Psychoanalysis and the Rite of Refusal

Abstract

What do patients want? The great conundrum of psychoanalysis is why it is so hard to change patients who ostensibly plead for help. And, why is change itself so often suspect, a “flight into health,” a resistance? This conundrum, this odd “refusal,” is the bane of psychoanalytic therapy and, at the same time, the machine that drives it. This essay explores the ramifications of refusal, suggesting that it is considerably more than resistance out of anxiety.

Notes

¹The affect in these dreams of death and dying is often remarkably bland, even accepting. They are not dreams of panic and despair, which leads me to believe they are may be premonitory of positive change.

²Perhaps Freud's treatments were simply not long enough! Many therapies were a short few months or several summers in a row.

³See Gedo (1999, p. 135) for an explication of this theme.