A Primer of Handling the Negative Therapeutic Reaction

A Primer of Handling the Negative Therapeutic Reaction

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In a negative therapeutic reaction the progress of treatment triggers a particular destructive dynamic in the patient. Initially, therapists considered it to be a result of the patient's pathology, but contemporary clinicians recognize that the therapist may significantly contribute to this process. Object relations clinicians see the individual as a social being that develops in relation to others whom the individual internalizes as good and bad objects. Jeffrey Seinfeld explores how an internal sabotaging self is identified with a rejecting object. This self is a reservoir of memories of how original caregivers rejected the child's needs, and the patient now expects the world to reject and disappoint her. If patients experience the therapist as a kind or caring person, they may feel that they are being lured into dependency and subsequent disappointment. Paradoxically, if patients feel attached to the therapist, this same attachment is experienced as a threatening dependency that must be destroyed. A relationship that could eventually strengthen the personality is rejected, and instead a negative reaction to the therapist and the therapeutic process is established.
Jeffrey Seinfeld shows that in order for patients to heal, they must separate from the internal bad objects.This is often done with aggression against the therapist, who must be able to withstand the intense hostility, rage, and abuse of the patient. Only by surviving this aggression in the negative therapeutic reaction can the therapist allow the patient to integrate good and bad part objects in the transference. The therapist can eventually serve as a bridge in the integration of the divided good and bad selves and objects. Through case histories Seinfeld illustrates his way of entering into the patient's internal world. By helping patients understand the transference of their internal objects, they begin to understand their own experience of self and others, which leads to character change.
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Product details

  • Hardback | 254 pages
  • 161 x 239.8 x 25.4mm | 580.61g
  • Jason Aronson Inc. Publishers
  • Northvale NJ, United States
  • English
  • 0765703637
  • 9780765703637
  • 1,797,943

Review quote

Jeffrey Seinfeld offers a clearly written, engaging, and much needed exploration of the work we all encounter in the clinical setting-that of the negative therapeutic reaction. Ongoing work with 'difficult' patients is rarely explored in such a thorough, readable, and theoretically grounded way. Seinfeld provides a careful deconstruction of cases many would consider to be beyond the scope of our psychotherapeutic paradigm: patients for whom action is more accessible than verbalization. In this way he encourages a great optimism about who is actually amenable to treatment. Through clinical vignettes he brings to life the sense of futility these cases can evoke, a feeling familiar to the beginning therapist as well as to the senior clinician. Seinfeld provides an array of paths to achieving the holding function he believes is necessary to traverse these prolonged therapeutic impasses. -- Carol Wachs, Psy.D., co author of Parent Therapy, A Relational Alternative to Working with Children Reading A Primer of Handling the Negative Therapeutic Reaction is like having a private supervisory consultation with the leading authority on the topic, Dr. Jeffrey Seinfeld. Using a question and answer format, this clinical social work scholar and charismatic proponent of the British School of Object Relations elucidates the negative therapeutic reaction by providing a rich clinical dialogue, complete with practical suggestions for intervention and management of untenable countertransference reactions. An outstanding introduction to object relations, this book explicates the essential clinical concepts and their treatment application. -- Carol Tosone, Ehrenkranz School of Social Work, New York University In A Primer of Handling the Negative Therapeutic Reaction, Seinfeld does more than discuss working with resistance in difficult patients. He weaves in essential pearls from old masters of the therapeutic art such as Klein, Anna Freud, Fairbairn, Jacobson and Searles, and presents an overall model for working with character defenses. He addresses in a very practical way the process of change in therapy. Patients and clinicians alike often revert to the fundamental question: Understanding is fine, but how can therapy lead to change? Seinfeld provides a series of rich clinical examples, including some with children, of working toward the kind of character change that can turn a patient's life around. These case histories illustrate his style of entering into the patient's internal world from the vantage point of focusing on the transference. Then, and only then, can the understanding of the patient's internal objects and how they determine the patient's current experience of self and others lead to character change. -- Frank Yeomans, Ph.D., Weill Medical College of Cornell University
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About Jeffrey Seinfeld

Jeffrey Seinfeld, Ph.D. is a full-time professor at New York University School of Social Work and a private consultant of the Jewish Board of Family and Children's Service. Dr. Seinfeld is a Scientific Member of the Object Relations Institute. He received his Ph.D. from New York University of Social Work and his M.S.W. from Hunter College of Social Work. He has authored and co-edited works in the fields of psychotherapy and clinical social work, including Interpreting and Holding: The Paternal and Maternal Functions of the Psychotherapist, The Bad Object: Handling the Negative Therapeutic Reaction in Psychotherapy, and The Empty Core: An Object Relations Approach to Psychotherapy of the Schizoid Personality. Dr. Seinfeld is in the private practice of psychotherapy in New York City.
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