An account of an effort to make a real connection with a paranoid, schizophrenic man obsessed with suicide. The short-term therapy took place in a state psychiatric hospital, observed by Job's long-term therapist and others on the psychology staff who offered support during and beyond the demonstration itself. The therapy brought out Job's bitter protests about all those responsible from birth on who failed him, and his review of this led him to greater suicidal efforts. The risk in this theraputic effort was clear from the beginning and it was acknowledged and faced throughout the effort. Therapist speaking to "Job" in final session: We are all part of a human experience. You have made me think about this, I always do think about it. I always come to understand that in any relationship there is a risk. In the psychotherapeutic relationship there's not only a risk, but a great burden of responsibility. Job: Yes, most definitely. I think that's one of the biggest mistakes that therapists make is that they don't realize sometimes where the person is at because of bringing out certain things. The biggest mistake a lot of psychologists make, they treat them like a patient, and treat an illness and not a person. Do you understand? Do you get what I'm trying to say!

This paper attempts to delineate a 5-year struggle within an intensive psychotherapeutic procedure to help a young adult male of nearly 30 years gain entry to the object world. The autistic defense of "Jess" against his symbiotic longings absorbed his superior intellect and psychic energies through his adolescence and adult life. The vicissitudes of the treatment relationship and the profound question of whether to attempt to gain entry to the autistic shell and thereby render Jess vulnerable to psychic pain is central to this presentation. His need to feel secure in his own boundaries compelled a life-long autistic/narcissistic adaptation designed to hold the real world at bay. Jess hungered constantly for human warmth and feared a loss of self if he yielded to this drive. Herein we witness man's eternal conflict.

This paper attempts to consider the capacity for remorse within the framework of Freud's structural theory. The standards leading to formation of superego as a functioning system are critical for tolerance of one's own humanness and of the human condition in others. On this rests the capacity for love and for empathy and remorse. The quest for revenge and the intolerance for guilt provide powerful unconscious dynamic forces which take precedence over love and respect. The latter dynamic is presented as explicating the absence of remorse and forgiveness.

This effort might be seen as an exploration of therapeutic impotence with a borderline personality in a treatment procedure that went on for a ten-year period. The main body of the paper is on the first four years of treatment which were intense in terms of the frequency of sessions and in terms of the successful efforts of the designated patient to frustrate the therapist and undo the treatment. The orientation of the therapist was based on the theory and technique of psychoanalytic developmental psychology so the patient's negativism and resistance were interpreted as his effort to maintain his ego boundaries. The blows to the therapist's professional narcisism were a measure of the patient's degree of pathological narcissism and low self-esteem.