What is the meaning of my resistance to psychotherapy?

Abstract

This paper is the record of a reflexive process which attempts to understand the meaning of my resistance to psychodynamic therapy. Through the method of reflexive research process and using a narrative style, I explore how repressed experiences from an abusive childhood were recalled to my conscious mind, how I began to understand the transference and its effect on the therapeutic relationship and finally how I came to recognize the resistance and appreciate the potential contained within such understanding. The paper concludes with a brief description of the ways in which this experience has influenced my practice.

Keywords:

• Heuristic research
• resistance
• introjection
• impingement
• false self
• repression
• dynamic unconscious

Introduction

The question to be researched is ‘What is the meaning of my resistance to psychodynamic therapy?’

Earlier this year, I shocked myself when I threatened my therapist by saying that I would fight her to the death if she came any closer. This was not an issue concerning a fear of external, physical proximity since we sit at a comfortable distance from each other and rarely move. The anxiety and fear that I was experiencing involved an internal state which I dimly perceived to be under threat as if something was advancing towards me. I could not name ‘it’ but was terrified of whatever it was.

For several weeks prior to the threat I had been experiencing negative feelings towards my therapist and the process and always became anxious as the weekly hour approached. Nightmares which had plagued me all my life intensified and whispers of disturbing images long forgotten slithered back into conscious awareness. But, however frightened I felt, threatening another person contrasted sharply with the image I had of myself as a kind, middle-aged grandmother. For several days, I was agitated by the occurrence and could think of nothing else. So I made a decision to search for answers. It has been more than merely a search, more of the magnitude of a quest, to discover what all this negativity means.

The method which I have used to conduct my research is heuristic, ‘concerned with meanings, not measurements; with essence, not appearance; with quality not quantity; with experience, not behaviour’ (Douglass & Moustakas, 1985, p.42). It is a search for the discovery of meaning and essence in significant human experience. The aim of this type of enquiry is not to prove or disprove any particular hypothesis (Douglass & Moustakas, 1985, p. 42), although one may well begin with beliefs or convictions regarding the question under research. In this instance, I had neither beliefs nor convictions but a profound dis-ease.

Heuristics sets out to discover the nature of a problem or phenomenon and explicate it as it exists in human experience. The power of this method lies in its potential for disclosing the truth. The researcher is free to follow the path of enquiry which leads to the revelation of truth through a variety of ways: written descriptions, metaphor, poetry, dance, song, art, dialogue (Douglass & Moustakas, 1985. p. 49). Because this particular enquiry is highly individualized and has proved to be a unique, creative challenge for me, heuristic research has been the ideal, flexible method to adopt. It is a developmental model concerned with processes over a period of time, thereby enabling the researcher to work through a particular experience from various perspectives with ever deepening understanding.

Heuristic research methodology

Heuristic research begins with an initial engagement, a question to be answered or a problem to be solved. Something occurs, a ‘critical incident’, an experience, a feeling of inner discomfort and with it a need to know what is happening and why. The critical incident for me was threatening my therapist and I used psychodynamic theory to analyse the experience because it resonated deep within me and gave meaning to the experience.

Following this initial engagement, Douglass and Moustakas outline a three-phase model of heuristic enquiry, an earlier version of the Moustakas (1990) six-stage model which in the case of this investigation involved the following stages.

Immersion

During this first stage, I became passionately and totally involved in the search for meaning, trying to clarify and identify exactly what the nature of the problem was. I had a problem, but I was not able to name it. For a time it was like a period of incubation with the focus on internal self-search. You ‘crawl inside yourself’ (Douglass & Moustakas, 1985, p. 44) as it were, to find out exactly what is going on there and try to give yourself access to every room in the house. Gradually as this initial process progressed, I became aware of a growing sense of meaning and direction as the parameters of the question began to emerge and be recognized. Eureka! I finally knew what my problem was. In the words of Freud, I was experiencing a ‘negative therapeutic reaction’ (Freud, 1933, p.578), resisting therapy with all the force I could muster. When I came to the point where I felt myself to be cornered, I fired a warning shot at the therapist. With this understanding I moved to the second stage of the research.

