What Is the Patient Really Resisting? When Resistance Becomes Character

In dynamic psychotherapy we talk about resistance often. The usual, simple reading: the patient is defending against feelings and impulses that were repressed because experiencing them once felt too dangerous. Mikkel Reher-Langberg, in the second volume of Fundamentals of Intensive Short-Term Dynamic Psychotherapy, shows that this is only half the picture. In a chapter titled, aptly, “What the Patient Resists,” he asks a question that sounds obvious and turns out to run much deeper: what is a patient actually resisting?

Resistance Woven Into Personality

The basic function of resistance is to maintain the repression of whatever lives in the dynamic unconscious. For most people with neurotic-level difficulties, though, the dynamic unconscious isn’t the only thing being resisted. Over time, resistance becomes woven into the very fabric of personality — psychoanalysis calls this character resistance.

The author points to an important consequence. Once this happens, resistance no longer just guards repressed content; it starts to target the very traits a person needs in order to pursue emotional gratification at all — wanting, will, expression, the entitlement to ask for something. When a person’s present-day striving toward closeness and gratification is subdued through this wide-scale deformation of character, the unconscious impulses have nothing left to attach themselves to. They find no path into conscious awareness. The dynamic unconscious ends up kept at bay indirectly — not through direct suppression of a feeling, but by starving the whole emotional life around it.

In practice, this looks familiar. A patient doesn’t so much avoid anger at his father as simply want very little, in general. He doesn’t so much suppress grief as live in a way that nothing much is allowed to move him.

Where It Comes From

Reher-Langberg explains this developmentally. A small child is naturally oriented toward pleasure and expression. She feels her needs intensely and expresses them with full force, with a strong will, never doubting her entitlement to love and gratification. But when those needs are frustrated, and the feelings that follow find no containment from caregivers, the child draws conclusions. She learns that her authentic self doesn’t fit inside her relationships with the people who matter most to her. That she can’t want too much, or too strongly. That showing her inner life is dangerous, and that feelings themselves are dangerous.

Adapting to her environment, the child builds a resistance that targets not only specific impulses but her original, living stance toward the world itself. The author describes this broader resistance as part of the child’s own will, turned against herself — and adds a striking phrase: resistance is “the heir to her pain.”

Resistance as Acting Out and Enactment

If resistance is the heir to old pain, it’s worth asking how that history actually shows up in therapy. Psychoanalysis has answered this question for over a century: more often in action than in memory.

Freud, in his 1914 essay “Remembering, Repeating and Working-Through,” already noticed that a patient frequently doesn’t remember what was repressed, but repeats it — acts it out — without knowing he’s repeating anything. His example: the patient doesn’t recall being rebellious and critical of his parents’ authority; instead he behaves that way toward the analyst. Freud tied this directly to resistance: the stronger the resistance, the more repeating — acting out — replaces remembering. In this sense, acting out is itself a form of defense. As long as repressed content can be discharged through action, there’s no need to face it in the painful work of remembering.

Later psychoanalysis added the concept of enactment. Theodore Jacobs introduced it in 1986, describing the reactivation of unconscious, unsymbolized emotional experience within the relationship between patient and therapist. Originally, the term referred to subtler moments in the therapeutic process, distinguished from the louder behaviors that fall under acting out. Enactment is understood as an interweaving of transference and countertransference, operating outside awareness and often nonverbally. In other words, the therapist is also a participant in an enactment.

This framing fits well with Reher-Langberg’s description. Character resistance isn’t a memory of childhood — it’s childhood’s living continuation. A patient who learned not to want too much doesn’t tell the therapist about it. He does it: polite, distant, expecting nothing. And the therapist, if not paying close attention, can unconsciously slip into the role of the people who once couldn’t hold his feelings. In ISTDP, this work happens precisely here and now, in the therapeutic relationship itself, where the old pattern can be seen, named, and lived through differently.

Why This Matters in the Room

This framing changes how a therapist looks at defense. Resistance isn’t an obstacle placed spitefully in the way of therapy. It’s a trace of past suffering and a past adaptation that was once necessary. At the same time, what once protected the person now cuts him off from desire, closeness, and vitality.

That’s why work in ISTDP isn’t only about reaching repressed feelings. Just as important is restoring the patient’s access to his own will and his own right to want. Later in the same chapter, drawing on the teaching of Rudolf Bleuler, the author discusses the four “pillars of the resistance,” as Davanloo called them — the functions resistance serves within the structure of character.

Who Should Read This

This passage shows exactly why we value the whole book. It joins classical psychoanalytic metapsychology with a very concrete, clinical understanding of what happens inside the therapeutic relationship. We’d recommend it to therapists especially — those who want to understand resistance not as an enemy, but as a patient’s history, written into his character.