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The problem of the modern-day therapist is the same as that of Freud who wrote, “The task of psychoanalysis is to help the patient say everything.” From this simple explanation of the analyst's mission two problems have emerged.
When the analyst asks the patient to talk, the patient develops a resistance to doing so. Freud was the first to discover this. He wrote that one hardly comes across a patient who does not attempt to reserve a region of himself for himself and to prevent treatment from touching that area. It is this activity that analysts refer to when they say the patient is resistant. Today's challenge, the narcissistic disorders, present even more difficulties for the talking cure. Narcissistic patients present us with nonverbal, symbolic communications or actions to express themselves, because they do not have the language with which to describe their conflicts.
A second discovery made by analysts was that, like patients, they do not want to hear everything, particularly those things that might wound the therapist's ego. The problem for therapists is that if the patient says everything it may arouse in the therapist very painful feelings and impulses. These, then, are the two main interferences to bringing about change through psychoanalysis. When the patient has trouble saying everything in the presence of the analyst, we speak of that as a transference resistance, and when the analyst has difficulty