A Primer of Handling the Negative Therapeutic Reaction
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)ReadingA Primer of Handling the Negative Therapeutic Reactionis 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)InA 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)