The patient who is difficult to reach
Book • 1975
This landmark paper by Betty Joseph outlines clinical observations and technical approaches for treating patients who resist traditional analytic engagement.
Joseph emphasizes focusing on patients’ modes of communication and the analyst’s countertransference as crucial data rather than only content.
She describes the enactments and defensive mechanisms that make patients hard to reach and offers strategies for staying alive in treatment.
The paper influenced subsequent work on borderline and non-symbolizing patients and remains essential reading for candidates.
It encourages slow, careful analytic work attuned to the patient's communicative method and rhythmic patterns.
Joseph emphasizes focusing on patients’ modes of communication and the analyst’s countertransference as crucial data rather than only content.
She describes the enactments and defensive mechanisms that make patients hard to reach and offers strategies for staying alive in treatment.
The paper influenced subsequent work on borderline and non-symbolizing patients and remains essential reading for candidates.
It encourages slow, careful analytic work attuned to the patient's communicative method and rhythmic patterns.
Mentioned by
Mentioned in 0 episodes
Mentioned by 
Harvey Schwartz
A Candidate Engages Patients Who are 'Difficult to Reach' with Pamela Polizzi, LCSW (New York)
