On Feldman's ‘Some views on the manifestations of the death instinct in clinical work’

Dear Sir,

Richard Alexander's thoughtful comments (2000), conjoining lost hope and despair with dead or dying mental states and the death instinct, induced me to review Michael Feldman's article ‘Some views on the manifestations of the death instinct in clinical work’ (2000), on which Alexander is commenting. It seems to me that the heart of the matter for Mr B is expressed in the second dream. He feels ill. The analyst goes away repeatedly, each absence progressively weakening him. This time the analyst's absence has been longer than usual. Mr. B feels that eventually he will succumb and his connection to the analysis and the analyst will die during one of these absences. He fears that the analyst either doesn't know and/or doesn't care. He experiences the analyst as young, feeding himself, engaged in social interaction and inadequate to the task of comprehending or rectifying the life and death situation in which he finds himself.

The next session begins with Mr B telling the analyst that he is in a ‘stage of grief’, that once the analyst had taken the first weekend/holiday, ‘it was over’ for them (p. 60). He had been very angry with the analyst for not attempting to resuscitate the relationship, but he saw that his hope of feeling that the analyst could understand the depth of his need and show him that he cared was gone The quality of their relationship ‘would have been zero’ had it been saved. Mr B in fact was still ‘very, very worked up’ over this situation and felt like shouting and screaming. But he settled for ‘a more deadly process’, spoke in a ‘desultory way’, created ‘an atmosphere which was imprisoning and tormenting’, and ‘silently nurtured his sense of injury and … resentment’ (p. 60). The patient had thought that the problem in the analytic relationship had been his responsibility, but now it was clear that it wasn't. He was ‘off the hook’ (p. 60) of having to do the work of the relationship, to access and make known his feelings of need and hopelessne