Introjection in psychotherapy

I was working with a client the other day who I have know over a 30 year period. She had a long term heroin addiction of 15 years but has not used for the last 10 years. The other day she reported she was in a car with a friend and he suddenly asked her if she wanted to use. This caught her completely unaware as she had not anticipated him suggesting such thing. In addition he had the heroin with him there with needles and so forth. This was a very real situation where she could have used again.

She reported that one of the first things that happened was she heard my voice in her head. To which I replied

“What did I say?”

The response that she gave were all Adult ego state comments such as:

“If I use now I wont get home in time for the children”.

“I am going to end up spending money that I do not have.”

“This will lead me down path that I really don’t want to go down.”

and so forth

In one way this was reassuring for me. As I have said before I have never said to a drug using client not to use drugs, or that drugs can be destructive. These are too Parent ego state for my liking and I have always avoided that with drug using clients.

Steam punk face

However I wouldn’t usually even say things like she said in her head with my voice. Instead I would be much more likely to ask a question so she came to her own conclusions. For instance, “If you used what would happen that day?”

This is a clear instance of her introjecting me.

Introjected therapist Jpeg

This provides an interesting insight into introjection in this instance. She hasn’t introjected what I have said but instead introjected my voice sound and quality. Then she has applied that introjected voice to her own words.

Also it highlights a flaw in the theory of the integrated Adult. Their position is that all introjects are defensive reactions, they are a defence mechanism. This is not true. Introjection can be used as a defence mechanism but they are also a normal part of human development. Her introjection of my voice is a good example of an introjection that is not a defence mechanism.

So in the theory of the integrated Adult are you meant to integrate the normal or healthy introjects into the Adult or not? Regardless of what the theory says I would be very loathe start “integrating” this introject as it was used by her to cope with a crisis situation.

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