title: The concept of the death drive: a clinical perspective.
abstract: This paper discusses Freud 's theory of the death drive in the light of clinical experience with severely self-destructive personality disorders, and contemporary object relations theory. Repetition compulsion, sadism and masochism, negative therapeutic reaction, suicide in depressed and in non-depressed patients, and destructive group processes are explored from this perspective. The paper concludes that the concept of the death drive is clinically relevant, but that this condition needs to be traced to the general dominance of aggressive affects as the primary etiological factor; only under severely pathological circumstances does this dominance lead to a focused drive to self-destruct.
authors.affiliation: New York Presbyterian Hospital, White Plains, New York 10605, USA. okernber@med.cornell.edu
authors.forename: Otto
authors.initials: O
authors.lastname: Kernberg
mesh_terms: D000374:Aggression / Q000523:psychology*; D001293:Attitude to Death; D003643:Death; D004328:Drive; D005619:Freudian Theory; D006801:Humans; D008398:Masochism / Q000150:complications / Q000523:psychology; D009042:Motivation; D009769:Object Attachment; D010554:Personality Disorders / Q000150:complications / Q000523:psychology; D011572:Psychoanalysis / Q000379:methods; D011574:Psychoanalytic Theory; D012448:Sadism / Q000150:complications / Q000523:psychology / Q000628:therapy; D012649:Self Concept; D016728:Self-Injurious Behavior / Q000150:complications / Q000523:psychology; D013405:Suicide / Q000523:psychology