The manifestation of transference during early psychotherapy sessions: Exploring an alternate data source for therapist narratives in transference research

Introduction: Previous transference studies have compared in‐session client narratives about significant others to in‐session client narratives about the therapist, limiting data to the information that clients are willing to share with the therapist. Method: The first three sessions of 30 therapies with high‐functioning individuals were examined using the Core Conflictual Relationship Theme (CCRT) method. Client narratives about others were drawn from the psychotherapy sessions and client narratives about the therapist were drawn from a Participant Critical Event (PCE) interview conducted after the third session of therapy. Results: Factor analyses of the CCRT components indicated several relational patterns: a complementary pattern of relating characterised by a devaluation of the therapist and idealisation of others; a concordant relational transfer where clients feel bad with both the therapist and others; and as clients experience control issues with significant others, they wish to adopt a submissive stance toward the therapist. The results suggest that the source of therapist narratives may influence the results of transference research.     

The manifestation of transference during early psychotherapy sessions

Despite the clinical use of therapeutic transference across various schools of psychotherapy, there have been relatively few empirical studies of this phenomenon, none of which has examined transference with a non‐pathological population. In this study, the core conflictual relationship theme (CCRT) method was used to examine the manifestation of therapeutic transference in the first three sessions of 22 counselling contracts with high‐functioning individuals. Factor analyses of the wish (W) and response of other (RO) components of the CCRT indicate a complementary pattern of relating in which the therapist is idealised and others are devalued. Within the response of self (RS) component, clients exhibited a concordant relational transfer whereby they had a negative response to both the therapist and others. Additionally, control issues emerged in the W component for significant others and in the RS component for the therapist.     

Intimate boundaries: Therapists’ perception and experience of erotic transference within the therapeutic relationship

Aim: This study explored therapists’ understanding and experiences of erotic transference within therapeutic relationships. Method: A small‐scale qualitative research project was undertaken with six therapists working within different counselling contexts. Data was collected through semi‐structured face‐to‐face interviews, and an Interpretative Phenomenological Analysis used for analysis of individual perception and experience. Findings: All participants had experienced what they understood to be erotic transference and/or sexual and loving feelings within therapy. There was little differentiation between the two phenomena, and both were often referred to interchangeably. There were contradictory views as to whether using the phenomena would be beneficial to client work, but there was a strong motivation to learn more about it. Therapists who encountered sexual attraction within therapy experienced feelings including shame and embarrassment. Supervisory support was seen to be beneficial. Implications/conclusion: The importance for therapists to acknowledge a lack of clarity that exists around the understanding of erotic transference and its relationship to sexual attraction within therapy is noted. Also, a recognition that better access to training regarding erotic transference and sexual responsibility within client relationships might be helpful to therapists in their work.     

Analysis of transference: A North American perspective

Using detailed clinical vignettes, the author illustrates and compares several North American approaches to the analysis of transference, tracing their origins in Freud's works and in various post-Freudian conceptualizations, including the writings of Anna Freud and Charles Brenner. Particular attention is paid to the work of Merton Gill, Evelyne Schwaber, Paul Gray, and the British analyst, Betty Joseph. Discussed and illustrated are controversies over the broader and narrower views of transference, the interpretation of action in the analytic setting, earlier and later interpretations of transference with particular emphasis on the contrast between contemporary Kleinian and ego psychological perspectives, the role of extra-transference interpretation, and the concept of the transference neurosis. An argument is made for an integrative approach, drawing upon different emphases, depending on the clinical circumstances and the point of affective immediacy for the patient, which may or may not coincide with the point of affective immediacy for the analyst.     

Playing with Dreams: The Introduction of a Third Party into the Transference Dynamic of the Couple

Dreams in couple therapy are expressions of the multiple discontinuous selves of partners and of interpersonal defenses. Two dreams offered during analytic couple therapy illustrate the use of transference and countertransference to observe disturbances in self-cohesion, communication of self-states, and attempts to affectively influence the partner. Dreams transferentially communicate the state of the realtionship, activate a third formation expressing shared pathology, and facilitate the growth of new aspects of the self seeking a more loving bond.     

Contemporary transference work and the analytic attitude: aims and methods--a clinical workshop

There are various ways of working as an analyst, and there are various ways of utilizing the concept and the phenomena of transference‐countertransference. I hope to draw an adequate picture of a way of working that is called ‘working‐in‐the‐transference’ as distinct from ways of working that ‘analyse transference’. The former has long been practised by many Jungians as well as by many psychoanalysts. As a method, it has aroused controversy in both groups, and is frequently both misunderstood and imitated. It can arouse strong anxiety. It can appear narrow and restrictive. It famously precludes a gamut of activities in which many analysts engage. Is working‐in‐the‐transference old fashioned, or does it deserve to be increasingly appreciated? Can it offer support and validation whilst remaining true to its conception? It was hoped that these questions would be addressed in the clinical material brought to the workshop. The emphasis in the workshop was on active participation and it was hoped that those attending would bring their clinical concerns for discussion.     

