What is it about?
People in therapy may understand where a painful pattern comes from and how it harms them, yet continue to feel and act in the same old way. Why does understanding so often fail to produce change? This article brings psychoanalytic thinking into dialogue with predictive processing, a framework that views the mind as continually forming expectations about ourselves, other people, and what is likely to happen. It proposes that resistance to change is shaped by two interconnected constraints. One is defensive: when a new experience evokes feelings that seem overwhelming or dangerous, its emotional impact may be avoided, dismissed, reduced, or become too difficult to process. The other is structural: even when a new experience is consciously understood and emotionally felt, our deepest expectations about ourselves and others may change only slowly because they are woven into our identity, relationships, and familiar ways of making sense of experience. Lasting change therefore requires new experiences not only to be repeated, but also to become meaningful and gradually integrated over time. The model helps explain why therapeutic change usually unfolds through small steps, setbacks, and repeated encounters with new ways of feeling and relating.
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Why is it important?
Resistance to change is one of the oldest puzzles in psychotherapy, but the processes that make it so persistent have remained difficult to specify. This model gives clinicians a more precise way to understand a common therapeutic impasse: is change currently limited because a feeling is too difficult to tolerate, or because an old expectation is too deeply embedded to be easily revised? These situations call for different therapeutic emphases. More broadly, the model connects psychoanalytic clinical thinking with contemporary accounts of how the mind and brain learn from experience, without reducing psychological meaning to brain mechanisms.
Perspectives
As a psychotherapist, I have repeatedly encountered the same paradox: a patient may understand a painful pattern very clearly and still continue to feel and act as though nothing has changed. I wrote this article to understand that gap without reducing resistance either to unwillingness or to insufficient insight. My aim was to bring psychoanalytic clinical thinking into dialogue with predictive processing and to offer clinicians a clearer way to ask what is limiting change at a particular moment. This distinction has also become useful in how I think about therapeutic impasses in clinical work, supervision, and teaching.
Anna Sokolova
Read the Original
This page is a summary of: Working through resistance: A neuropsychoanalytic model of defensive and structural resistance to change., Psychoanalytic Psychology, July 2026, American Psychological Association (APA),
DOI: 10.1037/pap0000609.
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