The projective-attributional trap: institutional dynamics in French assisted reproduction pathways after the 2021 bioethics law

Abstract

This theoretico-clinical article examines tensions in French assisted reproduction services after the 2021 bioethics law extended access to couples of women and single women. Drawing on composite clinical material from a reproductive medicine service, we define the projective-attributional trap as a recursive interaction in which projective dynamics heighten hostile interpretations of ambiguous cues, while those interpretations elicit defensive institutional responses that appear to confirm the initial hostility. The model distinguishes three levels (applicant–institution, institution–applicant, and intra-team dynamics) and an absent third, such as the donor or an undisclosed partner, that may amplify the circuit. Projective identification and hostile attribution bias (HAB) are treated as complementary but non-equivalent grammars: the first describes unconscious affective circulation; the second identifies context-sensitive cognitive and behavioural indices. We specify the concept’s heuristic rather than diagnostic status, the conditions under which the circuit may be interrupted, and implications for whole-team reflection, supervision and training. The framework remains a hypothesis requiring empirical testing.