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Can J Psychiatry. 1987 Mar;32(2):115-7. doi: 10.1177/070674378703200207.
With up to 50% of psychiatric patients refusing medication at some time during therapy, non-compliance can become a major treatment difficulty. This problem is compounded by the countertransference responses evoked within the therapists, and their tendency to react solely with information and exhortation rather than attempting to view non-compliance psychodynamically. When exploring with empathic concern, a number of common dynamic issues can be seen as playing a major role in drug refusal. Commonly at work are issues relating to projection, denial, identification, and transference difficulties that emerge in a relationship where a therapist offers a patient a pill.
在治疗过程中，高达50%的精神科患者会在某些时候拒绝服药，不依从可能成为主要的治疗难题。治疗师内心引发的反移情反应，以及他们倾向于仅以提供信息和劝告做出反应，而不是尝试从心理动力学角度看待不依从，使这个问题更加复杂。当带着共情关注去探究时，可以发现一些常见的动力学问题在药物拒绝中起主要作用。在治疗师给患者提供药丸的关系中出现的与投射、否认、认同和移情困难相关的问题通常在起作用。