Alchemy and the erotic transference: A Jungian approach

Abstract

In The Psychology of the Transference Jung showed a series of pictures which he discovered in an ancient alchemical text, the Rosarium philosophorum. He connected these to the effects of the transference in psychotherapy. This may seem an unnecessarily obscure way of looking at the transference, yet it makes remarkable sense. Although alchemy is often considered the sole province of Jungian analysis, it can also be seen as illuminating a psychodynamic approach to counselling. Written from a post-feminist viewpoint, a critical approach is taken to certain key Jungian terms. The paper is illustrated with two clinical examples.     

Psychoanalytic psychodrama in France and group elaboration of counter‐transference: Therapeutic operators in play therapy

In France, psychoanalytic psychodrama is mainly envisioned in its individual form – that is, a single patient working with a group of therapists. Its originality consists in bringing together several clinicians within a clinical experience that is shared as a group. This experience is fundamentally different from traditional individual therapies, psychotherapies or group co‐led therapies. Its configuration may be confusing or overwhelming due to the large number of co‐therapists involved in the setting. However, thanks to group elaboration based on the transferential‐countertransferential dynamics induced by the treated patient, this potential ‘cacophony’ can lead to fruitful psychic development embedded in play. This is tied to the co‐therapists' positioning in the transitional space shared with the patient as well as to the patient's subjective appropriation of their initiatives. By reflecting on clinical material taken from actual sessions as well as from the exchanges and elaborations occurring at their margins, this article shows how psychodrama and group come to metabolize the transferential elements, shaping the engagement of participants in the context of improvised play.     

Performative and enactive features of psychoanalytic witnessing: The transference as the scene of address

This paper will attempt to broaden the conception of witnessing in analytic work with traumatized patients by extending the idea to incorporate the patient’s developing and varied capacity for witnessing, as well as a witnessing that occurs within the analytic relationship itself. Actions occuring as part of traumatic repetition are understood to represent memory phenomena and are distinguised from dissociated self‐state experience. These experiences are not therapeutically intended to be symbolized, but rather lived‐through with the analyst, thus transforming the patient’s own relation to the experience. I suggest that the scene in which this living‐through takes place is the transference–countertransference matrix, and that it is the analytic encounter that allows traumatic repetition to take on the quality of a communication, an address to another, rather than remain meaningless reproduction. A clinical vignette illustrates the turning of trauma’s imperative for witnessing into an address in the analytic encounter.     

Psychodynamic counselling in an educational setting: Containing,transference and clientele

Abstract

The concepts of containing and transference, as well as the specific nature of the clientele, may, on a first approach, be used to differentiate psychodynamic counselling in an educational setting (PES) from the ‘pure gold’ of psychoanalysis. Further, it is argued that a realistic understanding of PES, given the constraints in which it operates, demands that the psychodynamic practitioner be prepared to cut her procedural cloth in accordance with the demands her clients place upon her. This makes PES a pragmatical practice rather than some lesser cousin of ‘orthodox’ psychoanalysis.     

Tradition and originality in the transference: a Coleridgean commentary

Abstract :  Some of S.T. Coleridge's observations about ' the mind's self-experience of itself ' and the nature of faith and trust are discussed in relation to the implicit tensions between 'tradition' (formal structure, received wisdom) and 'originality' (creativity, individuation), especially in the transference. The existential doubts of some analysands may undermine their confidence that their integrity will be fostered by the analytic relationship: so instead the trappings of 'tradition' (e.g. in the case of a trainee the assumption of a professionally endorsed status) may be appropriated as a spurious substitute for 'originality'.
It is argued that an anticipatory 'faith', albeit initially rather cerebral, may be necessary to sustain the analytic endeavour until a more intimate, heartfelt 'trust' can release the potential for individuation. Further consideration is given to the 'analytic attitude' that might best facilitate this process, and to how sensitivity to these dynamics may inform one's reading of the transference.     

On the edge: The psychoanalyst's transference1

Countertransference is a central topic in analytic work and in the literature. The concept of countertransference includes a basic question which has been understood in different ways. The author attempts to differentiate between the psychoanalyst's transference and his countertransference in the analytic process. It is hard to draw a line between them; analysts are always on the edge. The analyst's transference will be explored and described using three approaches: narcissism, regression profile and the analyst's phase of life. Regression profile is a new concept developed by the author, which may help us to understand the core of the analyst's transference in the analytic situation. She illustrates the topic by clinical vignettes.     

Supervision, transference and countertransference

The author discusses supervision, transference and countertransference as seen in the context of the clinical case of a patient who had been first seen as a training analysis case and who later, in a fortuitous way, was treated by the supervisor of the training analysis. The supervisor, who in the first instance did not recognize the patient, discusses the reasons for this unusual experience in terms of the presence and absence of transference during the analysis of this patient as a training case and the problems inherent in the task of supervising. The patient's feelings towards the first and the second analyst and the vicissitudes of transference and countertransference during the supervision of the training analysis and its influence on the presentation of the analytical sessions by the student are also detailed and discussed. The question of recorded supervision presentations and their possible influence on the dynamics of supervision is raised.     

