Am J Psychiatry 1989; 146:444-451
Copyright © 1989 by American Psychiatric Association
Splitting in hospital treatment
GO Gabbard
Menninger Clinic, Topeka, KS 66601-0829.
Splitting is a concept that is used in a variety of ways to describe
several different phenomena commonly seen in hospital treatment. As defined
in this paper, it should be reserved for situations in which intrapsychic
and interpersonal splitting occur simultaneously, recreating the patient's
internal object world in the milieu. Through projective identification,
staff members unconsciously identify with projected aspects of the patient
and behave accordingly. A clearer conceptual understanding of splitting in
the hospital allows for its differentiation from common variants of
splitting and for the development of strategies to manage splitting.
