The Negative Therapeutic Reaction in Question : When the Symptom Doesn’t Cease

Over the course of his various works, S. Freud introduced and developed a particular conceptual expression : the negative therapeutic reaction. This concept corresponds to a “need to be sick” or “need to suffer” which, because of the predominance of a “super-ego become particularly harsh and cruel,” opposes any attempt to effect a cure. Nearly a century after the publication of these writings, what about the negative therapeutic reaction today ? How has this concept been questioned by other authors, both in its epistemological value and in its clinical relevance ? In a therapeutic perspective, what are the treatment devices that can help people who don’t “want” to recover ? How can symptoms that don’t cease be dealt with ? To develop these issues, we will discuss the writings of S. Freud regarding the negative therapeutic reaction and we will then study how these writings have been reviewed by D. Anzieu and J. Lacan. Subsequently, we will examine the clinical relevance of these theories from the case study of a patient hospitalized in compulsory commitment and for whom therapeutic accompaniment does not prevent the repetition of suicidal acting out.