Steiner, J. (1989). The Psychoanalytic Contribution of Herbert Rosenfeld. Int. J. Psycho-Anal., 70:611-616.

(1989). International Journal of Psycho-Analysis, 70:611-616

The Psychoanalytic Contribution of Herbert Rosenfeld

John Steiner
Herbert Rosenfeld, who died on 29 November 1986, was such a prolific writer that it is impossible to
attempt a comprehensive survey of his contribution to psychoanalysis which was immense both in volume
and in substance. I will only review a few of his ideas and it will be clear that the selection is a personal one.
However, everyone would, I think, start by mentioning Mildred, his second training case, because in this early
paper (Rosenfeld, 1947), written when he was only 37 years old, much of what he was later to develop is
already apparent.
Mildred was a borderline patient who suffered extreme anxiety and developed depersonalized states in
response to ambivalent feelings especially whenever the positive transference was interpreted. She would
retreat into long silences, and described feelings of being cut off as if separated from the world by a blanket.
Rosenfeld observed how the depersonalization seemed to result from destructive attacks on the self which
arose whenever she became aware of wanting anything from the analyst. It seemed that a confusion developed
whenever loving feelings emerged and came into proximity with hate, and when she could not bear the
confusion, she reacted by knocking herself out. Something similar happened when she asked the analyst a lot
of questions, and when she did not get an immediate answer she complained of feelings of deadness and could
not remember what she had asked.
She became very suspicious of her analyst because she felt that she was trying to sort things out in her
mind while he was trying to muddle her up, and eventually a transference psychosis developed in which she
became convinced that the analyst was trying to intrude into her and take over her mind, making her afraid
that she would lose her own self. One day she even confessed that she was afraid that she might speak in a
strange accent. An impasse developed and she began to come late and miss sessions. Rosenfeld wrote, 'I must
admit that the alternation of states of narcissistic withdrawal and ego-disintegration seemed to me for some
time a problem which I was unable to solve. In spite of the difficulties, I adhered all the time to the
analytic technique in the hope that gradually a clearer pattern would show itself in the analytic situation' (p.
23).
It was his ability to persevere and in doing so to remain interested in his patient and what she was trying
to tell him which characterized Rosenfeld's work at its best. He came to the view that when a
psychotic transference leads to an impasse the situation can be saved and the impasse analysed if the analyst
is able to stay in the transference and to refrain from acting out. He himself had a unique capacity to do this
because of the way he could open himself to psychotic communications without seeming to be thrown by
them. He could thus avoid making moralistic judgements and was consequently able to put himself in the
patient's situation and to speak for the patient while at the same time retaining the psychoanalytic approach in
which both the positive and negative transference was analysed.
Even before he began his training as a psychoanalyst, Rosenfeld's interest in psychotic patients had led
him to attach himself to the Maudsley Hospital and the Tavistock Clinic
—————————————

Read to the British Psycho-Analytical Society at the Rosenfeld Memorial Meeting on 21 October 1987.
(MS. received October 1987)
Copyright © Institute of Psycho-Analysis, London, 1989
- 611 -

where his capacity to listen and take seriously what the patients had to tell him was already evident (Segal &
R. Steiner, 1987). Throughout his life he was to retain an openness to what his patients said and felt and he
seemed totally unafraid of the incomprehensible and violent communications of the psychotic patient. This
involved enormous courage and was not an easy act to follow, as I learned to my cost when I treated a
schizophrenic patient under his supervision some years ago.
Anyone who even begins to browse through the papers collected in his first book, Psychotic
States(Rosenfeld, 1965), will be struck by the vividness of his clinical descriptions. His paper on
the superego conflict in a schizophrenic patient was epoch making and gave a detailed account of
psychotic thinking. Together with Segal (1950) and Bion (1956), (1957), he was responsible for establishing
that the psychoanalytic method could be applied to the treatment of this most devastating of psychoses and
what is more could help us understand the mechanisms underlying it. In particular he was able to follow
the projection and re-introjection of a very fragmented ego which enabled him to understand both the bizarre
objects of the psychotic as well as the impoverished ego which results from projective identification.
His writing on psychosis gained him an international reputation as an expert on the analysis
of schizophrenia and this work is so well known that I will not review it here (Rosenfeld,
1952a), (1952b), (1965).
Instead I will start with his paper on confusional states (Rosenfeld, 1950) which I think is central to his
later work. He described how, 'under certain internal and external conditions when aggressive impulses
temporarily predominate, states may arise in which love and hate impulses and good and bad objects cannot
be kept apart and are thus felt to be mixed up or confused' (p. 53). Later Melanie Klein (1957) was able to
relate such confusions to the way envy leads to attacks on the good objectwhich is then turned bad as
a defence against envy and as a result of attacks on it.
The confusion Rosenfeld was describing lay between the good and bad object and between loving and
hating impulses which arose as a result of a breakdown of splitting and which he distinguished from the quite
different type of confusion which results from projective identification where what belongs to self and what
belongs to the object are confused. Both types are of course important but I believe the former, which could
be called primal confusion, is fundamental and underlies many subsequent states of confusion which are
prominent in psychotic and borderline states. Henri Rey (1979), in describing borderline patients, emphasized
that they were confused between good/bad, large/small, strong/weak, male/female, adult/child, and indeed on
any dichotomy since being unable to maintain the fundamental primal split between good and bad they could
not extend it to other categories.
Rosenfeld was impressed by how difficult it was for the patient to bear such states of confusion and he
described how more primitive and violent mechanisms, in particular pathological splitting, are brought into
play to try to deal with the confusional state. He felt that what particularly terrifies the patient is the way good
objects and good parts of the self became vulnerable to attack when they cease to be distinguishable from bad
objects and bad parts of the self. The clinical material in this paper comes from a schizophrenic painter who
could not distinguish between good and bad faeces and when his former analyst connected his dark paintings
with his desire to smear faeces he gave up painting altogether. Rosenfeld noticed that good faeces often
appeared in his material, for example as fertilizer, and as he helped him make such a differentiation he began
to paint again.
The importance of such primal confusions was something Rosenfeld was repeatedly to stress and he
emphasized it particularly in his papers on hypochondriasisand on acting out (Rosenfeld, 1964a), (1964b). I
believe it is most important of all in his work on narcissistic organizations (Rosenfeld, 1964c), (1971a) and I
have suggested that the organization has such a powerful hold on the personality because it provides order
and structure and hence gives relief from the unbearability of the confusional state.
The first paper on narcissism (1964c) begins with a review of the literature which can perhaps be
summarized by his comment that, 'much confusion would be avoided if we were to
- 612 -

