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Primum non nocere.
This paper takes as its point of departure an intriguing idea first put forward in 1906 by Sigmund Freud in a letter to C. J. Jung that after all, psychoanalysis is actually a cure effected through love (Freud, 1906). At the time he wrote this, Freud was not thinking of the analyst's feelings of love but had in mind the patient's transference. “Transference,” he wrote, “provides the impulse necessary for understanding and … where it is lacking the patient does not make the effort or does not listen when we submit our translation to him” (op.cit.). Freud was already recognizing circumstances under which patients resist interpretations. But it was not until 1910 that he addressed the issues of the analyst's countertransference and counter-resistance.
The problem of how to resolve the resistances of analysts as well as patients and how to get people to work with each other on achieving a cure underlies all the developments in technique since that time. As Spotnitz (1985) so succinctly observes, “To work productively with … patients, the analyst has to have the ability to get them to cooperate; the more uncooperative the patient, the more difficult it is to treat him successfully” (p. 38). The difficulty, Spotnitz says, lies in the willingness or the ability of the practitioner to make the emotional sacrifices that may be called for to deal with the patient's resistances.