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Dr. Ornstein's article is rich in clinical data and particularly useful to organize a discussion of aggression from my point of view, both because of the process detail and also because the analyst gives us so much of her own countertransference experience and reactions.
I want to make two general comments about the patient, before looking in closer detail at the clinical material. First, I see in Mr. Keonig, as he is described in the material, the toll of aggressive and destructive feelings, the degree to which rage and anger leave someone so deeply burdened. His depression has been both chronic and severe enough to have led to a “serious” suicide attempt, and the constrictions in his personal and social and public life speak of someone suffused in despair and ashamed. I think of this as manifestation of the burden of omnipotence, as Winnicott used the term, in which the danger and destructiveness of one's feelings and desires distort and diminish so many areas of living.
I also think it is important to note that this is a man who was traumatized by the violence of his father and whose childhood trauma and abuse is being played out and dissociatively reenacted in the tumultuous relationship with his lover. This is someone not simply burdened by violent feelings and destructive rage states, but one who is actually