This chapter discusses psychoanalytic definitions of psychic pain (Freud, Bion, Pontalis) in relation to two European realist texts which represent the tradition pre and post Freudian psychoanalysis: Leo Tolstoy’s Anna Karenina (1877) and Elena Ferrante’s The Days of Abandonment (2002), which latter novel intertextually invokes Tolstoy’s work of classic realism published almost a century and a half before. The chapter argues that, while modernist literary forms, and the body of criticism spawned by the latter, are most closely associated with the idea and depiction of psychic dissolution, psychological realism anticipated both the concerns and procedures of psychoanalysis and might be regarded as providing an adjunct to modern-day therapeutic practices.