recognize that the many clinically observable conditions which resemble Freud's description
of primary narcissism are in fact primitive object relations' (p. 170) and Rosenfeld is surely one of the
analysts who has made this view generally accepted.
He describes omnipotence, identification, and idealization as the three important features
of narcissism and shows in detail how narcissistic object relationsfunction as a defence against separateness.
The omnipotence and the identification function together, 'so that the object, usually a part-object like
the breast, is omnipotently incorporated and treated as the infant's possession; or the mother or breast are used
as containers into which are projected the parts of the self which are felt to be undesirable as they cause pain
or anxiety' (p. 170).
In introjective identification, 'the self becomes so identified with the incorporated object that all
separate identity or any boundary between self and object is denied' (p. 170). While in projective
identification, 'parts of the self omnipotently enter an object, for example the mother, to take over certain
qualities which would be experienced as desirable, and therefore claim to be the object or part-object' (p.
171).
The defence against any recognition of separateness is needed because separateness leads to feelings
of dependence and to an awareness of both good and bad qualities of the object as it is observed separate
from the self. The bad qualities result in frustration while the good qualities stimulate envy and both are
obviated by the narcissistic type of object relation. The patient gets rid of everything unpleasant and by
possessing the analyst he takes credit for every achievement. This leads to idealization of the self, of the
analyst and of the relationship. Later (Rosenfeld, 1971a) he was to recognize that in these idealized states
violence was never far away and that although not prominent in the conscious material, primitive envy was
present and split off. For example he said, 'Aggressiveness towards objects seems inevitable in giving up the
narcissistic position and it appears that the strength and persistence of omnipotent narcissistic object
relations is closely related to the strength of the envious destructive impulses' (p. 172).
Rosenfeld recognizes that a less narcissistic, more normal part of the patient is often available and he
defines the aims of treatment by suggesting that, 'To bring about an improvement the
omnipotent narcissism of the patient and all the aspects related to it have to be laid bare in detail during
the analytic process and to be integrated with the more normally concerned part of the patient. It is this part of
the analysis which often seems to be so unbearable'.
The paper on destructive narcissism and the death instinct (Rosenfeld, 1971a) raises fundamental issues
of both theory and technique. It is clear that Rosenfeld sees the death instinct as a clinical rather than a
theoretical concept which he feels can be observed in those states where a patient seems to be pulled towards
states of nothingness and death. For example he says, 'When he is faced with the reality of being dependent
on the analyst, standing for the parents, particularly the mother [the patient] would prefer to die, to be non-
existent, to deny the fact of his birth, and also to destroy his analytic progress and insight … which the
analyst, representing the parents, has created … Some of these patients become suicidal and the desire to die,
to disappear into oblivion, is expressed quite openly and death is idealized as a solution to all problems' (p.
173).
It is this pull to death which seems to express the death instinct in its most pure form and is often split off
so that it operates in a hidden silent way which has a profound effect on the personality and its capacity to
make object relationships. It is revealed most clearly when the narcissistic defence is confronted and may then
represent the stone wall which so often seems to meet us if we hope to make progress with these patients.
Narcissistic object relations seem to arise both as a defenceagainst the death instinct, as an effort to control
and bind it, and as an expression of its malignancy. Rosenfeld always admired Freud's insight into the silent
operation of the death instinct and felt that his own work provided confirmation of it.
The essence of the narcissistic organization is that destructive parts of the self are idealized and form the
core of an organization in combination with powerful destructive objects which keep good objects and good
parts of the self imprisoned and paralysed. The destructiveness is directed against 'any positive libidinal
- 613 -

