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Concepts
Psychosexual development
Psychosocial development
Conscious • Preconscious • Unconscious
Psychic apparatus
Id, ego, and super-ego
Libido • Drive
Transference • Ego defenses • Resistance “There is, however, another point of view which you may take up in order to understand the psychoanalytic method. The discovery of the unconscious and the introduction of it into consciousness is performed in the face of a continuous resistance (Widerstände) on the part of the patient. The process of bringing this unconscious material to light is associated with pain (Unlust), and because of this pain the patient again and again rejects it. It is for you then to interpose in this conflict in the patient’s mental life. If you succeed in persuading him to accept, by virtue of a better understanding, something that up to now, in consequence of this automatic regulation by pain, he has rejected (repressed), you will then have accomplished something towards his education. For it is an education even to induce a person who dislikes leaving his bed early in the morning to do so all the same. Psychoanalytic treatment may in general be conceived of as such a re-education in overcoming internal resistances.” (Sigmund Freud, 1959/1904, pp. 261-262) Although the term resistance as we know it today in psychotherapy is largely associated with Sigmund Freud, the idea that some patients “cling to their disease” (S. Freud, 1959/1904, p. 254) was a popular one in medicine in the nineteenth century and referred to patients whose maladies did not improve due, presumably, to the ‘secondary gains’ of social, physical, and financial benefits associated with illness (Leahy, 2001). Freud’s only contribution to that initial notion of resistance came as a side-effect from his larger, more revolutionary contribution to the field of psychology The dissemination and popularization of the influence of the unconscious on human behavior (Hergenhan & Olson, 2003). Accordingly, although Freud was trained in and familiar with the notion of secondary gain popular at the time (Freud, 1959/1926a, pp. 97-100), he came to see it as an unconscious phenomenon. Freud’s more specific contribution to the treatment of the mentally dis-eased was a model of human psychological functioning that offered an explanation of the primary gains that patients derive from their psychiatric symptoms (Fenichel, 1945; Wolitzky, 2003). This model explains that the symptoms represent an unconscious tradeoff in exchange for the sufferer being spared other, experientially worse, psychological displeasures (Unlusten). This conceptualization of primary gain is what Freud (1959/1896) labeled a “compromise formation,” (Kompromisslösung; p. 163). And while the distinction between primary gain (internal benefits) and secondary gain (external benefits) was not directly articulated by Freud, it was alluded to, for example “In civil life illness can be used as a screen to gloss over incompetence in one’s profession or in competition with other people; while in the family it can serve as a means for sacrificing the other members and extorting proofs of their love or for imposing one’s will upon them….we sum it up in the term ‘gain from illness’….But there are other motives, that lie still deeper, for holding on to being ill…[b]ut these cannot be understood without a fresh journey into psychological theory” (1959/1926b, pp. 222-223).
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Psychological Resistance Subcategories
Psychological Resistance Articles
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