The patient who is difficult to reach

This paper was first published in P. L. Giovacchini (ed.) Tactics and Techniques in Psychoanalytic Therapy, vol. 2, Countertransference, New York: Jason Aronson (1975): 205-16; and appears in E. Bott Spillius (ed.) Melanie Klein Today, vol. 2, Mainly Practice, London: Routledge (1988), 48-60.
In this chapter I intend to concentrate on some problems of technique, focusing on a particular group of patients, very diverse in their psychopathology, but presenting in analysis one main point in common. It is very difficult to reach them with interpretations and therefore to give them real emotional understanding. My aim is to discuss some manifestations of the problem and some technical issues that arise in handling this type of case. I shall not attempt to make a study of the psychopathology of these patients.