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Light though thou be, thou leapest out of darkness; but I am darkness leaping out of light, leaping out of thee!
Henry Smith began the session by introducing some ideas about the negative therapeutic reaction. Although it is often a puzzling phenomenon, he wondered whether it might be a reaction that appears in all analytic approaches. Do some patients respond negatively to their experience of being understood by the analyst, or to their own sense of progress, no matter the analyst's approach? Smith led us through the evolution of some of Freud's ideas about “negative reactions,” beginning with the Wolf Man. Freud's famous patient “showed a habit of producing transitory ‘negative reactions’; every time something had been conclusively cleared up, he attempted to contradict the effect for a short while by an aggravation of the symptoms which had been cleared up.” Freud reminded us that children often treat prohibitions in this same way. For example, when they are rebuked for something, they repeat it once more before stopping it. Smith noted the developmental nature of Freud's theory of the negative reaction. By 1923, Freud's more pessimistic view was evolving, as in The Ego and the Id. Freud knew that some patients react “inversely” to the treatment, demonstrating something within them that “sets itself against their recovery.” Freud identified this as a “moral” factor, “a sense of guilt, which is finding its satisfaction in the illness and refuses to give up the punishment of suffering” (p. 49). The discovery of the “unconscious sense of guilt” led Freud to study deeply masochistic patients who seemed to resist all therapeutic efforts and aims.