Smile of a Serial Killer

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Abstract

This essay traces a clinical case in which the danger in the analysand's destructiveness was deployed primarily through passivity and withdrawal. Problems of envy, fears of competition, and anxieties about loss and abandonment kept the treatment too frequently at impasse. The case is used to illustrate the way that countertransference collusions may mask highly destructive processes in treatments. Technical and theoretical considerations of work with such patients are discussed.