Tony White

I attended a workshop last week where the concept of extractive identification was discussed. This is a common process done by many psychotherapists. The therapist identifies with the client and then extracts that identification.

I did it today. A client reported that he lost his mother to cancer when he was seven years old. So we dealt with the various psychological ramifications of that. In the discussions however I discovered that after she died his father moved interstate for a time as he was so desperately ill with grief. Also he was placed in a house with good family friends and his brother and sister were moved to another family.

I then brought to his awareness that not only did he loose his mother, but that 7 year old boy also lost his father, two siblings, his home and bedroom and so forth all at once and that must have been quite devastating. His whole world of security had disappeared all at once.

This is an example of extractive identification. As a therapist my own Child ego state had identified with him and the pain I assumed he felt. Then I had ‘extracted’ that aspect of his experience by reporting it to him. In essence I had stolen from him. Extractive identification is literally theft form the client by the therapist.


Identification



By me reporting my identification to him I had made it impossible for him to ever achieve that by himself. I had stolen it from him for ever. The theft metaphor is an interesting one. Of course it rests on the assumption that if I report something to a client about their experience like I did above, then that results in less ‘gain’ to the client than if they achieved that awareness of their experience by them self. I think it is safe to say that many would agree that this assumption has some merit.

It has interesting implications for the therapeutic or transference relationship. It almost gives it an adversarial quality. The therapist can steal things from the client. Making prophetic and insightful type statements like I did may make me feel good but it is at the cost of the client having something stolen from them forever. The clients rights are violated when they have something stolen from them.


Can you steal their insights?



With the idea of the violation of the client’s rights and indeed in one form their ‘property’, then one immediately gets a stronger sense of boundary. What belongs to the client is more clearly defined when one considers extractive identification. In the medical field we hear about intrusive and nonintrusive medical procedures. Surgery to remove a persons appendix or gall stones is an intrusive medical procedure. It is intrusive because the doctor intrudes though the clients physical boundary (their skin, muscle and so forth). Of course nonintrusive medical procedures do not do this. Here they use other methods to treat the problem that do not involve intruding across the clients primary boundary of their skin.


Intrusive surgery?



With extractive identification one arrives at the same scenario. There can be both intrusive psychotherapeutic procedures and nonintrusive psychotherapeutic procedures. Extractive identification of course is an intrusive psychotherapeutic procedure. The therapist has sought to observe inside the client’s own psyche and then makes a comment about that observation to the client. Metaphorically the comment of the observation is the equivalent of the surgeon cutting into the patient’s skin with the scalpel.

So the client then has a sense of being intruded upon. “He’s reading my mind” maybe the kind of experience. Another good example of this would be hypnosis.

So in this way one can see extractive identification as not only theft from the client but also as an intrusion by the therapist into the private and intimate world of the client’s mind. This then begs two questions:

1. What are the psychological implications of this intrusion for the client (and therapist)
2. What is the fallout of this intrusion on the relational or the relationship between the client and the therapist.

Graffiti