chapter  4
11 Pages

Negative Th erapeutic Reaction in the Light of Object

ByRelations Th eory MATHIAS HIRSCH

Th e negative therapeutic reaction, as a paradoxical exacerbation of symptoms following a correct interpretation or any other event seen as progress in analysis or therapy, was discovered by Freud (1923). It was attributed by him to unconscious feelings of guilt because, according to him, the patient needed the illness to satisfy his or her need for punishment. Th is idea is based on the concept of instinctual drive: What requires punishment is the oedipal crime. However, progress in therapy may also be understood as separation from the dependency on internal objects opposing progress and the development of autonomy. Such departure from parental objects also causes feelings of guilt, namely separation guilt. A patient of Modell (1965) was not allowed to feel any better because, as he believed, his mother would otherwise have killed herself. Th e mother of a patient of mine fi rmly insisted on continuing to pay the patient a monthly allowance although the latter had long terminated her university studies and was earning a good salary. When the patient refused to accept the money, her mother declared desperately: “If I can’t give it to you any longer, my life is without meaning, I will kill myself then.” What connects the phenomenon of the negative therapeutic reaction with today’s topical issue of trauma is thus the great diffi culty traumatized persons have separating from the very objects once responsible for the trauma. Unfortunately, there is the apparent paradox that children receiving suffi cient love and respect are able to separate more easily, whereas children who were treated badly remain in greater dependency. According to Bowlby, “bitten lambs stay longer with the mother sheep.”