Surviving in absence--on the preservative and death drives and their clinical utility.

This paper offers a new theoretical and clinical look at the death drive in connection with the preservative drive. The author elaborates the flaws she sees in Freud's Beyond the Pleasure Principle (1920) and reformulates the transition between Freud's first drive theory and his second one within an implicit object relations theory. Simultaneously with this revised version of drive theory, a structural theory for the realm of healthy self- and object preservation and for pathological or deadened self and object parts is developed, including the devastating effects of trauma. Clinical material from an extended psychoanalysis shows how these concepts can help us understand these patients' absence and "deadness" and rethink the technical challenges they provide.