Resist the negation reflex: Minimizing reactance in psychotherapy of delusions

Kyle Arnold and Julia Vakhrusheva

Psychosis, 2016, vol. 8, issue 2, 166-175

Abstract: It is widely believed that it is countertherapeutic to confront delusions, but the underlying reasons why have not been clearly conceptualized. The present paper endeavors to clarify both (1) why confronting delusions is countertherapeutic, and (2) why therapists can feel tempted to do so. People experiencing delusions can elicit an automatic reaction in the disbelieving therapist that can be termed the negation reflex. The therapist may feel compelled to negate or disconfirm the patient’s delusions to defend his or her own belief in a stable reality. Doing so evokes psychological reactance and strengthens the imperviousness of the delusion. The negation reflex is part of an interpersonal feedback loop that maintains the delusion’s imperviousness. It is the therapist’s task to interrupt that feedback loop by resisting the negation reflex and implementing therapeutic practices designed to minimize reactance.

Date: 2016
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DOI: 10.1080/17522439.2015.1095229

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