ABOUT SUFFERING AND SACRIFICE IN THE CLINICAL ENCOUNTER

In Suffering and Sacrifice in the Clinical Encounter, the authors identify how patients seek to create what Freud termed a 'private religion'--and unconsciously substitute sacrificial enactments to protect them against the pain of separation, mourning, and loss of primary figures of attachment.

They investigate the function of sacrifice in its relationship to the development of manic defenses and pathological narcissism. The 'reversed roles' of victim and perpetrator-- central to the sacrificial process--when enacted in therapy can trigger feelings of shame, guilt and inadequacy in the therapist.

Perverse, vengeful, and sadistic transference distortions are explored to enable the therapist to appreciate the true nature of the patient's traumatic experience--allowing for the working-through of genuine separation and grieving. Methods are detailed to counter the tendency to become overly active and inappropriately involved when working with patients who have deadened their desire to improve.