ABSTRACT

Therapists working with clients who suffer from personality disorders, especially those who are severely narcissistic, are inevitably exposed to intense emotions of hate and hateful fantasies. This chapter looks into what kind of powerful forces are at stake in therapy when the client is full of hate, and the therapist is filled with countertransference feelings while at the same time, struggling to maintain a neutral, playful and exploratory approach. The origin of hate is a complex topic and raises the discussion whether hate is primarily related to a death instinct, to what extent hate is genetically determined or, to what extent primarily an emotional reaction to extreme frustration. Countertransference, provoked by hateful clients with severe personality disorders, frequently differs from what is experienced with clients with milder disorders or neurotic personality organisation by being far more intense, difficult to contain and not possible to verbalize directly.