’t cope with psychosis,” or “well, you know that you are a good psychotherapist.” And at the end of the session she ended with the question: “Do you think I should eat little? I ate one plate and moved it away. I'm too lazy to do anything else. They tell me to eat bread.” Therapist. It’s like we have a lot of time and no topic to discuss. On the other hand, there is little time and we don’t have time to talk. Patient. Karl, they put wet gunpowder! Psychotic patients intensively use projective identification in communications with others, the primary goal of which is to get rid of the unwanted. It should be noted that projective identification occurs only in relationships. Those. You definitely need an object into which you can put the unwanted or unbearable, and also which will accept the unwanted unbearable emotions, be able to process them and return them in a more bearable form and the subject (projector). For example, when a baby experiences fear, he shows it by crying. The mother’s task is to understand what is happening to the child, not to be scared herself, and to withstand his feelings and return them to the child in a more tolerable form. Everyone probably knows nursery rhymes to calm a child, such as: The pussy is in pain. The dog is in pain. And my baby will heal, heal, heal. Or: The fox is in pain. The wolf is in pain. My son (daughter) has pain and fly to the birch tree in the forest. These and many other nursery rhymes are aimed primarily at calming the child by giving or putting pain into another (pussy, dog, etc.). This is how the child learns to survive painful experiences. Edith Hargreaves wrote that in analysis the therapist in countertransference has to endure the intolerable indefinitely. And sometimes the “true interpretation” of what the patient feels causes him to relive painful moments in his life over and over again. And it is a “great relief” for the patient that “the analyst is able to work through his painful feelings in countertransference” and is thus able to give an “effective interpretation.” James Strachey 1934 gave an understanding of what “spontaneous interpretation” is. Interpretation consists of two phases. First, the analyst allows the patient to become aware of his impulses, feelings, which right now “will be consciously directed towards the analyst.” To make this interpretation, the analyst must be involved in the situation here and now, be in clear consciousness and understand the transference in order to direct the interpretation to the “point of greatest anxiety.” And now let's return to my patient. Throughout the transference session, she told me how hard it was for her without me, how she endured it, and lived for five days without psychosis, i.e. without me. Four days of a long weekend and today is the fifth day she lived in anticipation of our meeting. And at the end of the session: “Do I need to eat little?” - one session is so little, will she have enough until the next session. And my interpretation about the short amount of time, the patient told me with a quote from Munchausen that I had dampened her gunpowder, and she would not fly into psychosis, she would wait for the next session.