There are certain people who behave in a quite peculiar fashion during the work of analysis. When one speaks hopefully to them or expresses satisfaction with the progress of the treatment, they show signs of discontent and their condition invariably becomes worse. One begins by regarding this as defiance and as an attempt to prove their superiority to the physician, but late one comes to take a deeper and juster view. One becomes convinced, not only that such people cannot endure any praise or appreciation, but that they react inversely to the progress of the treatment. Every partial solution that ought to result, and in other people does result, in an improvement or a temporary suspension of symptoms produces in them for the time being an intensification of their illness; they get worse during the treatment instead of getting better. They exhibit what is known as a "negative therapeutic reaction".
There is no doubt that there is something in these people that sets itself against their recovery, and its approach is dreaded as though it were a danger. We are accustomed to say that the need for illness has got the upper hand in them over the desire for recovery. If we analyze this resistance in the usual way—then, even after fixation to the various forms of gain from illness, the greater part of it is still left over; and this reveals itself as the most powerful of all obstacles to recovery, more powerful than the familiar ones of narcissistic inaccessibility, a negative attitude towards the physician and clinging to the gain from illness.
In the end we come to see that we are dealing with what may be called a "moral" factor, a sense of guilt, which is finding satisfaction in the illness and refuses to give up the punishment of suffering. We shall be right in regarding this disencouraging explanation as final. But as far as the patient is concerned this sense of guilt is dumb; it does not tell him he is guilty, he feels iii. This sense of guilt expresses itself only as a resistance to recovery which it is extremely difficult to overcome. It is also particularly difficult to convince the patient that this motive lies behind his continuing to be iii; he holds fast to the more obvious explanation that treatment by analysis is not the fight remedy for his case.
According to the author, it would be more reasonable to think that the patients who exhibit dissatisfaction with the treatment are
A．openly resisting the treatment of the physician.
B．intentionally holding the physician in contempt.
C．spontaneously responding contrary to the physician's expectations.
D．purposely disregarding the praise or appreciation by the physician.
时间：2023-09-25 17:49:47
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