ABSTRACT
This chapter outlines the key elements of Kleinian theory as psychoanalysts apply to helping people with severe mental illness and, after overviewing Melanie Klein’s broad theoretical framework. It highlights particular clinical phenomena experienced in everyday work with the patient population. The chapter describes other key theoretical ideas to capture important clinical/emotional processes. The psychotic part, intolerant of frustration, gets rid of its perceptions and the part of the mind that registers them. The non-psychotic part of the personality which retains a capacity for tolerating psychic pain is able to experience jealousy or envy or disappointment without denying the experience and without attempting to change his attitude to the object in order to avoid these experiences. The chapter considers the four powerful concepts together as they have one outcome in common, a destruction of good and healthy internal and external object relations. These are destructive narcissism, narcissistic identificate, attacks on linking, and internal saboteur.
