The National Crash Severity Study data in which occupants sustained severe, critical-to-life, or fatal cervical injuries were reviewed. Of passenger cars damaged severely enough to be towed from the scene, it is estimated that one in 300 occupants sustained a neck injury of a severe nature. The neck-injury rate rose to one in 14 occupants for those ejected from their cars, although many of these injuries resulted from contacts within the car before or during the process of ejection. Severe neck injuries were rather rare in cars struck in the rear, but were more common in frontal and side impacts. Occupants between 16 and 25 years of age had such injuries more than twice as often as those in any other age group. Most of the neck injuries of a more severe nature involved the cervical spine or spinal cord. Injuries of the anterior aspect of the neck were relatively infrequent, and usually resulted from direct blunt impacts. National projections of the number of fatalities related to cervical injuries indicates that 5940 deaths, or approximately 20% of all in-car deaths, include fatal cervical spine injuries, and that about 500 cases of quadriplegia per year result from automobile accidents.
In the present paper I explore the notion of the parallel process, a controversial concept in psychoanalytic supervision. I suggest that the parallel process is essentially the operation of the defensive process of projective identification, which in some quarters is similarly viewed with skepticism and/or is mistakenly seen as primarily a malignant defense operating exclusively in severe character pathology (Kernberg, 1975; Mendelsohn, 2009). Further, I present several vignettes of psychoanalytic supervision where a series of parallel processes occurred, and I suggest that these parallel enactments are the result of the projective identifications which stimulated them. I agree with critical writers who say that simply suggesting the presence of a parallel process in the supervision adds no new information to the supervision, but I show how an exploration of the parallel enactments, which includes (1) exploring the patient-therapist dyadic dynamics, (2) a narrowly focused exploration of the dynamics of the therapist/presenter, and (3) and an exploration of the dynamics of the therapist-supervisor dyad, can enrich the treatment, as well as the supervision. Finally I suggest that while the projective identification that occurs in the supervisory dyad does not always lead to a parallel process, every parallel process is the result of projective identification(s). I further suggest that while every parallel process does not lead to an enactment via projective identification, enactments can only occur via the parallel process instigated by projective identification.
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