Acquisition

This is the time when you open yourself wide to new information. In fact, open to anything which will add richness to or extend the understanding of the question and raise the activity of data collection to new heights of discovery, mystery and awe.

Of the six concepts which Douglass and Moustakas suggest, it is critical to develop in this second phase of research (see note) concepts which therapists in training learn about in varying degrees and use increasingly as research and training proceeds. In my view, this is what makes heuristic research so accessible to the practitioner. For instance, as part of my training I was encouraged to engage in self-dialogue when I reflected on various clinically related phenomena. These concepts are not to be taken as a prescription since we use them as and when they are appropriate along the path which we have chosen to follow.

The path of enquiry which held the most promise for me was reading psychoanalytic theory, which prompted self-dialogue and enabled me to differentiate between true and false in relation to my own experience (Douglass & Moustakas, 1985, p. 51). Gradually identification with certain aspects of the literature began to emerge with a clarity which often astonished and delighted me and I was able to understand my resistance in the light of psychoanalytic theory.

But with this understanding came the recall of painful repressed events from my childhood and I am grateful to others who allowed me to articulate them for the first time as an adult. One memory often led to another and, as other people responded with their wisdom and insight, I understood myself more clearly through their eyes. On one occasion, I said that I knew I was wicked. I was gently corrected: ‘No, you believed you were wicked’. This change from fact to perception was truly cathartic. It was during this phase of the research that I wrote the following narrative based on memories of my childhood experience.

The narrative

The wicked little girl sat huddled in a corner with her back pressed against the hard wall; legs drawn up, head slumped forward, arms clasped tightly round her knees in an effort to protect herself. She did not understand the reason for this particular beating, but then she never did. It was always the same; anger, violence, fear, pain, confusion and finally despair. She must be very wicked for her mother to do this again and indeed she felt wicked at this moment in time. Despair always gave way to terrifying rage with the murderous thoughts flooding her inexperienced mind. How do you kill a powerful giant? The wicked little girl had never heard of poison. She had never seen a gun or learnt of its power and since reading was a skill so recently mastered, the mighty sword of Saint George was unknown.

‘Grandma has a knife which she uses to cut meat. She says it is very sharp and I must never touch it.’

The wicked little girl sat perfectly still and imagined. Her hand grasped the very sharp knife and she plunged it again and again and again into the body of her mother until at last she lay dead, soaking in pools of crimson blood. Only then did the wicked little girl move. She came back to reality and considered the horror of what she had done. The wicked little girl knew that only the very wickedest of people kill another. Then they are caught and taken by a policeman and hanged. She knew that too. Something must be done to punish this wicked child and she knew exactly how to do it.

The wicked little girl lived in a slum dwelling near to the Tower of London. Kind people had sand brought in a huge container all the way up the River Thames. The sand was dumped on the bank of the river by Traitor's Gate and all the poor children came to play on the sand and to pretend that they were at the seaside. The wicked little girl had never seen the sea, so this thought was of no consequence to her. Besides, she did not especially like the gritty sand, but she was fascinated by the Tower and the crown jewels.

You could tell that the wicked little girl was poor by the shabbiness of her second-hand clothes. You could tell too that she was ugly with her thick, pebble National Health glasses and her bright red hair which made the street children call her ‘four eyes’ and ‘ginger’. The Beefeaters in the Tower knew that she was poor, because she never had the sixpence which was the payment required for the privilege of climbing the winding stairs in order to gaze at the dazzling jewels set in magnificent crowns. But the Beefeaters were kind and the lack of sixpence never became an issue. She saw the jewels whenever she wished.

Today the wicked little girl and her caretaker did not visit the crown jewels. Instead, they went straight into the White Tower which was the strongest fortress of the castle. They had a plan which needed to be accomplished swiftly and secretly, before anyone had time to find out and stop them. The White Tower was the keep of the castle where prisoners died in dungeons and from which there could be no escape. The caretaker knew this to be a fact. The wicked little girl must be imprisoned within this fortress so that she could not do the very wicked things that she imagined. Then both she and her mother would be safe.

