Dynamic Psychotherapy and Its Frustrations

Abstract

Resistance in therapy is opposition to change. Freud demonstrated that psychological symptoms serve a purpose that, once it is understood, explains their necessity for the patient. For psychoanalysts and psychoanalytically oriented psychotherapists, symptoms are not the indicators of what is wrong but are instead a demonstration of how the patient is trying to guard a vulnerable area of his emotional life and protect himself from further pain. Clearly, in most cases, these coping mechanisms will not readily be given up. Every one of us in his character development comes to use various compensating and protective traits meant to fend off embarrassment, guilt, self-doubt, and other threats to his sense of integrity. People do not come to see us because they are upset about the way that their personality evolved; they come because, for one reason or another, the particular adaptations that they have made to life no longer work. Whether they realize it or not, what our patients want from us is to be shown how to restore the balance that they had achieved without their having to make any fundamental changes in the way they see themselves and others. Sometimes it is possible and reasonable to take this course; when it is not, one must sooner or later work against the patient’s resistance to change. To use an analogy, if a person has been walking with the aid of a crutch, no matter how much he may desire it, when it comes time to do without it there is a doubt as to whether or not his legs alone will really support him and there is a strong tendency to cling to the now no longer necessary support.