How is it possible for two beings to connect solely out of an overwhelming need to destroy each other? The concept of a perverse couple relationship, which is developed in this book, does not primarily refer to sexual practices. The pathology of such relationships does not necessarily manifest in blows and screams, but in the refined psychological strategies employed by one or both partners to derive pleasure at the expense of the other, in the destruction of the other. The perverse individuals are masters of the art of paradox and insinuation, of subtle malice and ambiguity. They use communication not to communicate, but to destabilize the other. With their arrogant behavior and hostility, these patients threaten the professional self-understanding of the therapist.