ABSTRACT
This chapter focuses on the ongoing debate about the technical issues involved in making contact with disturbed patients who suffer the damaging effects of an ego-destructive superego, and whose emotional functioning and development are severely impaired by 'therapeutic inaccessibility'. It describes 'double-sided interpretation', and illustrates how this particular formulation can be applied in practice. The chapter outlines the theoretical aspects that place in context and form the foundations to the background of the double-sided interpretation, followed by the relevance of their use in analytic work with patients, and then discusses some clinical material from the analysis of a borderline/narcissistic patient who was three years into his analysis at the time in question. Freud's structural model of the mind is built on conflict between the life and the death instincts with their libidinal and destructive aspects. The power of a severely narcissistic or borderline patient's affects can take over the mind and make it difficult for the analyst to think.
