The Analyst and the Crisis of the Therapeutic Relationship

During the analytic process it is inevitable for the analyst to be faced with a particularly difficult, if not critical situation which, at times, may appear to be unbearable. A good analytic relationship may have been established and the process may seem to be proceeding towards a positive outcome, i.e., the patient feels confident in his relationship with the analyst, his or her symptoms gradually abate, and the patient perceives a new trend toward self-realization. Then the patient experiences a sudden recrudescence of his symptoms, a sudden depression, and may even threaten to abandon therapy.

In this regard, in his book “I and Es” of , Freud speaks about the reaction to therapeutic progress or to a partial or temporary abatement of the symptoms, with a worsening of their condition. According to Freud, resistance functions underlie this reaction, such as challenging the therapist, holding on to minor benefits of the disease, or narcissistic inaccessability. A thorough examination of this resistance shows the presence of a more complicated and difficult obstacle that has to be overcome and solved. There is “no doubt that in such individuals there is something that resists recovery, and its approach is feared—like danger. It is said that in this patient, not the will to recover, but the need to be sick has the upper hand….” The patient may be having feelings of guilt and does not want to give up the punishment of suffering. The patient is not aware that he feels guilty, he simply feels ill. This feeling of guiltiness is externalized only in the form of resistance.

Freud warns that it is not easy for the analyst to cope with the obstacle represented by an unconscious feeling of guilt and that it is absolutely impossible to fight against it directly. The only possibility is to bring to the surface the repressed unconscious grounds of this feeling of guilt; however, the process is slow and its outcome by no means guaranteed. In his attempt to oppose the negative forces