Some psychodynamics of non-compliance

With up to 50% of psychiatric patients refusing medication at some time during therapy, non-compliance can become a major treatment difficulty. This problem is compounded by the countertransference responses evoked within the therapists, and their tendency to react solely with information and exhortation rather than attempting to view non-compliance psychodynamically. When exploring with empathic concern, a number of common dynamic issues can be seen as playing a major role in drug refusal. Commonly at work are issues relating to projection, denial, identification, and transference difficulties that emerge in a relationship where a therapist offers a patient a pill.