relationship and any libidinal part of the self which experiences need for an object and the desire to depend on
it'. Here Rosenfeld distinguishes between libidinal narcissism, which arises from the idealization of good
objects and good parts of the self, and destructive narcissism. He was later to make much of this distinction
which, in my view, is somewhat artificial since he clearly recognized that both are always present and that
libidinal narcissism quickly changes to destructiveness if the idealization is dented.
He stressed the organized nature of narcissistic object relations in which parts of the self and objects are
held together in a rigid structure by means, which in phantasy, are personified so that in the
patient's material the organization appears as a gang or mafia dominated by a powerful leader. 'The main aim
seems to be to prevent the weakening of the organization and to control the members of the gang so that they
will not desert the destructive organization and join the positive parts of the self or betray the secrets of the
gang to the police, the protecting superego, standing for the helpful analyst, who might be able to save the
patient' (p. 174).
Rosenfeld describes how the organization may have a psychotic structure into which the more sane parts
of the personality are pulled, or it may be more perverse. Indeed it does seem that sado-masochistic
relationships, in the form of seductions and threats, are the means by which the organization keeps its
members together.
This has, I think, been Rosenfeld's most influential paper and in my view deservedly so. It enables the
analyst to recognize the operation of the most destructive parts of the personality without overlooking the
more constructive parts which Rosenfeld thinks of as the libidinal self, which is often overwhelmed,
imprisoned and feels itself abandoned. Of course it is not always that straightforward and I have argued that
the so-called libidinal self is not always as innocent a victim as the patient makes out, since it gets
into complex collusions with the destructive parts. Indeed the whole organization arises as a defence against a
confusional state which it does not really resolve because the order which is created is artificial (Steiner,
1982).
Narcissistic object relations depend on the operation of projective identification which means that the
patient does not really relate to separate objects but to parts of the self embedded in objects. It is natural
therefore that Rosenfeld went on to write about projective identification, and the best of the papers on
this subject was given in a symposium in Canada and remained tucked away in a little known collection from
this conference (Rosenfeld, 1971b); (fortunately now reprinted in Spillius, 1988). In this paper, Rosenfeld
describes several different types of projective identification and several different motives for using it. First he
distinguishes projective identification used for communication from projective identification used to unburden
the psyche of unwanted parts. He recognizes that both may be operating simultaneously but he sees it as
important to distinguish the two. If the patient is trying to communicate he wants the analyst to understand,
while if he is trying to evacuate he wants the analyst to sanction the evacuation, and interpretations may then
be seen as a counter-projection on the part of the analyst. Here again I think he makes too much of this
distinction because it is often precisely when the patient is violently evacuating that he most needs to
be contained and understood.
He also discusses projective identification as a means of controlling the analyst and describes two ways
in which it is used to enact a fantasy of living right inside the analyst. In the delusional form the patient seems
to enter a mad world where he believes that 'inside the delusional object there is complete painlessness and
freedom to indulge in any whim. It also appears that the self within the delusional object exerts a powerful
suggestive and seductive influence on saner parts of the personality in order to persuade or force them to
withdraw from reality and to join the delusional omnipotent world'.
In the parasitic form the patient behaves like a parasite, 'living on the capabilities of the analyst who is
expected to function as his ego. Severe cases of parasitism may be regarded as a state of total projective
identification … [The patient] generally behaves in an extremely passive silent and sluggish manner,
demanding everything and giving nothing in return. This state can be extremely chronic and the analytic work
with such patients is often minimal' (p. 120).
Later in his paper on primitive object relations (1983), Rosenfeld discussed the parasitic types further
and linked them with the Nirvana-like experiences which involve a primitive desire to live in a state of
pleasurable fusion with an
- 614 -

object. They are also similar to symbiotic fantasies in which the patient wants to feel that the analyst has
identical feelings and experiences in a mutual relationship with the patient. The patient may project these
symbiotic fantasies and believe that the analyst has a similar desire for fusion. It must be stressed that this is a
very different understanding of symbiosis to that held by Mahler, who saw symbiosis as a state of
undifferentiation between mother and child while Rosenfeld considers it to result from massive projective
identification.
In his later years Rosenfeld became especially interested in technical issues and argued in particular
against types of interpretation which he saw as uncontaining and even persecuting (Rosenfeld, 1987). He saw
how the development of a psychotic transference led to an impasse between patient and analyst and he tried to
study the way the analyst failed to understand the impasse and consequently failed to help the patient emerge
from it. In particular he stressed that we must be open to the patient's communication, to register it, to try to
understand it, and not to act out our own pathology when provoked by it.
The type of failure which concerned him most occurs when the analyst interprets that the patient is to
blame for transference difficulties when in fact these arise from traumatic experiences which are then relived
once more with the analyst. This view is connected with Rosenfeld's increasing conviction that many
psychotic and borderline patients were severely traumatized and that this trauma leads them to recreate the
unsatisfactory object relations in the analysis. In particular he believed that some psychotic
and borderline patients have been violently projected into in their earliest relationships and that it is this sort
of violent projection which these patients are able to provoke on the part of the analyst. We have learned to
recognize how subtle such provocations can be and Rosenfeld's hope was that an awareness of the compulsion
to repeat may prevent the analyst from simply reacting, and enable him to understand what the patient was
going through and what he needed from the analyst.
This applies to most transference situations but Rosenfeld was especially addressing those cases of
impasse which result either from an erotized transference in which the patient comes to believe that the
analyst is secretly in love with him or from a persecutory transference in which he believes the analyst hates
him. He urges the analyst, at these times, to pay careful attention to the patient's material for precise
information about such delusional beliefs and to scrutinize his own reactions to see if he might have
encouraged such beliefs.
This is related to his observation that delusion formation in psychotic or borderline patients often results
from the failure of the analyst to open himself to a particularly worrying anxiety. For example, if the patient
perceives the analyst as depressed and despairing and if the possibility that this is a correct perception is not
taken seriously and interpreted, then the patient may become delusionally convinced that the analyst is
suicidal but cannot bear to admit it. Again if the analyst simply interprets idealization of him as the
patient's fantasy, he may believe that the analyst does this because he cannot admit his own contribution.
The delusion can then develop that the analyst is secretly in love with the patient and that he avoids
mentioning this to protect himself.
These are important issues of technique and attention to them can help us to recognize the way we can
enact the patient's fantasies rather than analyse them. Even the most experienced analyst can find himself
caught up with the patient in an acting out and it may need a third person such as a colleague or supervisor to
help extricate us.
In my experience the struggle with impasse is usually stormy and the analyst is often repeatedly thrown
from a position of calm neutrality and finds himself beingprovoked, seduced and pressured in ways which
reveal shortcomings in his personality and in his analytic skill. If he can persevere, and most important, if he
can retain his basic psychoanalytic attitude, this is sometimes recognized by the patient and a sense of
grudging respect may develop towards the analyst and towards psychoanalysis. With time the analyst will
sometimes come to be seen as a good object but this can easily become an idealization. If the persecutory
view of the analyst remains prominent the idealization may be necessary to keep the persecution at bay.
Rosenfeld recognized that idealization of the analyst can be a defence against feelings of rejection and
hostility but argued that it is
- 615 -

