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The patterns of rejection of psychoanalytic psychotherapy observed in certain patients appear to constitute the syndrome of the “treatment-rejecting patient.”
For nearly two decades the author has been impressed by the remarkably forceful devices for rejecting, or getting rejected, from treatment revealed by a sizable number of patients suffering from this symptom complex.
We are calling attention to diagnostic observations which are to be clearly differentiated from the more usual “resistance patterns.” Hard and fast lines cannot be drawn between the two, and a certain degree of overlapping is probably inevitable. Such references as “preanalytic resistance”1 and insuperable barrier2 in the treatability of the narcissistic patient touch on aspects of this problem. However, while the literature, especially the technical,3 is replete with comments on patients who break off, abandon or discontinue analysis, this paper is limited to material aiding in the recognition of the particular psychological behavior in a specific treatment-rejecting syndrome.
The study is focussed on how and why these patients have been so expert in inducing dismissal from psychoanalysis and analytic psychotherapy with such cliches as “unanalyzable,” “untreatable,” “incurable,” “too resistant,” “too refractory,” or “unsuitable for psychoanalysis.” Even when referral is made, the consultant's prognosis