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Defense and resistance in the psychoanalytic process.

¹School of Medicine, Hebrew University-Hadassah.

Psychoanalytic Review

|May 8, 2000

Summary

Psychic defense and therapeutic resistance often overlap, blurring distinctions between internal coping mechanisms and external treatment responses. This overlap is particularly evident in patients with severe personality disorders, impacting therapeutic outcomes.

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Area of Science:

Psychology
Psychiatry
Psychoanalysis

Background:

The concepts of psychic defense and therapeutic resistance are typically viewed as distinct psychological functions.
Defense relates to general psychic functioning, while resistance is associated with the therapeutic process.

Observation:

Clinical practice reveals frequent overlap between defense and resistance behaviors.
Patient actions can signify either or both concepts, complicating interpretation.
What appears as resistance may actually be a defense mechanism.

Findings:

The distinction between defense and resistance is not constant and can be fluid.
This ambiguity is prominent in analyzing psychosomatic patients and those with severe personality disorders.
Early life deficiencies in holding and mothering impair structuralization and differentiation between internal and external threats.

Implications:

Understanding the interplay of defense and resistance is crucial for effective psychotherapy, especially with complex patient populations.
Therapeutic strategies may need adjustment based on the underlying function of patient behaviors.
Early developmental experiences significantly shape the capacity to differentiate and manage internal versus external challenges.

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