ABSTRACT
This chapter traces the Freudian concept, the subsequent development, and the contemporary understanding of negative therapeutic reaction (NTR). It discusses some clinical material, which exemplifies some of the features of the NTR in a psychoanalytic therapy. The relationship between the clinical concept of the negative therapeutic reaction, Sigmund Freud's concept of negation, "the work of the negative", and the intrapsychic forces of destruction exemplified by Freud's concept of the death instinct is complex and deserves careful theoretical and clinical investigation. The NTR remains a psychoanalytic concept in good standing, provided that it is clearly defined. Freud's definition has been reconfirmed and elaborated over time. He stresses that the patient's suffering is key to moral masochism and to its manifestation in the NTR during analysis. Karen Horney describes several possible reactions to a successful interpretation by the analyst that she found to characterize patients who exhibit negative therapeutic reactions.
