4. Resistance

The vocabulary employed to deal with the patient's resistance is confusing and rich in metaphors whose primary meaning is based on man's struggle for existence, or even on war. In fact, it contradicts common sense that a patient seeking help because of emotional or psychosomatic suffering should also display forms of behavior that Freud summarized by the term “resistance.” Yet most important is that we emphasize that at the same time patients primarily seek special help in the relationship to their doctor and the transference relationship to the psychotherapist. The appearance of resistance phenomena is secondary; they are the consequence of disturbances which lead inevitably to resistance in one form or another. Such disturbances in the therapeutic relationship provided the occasion for the original observation of resistance. Thus we can still say with Freud (1900a, p. 517), “Whatever interrupts the progress of analytic work is a resistance.” Analytic work is performed in the therapeutic relationship. Thus the basic pattern exhibited by resistance is directed against the transference relationship which is being sought (see Chap. 255).

The patient seeking help comes to realize, just like his therapist, that the process of change itself is unsettling because the balance that the patient has attained, even at the cost of serious restrictions of his internal and external freedom of movement, guarantees a certain degree of security and stability. On the basis of this balance, events are unconsciously expected and imagined, even though they may be unpleasant in nature. Although the patient consciously desires a change, a self-perpetuating circle is created, maintained, and reinforced because the balance, however pathological its consequences may be, contributes decisively toward reducing anxiety and insecurity. The many forms that resistance takes have the function of maintaining the balance which has been achieved. This reveals different aspects of resista