ABSTRACT
Esther Bick was a superb clinician as well as a brilliant observer of infants. One of the many things she taught in the supervision on my first (five times weekly) case was the distinction between types of, and motives for, destructiveness. My little 4-year-old patient, "Laura", was a narcissistic and violently destructive child. She attacked me and the room relentlessly, often with great triumph and pleasure. One day the session started peacefully, with Laura painting. Suddenly, she noticed a small paint-stain on her spotless dress. She erupted once again with violence, which I linked with her usual furious impatience and intolerance of imperfection or frustration. Mrs Bick, however, suggested that at this moment it seemed to be more to do with unbearable guilt about damage. She saw the violence as escalating out of desperation as a result of a phantasy of an irreparable object, rather than as a defence against persecutory frustration. And she stressed the escalation: the way the guilt could feed the violence and the violence the guilt. This was only one revelation among many, but it was typical. Her capacity to see the dark side of human nature and yet have compassion for its vulnerability and weakness was a great inspiration.
