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Inevitably during the course of psychotherapy, the therapist must deal with his patient's hostile feelings, particularly as they become manifest in the transference. Hostility, as a generic term, serves to summarize an ensemble of observable tendencies and inferred affect. This paper will attempt to describe differing patterns of affective expression, all of which can be classified meaningfully under the general heading of hostility. It is the thesis of this communication that various forms of hostility can be distinguished and that such a distinction is therapeutically valid and useful.
During the therapeutic session the psychotherapist is constantly alert to the diverse manifestations of anger and hatred emanating from his patient. Intuitively he sifts and sorts the cues, inquiring silently, “What is the patient trying to say? Or avoid saying? What is he experiencing at the moment? The way he blasts me today with a deluge of words is obviously hostile, but is this the same sort of hostility expressed a week ago when he was painfully and angrily silent?”
A gamut of hostile emotion experienced by the patient is seen further in the range of fantasies he may produce. His fantastic productions may be of murderous attack with a deadly weapon; of engulfing assimilation of the therapist's person; of blind primitive destruction; or of devastating intellectual competition. We are prone to classify these productions in terms of their primitive or infantile quality, and to refer them to theoretically relevant stages of personality development. However hostile expression is classified, an analysis of the various forms of hostility should be useful from the point of view of therapeutic understanding and manipulation.