Psychotherapy with Failures of Psychoanalysis

Abstract

From time to time patients come to one who have had years of unsuccessful psychotherapy and are in desperate need of help. To undertake the treatment of such patients is to face many difficulties. Understandably they are suspicious of the new therapist; it will not do if he reminds them of the one who disillusioned them, but if they come to like or trust him they may feel that they are being disloyal to their first therapist, to whom they still have some attachment. If they notice improvement in their condition it gives them no pleasure, for they know that they have relapsed after appearing to improve in the past. On the other hand, any setback upsets them greatly; they are convinced that they will never get well, and blame either the therapist or themselves or both. They have been made to feel that analysis is the only worthwhile therapy, and that there must be something quite specially wrong with them if it cannot help them as it has helped others; so their depression and sense of failure are reinforced. Often it is not only their psychological condition but also their realistic situation that has deteriorated, sometimes beyond repair.