The negative therapeutic reaction in psychoanalysis is the paradoxical phenomenon whereby a plausible interpretation produces, rather than improvement, a worsening of the analysand's condition.
[1] The following year he offered the alternative formulation of a need for punishment instead;[2] but in his thirties summation it was again unconscious guilt to which he attributed "the negative therapeutic reaction which is so disagreeable from the prognostic point of view".
[4] The negative therapeutic reaction is unusual in psychoanalytic history in never being the subject of major controversy, while still be steadily worked on and reformulated in later analytic phases.
[5] Joan Riviere pointed to the neurotic's fear of any change in condition, even from worse to better, while the desire to spite the analyst may also be a motive.
[7] Object relations theory has also pointed to the way that underdoing defences means the patient experiencing their underlying conflicts more fully, and reacting negatively to that.