Levels of sameness: Understanding 'resistance' at the level of the therapeutic system

摘要

The psychoanalytic idea of 'resistance' is reframed in terms of a system's inherent tendency to seek stability in the face of change. Resistance is considered on two levels: the intrapsychic level at which an individual seeks to avoid the experience of psychic pain or discomfort, and the interpersonal level at which the therapist and client together constitute a therapeutic system that can manifest an isomorphic tendency to avoid discomfort and to thereby maintain a problem or symptom. The implications for psychotherapy and for psychotherapists of this understanding of resistance are examined. The argument is supported by a juxtaposition and comparison of the therapeutic approaches of two therapists who made their respective marks in psychodynamic and family therapy practice, respectively, during the 1970s - Habib Davanloo, who focused on overcoming intrapsychic resistance, and Salvador Minuchin, whose focus was, in those days, on overcoming resistance at the level of the family system. Both of these therapists created and managed instability within the therapeutic system in order to bring about change in otherwise unchanging problematic circumstances.