important not to break down such idealization too abruptly or to do so simply out of principle.
He felt that a more supportive and less punitive attitude to the patient results if it is recognized how
repeated traumatizations can sometimes produce extreme sensitivity to hurt and rejection. Rosenfeld refers to
'thin-skinned' narcissistic patients and believed that 'an overemphasis on their destructiveness is particularly
dangerous if it inhibits or increases their difficulty in building up satisfactory object relations … It is
particularly important to help them to retain the positive aspects in their narcissistic organization by making
them aware of the conflict with the destructive narcissistic part of themselves with which they
are not identified' (Rosenfeld, 1987p. 273).
In his concern to protect the patient from bad analysis Rosenfeld does seem to have emphasized one type
of danger without balancing it sufficiently by stressing the danger of encouraging idealization which often
goes with a reluctance on the analyst's part to allow himself to be experienced as a bad object. It is important
not to be provoked aggressively to confront an idealization which the patient may continue to need for
defensive purposes but eventually it becomes necessary to tackle it. No real development is possible unless
the patient can take responsibility for his own destructiveness and we cannot shirk our responsibility in
helping him face it. If we want to retain a balance and stay in touch with the patient's deeper needs we must
take up both the positive and the negative transference as it appears in the patient's material. It is on this issue
of balance that disagreement has developed between Rosenfeld and some of his colleagues, myself included.
I believe these disagreements need not distract us from recognizing Rosenfeld's greatness. His loss leaves
a real gap in the British Psycho-Analytical Society and I believe it will take some time for all of us to regain
our equilibrium as we struggle to mourn him and to assimilate his teaching.

SUMMARY
A brief review of the work of Herbert Rosenfeld is presented. This emphasizes his fundamental
contribution to the understanding and treatment of psychotic and borderline states.

REFERENCES
BION, W. R. 1956 Development of schizophrenic thought Int. J. Psychoanal. 37:344-346 Reprinted in
Second Thoughts London: Heinemann, 1967 [→]
BION, W. R. 1957 Differentiation of the psychotic from the non-psychotic personalities Int. J.
Psychoanal. 38:266-275 Reprinted in Second Thoughts London: Heinemann, 1967 [→]
KLEIN, M. 1957 Envy and Gratitude London: Tavistock Publications. Reprinted in The Writings of Melanie
Klein 3. London: Hogarth Press, 1975 pp. 176-235 [→]
REY, J. H. 1979 Schizoid phenomena in the borderline In Advances in the Psychotherapy of the Borderline
Patient ed. J. LeBoit & A. Capponi. New York: Jason Aronson, pp. 449-484 Reprinted in Melanie Klein
Today. 1. Mainly Theory ed. E. B. Spillius, 1988
ROSENFELD, H. A. 1947 Analysis of a schizophrenic state with depersonalisation Int. J.
Psychoanal. 28:130-139 Reprinted in Psychotic States London: Hogarth Press, 1965 [→]
ROSENFELD, H. A. 1950 Notes on the psychopathology of confusional states in chronic schizophrenia Int.
J. Psychoanal. 31:132-137 Reprinted in Psychotic States London: Hogarth Press, 1965 [→]
ROSENFELD, H. A. 1952a Notes on the psychoanalysis of the superego conflict in an acute schizophrenic
patient Int. J. Psychoanal. 33:111-131 Reprinted in Psychotic States London: Hogarth Press 1965 and
also in New Directions in Psychoanalysis ed. M. Klein et al. London: Tavistock Publication, 1955 [→]
ROSENFELD, H. A. 1952b Considerations regarding the psychoanalytic approach to acute and chronic
schizophrenia Int. J. Psychoanal. 35:135-140 Reprinted in Psychotic States London: Hogarth Press,
1965 [→]
ROSENFELD, H. A. 1964a The psychopathology of hypochondriasis In Psychotic States London: Hogarth
Press, 1965
ROSENFELD, H. A. 1964b An investigation into the need of neurotic and psychotic patients to act out
during analysis In Psychotic States London: Hogarth Press, 1965
ROSENFELD, H. A. 1964c On the psychopathology of narcissism: a clinical approach Int. J.
Psychoanal. 45:332-337 Reprinted in Psychotic States London: Hogarth Press, 1965 [→]
ROSENFELD, H. A. 1965 Psychotic States London: Hogarth Press, 1965 [→]
ROSENFELD, H. A. 1969 On the treatment of psychotic states by psychoanalysis: an historical
approach Int. J. Psychoanal. 50:615-631 [→]
ROSENFELD, H. A. 1971a A clinical approach to the psychoanalytic theory of the life and death instincts:
an investigation into the aggressive aspects of narcissism Int. J. Psychoanal. 52:169-178 [→]
ROSENFELD, H. A. 1971b Contributions to the psychopathology of psychotic patients. The importance of
projective identification in the ego structure and object relations of the psychotic patient In Problems of
Psychosis ed. P. Doucet & C. Laurin. Amsterdam: Excerpta Medica. Reprinted in Melanie Klein Today.
1. Mainly Theory ed. E. B. Spillius, 1988
ROSENFELD, H. A. 1983 Primitive object relations Int. J. Psychoanal. 64:261-267 [→]
ROSENFELD, H. A. 1987 Impasse and Interpretation New Library of Psychoanalysis, 1. London and New
York: Tavistock Publications and the Institute of Psycho-Analysis. [→]
SEGAL, H. 1950 Some aspects of the analysis of a schizophrenic Int. J. Psychoanal. 31:268-278 Reprinted
in The Work of Hanna Segal New York: Jason Aronson, 1981 [→]
SEGAL, H. & STEINER R. 1987 Obituary. H. A. Rosenfeld 1910-1986 Int. J. Psychoanal. 68:415-419 [→]
SPILLIUS E. B. 1988 Melanie Klein Today. 1. Mainly Theory New Library of Psychoanalysis, 7. London
and New York: Tavistock Publications and the Institute of Psycho-Analysis. [→]
 STEINER, J. 1982 Perverse relationships between parts of the self: a clinical illustration Int. J.
Psychoanal. 63:241-251 [→]

Steiner, J. (1989). The Psychoanalytic Contribution of Herbert Rosenfeld. Int. J. Psycho-Anal., 70:611-616.

