WAYNE MASON 17 March 2010

History of Transference

HISTORY OF TRANSFERENCE 1  Freud commenced practice in Vienna as a neurologist in 1886 and was exposed to many “nerve patients”  Treatments available were of a physical nature such as electrotherapy (Erb) and rest cures (Weir Mitchell)  Freud also used hypnotic suggestion (Mesmer, Charcot, Bernheim, Liebeault) under Breuer’s influence  Breuer referred to it as the “cathartic’ method

HISTORY OF TRANSFERENCE 2 This was then adapted to an exploration of the origin of symptoms. This was further adapted to the application of pressure to the patient’s head to overcome resistance. This was later replaced by “insistence and encouragement” but it became “too much of a strain on both sides” So finally the technique of free association evolved

HISTORY OF TRANSFERENCE 3 At this point in time Freud regarded hysteria as due to a disruption in associations The affect associated with one memory had been “transferred” to something else Hence the origin of the term transference Note that at this point transference is an intra- psychic event

HISTORY OF TRANSFERENCE 4 Because of this the task of therapy is to connect up the memory and the affect It was also regarded as an obstacle This probably accounts for the archaeological and detective metaphors Note: Freud first uses the term “splitting of consciousness” in this context

HISTORY OF TRANSFERENCE 5 Breuer’s case of Anna O (1880 – 1882) intrigues Freud(chimney sweeping) Breuer fled from her amorous advances to him at the end of the hypnotherapy, believing them to be real Freud argued this was an artefact of the treatment – transference – rather than a genuine love relationship

HISTORY OF TRANSFERENCE 6 Dora 1901 This is an illustration of a case that went badly wrong, in part because Freud failed to recognise and interpret the transference There were however other serious problems with the case that went unrecognised By now transference is becoming an interpersonal event

HISTORY OF TRANSFERENCE 7 In 1912 Freud spells it out in “The Dynamics of Transference”: “each individual...has acquired a specific method of his own in his conduct of his erotic life......this produces what might be described as a stereotyped plate (or several such), which is constantly repeated...” (P99) Note the emphasis on “erotic life”

What is Transference?

What Is Transference? 1 “What are transferences? They are new editions or facsimiles of the impulses and phantasies which are aroused during the progress of the analysis; but they have this peculiarity, which is characteristic for their species, that they replace some earlier person by the person of the physician.” Freud 1905

What Is Transference? 2 “For psycho-analysis, a process of actualisation of unconscious wishes. Transference uses specific objects and operates in the framework of a specific relationship established with these objects. Its context par excellence is the analytic situation. In the transference, infantile prototypes re- emerge and are experienced with a strong sensation of immediacy.” LaPlanche & Pontalis

What Is Transference? 3 “It became clear that erotic feelings were only one example of the kinds of intense feeling that a patient could develop for the therapist, which could in fact include the whole range of feelings that one human being can have for another; and moreover that these feelings could be accepted, ‘worked through’ and resolved, provided they were confined to

What Is Transference? 3 (cont)...verbal expression and were traced to their origins in the past, usually of course in the relation with parents.” Malan 1979, P74

What Is Transference? 4 Essentially it is an emotional relationship with the therapist that has its origins in the patient’s past rather than in their relationship in the present. At times this will be very obvious, and at other times it will be subtle and may take a long period of time to manifest

Why Make Transference Interpretations?

Why Make Transference Interpretations? 1 This is often the only way the patient will have an opportunity to become aware of the displacement of his feelings onto the therapist By doing so the patient has an option to re- work an old traumatic relationship from the past and arrive at a different resolution Note that transference interpretations are not always immediately curative, and may require “working through”

Why Make Transference Interpretations? 2 Transference interpretations are of necessity almost always very painful for a patient Occasionally immediate relief may be an outcome Usually it means very painful feelings from childhood are experienced with immediacy in the therapy, and often towards the therapist

Formulation of Transference Interpretations

Formulation 1 Not “You are reacting towards me as if I am your father” This may well be true but is rather intellectual and is not ‘experience-near’

Formulation 2 Rather “You hate the feeling that I am in control of you” This brings the interpretation into the therapist- patient relationship and allows the patient to experience and explore current feelings towards the therapist The connection with the past may be made immediately, or much later in time, by either patient or therapist

COUNTERTRANSFERENCE

COUNTERTRANSFERENCE 1 “It is a very remarkable thing that the (system) unconscious of one human being can react upon that of another, without passing through the (system) conscious.” (Freud 1915 The Unconscious P194)

COUNTERTRANSFERENCE 2 Freud made only 4 mentions of countertransference 1910 Letter to Jung 2 February The Future Prospects of Psychoanalytic Therapy March 1910 Nuremburg 1911 Letter to Jung 31 December Observations on Transference Love

COUNTERTRANSFERENCE 3 Therapist’s Transference As for the patient To the patient To the patient’s transference

COUNTERTRANSFERENCE 4 Heimann 1950 “On Countertransference” Re-defines countertransference “All the feelings which the analyst experiences towards his patient” “The analyst’s counter-transference is an instrument of research into the patient’s unconscious” Note that ‘feelings’ are not unconscious

Using Countertransference Patient free associates Therapist meets this with evenly suspended attention Therapist notes own internal reactions Therapist decides if reactions are from own pathology or stimulated by patient Therapist decides if reactions can be used to inform an interpretation

Concordant Identifications Racker Therapist identifies with corresponding aspect of patient Therapist’s id with patient’s id, etc. Can be thought of as similar to empathy, but more is involved than feeling what the patient feels Processes of introjection and projection are involved

Complementary Identifications Racker Patient treats the therapist as an internal object It is “as if” the patient projects an aspect of self “onto” or “into” the therapist in a desperate attempt to have the therapist experience and understand what is unbearable for the patient Occurs when concordant identification fails Underlines what Heimann describes Basis of modern view of countertransference Similar processes of introjection and projection

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