They went together into the keep, the wicked little girl and her caretaker, but the caretaker came out alone quite satisfied. Although she was satisfied, she was not happy.

No-one noticed the difference. The mother thought that it was the wicked little girl who came back and she never knew that her own daughter had been locked away inside the keep, huddled in a corner with her back pressed against the hard, protective wall. She would not have cared if she had known, for she did not like the wicked little girl at all. Who could?

So the caretaker took the place of the wicked little girl and grew up to become a very good little girl who did all that she could to please everyone and make them like her. She was very clever and worked hard at school. Her teachers were pleased with her and the good little girl pretended that she was happy and safe. Of course, she was still ugly, but that had to be endured. In time, the wicked little girl was banished from the memory of the good little girl until it was as if she had never existed. And then the good little girl believed in her own creation.

The years went by and the good little girl grew. Every once in a while, a fleeting memory of a strong white tower with a tiny self crouched inside, drifted into conscious thought. But as the good little girl became taller, the tower diminished in size until finally, when the good little girl was an adult, the memories seemed to be of a model village. The adult could not really recall where she had seen it, but she knew that she had.

The only problem was the whimper. It came softly through the cobwebs of the memory and loudly through the terror of the nightmares, persistently calling for help and release. The dreams disturbed the adult, but she could not understand why they came and she never connected them to the vague memories of the model village. The plight of the child had been obliterated by the demands of living; education, the making of the marriage, care of the family, a successful career – and the need to please everyone.

Decades passed. The marriage became secure and happy, the career was completed by retirement and the grown-up children went to live abroad. The adult had time for herself now, so she returned to university and began a degree in therapeutic counselling. This is the start of her journey back; to release the imprisoned child and move towards integration and health.

I have always had an exaggerated fear of sharp knives and always had nightmares, but it never occurred to me to ask ‘what does it mean?’. Many people have nightmares and sharp knives are extremely dangerous. Besides this, living is complicated enough without exacerbating it by enquiry. My grandmother always had an explanation for everything which was unusual about me and I received her explanations as fact. In this manner I grew up, accepting the way things were, questioning nothing. I believe that things would have continued this way until my death, had it not been for this course and the radical impact it has had on my thinking.

Realization

During the period of acquisition I had collected many fragments of illumination which, although within the frame of enquiry, were lying in a heap. If ever I was to answer the question with which I began the quest, all of these fragments needed to be integrated into a whole. In the phase of realization, which includes the writing of this paper, it seems rather like doing a jig-saw but with a difference: I have no picture to follow and, until the last piece is in place, I have no precise concept of what the picture is going to be. But there the analogy of a jig-saw ends, because I am sure that this is not a flat, 2-D, inanimate puzzle that I have invested so much of myself in. It is a unique and integrated image with a powerful life of its own. At the conclusion of this research, I hope that I will be able to call the problem by name, understand its function, grasp its source and, finally, divest it of power (Douglass & Moustakas, 1985, p. 42 ).

It was in this phase that I began to give meaning to the experience in the light of psychoanalytic theory. As I analysed the data in this way, my understanding of the experience began to constellate into three broad groups:

1.	the recall of repressed events;
2.	the significance of the transference in therapy;
3.	the meaning of the resistance.

It is within the parameters of these three constellations that I shall continue the narrative.

