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In this thoughtful new volume, the author attempts to explicate the negative therapeutic reaction from an object relations perspective. He views this phenomenon as always involving a mixture of structural deficit, that is, a lack of internalized positive self- and object representations and an identification with a bad object. Lack of positive experiences with early parental objects accounts for the former. He accounts for the latter as follows: Early parenting figures reject the child's need for positive object experience, with the result that the child, identifying with the actual rejecting object in external reality, may actively reject his own need for loving, caring figures. Seinfeld suggests that this identification with a rejecting bad object leads such patients to reject the therapist's efforts to be helpful. He also postulates that the lack of real positive object experiences early in life makes it difficult for such persons to be receptive to internalizing a new positive object experience. The author's metapsychological framework for understanding these phenomena involves a synthesis of Jacobson and Fairbairn. Drawing on their ideas, Seinfeld proposes that in the negative therapeutic reaction “the negative self- and object representation unit splits off a positive self- and object representation unit” (p. 14).
I find this formulation problematic for several reasons. The author does not distinguish sufficiently between identification