Personality disordered couples often seem impervious to change, leaving even the most skillful therapist frustrated, entangled, and at wit's end. Unable to tolerate their fear and pain, these couples reactively act out and engage in ruthless personal attacks against self, spouse, and therapist. Charles McCormack has constructed a new therapeutic approach to work with the acting-out, primitive defenses, and undifferentiated dyadic relationships characteristic of these troubled and troublesome couples.In therapy, the underlying dynamics and motivations of such provocative behavior are brought to awareness, as the therapist allows himself to identify with his own primitive self. McCormack describes this process with detailed clinical vignettes of both the verbal exchanges of the couple and the therapist's inner experience.