Psychoanalysts learn most about themselves, their patients, and their technique from cases where standard methods do not seem to work. In The Misuse of Persons, Stanley Coen describes such a group of patients. Diverse in their psychopathology, they are similar in their abundance of unconscious rage and destructiveness as well as the mechanisms they have developed to manage these forces. They resist change, and their analyses are characterized by prolonged stalemates.

Coen points out that there are two major obstacles in treating these patients. First, they are terrified of their unconscious rage and destructiveness and will do whatever they can to disown these forces and keep them from being engaged in the analytic relationship. Second, their pathological dependency—the principle mechanism for managing these dangerous forces—operates in opposition to the analytic process. Pathologically dependent patients attach themselves to their analysts, offering themselves up as helpless and disabled. They submit to what they perceive as the greater