At a more abstract level, which Freud called his "metapsychology," he said in the 1920s that we are anxious due to the clash between the "life instinct" and "death instinct." His followers did not like this theory. Most present-day Freudians with an academic focus, such few as there are, therefore start with attachment theory, separation anxiety, wishes, and the development of repression and other "defense mechanisms." As for the psychoanalysts, they start with the idea that the basic conflict is between sexual and aggressive instincts, which was Freud's pre-1920 theory of the instinctual clash.
There comes a point when the patients resist an interpretation, but the therapist persists because there is this something called "resistance," based on defense mechanisms and the partial pleasure derived from holding on to the symptoms. (On this score, there is evidence in The Interpretation of Dreams and in some of his famous case histories, that Freud debated and argued with his patients about interpretations of dreams and symptoms. That is, he did actively try to combat and overcome resistance if he thought he was on the right track, which is certainly ammunition for the social psychology critics.) Since the therapist is a respected authority, this creates a situation of "cognitive dissonance." Who to believe, oneself or the therapist?
Freuds psychodynamic approach and rogers humanistic approach
Okay, let's turn to present-day critics of Freud, who say that strong denials are not a sign of some underlying resistance that is verified by subsequent events. Instead, they say that the ongoing discussion of the issue between a therapist who is privately convinced he/she is right leads to an eventual "conversion" of the patient to a new viewpoint. These critics base their claims on interviews with patients, transcripts of psychotherapy records, and depositions and records from court cases starting in the 1980s and running into the early 1990s.