ABSTRACT
The loss, guilt, separation, and dependence of the depressive state are corrupted by paranoid phantasies and experienced in a violent and traumatic way. This chapter presents the case material that shows how particular patients struggle with rudimentary footholds in the depressive position that are fragile and brittle and easily crumble under this more primitive paranoid vision of the self and object. Gambling and the search for an ideal woman served as a temporary, fragile escape into a magical excitement and a sense of belonging and soothing. Instead of longing for the disappointing arid hurt object and then dreading its revengeful return and therefore trying to avoid or escape its arrival, the patient can begin to see themselves and their objects as flawed but available, separate and different but understanding, safe, and supportive. The chapter focuses on patients who are unable to successfully defend from the dual psychological impact of pathological phantasy states from both psychic positions.
