Introjection in the therapy process

On July 30th, 2010 I wrote a post about Carl Rogers and his therapy. He proposed that a therapist needs to display 3 qualities when working with a client. These are:

Genuiness - Therapist is aware of his own feelings, thoughts and attitudes and these are not concealed from the client.

Empathy - Understanding the client’s experience from the client’s point of view.

Unconditional positive regard - Conveying to the client that they are worthwhile humans no matter what they do.



If these happen then over time this positive relationship is seen to bring alive the person’s natural desire to grow towards health. The Free Child aspect of the personality ‘sparks’ up and the person naturally grows towards psychological health. A reasonable hypothesis that has been widely accepted by the therapeutic community one could say.

However there is another aspect to this. Another feature of the therapeutic process and that is the mechanism of introjection. Any two people who form any sort of relationship then introjection will occur between them. It will happen unconsciously and relentlessly. It will happen to everyone but the extent and rate of introjection can vary between people and circumstances.

The therapeutic environment is a prime breeding ground for introjection of the therapist by the client. It is well designed for this to happen at least in some ways.

Introjection can be explained theoretically as the incorporation of the therapist into the client’s Parent ego state. Over time the client will incorporate the therapist’s personality into their own via this mechanism. The therapist’s personality becomes part of the client’s personality. It will happen back the other way but to a lesser degree.



I recall a number of years ago I used to run a respite programme for an organisation called ARAFMI (Association for Relatives and Friends of the Mentally Ill.) We took away on a holiday 7 people with chronic mental illness so their carers at home (usually their parents) could have one week respite from caring for them. So myself and an assistant lived in close contact with 7 people for a week who usually were diagnosed with either chronic schizophrenia, bipolar or psychotic depression. I tell you what, it was one of the best learning experiences I ever had about these types of mental illness. I learnt more about how they think, feel and function that I ever could with a 5 year degree.

However my point is I lived in close contact with a group who were heavily medicated, had been for a long time and were probably going to be for a long time. Because of the medication many were quite over weight or obese and they generally had this slow moving sort of swaying way of walking. By the end of the week I would be walking like them! Without even knowing it I began to walk like them. The introjection process on display.

In the counselling setting introjection will occur more, the longer the client has been seeing the therapist, the more frequent the client sees the therapist and the stronger the transference the client has for the therapist. The more these three conditions are met the more the client will introject the therapist as part of their personality.


Will these children wear helmets when they ride a bike in the future?

If the therapist is being genuine, empathetic and giving positive unconditional regard then the client will introject that. If the client starts to take this in as part of their own personality then they are going to treat their own Child ego state in these ways as well. If that happens then the person will start to feel better about self and thus grow in a more psychologically healthy way. Another explanation why the Rogers therapeutic approach may be successful.

However unfortunately it works both ways. If a therapist uses painful therapeutic techniques then that attitude or ‘permission’ will be introjected as well. Many therapeutic techniques are painful to some degree and involve the client regressing and experiencing painful emotions and confronting old painful memories. If the therapist allows this to happen and indeed promotes it as most do then the client will introject that into their Parent ego state as shown in the diagram. I use such techniques at times and thus one needs to be cautious of such therapeutic techniques and the introjection that occurs.



Then there are the pharmacotherapies like methadone for heroin addiction. There is an inherent contradiction in these approaches. The therapist says “Take these drugs, so you don’t take drugs”. The permission to take drugs is introjected by the client by the very actions of the therapist. Again, I am not anti methadone and have seen it be useful for some opiate users. However in any over all treatment plan one must be at least aware of this contradiction and introjection occurring in the client.

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Sameness in relationships **

In relationships of any depth there is a natural tendency for both parties over time to become more the same. They will tend to become more like one another.

When any two people spend time together they will tend to model and introject each other. This is inevitable and indiscriminate and can not be avoided. Humans will instinctively do it whether they are aware of it or not.

This process is easily explained in transactional analysis

This shows how the wife models or introjects her husband’s personality into her own Parent ego state and of course he does the same with her over time. As mentioned before this process can not be avoided and will happen instinctively.

The copying relates to the behaviour, thoughts, attitudes and feelings of the other. All these parts of the others personality become our own after time. However husbands and wives do not end up as clones of each other and they do remain different over time. Of course the Parent ego state is but just one aspect of the personality and we all also have an Adult and Child ego state and these can be quite different between the two partners. However there is a tendency to sameness in the way described and this does not have to be an equal process.

Modeling can even occur between animal and human

People will tend to model more on those who are of more perceived potency and emotional importance. Thus the introjection between the married couple may be at different degrees. That is, one does more introjection than the other and generally speaking it is the more dominant party in the relationship who will be introjected more than the other way around.

This has been studied in some depth before and is presented in the DSM-IV by the American Psychiatric Association (1994) who discuss the Folie a Deux or a shared delusional disorder. In this case two people who are in a close relationship over time develop the same delusional belief system. There tends to be one dominant party and the more submissive party takes on the delusion of the other. This means that should the relationship end the more submissive party will tend to drop the delusion over time even though the submissive party probably has a tendency to have the same delusional beliefs.

Of course they don’t have to be delusional beliefs but can be beliefs or views about anything including religious views, political views, attitudes to neighbours, relatives, friends and so forth.

It should be noted that even after the introjection has taken place there are other potent psychological processes at work that further develop the sameness in a couple. The most obvious example of this is the phenomena of group think. In this situation when two or more people get together there is internal pressure in the group towards uniformity which leads the group to come up with same consensus that maybe false or not.

Group think can result in:

Illusion of invulnerability that can encourage excessive optimism and risk taking

Unquestioned belief in the group’s morality and goals which can result in the group members ignoring the consequences of their actions

Self censorship of deviations in the group’s beliefs and goals

Suppression of dissent by more powerful members in the group

Feelings of anonymity

Discount self responsibility

As two people talk and discover that they tend to have the same attitude or opinion about something this can give them a false sense of security as is described above. “If others think the same as I do then that makes my views more correct or right” is the reasoning behind group think. Thus if a husband and wife have introjected similar views from the other about something, group think can play a part in further fostering the sameness.

Most often this does not matter all that much if they are political views, religious views or dislike for their next door neighbours. However if the views will tend to incite racial hostility or religious persecution then there is a much more serious problem.

This can also involve similar views about suicide. That is, views like suicide is an OK solution to a problem, everyone has the right to choose and so forth. If they have introjected these from each other and then have a sense of group think, in extreme cases one can end up with the suicide pact. Both parties agree to suicide at the same time.

Even if there is no suicide pact it will make suicide a more easy choice for one of the parties in the relationship for the reasons just mentioned. Thus in working with the suicidal it is instructive to make an assessment of the relationships that the suicidal individual is involved at that time to see if any of these psychological processes are at work.

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