Treatment of the Difficult Patient in Psychotherapy

Abstract

Difficulty in psychotherapy may be viewed as excessive effort by the therapist, perhaps taking the form of the therapist's struggle against resistance. It is experienced by the therapist as being unable to understand the patient or that he may be defensively confused by the patient. Different patterns of difficulty may be stimulated by the various phases of therapy or by the therapist's level of experience. Although difficulty may be responded to in different ways by therapists it is stressed that it is an essential component in promoting therapeutic change. Several cases help to clarify the meaning of difficulty.