(1989). International Journal of Psycho-Analysis, 70:611-616

The Psychoanalytic Contribution of Herbert Rosenfeld

John Steiner
Herbert Rosenfeld, who died on 29 November 1986, was such a prolific writer that it is impossible to
attempt a comprehensive survey of his contribution to psychoanalysis which was immense both in volume
and in substance. I will only review a few of his ideas and it will be clear that the selection is a personal one.
However, everyone would, I think, start by mentioning Mildred, his second training case, because in this early
paper (Rosenfeld, 1947), written when he was only 37 years old, much of what he was later to develop is
already apparent.
Mildred was a borderline patient who suffered extreme anxiety and developed depersonalized states in
response to ambivalent feelings especially whenever the positive transference was interpreted. She would
retreat into long silences, and described feelings of being cut off as if separated from the world by a blanket.
Rosenfeld observed how the depersonalization seemed to result from destructive attacks on the self which
arose whenever she became aware of wanting anything from the analyst. It seemed that a confusion developed
whenever loving feelings emerged and came into proximity with hate, and when she could not bear the
confusion, she reacted by knocking herself out. Something similar happened when she asked the analyst a lot
of questions, and when she did not get an immediate answer she complained of feelings of deadness and could
not remember what she had asked.
She became very suspicious of her analyst because she felt that she was trying to sort things out in her
mind while he was trying to muddle her up, and eventually a transference psychosis developed in which she
became convinced that the analyst was trying to intrude into her and take over her mind, making her afraid
that she would lose her own self. One day she even confessed that she was afraid that she might speak in a
strange accent. An impasse developed and she began to come late and miss sessions. Rosenfeld wrote, 'I must
admit that the alternation of states of narcissistic withdrawal and ego-disintegration seemed to me for some
time a problem which I was unable to solve. In spite of the difficulties, I adhered all the time to the
analytic technique in the hope that gradually a clearer pattern would show itself in the analytic situation' (p.
23).
It was his ability to persevere and in doing so to remain interested in his patient and what she was trying
to tell him which characterized Rosenfeld's work at its best. He came to the view that when a
psychotic transference leads to an impasse the situation can be saved and the impasse analysed if the analyst
is able to stay in the transference and to refrain from acting out. He himself had a unique capacity to do this
because of the way he could open himself to psychotic communications without seeming to be thrown by
them. He could thus avoid making moralistic judgements and was consequently able to put himself in the
patient's situation and to speak for the patient while at the same time retaining the psychoanalytic approach in
which both the positive and negative transference was analysed.
Even before he began his training as a psychoanalyst, Rosenfeld's interest in psychotic patients had led
him to attach himself to the Maudsley Hospital and the Tavistock Clinic
—————————————