The recall of repressed events

In therapy, I was frightened because I imagined something of vast and terrifying proportions pursuing me with malevolent intent. During this time, nightmares became more frequent until I could feel the breath on my heels. When I disclosed this, my therapist identified the ‘thing’ as a repressed object desiring to return to the conscious. She directed me towards a paper written by Fairbairn which I found especially helpful. It enabled me to understand how, as a small child suffering the uncontrolled and unpredictable anger of my mother, I identified her as a bad person (an object) and this for me had been intolerable (Fairbairn, 1952, p.63). In another paper, Fairbairn proposed that ‘the ultimate goal of libido’ was in fact the object and not the erotic zones of the body as Freud had believed (Fairbairn, 1952, p.31). In a very young child, the libidinal drive is powerful and irresistible so, if Fairbairn's theory held truth, I would have had no option but to pursue my mother in spite of the fact that I was terrified of her violence and cruelty. I remembered many occasions when, as a child, I desperately wanted her and was willing to live in torment in order to reach her. As a consequence of this reading, I found myself with two beliefs. I desperately needed my mother and yet her ‘bad’ condition was intolerable to me. This situation seriously compromised my sense of safety and the well being essential for healthy development so, as a moral defence, I sought to purge my object of badness, drawing it like poison, out of her and into me. By taking on this burden of badness I believed that I would create for myself an object that was good and then my external security would be upheld (Fairbairn, 1952, p. 65). Earlier, Freud had described a process whereby the object was ‘drawn back inside the self’ from the external world into the internal space, a process he called introjection. He too understood this process to be problematic (Hinshelwood, 1994, p. 18).

As a clearer idea emerged of how I attempted to cope with my childhood, I realized that, try as I might, such frequent abuse at an early age was too intense for me. This impingement, that which interrupted my ‘continuity of being’, created a trauma which left me no other option but to react (Abram, 1996, p.163). On one vividly recalled occasion, I was dragged into the street and beaten publicly. At last, I am able to understand that it was my reaction to this particular beating which caused the final and ultimate damage. I was used to the pain, but the public shame was a new experience and my rage towards my mother overwhelmed me. This sense of shame, combined with the trauma, created a fantasy which drew its energy from the intensity of the anger I felt that day (Kalsched, 1996, p.71). In my imagination, I found my grandmother's sharp carving knife and plunged it repeatedly into the body of my mother until she was dead. When I regained some equilibrium, it was the horror of what I had done which caused me to take action and punish myself.

The action I took was entirely dependant on the success of my former identification with the bad object (Freud, 1933, p. 528). I was persuaded that I was the one who was totally wicked and believed that my good mother needed protection from me if she was to survive. I also needed protection both from the consequences of my murderous intentions and the belief that my mother disliked me and wanted to get rid of me. Drastic action needed to be taken and I knew precisely what to do. I took myself off to the Tower of London, a favourite play area for me in those days, and incarcerated my wicked self in the dungeon of the keep. Because, in my terror and rage, I was unable to distinguish fact from fiction, the dramatic combination of trauma and fantasy had a profound effect on my psyche and made the trauma worse (Kalsched, 1996, p.71). As I sought to defend myself against the perceived threat of annihilation, I hid the core of myself away, a primitive defence known as splitting (Jacobs, 1998, p.68). This defence was intended to hide and protect my core self but, in reality, I lost connection with my true self and a false, caretaker self took over (Abram, 1996, p.159). The newly appointed caretaker took its role very seriously and became equipped with the strength of my childish aggression (Freud, 1933, p.573). Nothing, nobody would ever be allowed to access me again and all of the memories surrounding this time of my life were filed away into the unconscious, a process known as repression (Jacobs, 1988, p.11).

The significance of the transference

I began therapy over a year ago in a tentative frame of mind. I was aware of the fact that forty hours was mandatory and also that this was to be no ordinary relationship (Clarkson, 1995, p.6). I was, however, totally unaware of the activity of a dynamic unconscious directing me to choose a female, psychodynamic therapist upon whom I could transfer my lifelong yearning for a ‘good-enough’ mother. Neither was I aware that, in order to fulfil this yearning, I would need to accomplish the transference of a bad inner object while holding my therapist responsible for my emotional development in this failed area (Symington, 1986, p.112). But, in reality, this is what occurred:

