It is widespread opinion among therapists that serious pathologies take over the analytical treatment, designed for average neurotic patients. Based on a long clinical experience and through a reflection on the causes of the failure in structuring of the psyche in some patients, unable to symbolize and to give meaning to their own emotional states, Franco De Masi manages to undermine such a cliché. For decades he has been treating or supervisioning the so-called "intractable": the perverses, the borderline psychotics, those in which the pathogen constellations have settled so prematurely to obscure the very perception of suffering and to make the job of finding diseased parts a real deconstructive effort. The analyst here must indeed resort to the intrapsychic interpretations rather than the classic ones, focused on the transfert. For De Masi the psychopathology of these patients from a brake element not only becomes a factor of disturbance and a fruitful stimulus of the daily therapeutic activity, but it is also - and it is one of the innovative aspects of the book - the land of a revitalizated anchor of the psychoanalysis to the clinic.