The death instinct has been debated, devalued, criticized, and ignored by various analysts and analytic schools. Nevertheless, it remains a viable part of Kleinian theory. This paper explores the advantages of the concept from both a clinical and theoretical perspective. Due to their self-destructive ways, certain patients seem to create difficult and destructive transference-countertransference patterns. Clinically, they need a period of intrapsychic and interpersonal containment, followed by analysis of the death instinct in its clinical manifestations, followed by the working through of primitive states of paranoid-schizoid loss and persecution. Case material, focusing on the analysis of the death instinct, is used for illustration.