Reality Transformed to Dream

This article is based on a lecture held during two public seminars in Stockholm (May 2005 and January 2006) arranged by the Swedish Psychoanalytic Association to commemorate Ludvig Igra and his achievements in the field of psychoanalysis. The author addresses the often painful phenomenon that the patient is not getting better but rather worse just when the analyst thinks he has understood and productively interpreted the unconscious dynamic behind the patient's symptoms. Through the use of a clinical example, the concept of negative therapeutic reaction is discussed with special reference to Abraham, Rosenfeld, Joseph and Igra.