The Patient's Experience of Resisting in Psychotherapy
Dissertation, Georgia State University - College of Arts and Sciences (
1989)
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Abstract
The phenomenon of resistance has been the topic of considerable theoretical discussion since Freud first introduced the term in 1895, and the sparse research, conducted from a natural science perspective, has approached this phenomenon from the "outside", i.e., from the position of observer. Using an empirical phenomenological methodology, the intent of the present study was to illuminate the waning of resistance through describing the experience of an aspect of resisting as it is lived by the patient in long-term psychotherapy. In response to objections that resistance is an unconscious process, a pilot study confirmed that resisting is a genuine phenomenon with aspects available to awareness, that people can identify with it, and can provide descriptions of their internal experiences of it. The aspect of resisting investigated here was circumscribed as the difficulty the patient encounters in talking about or expressing something beneficial and instances of patient-therapist disagreement were specifically excluded. ;Five interviews with psychotherapy patients yielded individual situated structures from which was generated a general structure of the experience of resisting. The results indicated that resisting is a longitudinally-developing dynamic process, co-constituted by overlapping and interrelated temporal phases which encompass personal history as experienced in the lived present, an internal conflict expressed in a divided consciousness of self, therapist, and situation, an evolving isolation and hopelessness based on unsuccessful avoidance, an ambivalent wish for rescue, and an increasing sense of urgency as the outcome assumes critical proportion for the continuation of therapy and the therapeutic relationship. With a positive outcome, the patient experiences an enhanced sense of authenticity and power, a new depth of intimacy with the therapist, and an increased meaningfulness in the therapeutic work, all of which tend to endure. At the same time, the fears upon which the resisting was based continue to echo in other areas of the patient's life. The author concludes that resistance is most usefully, meaningfully, and accurately conceptualized as a process which is unique to psychotherapy, and as such, is not equivalent to the patient's character, nor to its source or the reasons for it