Almost Impossible Cases

Delimiting the margin that makes a patient treatable or untreatable is an operation fraught with risk, most of all because the different psychopathological variables and their interaction always produce specific profiles which never match each other perfectly. This makes it extremely difficult to derive precise data and criteria for determining in advance the conditions of treatability and the outcomes of psychotherapeutic intervention. Weakness of self, impairment in integration, egocentrism, lack of empathy and poor moral sense, and high level of narcissism are described as the principal variables that must be considered in evaluating the level of treatability.