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Abstract

The author presents an approach enhanced by Freud in some works for thetheoretical understanding and therapeutic approach of serious pathologies suchas narcissistic, borderline and psychotic. In 1920, 1923, 1933, 1937 and 1938, Freud pointed to the importance of valuing the phenomenon of fusion and defusionof drives for the understanding of some serious pathologies. The defusion provokesan alteration in the operativeness of the self-preservation forces, in the internal relations of the self and with objects. The inversion of the self-preservation forcesis observed in the suicide, in the melancholic, in the frames of severe negative therapeutic reaction, and serious psychosomatic disturbances. When the deathdrive, represented (performed) by the destructiveness, is defused of Eros it leadsto bordering acting. The Psychoanalysis is presented as a heroic resource in thetreatment of these disturbances. The clinical material refers to a seriously ill patient whose extreme actings were a true flirt with the death. The transference ofthese patients is always very disturbed and the countertransference is overburden. An attitude of tolerance, patience, empathy and trust in the psychoanalytic workis fundamental in the analyst’s person.