Read to the British Psycho-Analytical Society at the Rosenfeld Memorial Meeting on 21 October 1987.
(MS. received October 1987)
Copyright © Institute of Psycho-Analysis, London, 1989
- 611 -
where his capacity to listen and take seriously what the patients had to tell him was already evident (Segal &
R. Steiner, 1987). Throughout his life he was to retain an openness to what his patients said and felt and he
seemed totally unafraid of the incomprehensible and violent communications of the psychotic patient. This
involved enormous courage and was not an easy act to follow, as I learned to my cost when I treated a
schizophrenic patient under his supervision some years ago.
Anyone who even begins to browse through the papers collected in his first book, Psychotic
States(Rosenfeld, 1965), will be struck by the vividness of his clinical descriptions. His paper on
the superego conflict in a schizophrenic patient was epoch making and gave a detailed account of
psychotic thinking. Together with Segal (1950) and Bion (1956), (1957), he was responsible for establishing
that the psychoanalytic method could be applied to the treatment of this most devastating of psychoses and
what is more could help us understand the mechanisms underlying it. In particular he was able to follow
the projection and re-introjection of a very fragmented ego which enabled him to understand both the bizarre
objects of the psychotic as well as the impoverished ego which results from projective identification.
His writing on psychosis gained him an international reputation as an expert on the analysis
of schizophrenia and this work is so well known that I will not review it here (Rosenfeld,
1952a), (1952b), (1965).
Instead I will start with his paper on confusional states (Rosenfeld, 1950) which I think is central to his
later work. He described how, 'under certain internal and external conditions when aggressive impulses
temporarily predominate, states may arise in which love and hate impulses and good and bad objects cannot
be kept apart and are thus felt to be mixed up or confused' (p. 53). Later Melanie Klein (1957) was able to
relate such confusions to the way envy leads to attacks on the good objectwhich is then turned bad as
a defence against envy and as a result of attacks on it.
The confusion Rosenfeld was describing lay between the good and bad object and between loving and
hating impulses which arose as a result of a breakdown of splitting and which he distinguished from the quite
different type of confusion which results from projective identification where what belongs to self and what
belongs to the object are confused. Both types are of course important but I believe the former, which could
be called primal confusion, is fundamental and underlies many subsequent states of confusion which are
prominent in psychotic and borderline states. Henri Rey (1979), in describing borderline patients, emphasized
that they were confused between good/bad, large/small, strong/weak, male/female, adult/child, and indeed on
any dichotomy since being unable to maintain the fundamental primal split between good and bad they could
not extend it to other categories.
Rosenfeld was impressed by how difficult it was for the patient to bear such states of confusion and he
described how more primitive and violent mechanisms, in particular pathological splitting, are brought into
play to try to deal with the confusional state. He felt that what particularly terrifies the patient is the way good
objects and good parts of the self became vulnerable to attack when they cease to be distinguishable from bad
objects and bad parts of the self. The clinical material in this paper comes from a schizophrenic painter who
could not distinguish between good and bad faeces and when his former analyst connected his dark paintings
with his desire to smear faeces he gave up painting altogether. Rosenfeld noticed that good faeces often
appeared in his material, for example as fertilizer, and as he helped him make such a differentiation he began
to paint again.
The importance of such primal confusions was something Rosenfeld was repeatedly to stress and he
emphasized it particularly in his papers on hypochondriasisand on acting out (Rosenfeld, 1964a), (1964b). I
believe it is most important of all in his work on narcissistic organizations (Rosenfeld, 1964c), (1971a) and I
have suggested that the organization has such a powerful hold on the personality because it provides order
and structure and hence gives relief from the unbearability of the confusional state.
The first paper on narcissism (1964c) begins with a review of the literature which can perhaps be
summarized by his comment that, 'much confusion would be avoided if we were to
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recognize that the many clinically observable conditions which resemble Freud's description
of primary narcissism are in fact primitive object relations' (p. 170) and Rosenfeld is surely one of the
analysts who has made this view generally accepted.
He describes omnipotence, identification, and idealization as the three important features
of narcissism and shows in detail how narcissistic object relationsfunction as a defence against separateness.
The omnipotence and the identification function together, 'so that the object, usually a part-object like
the breast, is omnipotently incorporated and treated as the infant's possession; or the mother or breast are used
as containers into which are projected the parts of the self which are felt to be undesirable as they cause pain
or anxiety' (p. 170).
In introjective identification, 'the self becomes so identified with the incorporated object that all
separate identity or any boundary between self and object is denied' (p. 170). While in projective
identification, 'parts of the self omnipotently enter an object, for example the mother, to take over certain
qualities which would be experienced as desirable, and therefore claim to be the object or part-object' (p.
171).
The defence against any recognition of separateness is needed because separateness leads to feelings
of dependence and to an awareness of both good and bad qualities of the object as it is observed separate
from the self. The bad qualities result in frustration while the good qualities stimulate envy and both are
obviated by the narcissistic type of object relation. The patient gets rid of everything unpleasant and by
possessing the analyst he takes credit for every achievement. This leads to idealization of the self, of the
analyst and of the relationship. Later (Rosenfeld, 1971a) he was to recognize that in these idealized states
violence was never far away and that although not prominent in the conscious material, primitive envy was
present and split off. For example he said, 'Aggressiveness towards objects seems inevitable in giving up the
narcissistic position and it appears that the strength and persistence of omnipotent narcissistic object
relations is closely related to the strength of the envious destructive impulses' (p. 172).
Rosenfeld recognizes that a less narcissistic, more normal part of the patient is often available and he
defines the aims of treatment by suggesting that, 'To bring about an improvement the
omnipotent narcissism of the patient and all the aspects related to it have to be laid bare in detail during
the analytic process and to be integrated with the more normally concerned part of the patient. It is this part of
the analysis which often seems to be so unbearable'.
The paper on destructive narcissism and the death instinct (Rosenfeld, 1971a) raises fundamental issues
of both theory and technique. It is clear that Rosenfeld sees the death instinct as a clinical rather than a
theoretical concept which he feels can be observed in those states where a patient seems to be pulled towards
states of nothingness and death. For example he says, 'When he is faced with the reality of being dependent
on the analyst, standing for the parents, particularly the mother [the patient] would prefer to die, to be non-
existent, to deny the fact of his birth, and also to destroy his analytic progress and insight … which the
analyst, representing the parents, has created … Some of these patients become suicidal and the desire to die,
to disappear into oblivion, is expressed quite openly and death is idealized as a solution to all problems' (p.
173).
It is this pull to death which seems to express the death instinct in its most pure form and is often split off
so that it operates in a hidden silent way which has a profound effect on the personality and its capacity to
make object relationships. It is revealed most clearly when the narcissistic defence is confronted and may then
represent the stone wall which so often seems to meet us if we hope to make progress with these patients.
Narcissistic object relations seem to arise both as a defenceagainst the death instinct, as an effort to control
and bind it, and as an expression of its malignancy. Rosenfeld always admired Freud's insight into the silent
operation of the death instinct and felt that his own work provided confirmation of it.
The essence of the narcissistic organization is that destructive parts of the self are idealized and form the
core of an organization in combination with powerful destructive objects which keep good objects and good
parts of the self imprisoned and paralysed. The destructiveness is directed against 'any positive libidinal
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relationship and any libidinal part of the self which experiences need for an object and the desire to depend on
it'. Here Rosenfeld distinguishes between libidinal narcissism, which arises from the idealization of good
objects and good parts of the self, and destructive narcissism. He was later to make much of this distinction
which, in my view, is somewhat artificial since he clearly recognized that both are always present and that
libidinal narcissism quickly changes to destructiveness if the idealization is dented.
He stressed the organized nature of narcissistic object relations in which parts of the self and objects are
held together in a rigid structure by means, which in phantasy, are personified so that in the
patient's material the organization appears as a gang or mafia dominated by a powerful leader. 'The main aim
seems to be to prevent the weakening of the organization and to control the members of the gang so that they
will not desert the destructive organization and join the positive parts of the self or betray the secrets of the
gang to the police, the protecting superego, standing for the helpful analyst, who might be able to save the
