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Sheiner, S. (1961). The Therapy of Severe Alienation. Am. J. Psychoanal., 21(2):242-251.

(1961). American Journal of Psychoanalysis, 21(2):242-251

The Therapy of Severe Alienation

Sara Sheiner, M.D.

I am Going to describe what went on in the analytic experience I have had and am having with a particular person. I can say that he was full of rage and hate; that he was morbidly dependent;1 that he demanded and rejected symbiosis; that he was self-destructive to the extreme. I have said little unless I emphasize that the presenting point of contact between us and the major obstruction to contact was his alienating2—active alienating—as a life-saving defense, and an inevitable part of the neurotic process of development.

He was a young man in his thirties when he first came to see me and felt overpowered by an incessant urge to kill himself. Anyone as sick, he said, anyone as unfeeling and contemptible as he was did not deserve to live. He believed it to be a law of nature that the unfit must die or be killed off. He lived with an unceasing conviction that he was of the unfit. Only when he was desperate and “at the bottom,” when there was no other way to turn, would he feel an unidentifiable surge of opposition to this self-malevolence. At these times he would experience a relaxation of tension and a clear but distant awareness that his usual way of feeling was “wrong.” This clarity would be followed by a blurring and numbing of all feelings.

He had been excruciatingly and bitterly anxious for as long as he could remember. Lurking within him was a volcanic rage, a rage that erupted violently, leaving him spent and guilty when it receded.

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