Working with the contemptuous client in psychotherapy

Abstract

The purpose of this case study is to explore the issue of contempt in the therapeutic relationship. The aims are twofold; namely, to illustrate to what extent the case studied throws light on existing theories on contempt in psychotherapy, and to enquire about which stance adopted by the therapist is most appropriate in the therapeutic interaction with a contemptuous client. It investigates the validity of using the case study method in examining both the content and the process of this particular course of psychotherapy. Literature on contempt in psychotherapy is reviewed, as well as the foundation-stone on which it rests, namely, the Kleinian approach to envy . The concepts of the superego and false self are also drawn upon in understanding this particular client's dynamics. The client's therapy is then presented and explored, in order to gain insight into how a psychotherapist's understanding of the contemptuous client can clarify the process of therapy. It highlights the limitations and potentialities that exist in working in this sphere of resistance, and raises questions relevant to therapists faced with these clients. The case study shows how theory in this area is helpful in understanding the contemptuous client, and that the ability of the therapist to endure and survive the contempt of the client is a crucial factor in working with the contemptuous individual.