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Simpson, D. (2013). A Patient Who Could not Allow Himself to Really Get Better. Brit. J. Psychother., 29(1):25-40.

(2013). British Journal of Psychotherapy, 29(1):25-40

Clinical Practice

A Patient Who Could not Allow Himself to Really Get Better

David Simpson

Starting from Freud's concept of the negative therapeutic reaction, the author contrasts Abraham's and Riviere's description of a particular type of patient who does not recover in psychoanalysis, with Klein's description the phenomenon, seen in many types of patient, of setback following helpful interpretation. He describes his clinical work with a man that corresponds with Riviere's description of being unable to improve because of his guilt and despair about his maternal object. The author believes that this originated in this man's childhood fear of evoking envy and guilt in his mother. As a result he developed a defensive barrier to protect his maternal object from his impulses which prevents him penetrating the world with passion and being successful. He is trapped by his devotion to serve his maternal object and he suffers from melancholia which is ‘borrowed’ from it.

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