Negative Therapeutic Reaction and the Compulsion to Disappoint the Other, April 16, 2016 - Toronto

Saturday, April 16, 2016, 8:00 am – 4:00 pm
Hart House, University of Toronto

Negative Therapeutic Reaction and the Compulsion to Disappoint the Other
Presenter: Léon Wurmser
Discussant: Charles Hanly

Very often when we work with patients with severe neuroses we have to contend with what Freud (1923) called the “negative therapeutic reaction”: that every progress in the analytic or therapeutic work is paradoxically followed by a clinical deterioration. The entire therapy and their life as a whole seem to be strongly influenced or even pervaded by a sense of negativity, nothing good is allowed to stand. These patients struggle with guilt, shame, the subversive unholy trinity of envy, jealousy, and resentment, attachment to pain, turning trauma from passive to active, conflicts within the superego, fear of gratitude, and the defensive use of omnipotence of responsibility. The case presented demonstrates these complex dynamic factors and treatment challenges.

Childhood Traumatic Experience and Developmental Interference
Presenter: Harold P. Blum
Discussant: Margaret Ann Fitzpatrick Hanly

The young man began psychoanalysis complaining of generalized anxiety and depressed moods since his late adolescence. Although well functioning in many areas, he was dependent, needy, and gratified by the intimacy and frequency of the psychoanalytic situation. Interpretation of his intrusive fantasy life was synergistic with retrieval and reconstruction of pathogenic childhood traumatic experience. Born to adolescent parents, he progressively mastered ongoing developmental interference. A very rewarding analytic outcome was achieved without the ancillary use of pharmacological agents or supportive psychotherapy.

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