On the clinical usefulness of the concept of death instinct.Int J Psychoanal. 1993 Feb; 74 (Pt 1):55-61.IJ
Freud's concept of the death instinct is often considered as a purely biological speculation, and very few psychoanalysts consider it useful in clinical work. Yet Freud was led to it by purely clinical problems. Klein used Freud's concept of the duality of instinct in her clinical work, but mainly she addressed herself to the conflict between love and hate of the object, considering hate as an expression of the deflected death instinct. I contend that the death instinct from the beginning is directed at both the perceived object and the perceiving self, resulting in such phenomena as pathological projective identification, described by Bion. The defences against the death instinct create vicious circles leading to severe pathology. I try to show in some clinical examples how analysing those vicious circles, and confronting the death instinct in the stable setting of analytic work, can lead to a mobilisation of the life forces in the patient.