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L'auteur examine les conséquences cliniques de l'échec de l'organisation du conflit d'ambivalence, il précise les logiques paradoxales qui se développent alors, en particulier dans les formes de réaction thérapeutique négative. Puis il explore quatre conjonctures traumatiques primaires qui contribuent à mettre en échec l'intrication pulsionnelle première et la future capacité du sujet à organiser un conflit d'ambivalence susceptible de freiner les manifestations cliniques de la destructivité.
The author examines the clinical implications of situations where the conflict of ambivalence—the differentiation between love and hate—has failed to develop a coherent psychic organization. Several paradoxes result, which are described and explored, particularly manifestations of negative therapeutic reaction. This is followed by exploration of four kinds of primary traumatic development that interfere with drive fusion and the individual's future capacity to organize a conflict of ambivalence capable of constraining the clinical manifestations of destructiveness.
Keywords: destructiveness, survival of the object, death instinct, ambivalence, conflict, paradoxical thinking, pathological fusion of instincts, negative therapeutic reaction