Delusional Hate: Primary Identification in the Case of a Gifted Patient with a Predatory Mother

This paper identifies a delusional form of hate that emerged in the treatment of a gifted patient. The hate is described as reflecting the patient's identification with his mother's emotion—with her hate rather than with her entire self. The paper borrows from a dynamic outlined by Green (1983) in his theory of the dead mother syndrome, in which a child with a depressed mother, deprived of the possibility of a true relationship with her as a person, identifies instead with her absence. The key defense in this dynamic is primary identification. The case presented here outlines an analogous mother—child dynamic in my patient's history, yet it is premised on hate rather than absence. The hate is termed delusional because it automatically applies a fixed, primal narrative of “kill or be killed” to any and every relationship in the patient's life. I describe my initially dissociative response to the patient's manifestation of delusional hatred and explain how this dissociation is eventually broken—thus allowing the hatred to become more interpersonal, and therefore less delusional, in nature.