Sadism in transference On the relationship of death drive and negative therapeutic reaction

摘要

The negative therapeutic reaction is one of the demanding phenomena that an analyst can be confronted with in psychoanalytical treatment. It can lead to stagnation, setbacks or in the case of malignant processes to termination of treatment and other destructive means of acting out. If, however, the negative therapeutic reaction is viewed as a result of the process of treatment, as an outcome of the ongoing transference between patient and analyst, a new perspective of the inner psychic issues and conflicts that led the patient into treatment in the first place can be gained. Dealing with these issues reveals that a notion of Freud, in which he suggested looking at the negative therapeutic reaction in the context of death drive, enables a productive view of this reaction. From a clinical perspective the initial point would be an interpretation that allows the negative therapeutic reaction to be understood as the patient's sadism directed towards the analyst.