Negative therapeutic reaction

Last updated

The negative therapeutic reaction in psychoanalysis is the paradoxical phenomenon whereby a plausible interpretation produces, rather than improvement, a worsening of the analysand's condition.

Contents

Freud's formulations

Freud first named the negative therapeutic reaction in The Ego and the Id of 1923, seeing its cause, not merely in the analysand's desire to be superior to their analyst, but (more deeply) in an underlying sense of guilt: "the obstacle of an unconscious sense of guilt....they get worse during the treatment instead of getting better". [1] The following year he offered the alternative formulation of a need for punishment instead; [2] but in his thirties summation it was again unconscious guilt to which he attributed "the negative therapeutic reaction which is so disagreeable from the prognostic point of view". [3]

Precursors to the idea can be found in his own article Criminals from a sense of guilt, as well as in Karl Abraham's 1919 article on envy and narcissism as enemies of the analytic work. [4]

Later developments

The negative therapeutic reaction is unusual in psychoanalytic history in never being the subject of major controversy, while still be steadily worked on and reformulated in later analytic phases. These have added additional motivations behind the reaction to that singled out by Freud. [5] Joan Riviere pointed to the neurotic's fear of any change in condition, even from worse to better, while the desire to spite the analyst may also be a motive. [6] Lacan highlighted the role of amour propre in the hatred of being helped by any outside force. [7] Object relations theory has also pointed to the way that underdoing defences means the patient experiencing their underlying conflicts more fully, and reacting negatively to that. [8]

See also

Related Research Articles

<span class="mw-page-title-main">Jacques Lacan</span> French psychoanalyst and writer (1901–1981)

Jacques Marie Émile Lacan was a French psychoanalyst and psychiatrist. Described as "the most controversial psycho-analyst since Freud", Lacan gave yearly seminars in Paris, from 1953 to 1981, and published papers that were later collected in the book Écrits. Transcriptions of his seminars, given between 1954 and 1976, were also published. His work made a significant impact on continental philosophy and cultural theory in areas such as post-structuralism, critical theory, feminist theory and film theory, as well as on the practice of psychoanalysis itself.

Psychoanalysis is a set of theories and therapeutic techniques that deal in part with the unconscious mind, and which together form a method of treatment for mental disorders. The discipline was established in the early 1890s by Sigmund Freud, whose work stemmed partly from the clinical work of Josef Breuer and others. Freud developed and refined the theory and practice of psychoanalysis until his death in 1939. In an encyclopedic article, he identified the cornerstones of psychoanalysis as "the assumption that there are unconscious mental processes, the recognition of the theory of repression and resistance, the appreciation of the importance of sexuality and of the Oedipus complex." Freud's colleagues Alfred Adler and Carl Gustav Jung developed offshoots of psychoanalysis which they called individual psychology (Adler) and analytical psychology (Jung), although Freud himself wrote a number of criticisms of them and emphatically denied that they were forms of psychoanalysis. Psychoanalysis was later developed in different directions by neo-Freudian thinkers, such as Erich Fromm, Karen Horney, and Harry Stack Sullivan.

Free association is the expression of the content of consciousness without censorship as an aid in gaining access to unconscious processes. The technique is used in psychoanalysis which was originally devised by Sigmund Freud out of the hypnotic method of his mentor and colleague, Josef Breuer.

Transference is a phenomenon within psychotherapy in which repetitions of old feelings, attitudes, desires, or fantasies that someone displaces are subconsciously projected onto a here-and-now person. Traditionally, it had solely concerned feelings from a primary relationship during childhood.

Repression is a key concept of psychoanalysis, where it is understood as a defense mechanism that "ensures that what is unacceptable to the conscious mind, and would if recalled arouse anxiety, is prevented from entering into it." According to psychoanalytic theory, repression plays a major role in many mental illnesses, and in the psyche of the average person.

In Freudian psychology and psychoanalysis, the reality principle is the ability of the mind to assess the reality of the external world, and to act upon it accordingly, as opposed to acting according to the pleasure principle. The reality principle is the governing principle of the actions taken by the ego, after its slow development from a "pleasure-ego" into a "reality-ego".

<span class="mw-page-title-main">Four discourses</span> Concept in Lacanian psychoanalysis

Four discourses is a concept developed by French psychoanalyst Jacques Lacan. He argued that there were four fundamental types of discourse. He defined four discourses, which he called Master, University, Hysteric and Analyst, and suggested that these relate dynamically to one another.

