Metapsychological Perspectives on Psychic Survival explores the integration of traumatic helplessness in the course of psychoanalytic treatment. Based on the author’s many years of experience of working with psychotic and severely traumatised patients, this book offers guidelines to approach extreme psychic trauma in the therapeutic setting. Simo Salonen links psychic representation of the elementary drive phenomena and metaphorical thinking to primary identification understood as a mode of object finding. The collapse of this connection signifies a radical psychic trauma, the integration of which into the temporal continuity of an individual’s life is an essential task for psychoanalysis. Another key element of this book is Salonen’s notion of the primal representative matrix, referring to a resource of primary narcissism that an individual has been endowed with, carrying vital meanings. Also explored is the crucial work of mourning, as the result of which the impoverished ego may recover its primary narcissistic resources. Using insights from numerous case studies, Salonen offers a new way of understanding severe trauma, which can be used to advance both psychoanalytic theory and clinical practice. Metapsychological Perspectives on Psychic Survival will be of great interest to psychoanalysts and psychoanalytic psychotherapists.