Becoming Able to Feel Hate: The Treatment of a Psychotic Somatizing Patient*

All psychoanalysts sooner or later must deal with patients whose intense, unacknowledged suicidal and homicidal wishes lead them to commit self-destructive or object-destructive acts.

The transference resistance of such patients inevitably generates murderous or suicidal countertransference feelings.

My resistances to feeling suicidal and homicidal feelings were reflected in my treatment of Mrs. A. These resistances were progresively resolved in supervision and in my own treatment.

Mrs. A generated powerful negative feelings. Both her ex-husband and her daughter attempted suicide.

My original attempts to deal with her negative feelings were unsuccessful. I was either obliterating them at the source (by comforting her or trying to “fix” her) or not experiencing them (by falling asleep).

Working with Mrs. A. was especially challenging for me because of my perception that she and my mother shared significant personality traits and dynamics. My conscious and unconscious wishes to get rid of the patient may have been mitigated by my sense that treating her was helping me in an unresolved conflict with my mother. This appears to have been the countertransference glue that kept us together. I was gradually able to separate from the original and the countertransference object by allowing myself to feel rage at both.