The Negative Therapeutic Reaction

In Analysis Terminable and Interminable, Freud (1937) speaks of the negative therapeutic reaction, linking it to the effects of the death drive, after having linked it in his earlier writings (The Ego and the Id, 1923) to unconscious guilt, masochism, the need for punishment and the resistances of the superego.

Anyway, it is defined as a paradoxical aggravation during the course of a treatment, occurring after an improvement and particularly, says Freud, when one has drawn the patient's attention to this improvement. It is considered as a particularly tough resistance, which, like a quicksand in which the analyst is caught, sucks and traps him all the more as he increases his efforts (interpretations) to escape from it.

Nevertheless, it is not the equivalent of a failure of the analysis, although it can be a cause, due to a rupture or to getting bogged down in an interminable treatment. It bears witness to a specific psychic organisation of narcissistic problems of identity, with a relationship to the primary object that is marked by pain, frustration and failure to adjust to the patient's needs (including the failure to recognise the child as a distinct individual). It is the transference reactivation of this unbearable pain which raises a radical opposition to the transformative potential of the analysis. The patient clings hatefully and desperately to the analyst, who is experienced as a reincarnation of this passionately cathected primary object whom there can be no question of losing, but to whom there can equally be no question of “yielding”. The patient “reacts” to the analyst by opposing every “action” on the latter's part, because to change, to be transformed, would feel like submission to the object and a defeat of identity. “Change!” the patient hears the analyst saying. “Renounce your suffering!” “I would rather die!” replies the patient. “Rather die than be healed, give in to you, give you pleasure, lose you.”

“To get better” would be to lose the object: n