ABSTRACT
The focus of this chapter is an exploration of the continuing advances in psychoanalytic treatment with complex psychopathology, along with what feels to be an inevitable corresponding adversary towards the practice of psychoanalysis. In the spirit of Bion’s assertion that our patients are “our best and most highly qualified collaborators”), this chapter draws on clinical vignettes from patients with complex presentations that I have experienced as illustrating, confirming and expanding psychoanalytic understanding. It explores the defensive structures that seem to unconsciously work to disrupt our work and our attempts to construct understanding(s) by listening into and attempting to translate these defensive constellations within ourselves. Patients suffering from severe dissociative disorder have experienced trauma and take desperate measures in an attempt to preserve vital information where the evidence of these traumas are preserved to later be put together only if the circumstances facilitate it.
