ABSTRACT
Some paranoid-schizoid masochistic patients are so immobilized with rage, loss, envy, and primitive guilt that they make for near impossible transference blockades. They have a profound sense of grievance which can manifest in different ways. This grievance is a direct result of intrapsychic experiences, phantasies, of loss and persecution. Spillius elaborate the link between loss, envy, and masochism. Core feelings and phantasies of grievance and 'keeping score' are very much in line with what Freud (1916) described in his paper on the 'exceptions'. Masochistic patients functioning more in the paranoid-schizoid position are unable to formulate this reparative demand. Caper (1988) has described the internal process whereby such intentionality is created: Internal objects are formed by the two-stage process of projecting one’s loving or hating impulses into an appropriate external object (thereby bringing it to psychological life), and then introjecting this object.
