The negative therapeutic reaction in
psychoanalysis
PsychoanalysisFrom Greek: + . is a set of theories and therapeutic techniques"What is psychoanalysis? Of course, one is supposed to answer that it is many things — a theory, a research method, a therapy, a body of knowledge. In what might b ...
is the paradoxical phenomenon whereby a plausible interpretation produces, rather than improvement, a worsening of the analysand's condition.
Freud's formulations
Freud first named the negative therapeutic reaction in ''
The Ego and the Id
''The Ego and the Id'' (german: Das Ich und das Es) is a prominent paper by Sigmund Freud, the founder of psychoanalysis. It is an analytical study of the human psyche outlining his theories of the psychodynamics of the id, ego and super-ego, w ...
'' 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". The following year he offered the alternative formulation of a need for punishment instead; 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".
Precursors to the idea can be found in his own article
Criminals from a sense of guilt, as well as in
Karl Abraham
Karl Abraham (; 3 May 1877 – 25 December 1925) was an influential German psychoanalyst, and a collaborator of Sigmund Freud, who called him his 'best pupil'.
Life
Abraham was born in Bremen, Germany. His parents were Nathan Abraham, a Jewish ...
's 1919 article on envy and
narcissism
Narcissism is a self-centered personality style characterized as having an excessive interest in one's physical appearance or image and an excessive preoccupation with one's own needs, often at the expense of others.
Narcissism exists on a co ...
as enemies of the analytic work.
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.
Joan Riviere
Joan Hodgson Riviere (28 June 1883 – 20 May 1962) was a British psychoanalyst, who was both an early translator of Freud into English and an influential writer on her own account.
Life and career
Riviere was born Joan Hodgson Verrall in Bri ...
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.
Lacan
Jacques Marie Émile Lacan (, , ; 13 April 1901 – 9 September 1981) 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 ...
highlighted the role of
amour propre
''Amour-propre'' (; ) is a French term that can be variously translated as "self-love", "self-esteem", or "vanity". In philosophy, it is a term used by Jean-Jacques Rousseau, who contrasts it with another kind of self-love which he calls ''amour ...
in the hatred of being helped by any outside force.
Object relations theory
Object relations theory is a school of thought in psychoanalytic theory centered around theories of stages of ego development. Its concerns include the relation of the psyche to others in childhood and the exploration of relationships between ...
has also pointed to the way that underdoing defences means the patient ''experiencing'' their underlying conflicts more fully, and reacting negatively to that.
See also
References
{{Reflist, 2}
Further reading
*
Karen Horney, The Problem of the Negative Therapeutic Reaction' (1936)
* J. Seinfeld, ''A Primer of Handling the Negative Therapeutic Reaction'' (2002)
External links
Negative Therapeutic Reaction
Freudian psychology
Psychoanalytic theory