As the positive transference relationship developed and I became secure within it, I found that I was able to disclose many things about my childhood which I had never shared with anyone else and which, until this time, had seemed to be forgotten. Many essential things had been retained in these memories and, as they were extracted by analysis (Freud, 1914, p.148), I found that my anxiety levels were rising. Let me take an example of this. I shared the occasion when, as a small girl, I had endured a public beating which shamed me and was severe enough to tear my knickers and expose my vagina. My therapist noticed that I had shown no feeling for myself as I shared my story but that she had felt distress and outrage on my behalf. I experienced her response as reparative and, although by now quite fearful, I found some courage to continue. This particular incident released a flood of ‘forgotten’ memories which, as they emerged, stampeded towards my therapist bearing the hatred I had felt for my first object (Symington, 1986, p. 107). As I had once in fantasy threatened to kill my mother, I now reproduced this threat, not as a memory but as an action. Through this act of repetition, I had conjured up a piece of real life (Freud, 1914, p.152) which terrified me then, as it had done in the past. The repressed had finally returned and I was once again lured into the activities of the bad object as I had been as a child (Symington, 1986. p.110). I believed that my mother wished to dispose of me, I attempted to dispose of myself and now I wanted to dispose of my therapist.

But the therapist was not my mother and the calm acceptance with which the threat was received created an especially favourable condition and held me fast in the whirlwind of the fear. This transference relationship became for me ‘an intermediate region between illness and real life’ (Freud, 1914, p.154) and I found that, gradually, I was able to move securely forward to a place of healing. It was within the security of this ‘intermediate region’ that I gradually developed the ego strength I needed to face my ‘intra-psychic conflicts’ and assume responsibility for them (Hoag, 1992, p.418).

The meaning of the resistance

I believe now that the meaning of my resistance to therapy can be understood as the defensive response of the false caretaker system, called into existence by the original trauma and now threatened by a repeat of that trauma through the process of remembering. Allow me to explain.

As the therapy proceeded and repressed memories were recovered, I became irrationally convinced that I was in extreme danger. As far as the caretaker was concerned, I was indeed facing the ultimate danger, the danger of experiencing once more the affects of the trauma which led to dissociation and splitting in the first place. Re-integration must never be allowed to occur and I am able to give an example of the resistance in action.

I had just read aloud the story of the wicked little girl and when I looked up my therapist was crying. Why would she do that since I felt nothing? I reacted negatively to her compassion and resisted her tears. I spoke to myself (as my mother used to speak to me). ‘It is utterly futile and contemptible to feel like this, to show this level of weakness. You must remain strong. She is trying to manipulate you and trap you. Keep away from her my girl. The last thing you need is sympathy.’ Only later was I able to receive this as a reparative act (Clarkson, 1995, p.109).

Although the original intention of the caretaker was to protect the vulnerable child, having imprisoned her in the Tower, it assumed a role far in excess of protector. It imitated the behaviour of the bad mother by criticizing and persecuting the child at every opportunity, making life hell. It became an ‘internal saboteur’ (Fairbairn, 1952, p.101), wielding greater power than my ego. Now, here we were remembering all that should remain repressed, challenging not only the authority but the need for the caretaker's very existence. The aim of the caretaker had always been survival not individuation (Kalsched, 1996, p. 66) and now it fiercely refused to give up its role and allow dissociated traumatized affects to be re-experienced and healed.

Quite unexpectedly during this time, and much to my surprise, I found that I had become strongly attached to this persecuting inner object and wished to collude with its desire to resist (Kalsched, 1996, p.55). I really wanted to co-operate with the therapeutic process but I ‘agreed’ with the caretaker not to. I requested a break from therapy which was firmly denied. I arrived for the hour determined not to work. I agreed that it was far better to hide away than be known. It was during this phase of the analysis that I shared recalled memories of hiding physically as a child whenever I was afraid, under rows of coats at school, in a small dark broom cupboard, at the bottom of a wardrobe, anywhere that would be a substitute for the Tower and keep me safe. Now, as I remembered the Tower and why I had been incarcerated there all my life, the terror returned and my hatred for my mother transferred to my therapist. I defended myself by acting out the ultimate resistance. I threatened to kill her as I had once wanted to kill my mother. The shock of wanting this brought me to my senses as I have already described and, for some time after this event, my psyche became ‘the battleground on which the titanic forces of dissociation and integration were at war with my personal spirit’ (Kalsched, 1996, p.26). My ego was weak then and, although the war was painful, I believe now that victory was never in doubt. This belief rests on a threefold dynamic. The repressed had returned and I had survived. The transference relationship held me securely while my ego grew strong enough to challenge the activity of the caretaker and assume its rightful role. Finally, I became aware of the intentions of a loving God who had long ago searched and known me and now wanted me to search and know myself in a far deeper way.

