In counteractive therapies, that imperative emotional necessity would typically remain unrecognized and intact as the therapist works to build up Richard’s trust in his proven knowledge and skills at work, aiming to correct his “incorrect” and “irrational” self-doubts. How likely is that to bring about a lasting shift, given that the underlying, passionate, urgent need for self-doubt remains in force? Counteractive overlays may take effect temporarily, but then they usually prove to be no match for the compelling intensity of the client’s implicit pro-symptom position, and relapse occurs.
