Schmitt L, Bui E
Service universitaire de psychiatrie et de psychologie médicale de Toulouse, hôpital de Casselardit Purpan 31059 Toulouse cedex.
Encephale. 2009 Dec;35 Suppl 7:S314-8. doi: 10.1016/S0013-7006(09)73494-3.
The term treatment barrier describes obstacles to the treatment process. These obstacles affect the patient: there may be melancholic crypts in encysted trauma ; there may be a link rooted to a dead person in the form of attachment to the internal object: there are different forms of moral masochism. Barriers relating to the therapist may be seen in therapists who take a dogmatic position: the therapist must realise these counter-attitudes and their impatience or irritation movements. In the patient doctor-interaction, understanding previous treatment failures and the relationship style developed with other therapists plays an important role. The concept of the negative therapeutic reaction in which any clinical progress returns to aggravation must also be investigated.
“治疗障碍”一词描述了治疗过程中的阻碍。这些阻碍会影响患者：在包裹性创伤中可能存在抑郁性隐窝；可能存在以对内在客体的依恋形式与死者相连的关系；存在不同形式的道德受虐狂。与治疗师相关的障碍可见于持教条立场的治疗师：治疗师必须意识到这些反态度及其不耐烦或恼怒的举动。在医患互动中，理解既往治疗失败的情况以及与其他治疗师形成的关系模式起着重要作用。对任何临床进展都会回归到病情加重的消极治疗反应这一概念也必须进行研究。