Kalsched (1996) writes that:

The selfsame powers that seemed so set on undermining our therapeutic efforts – so ostensibly devoted to death, dismemberment and annihilation of consciousness – are the very reservoir from which new life, fuller integration and true enlightenment derive – if they are humanized through the transformative process of ‘good enough’ psychoanalysis. (P. 61)

I have been privileged to experience this.

Findings and conclusion

Earlier in this paper, I wrote that my hopes for this project were to ‘call the problem by name, understand its function, grasp its source and finally divest it of power’. I believe that I have successfully accomplished this mission statement and it has had a significant influence on my professional development and my relationships with others.

For example, I am no longer disturbed by patient resistance because, in my experience, resistance is indeed a reservoir, something to be explored and understood since ‘one cannot overcome an enemy who is absent or not within range’ (Freud, 1914, p.152). Resistance holds the keys to all that has been repressed and working with this phenomenon ‘effects the greatest change in the patient’ (Freud, 1914, p.155).

During my research, I have acquired a deeper knowledge of psychodynamic theory which has become grounded not in intellect alone, but in the inmost part of my being. This new wisdom has become mine as I have seen myself reflected in the understanding and experience of others. Now, it accompanies me into every situation and I believe that it must influence my perception of a patient's problems and needs.

As I began the research to reveal the meaning of my resistance to therapy, I found that it was necessary for me to extricate my issues from the issues of others and hold them separately. Having done this, I was able to explore my issues, to come to understand them and to deal with them in a decisive, compassionate manner. This was altogether a new experience for me and I had to acquire this skill, but now I am able to accomplish this in all my relationships and life is much less stressful. In my view, this is one of the skills used in the recognition of counter-transference which might occur unexpectedly in therapy at any time.

Finally, but by no means exhaustively, I have had a powerful experience of a transference relationship which has allowed me to repeat my traumatized past in safety and move on to a place of increased wholeness. This experiential understanding has shown me the value of working within this relationship and cleared up much of the confusion I have had since I began training. I believe that I am already open and alert to signals which I failed to recognize in the past and I look forward to engaging with my patients from this position of increased competence and confidence.

Limitations

In closing, I must make mention of what for me appears to be the limitations of this research. Although validated by the honoured works of other psychotherapists, it is nevertheless subjective and concerned with my own experience. There are, however, ways in which the research could be further validated by more extensive research. First, I could investigate my own position more fully, including the limits of my theoretical perspective. Second, I could share my experience with a group of others who had also encountered resistance in their own therapy in order to determine whether their experience resonated with mine. Indeed, disseminating the work in this paper is a step in that direction.

Postscript

On Saturday 8 November 2003, my husband and I went to the Tower of London. We entered the White Tower together and symbolically released the child from the dungeon. She had been imprisoned there for 57 years.

Steps of heuristic enquiry

1.	Immersion (exploration of the question or theme)
2.	Indwelling, internal frame of reference, self search
3.	Acquisition (collection of data)
4.	Tacit knowing, intuition, inference, self-dialogue, self-disclosure
5.	signitive symbolic representation
6.	Realization (synthesis)
7.	Intentionality, verification, dissemination (Douglas & Moustakas, 1985, p.46).

Acknowledgements

I would like to thank all those who have been involved in the creation of this paper and who have encouraged me throughout the process. In particular I would like to thank my therapist for giving me a safe space to repeat and remember, my tutor John Lees who first taught me to question and reflect and my husband David who believed all along that I could do it!