patient' (p. 174).
Rosenfeld describes how the organization may have a psychotic structure into which the more sane parts
of the personality are pulled, or it may be more perverse. Indeed it does seem that sado-masochistic
relationships, in the form of seductions and threats, are the means by which the organization keeps its
members together.
This has, I think, been Rosenfeld's most influential paper and in my view deservedly so. It enables the
analyst to recognize the operation of the most destructive parts of the personality without overlooking the
more constructive parts which Rosenfeld thinks of as the libidinal self, which is often overwhelmed,
imprisoned and feels itself abandoned. Of course it is not always that straightforward and I have argued that
the so-called libidinal self is not always as innocent a victim as the patient makes out, since it gets
into complex collusions with the destructive parts. Indeed the whole organization arises as a defence against a
confusional state which it does not really resolve because the order which is created is artificial (Steiner,
1982).
Narcissistic object relations depend on the operation of projective identification which means that the
patient does not really relate to separate objects but to parts of the self embedded in objects. It is natural
therefore that Rosenfeld went on to write about projective identification, and the best of the papers on
this subject was given in a symposium in Canada and remained tucked away in a little known collection from
this conference (Rosenfeld, 1971b); (fortunately now reprinted in Spillius, 1988). In this paper, Rosenfeld
describes several different types of projective identification and several different motives for using it. First he
distinguishes projective identification used for communication from projective identification used to unburden
the psyche of unwanted parts. He recognizes that both may be operating simultaneously but he sees it as
important to distinguish the two. If the patient is trying to communicate he wants the analyst to understand,
while if he is trying to evacuate he wants the analyst to sanction the evacuation, and interpretations may then
be seen as a counter-projection on the part of the analyst. Here again I think he makes too much of this
distinction because it is often precisely when the patient is violently evacuating that he most needs to
be contained and understood.
He also discusses projective identification as a means of controlling the analyst and describes two ways
in which it is used to enact a fantasy of living right inside the analyst. In the delusional form the patient seems
to enter a mad world where he believes that 'inside the delusional object there is complete painlessness and
freedom to indulge in any whim. It also appears that the self within the delusional object exerts a powerful
suggestive and seductive influence on saner parts of the personality in order to persuade or force them to
withdraw from reality and to join the delusional omnipotent world'.
In the parasitic form the patient behaves like a parasite, 'living on the capabilities of the analyst who is
expected to function as his ego. Severe cases of parasitism may be regarded as a state of total projective
identification … [The patient] generally behaves in an extremely passive silent and sluggish manner,
demanding everything and giving nothing in return. This state can be extremely chronic and the analytic work
with such patients is often minimal' (p. 120).
Later in his paper on primitive object relations (1983), Rosenfeld discussed the parasitic types further
and linked them with the Nirvana-like experiences which involve a primitive desire to live in a state of
pleasurable fusion with an
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object. They are also similar to symbiotic fantasies in which the patient wants to feel that the analyst has
identical feelings and experiences in a mutual relationship with the patient. The patient may project these
symbiotic fantasies and believe that the analyst has a similar desire for fusion. It must be stressed that this is a
very different understanding of symbiosis to that held by Mahler, who saw symbiosis as a state of
undifferentiation between mother and child while Rosenfeld considers it to result from massive projective
identification.
In his later years Rosenfeld became especially interested in technical issues and argued in particular
against types of interpretation which he saw as uncontaining and even persecuting (Rosenfeld, 1987). He saw
how the development of a psychotic transference led to an impasse between patient and analyst and he tried to
study the way the analyst failed to understand the impasse and consequently failed to help the patient emerge
from it. In particular he stressed that we must be open to the patient's communication, to register it, to try to
understand it, and not to act out our own pathology when provoked by it.
The type of failure which concerned him most occurs when the analyst interprets that the patient is to
blame for transference difficulties when in fact these arise from traumatic experiences which are then relived
once more with the analyst. This view is connected with Rosenfeld's increasing conviction that many
psychotic and borderline patients were severely traumatized and that this trauma leads them to recreate the
unsatisfactory object relations in the analysis. In particular he believed that some psychotic
and borderline patients have been violently projected into in their earliest relationships and that it is this sort
of violent projection which these patients are able to provoke on the part of the analyst. We have learned to
recognize how subtle such provocations can be and Rosenfeld's hope was that an awareness of the compulsion
to repeat may prevent the analyst from simply reacting, and enable him to understand what the patient was
going through and what he needed from the analyst.
This applies to most transference situations but Rosenfeld was especially addressing those cases of
impasse which result either from an erotized transference in which the patient comes to believe that the
analyst is secretly in love with him or from a persecutory transference in which he believes the analyst hates
him. He urges the analyst, at these times, to pay careful attention to the patient's material for precise
information about such delusional beliefs and to scrutinize his own reactions to see if he might have
encouraged such beliefs.
This is related to his observation that delusion formation in psychotic or borderline patients often results
from the failure of the analyst to open himself to a particularly worrying anxiety. For example, if the patient
perceives the analyst as depressed and despairing and if the possibility that this is a correct perception is not
taken seriously and interpreted, then the patient may become delusionally convinced that the analyst is
suicidal but cannot bear to admit it. Again if the analyst simply interprets idealization of him as the
patient's fantasy, he may believe that the analyst does this because he cannot admit his own contribution.
The delusion can then develop that the analyst is secretly in love with the patient and that he avoids
mentioning this to protect himself.
These are important issues of technique and attention to them can help us to recognize the way we can
enact the patient's fantasies rather than analyse them. Even the most experienced analyst can find himself
caught up with the patient in an acting out and it may need a third person such as a colleague or supervisor to
help extricate us.
In my experience the struggle with impasse is usually stormy and the analyst is often repeatedly thrown
from a position of calm neutrality and finds himself beingprovoked, seduced and pressured in ways which
reveal shortcomings in his personality and in his analytic skill. If he can persevere, and most important, if he
can retain his basic psychoanalytic attitude, this is sometimes recognized by the patient and a sense of
grudging respect may develop towards the analyst and towards psychoanalysis. With time the analyst will
sometimes come to be seen as a good object but this can easily become an idealization. If the persecutory
view of the analyst remains prominent the idealization may be necessary to keep the persecution at bay.
Rosenfeld recognized that idealization of the analyst can be a defence against feelings of rejection and
hostility but argued that it is
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important not to break down such idealization too abruptly or to do so simply out of principle.
He felt that a more supportive and less punitive attitude to the patient results if it is recognized how
repeated traumatizations can sometimes produce extreme sensitivity to hurt and rejection. Rosenfeld refers to
'thin-skinned' narcissistic patients and believed that 'an overemphasis on their destructiveness is particularly
dangerous if it inhibits or increases their difficulty in building up satisfactory object relations … It is
particularly important to help them to retain the positive aspects in their narcissistic organization by making
them aware of the conflict with the destructive narcissistic part of themselves with which they
are not identified' (Rosenfeld, 1987p. 273).
In his concern to protect the patient from bad analysis Rosenfeld does seem to have emphasized one type
of danger without balancing it sufficiently by stressing the danger of encouraging idealization which often
goes with a reluctance on the analyst's part to allow himself to be experienced as a bad object. It is important
not to be provoked aggressively to confront an idealization which the patient may continue to need for
defensive purposes but eventually it becomes necessary to tackle it. No real development is possible unless
the patient can take responsibility for his own destructiveness and we cannot shirk our responsibility in
helping him face it. If we want to retain a balance and stay in touch with the patient's deeper needs we must
take up both the positive and the negative transference as it appears in the patient's material. It is on this issue
of balance that disagreement has developed between Rosenfeld and some of his colleagues, myself included.
I believe these disagreements need not distract us from recognizing Rosenfeld's greatness. His loss leaves
a real gap in the British Psycho-Analytical Society and I believe it will take some time for all of us to regain
our equilibrium as we struggle to mourn him and to assimilate his teaching.

