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Recently psychoanalysis has paid increasing attention to the problem of patients who present an intense oppositional stance, described by Lane, Hull, and Foehrenbach (1991) as “an addiction to negativity.” This form of resistance may not only be to change but also to any sort of soothing or comfort from the therapist. It has been linked to the negative therapeutic reaction, a paradoxical worsening in symptoms following correct analytic work or initial improvement. Explanations for this reaction have been related to various theoretical positions.
Freud attributed the Wolf Man's “transitory negative reactions” as each symptom was analyzed to a sort of stubbornness or “anal defiance,” like a child's need to appear to disobey a prohibition by repeating the forbidden action one more time so that later obedience would seem to be his own will. Later the occurrence of negative reactions became one of the foundations of the structural theory; in “The Ego and the Id” Freud attributed negative reactions to unconscious superego-imposed guilt or to guilt “borrowed” by identification with a guilt-ridden libidinal object. Even later, in “Analysis Terminable and Interminable,” he pessimistically linked negative reactions to an excess of thanatos over libido.
Horney (1936) described the interpersonal aspects of the negative reaction as related to the appearance of narcissistic factors and envy of the analyst as sources of resistance. Riviere (1936) described the negative reaction from a Kleinian theoretical view as a manic flight from the depressive position by a patient who fears that his own aggression will be totally destructive and who has to protect his internal objects by omnipotent control over his impulses.
The negative therapeutic reaction is as much to the therapeutic situation as it is to individual interpretations. These patients may seem almost determined to destroy the process of analysis and any hope of improvement, and some interpretations of the negative reaction have