The author presents a long-term psychotherapy process that illustrates the challenges of helping a patient with a severe personality disorder to engage in the process of mentalizing. Illustrative therapist-patient dialogue from several sessions over the course of the psychotherapy supports the author's conclusion that, despite the therapist's perseverance, the patient remained stuck in her determination to use the therapist as a means toward self-sabotaging practical ends rather than establishing a relationship that would support reflection and growth.
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