ABSTRACT
This chapter describes that the evocative quote from paediatrician and psychoanalyst Donald Winnicott illuminates a core therapeutic challenge for therapists undertaking psychodynamic treatment of patients with severe character pathology. During the initial consultation, Prudence informed that her outpatient therapist sent her to the hospital because she had resumed deep cutting, carving through layers of muscle and severing nerves, requiring surgical repair. Unlike the pharmacist/mother, the therapist, holding the analytic frame as a guide, can open the way to a therapeutic story by taking up the assigned role, and, in time, help the patient transform the actualised fantasy into a therapeutic story. When patients engage in actualisation of a fantasy, the therapist must take up a role unconsciously assigned by the patient in order to move from traumatic actualisation to potential therapeutic play and the emergence of a therapeutic story. In the deep play of the transference, the therapist must let himself be created as the heretofore unknown partner to this crucial scene.
