You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
The issue of therapeutic change in psychoanalysis—what it consists of, how it comes about, what promotes and what hinders it—has occupied analysts since the very beginning. Although only a small proportion of the psychoanalytic literature has dealt specifically with the mechanisms by which therapeutic effects are achieved (Strachey, 1934; Fenichel, 1941), one also might say that there is hardly any analytic writing that does not bear in some way on this question. The purpose of this paper is to consider a special aspect of therapeutic change that, despite its importance and despite the breadth of the psychoanalytic literature, has failed singularly to receive attention. I am referring to a network of attitudes and concerns perhaps best described as the patient's fear of change. Its principal manifestation is a fear of treatment.
The thesis of this paper is that the fear of change is central to the whole analytic endeavor and that it influences in characteristic ways the course and the very outcome of the analysis. Although its manifestations are not only familiar to analysts but even routinely understood as part of the general problem of resistance, it is my impression that much of what presents itself clinically as resistance might profitably be looked upon as an expression (and consequence) of the patient's fear of change.