Abstract
This article discusses the experience of therapeutic work with those who have suffered prolonged and repeated trauma and relates this to the concept of destructive narcissism introduced by Herbert Rosenfeld (1971, 1987). There is a focus on the extreme experiences of torture and abuse of an evil, sadistic nature, whether this be represented within the inner world or based on actual events. Alongside clinical discussion of patients, I also set out to understand a particular countertransference experience of the therapist. This is of a two-fold nature: one of feeling as though pinned to the spot like a captive and the other of having a sense of being on an edge, that is to say alert to some unknown danger. The overall effect is of being in constant suspense. At these moments I am unable to function as a thinking, containing therapist. In attempting to understand this absence of a capacity to think reflectively, I introduce ideas of Ronald Britton.