ABSTRACT
Professionals who work with drug abusers encounter many challenges and significant therapeutic issues which stem from the unique characteristics of this population. Some issues concern the therapist’s difficulties containing the patient’s internal destructiveness, which is expressed in prolonged drug abuse despite the consequences, and in intensive projective identification. Actually, the encounter with such challenging patients is an encounter with the death instinct that threatens to annihilate the patient, the therapist’s ability to exist analytically, and the therapeutic process. By discussing some of Freud’s, Kernberg’s and Betty Joseph’s ideas, I try to shed light on these complex issues and offer therapeutic interventions for therapists who daily cope with the destructive self-administration of drugs, overwhelming projective identification, and intense countertransference.