Playing with Fire: Countertransference and Clinical Epistemology

This article explores both theoretical and practical concepts related to the therapist's use of the self in psychotherapy. Particular emphasis is placed on the potential clinical value of countertransference. It is argued that awareness and resolution of personal issues are required for therapists to draw profitably from their own experiences in working with clients. Specific steps in translating the concept of the wounded healer into clinical practice are offered, along with examples from the author's own practice.     

Being, thinking, creating: when war attacks the setting and the transference counter-attacks

When trauma enters into the reality of the analyst and of the analysand, when it attacks the setting, what becomes of the analyst’s role? How can transformations be brought about? With reference to three clinical situations, the author attempts to explore how the articulation between transference and countertransference – the inter‐relation – structures the situation; the analyst must remain in his or her role as analyst through managing to create and to reflect upon the clinical aspects of that situation when faced with the unpredictability of what war brings in its wake. It then becomes possible to see how the work of the negative can be confined to the outer limits of the setting.     

Repression, transference and reconstruction

Whereas Peter Fonagy almost dismisses the importance of repression and the recovery of repressed and suppressed memory, the author believes that the analysis of repression retains importance in clinical psychoanalysis. Transference is a return of the repressed, with repressed memories embedded within a fundamental unconscious fantasy constellation. Moreover, transference is an essential, but not the only, route to the understanding and analysis of the patient. Nor should transference be confused with the real or new analytic relationship. The author does not regard the dynamic unconscious as definitely registered and retrieved in procedural memory, awaiting further research. A focus on the present 'self with other' model of therapeutic action neglects pathogenesis and the importance of childhood and its psychoanalytic reconstruction.     

Art within analysis: scapegoat, transference and transformation

Through clinical example and pictorial illustration, the author examines ways in which art offers a particular means of psychological transformation in states which may otherwise be in expressable. A transference to the art work itself is proposed. It is submitted that, mediated within the transference/ countertransference dynamic, this 'scapegoat transference' facilitates a particular process of psychological differentiation. The aesthetic qualities of art presented within analysis will resonate with other countertransference affects. Clinical material demonstrates how observation of this--aesthetic countertransference--leads to a distinction between the 'diagrammatic' and the 'embodied image. The process of integration of shadow material is furthered by the temporary safe-keeping of the art work by the analyst.     

The death of an analysand: transference, countertransference and desire

This paper is offered as an exploration of transference and countertransference issues when, in the process of analysis, the analysand becomes terminally ill. Written from the point of view of the analyst, eros and boundary issues are discussed. It is proposed that those who are about to die may form particularly intense erotic attachments and that this is characteristic of a speeded up individuation process. The paper is based on the case of a suicidally depressed man who formed an immediate, dependent and erotic transference. After three months, he was diagnosed as having an inoperable lung cancer. From then on the analytic frame was challenged by pressures to act out in a number of different ways. It is argued that gender difference and the heterosexual pairing facilitated the differentiation of adult, sexual and Oedipal feelings from infantile, pre-Oedipal ones. Maintenance of the analytic frame enabled the individuation process to continue to the end.     

Types of sexual transference and countertransference in psychotherapeutic work with children and adolescents

The question of normal sexuality begins to arise in the treatment of severely sexually abused or sexually offending patients. The author suggests that it is an interesting and delicate moment during the process of recovery when less perverse, more normal sexuality appears mixed with, or even disguised by, the more habitual perverse fantasies. Writers in the adult field have drawn distinctions between perverse, eroticized and normal erotic transferences, and between Oedipal and post-Oedipal sexuality. Some have also distinguished between countertransferences in the analyst of an erotised versus a normal erotic nature. The paper discusses whether these distinctions could have any relevance for child patients. Freud and Klein have taught us much about the child's sexuality in relation to his interest in and attraction to his parents as sexual beings. But can we also detect some origins in earlier experiences in infancy of the child's later capacity to feel himself a sexual being capable of being wanted by an other? How might such a feeling of sexual self-worth differ from narcissism and from sexualised exhibitionism? The paper asks how therapists might deal with such problems and such possibly healthy developments.     

Beyond transference,countertransference, the silences and the opinion1

The author examines several works of an intersubjectivist trend, as well as writings by Hanly, Cavell and Bion, defending many of the named psychoanalysts' viewpoints. These viewpoints are expressed in the search and the struggle for truth, recognizing, like Popper, that truth exists but that we cannot know with certainty whether and when we touch upon it, only that this endless effort merits a lifetime's work because it is the attempt at an encounter with ourselves‐the true encounter. The author explains the criticisms by Green of Jacobs, and defends the maintenance of ‘a certain possible neutrality’ (Eizirik). He poses some questions with regard to Ogden's ‘third subject’, considering it, among other aspects, from the supervisory point of view, which may demonstrate the existence of ‘a certain possible objectivity’ of the emotional confl ict. He develops some criticisms concerning silence as an interpretative action by Ogden, and summarizes two case histories. Both were unconsciously attempting to manipulate the analyst intensely‐one of them to get the analyst to intervene in his love life, and the other to interrupt acting out.