SUMMARY
A brief review of the work of Herbert Rosenfeld is presented. This emphasizes his fundamental
contribution to the understanding and treatment of psychotic and borderline states.

REFERENCES
BION, W. R. 1956 Development of schizophrenic thought Int. J. Psychoanal. 37:344-346 Reprinted in
Second Thoughts London: Heinemann, 1967 [→]
BION, W. R. 1957 Differentiation of the psychotic from the non-psychotic personalities Int. J.
Psychoanal. 38:266-275 Reprinted in Second Thoughts London: Heinemann, 1967 [→]
KLEIN, M. 1957 Envy and Gratitude London: Tavistock Publications. Reprinted in The Writings of Melanie
Klein 3. London: Hogarth Press, 1975 pp. 176-235 [→]
REY, J. H. 1979 Schizoid phenomena in the borderline In Advances in the Psychotherapy of the Borderline
Patient ed. J. LeBoit & A. Capponi. New York: Jason Aronson, pp. 449-484 Reprinted in Melanie Klein
Today. 1. Mainly Theory ed. E. B. Spillius, 1988
ROSENFELD, H. A. 1947 Analysis of a schizophrenic state with depersonalisation Int. J.
Psychoanal. 28:130-139 Reprinted in Psychotic States London: Hogarth Press, 1965 [→]
ROSENFELD, H. A. 1950 Notes on the psychopathology of confusional states in chronic schizophrenia Int.
J. Psychoanal. 31:132-137 Reprinted in Psychotic States London: Hogarth Press, 1965 [→]
ROSENFELD, H. A. 1952a Notes on the psychoanalysis of the superego conflict in an acute schizophrenic
patient Int. J. Psychoanal. 33:111-131 Reprinted in Psychotic States London: Hogarth Press 1965 and
also in New Directions in Psychoanalysis ed. M. Klein et al. London: Tavistock Publication, 1955 [→]
ROSENFELD, H. A. 1952b Considerations regarding the psychoanalytic approach to acute and chronic
schizophrenia Int. J. Psychoanal. 35:135-140 Reprinted in Psychotic States London: Hogarth Press,
1965 [→]
ROSENFELD, H. A. 1964a The psychopathology of hypochondriasis In Psychotic States London: Hogarth
Press, 1965
ROSENFELD, H. A. 1964b An investigation into the need of neurotic and psychotic patients to act out
during analysis In Psychotic States London: Hogarth Press, 1965
ROSENFELD, H. A. 1964c On the psychopathology of narcissism: a clinical approach Int. J.
Psychoanal. 45:332-337 Reprinted in Psychotic States London: Hogarth Press, 1965 [→]
ROSENFELD, H. A. 1965 Psychotic States London: Hogarth Press, 1965 [→]
ROSENFELD, H. A. 1969 On the treatment of psychotic states by psychoanalysis: an historical
approach Int. J. Psychoanal. 50:615-631 [→]
ROSENFELD, H. A. 1971a A clinical approach to the psychoanalytic theory of the life and death instincts:
an investigation into the aggressive aspects of narcissism Int. J. Psychoanal. 52:169-178 [→]
ROSENFELD, H. A. 1971b Contributions to the psychopathology of psychotic patients. The importance of
projective identification in the ego structure and object relations of the psychotic patient In Problems of
Psychosis ed. P. Doucet & C. Laurin. Amsterdam: Excerpta Medica. Reprinted in Melanie Klein Today.
1. Mainly Theory ed. E. B. Spillius, 1988
ROSENFELD, H. A. 1983 Primitive object relations Int. J. Psychoanal. 64:261-267 [→]
ROSENFELD, H. A. 1987 Impasse and Interpretation New Library of Psychoanalysis, 1. London and New
York: Tavistock Publications and the Institute of Psycho-Analysis. [→]
SEGAL, H. 1950 Some aspects of the analysis of a schizophrenic Int. J. Psychoanal. 31:268-278 Reprinted
in The Work of Hanna Segal New York: Jason Aronson, 1981 [→]
SEGAL, H. & STEINER R. 1987 Obituary. H. A. Rosenfeld 1910-1986 Int. J. Psychoanal. 68:415-419 [→]
SPILLIUS E. B. 1988 Melanie Klein Today. 1. Mainly Theory New Library of Psychoanalysis, 7. London
and New York: Tavistock Publications and the Institute of Psycho-Analysis. [→]
 STEINER, J. 1982 Perverse relationships between parts of the self: a clinical illustration Int. J.
Psychoanal. 63:241-251 [→]