A Clinician's Guide to Pathological Ambivalence

Book excerpt: Resistant. Oppositional. Borderline. Mental health professionals commonly use such terms to describe patients who, despite expressing a strong desire to reduce their emotional distress, repeatedly reject or ignore their therapist's interpretations andadvice. When this continues session after session, both patient and therapist end up feeling stuck and frustrated.This book offers an alternative interpretation of patients' apparent resistance, termed pathological ambivalence, which is rooted in early experience, biological functioning, and psychological narrative. The concept of pathological ambivalence draws from several established theoretical perspectives in explaining why some people seem to sabotage their progress in psychotherapy and how some therapists become unintentional enablers.