PubMed · 10252765
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W R Flynn, W E Stratton. 1981. Managing problem employees.. https://doi.org/10.1002/hrm.3930200206
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Theoretical literature is contradictory in most areas, but virtually all theories agree on the existence of patient resistance and propose similar implications, meanings, and effects of its manifestation. However, theories differ widely in both the assumed causes of resistance and the methods of dealing with resistant patients. Common to various theoretical definitions is an assumption that resistance is both a dispositional trait and an in-therapy state of oppositional, angry, irritable, and suspicious behaviors. Reactance is a special class of resistance that is manifest in oppositional and uncooperative behavior. Resistance bodes poorly for treatment effectiveness. Nondirective and paradoxical strategies have been found to be quite successful in overcoming resistant and reactant states, while matching low-directive and self-directed treatments with resistant patients circumvents the effects of resistance traits.
At first sight, the concept of "person" appears in psychiatric terminology only in the negative sense, i.e., as in depersonalization. However, self-alienation may be regarded as the hallmark of mental illness in general and is based on the ambiguous structure of human personality itself. Thorough analysis of the concept of the person is therefore indispensable to understanding psychopathology. This paper focuses on the contrast of "persona" ("mask" or "role") on the one hand to "person" as an individual self on the other. Their dialectical relation derives from basic anthropological structures such as sociality, self-reference, self-transcendence, and fictionality. As can be shown, the historical and cultural ontogeny of the personality includes experiences of self-alienation which may become relevant for psychiatry as depersonalization syndromes. The example of depression is used to illustrate vital and emotional depersonalization, whereas schizophrenia may be described as "intentional depersonalization." Following this line of reasoning, the classic schizophrenic experiences of alien control or thought insertion are interpreted as a disturbance in the fundamental personality structures.