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Splitting in hospital treatment

Published Online:https://doi.org/10.1176/ajp.146.4.444

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.

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