Dear Sir

I am responding to Michael Feldman's article, ‘Some views on the manifestations of the death instinct in clinical work’ (IJP, 81: 53-65), which I found quite interesting but also a bit vexing, as it continues a trend in which clear distinctions between matters of physical survival and those having to do with the survival of ‘the life of the mind’ remain obscure. In other words, Feldman, in his explorations into the concept of the death instinct, fails to recognise that the essential things that these patients bring into the consultation room are emanations coming from a realm of lost hope and despair, which frequently appear in a form that approximate to a dead or dying mental state, as