Psychological resistance

Psychological resistance is the phenomenon often encountered in clinical practice in which patients either directly or indirectly oppose changing their behavior or refuse to discuss, remember, or think about presumably clinically relevant experiences.

The discovery of resistance (German: Widerstand) was central to Sigmund Freud's theory of psychoanalysis: for Freud, the theory of repression is the corner-stone on which the whole structure of psychoanalysis rests, and all his accounts of its discovery "are alike in emphasizing the fact that the concept of repression was inevitably suggested by the clinical phenomenon of resistance".

In an early exposition of his new technique, Freud wrote that "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 on the part of the patient. The process of bringing this unconscious material to light is associated with pain, and because of this pain the patient again and again rejects it". He went on to add that "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...Psychoanalytic treatment may in general be conceived of as such a re-education in overcoming internal resistances".

Although the term resistance as it is known today in psychotherapy is largely associated with Sigmund Freud, the idea that some patients "cling to their disease" was a popular one in medicine in the nineteenth century, and referred to patients whose maladies were presumed to persist due to the secondary gains of social, physical, and financial benefits associated with illness. While Freud was trained in what is known as the (secondary) gain from illness that follows a neurosis, he was more interested in the unconscious processes through which he could explain the primary gains that patients derive from their psychiatric symptoms.

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