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.
