Issues of love and hate underpin our work as psychiatrists and psychotherapists, informing our attitudes and decisions. Stories of love and hate abound with our patients, perhaps even more starkly now than in the clinics of Suttie's day, with increasingly common revelations of childhood physical and sexual abuse, often perpetrated by parents. Helping patients to deal with extremes of love and hate is fundamental to the process as well as the content of therapy, and even the most biologically-minded colleagues must at times wonder why particular patients sabotage every attempt to care for them, why some patients attract superhuman efforts from nursing staff, and why some patients seem to get under our skin when others leave us feeling cold and unsympathetic.