The benefits of using projective test methods as therapeutic leverage in the treatment of patients who pose a danger to themselves or to others

In this article, we explore the specific issues involved in using projective tests within a specific context of care, the Special Psychiatric Unit for Difficult Patients (Unite pour malades difficiles, UMD). After presenting the particularities of this unit, tasked with providing a hyper-containment on both the environmental and psychic level, we review the inherent issues relating to the projective test situation, and their potential repercussions within this particular context of care. On the basis of institutional specificities, but also using the case study of Mr. X, whose clinical characteristics lie at the crossroads of the extreme and the formless, we question the outlines of the projective test situation, the nature of its execution, as well as its solicitations of transference. Finally, we discuss the potential therapeutic outcomes, as well as the questions raised by the use of Rorschach and TAT with patients, at a site where part of the care package includes confinement.