OMNIPOTENT DELUSIONS OF BADNESS: SOME PSYCHODYNAMIC MEANINGS AND COUNTERTRANSFERENCE CHALLENGES

This paper describes several character disordered patients who had suffered considerable childhood neglect and who subsequently harbored conscious beliefs in their fundamental badness. This seemed related to a grandiose sense of their own destructiveness, which in turn evoked enormous guilt and reinforced their certainty that they were bad. This delusional certainty fueled sadomasochistic ways of relating to self and others and self-destructive preoccupations. The paper explores the multiple functions which the delusions of badness serve and the technical challenges involved when working in depth with such persons.