Abstract
The author considers how treatment resistance in technology-mediated work with obsessional neurotic patients can differ from that of in-person sessions, and she then gives corresponding recommendations for clinicians. Three types of resistance are discussed—partially conscious resistance, linguistic resistance, and transferential resistance—with a focus on transferential resistance and its unconscious determinant. The transferential dynamics of obsessional neurosis are explained using the theory of Jacques Lacan, and then these dynamics are tied to manifestations of treatment resistance. The author provides case examples of technology-mediated analytic work with obsessional neurotics and highlights how resistances can be detected and worked through. Working through resistances effectively depends upon making an accurate structural diagnosis and directing the treatment accordingly, but it also rests upon being attuned to the alterations in the medium of a technology-mediated session.
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