<i>The Four Fundamental Concepts of Psychoanalysis</i> 1973 seminar by Jacques Lacan

The Four Fundamental Concepts of Psychoanalysis is the 1978 English-language translation of a seminar held by Jacques Lacan. The original was published in Paris by Le Seuil in 1973. The Seminar was held at the École Normale Supérieure in Paris between January and June 1964 and is the eleventh in the series of The Seminar of Jacques Lacan. The text was published by Jacques-Alain Miller.

<span class="mw-page-title-main">Ego ideal</span> Freudian concept

In Freudian psychoanalysis, the ego ideal is the inner image of oneself as one wants to become. It consists of "the individual's conscious and unconscious images of what he would like to be, patterned after certain people whom ... he regards as ideal."

In the psychology of defense mechanisms and self-control, acting out is the performance of an action considered bad or anti-social. In general usage, the action performed is destructive to self or to others. The term is used in this way in sexual addiction treatment, psychotherapy, criminology and parenting. In contrast, the opposite attitude or behaviour of bearing and managing the impulse to perform one's impulse is called acting in.

Otto Fenichel was a psychoanalyst of the so-called "second generation".

Resistance, in psychoanalysis, refers to the client's defence mechanisms that emerge from unconscious content coming to fruition through process. Resistance is the repression of unconscious drives from integration into conscious awareness.

Identification is a psychological process whereby the individual assimilates an aspect, property, or attribute of the other and is transformed wholly or partially by the model that other provides. It is by means of a series of identifications that the personality is constituted and specified. The roots of the concept can be found in Freud's writings. The three most prominent concepts of identification as described by Freud are: primary identification, narcissistic (secondary) identification and partial (secondary) identification.

Metapsychology is that aspect of any psychological theory which refers to the structure of the theory itself rather than to the entity it describes. The psychology is about the psyche; the metapsychology is about the psychology. The term is used mostly in discourse about psychoanalysis, the psychology developed by Sigmund Freud, which was at its time regarded as a branch of science, or, more recently, as a hermeneutics of understanding. Interest on the possible scientific status of psychoanalysis has been renewed in the emerging discipline of neuropsychoanalysis, whose major exemplar is Mark Solms. The hermeneutic vision of psychoanalysis is the focus of influential works by Donna Orange.

Edward George Glover was a British psychoanalyst. He first studied medicine and surgery, and it was his elder brother, James Glover (1882–1926) who attracted him towards psychoanalysis. Both brothers were analysed in Berlin by Karl Abraham; indeed, the "list of Karl Abraham's analysands reads like a roster of psychoanalytic eminence: the leading English analysts Edward and James Glover" at the top. He then settled down in London where he became an influential member of the British Psycho-Analytical Society in 1921. He was also close to Ernest Jones.

A training analysis is a psychoanalysis undergone by a candidate as a part of her/his training to be a psychoanalyst; the (senior) psychoanalyst who performs such an analysis is called a training analyst.

<span class="mw-page-title-main">Joan Riviere</span> British psychoanalyst (1883–1962)

Joan Hodgson Riviere was a British psychoanalyst, who was both an early translator of Freud into English and an influential writer on her own account.

Lacanianism or Lacanian psychoanalysis is a theoretical system that explains the mind, behaviour, and culture through a structuralist and post-structuralist extension of classical psychoanalysis, initiated by the work of Jacques Lacan from the 1950s to the 1980s. Lacanian perspectives contend that the human mind is structured by the world of language, known as the Symbolic. They stress the importance of desire, which is conceived of as perpetual and impossible to satisfy. Contemporary Lacanianism is characterised by a broad range of thought and extensive debate between Lacanians.

Negative transference is the psychoanalytic term for the transference of negative and hostile feelings, rather than positive ones, onto a therapist.

Bruce Fink is an American Lacanian psychoanalyst and a major translator of Jacques Lacan. He is the author of numerous books on Lacan and Lacanian psychoanalysis, prominent among which are Lacan to the Letter: Reading Écrits Closely, The Lacanian Subject: Between Language and Jouissance (1995), Lacan on Love: An Exploration of Lacan's Seminar VIII and A Clinical Introduction to Lacanian Psychoanalysis: Theory and Technique.

References

  1. S. Freud, On Metapsychology (PFL 11) p. 390-1
  2. S. Freud, On Metapsychology (PFL 11) p. 421
  3. S. Freud, New Introductory Lectures on Psychoanalysis (PFL 2) p. 143
  4. H. Etchigoyen, The Fundamentals of Psychoanalytic Technique (2005) p. 739
  5. H. Etchigoyen, The Fundamentals of Psychoanalytic Technique (2005) p. 738=9
  6. O. Fenichel, The Psychoanalytic Theory of Neurosis (1946) p. 298 and p. 559
  7. J. Lacan, Écrits (1997) p. 13
  8. D. Bell, Reason and Passion (1997) p. 107-8

Further reading