the therapist has a penchant for dreams, then the
therapist may be deluged with dream material. In
some instances, the patient’s feelings or ideas about
the therapist may begin to dominate the sessions.
This can be very flattering until the therapist realizes
that this interest is just a way of avoiding the real
problems. Another form of resistance is the tendency
to omit or censor certain information.
Resistance is also evidenced when a patient
repeatedly comes late, cancels appointments with-
out good reason, forgets meetings, and so on. The
therapist may also begin to notice that a variety of
“real”events in the patient’s life seem to be con-
spiring against the sessions. For example, the patient
may begin missing sessions because of a succession
of physical illnesses or may constantly ask to change
appointment times to meet one daily crisis after
another.
Nearly anything can become a form of resis-
tance. As the patient’s defenses are addressed, there
is sometimes an intensification of symptoms. But the
opposite can also take place so that an actual“flight
into health”occurs—the patient gets better. It is
almost as if, in the first instance, the patient is saying,
“Don’t make me confront these things. I’m getting
worse.”In the second instance, the patient is saying,
“See, I don’t need to deal with these matters. I’m
getting better.” Another method is“acting out.”
Here the patient attempts to escape the anxiety gen-
erated in therapy by indulging in irrational acts or
engaging in potentially dangerous behavior. For
example, a patient suddenly takes up mountain
climbing or begins to use cocaine or heroin. Still
other patients flee into“intellectualization.”Experi-
ences or memories become stripped of their
emotional content and are dissected calmly and
rationally. Everything becomes cold and detached.
Losing one’s job becomes an occasion for an elabo-
rate, intellectual discussion of economic conditions
or the shift to high technology. Feelings are ignored,
and the experience is handled by a flight into
rationality.
In one form or another, resistance goes on
throughout the course of therapy. In one sense,
it is an impediment to the swift resolution of neu-
rotic conflicts. But in another sense, it is the cen-
tral task in therapy. The resistance that goes on in
therapyprobablymirrorswhathashappenedin
real life. If resistance during therapy can be ana-
lyzed and the patient made to understand its true
function, then such defenses will not be as likely to
operate outside the therapist’s office. The follow-
ing is an example of how one therapist met the
problem of resistance.A Case Illustration of Resistance
The wife of a minister has been in therapy for several
months. In the previous session, a series of inter-
pretations were made regarding her tendency to
see her husband rather than herself as completely
responsible for their unsatisfactory sexual
adjustment.
Therapist:You don’t seem very responsive today.
Patient:I don’t have much on my mind.
Therapist:You seem almost impatient.
Patient:I was just thinking what a stupid little office
this is. It’s so oppressive.
Therapist:That’s strange. You never commented on it
till now.
Patient:I never thought about it until now.There is a long silence during which the patient glances at
her watch twice. Finally, the therapist breaks the silence.
Therapist:I wonder if all this has anything to do with
what we discussed last time.
Patient:I just knew you were going to say that. Well,
I don’t think so because I can’t recall what it was
we talked about.
Therapist:Is that right? (Smiling)
Patient:Well...as a matter of fact...well, I think it is
my husband’s fault. He can be so aggressive. With
other people he seems so patient and under-
standing, but...
The session continues, and there is further exploration
into the patient’s sexual attitudes.PSYCHOTHERAPY: THE PSYCHODYNAMIC PERSPECTIVE 353