The many faces of self-harm

This paper explores why open dialogue on the subject of erotic transference and countertransference is so difficult and attempts to offer an understanding of these phenomena which might enable counsellors to work more confidently with it. It also briefly examines the author's own research on therapists' thoughts and experiences of erotic transference, seeking to differentiate between inappropriate sexual contact between clients and therapists and the experience of erotic transference in the context of therapy as a reworking of the Oedipal relationship. Case examples illustrating the experience of countertransference within the therapeutic situation and how its presence can act as a help or a hindrance are offered. The paper concludes by examining the need to reflect on the erotic transference in therapeutic work and proposes its usefulness as a therapeutic tool. Suggestions about how the erotic transference can be managed to therapeutic effect are also explored.     

Transference across gender lines

Four clinical examples of oedipal-based transference across gender lines are presented with the aim of illustrating (1) its existence, (2) the defenses against its emergence, and (3) the use of the analyst's gender as both an organizer of and resistance to certain transference manifestations. Factors that contribute to the availability for analysis of cross-gender transference are discussed, as are the resistances and other obstacles to its actualization.     

Purposive aspects of the erotic transference

This paper illustrates the erotic transference of a male patient towards his female analyst and the pressures and resistances within the transference and counter-transference to act out sexually. The patient's desire to act out sexually is seen both as a form of repetition compulsion within the transference and, in its purposive aspect, as an expression of the patient's need to find a loving breast and an empathic father. The patient's confused sexual identity is seen as a narcissistic defence against the experience of unbearable frustration in the pre-Oedipal stage. Through internalizing a new primal scene, the patient is able to separate from his past and to work through the Oedipus complex within the transference.     

Pete the diesel: Psychotherapy with a severely disturbed five-year-old boy

The psychic significance of the figure of the grandmother in psychodynamic psychotherapy has received scant attention. This paper develops the concept of the ‘grandmaternal transference’ in parent–infant psychotherapy and explores its identification, its possible functions and its therapeutic significance. The grandmaternal transference has special relevance to parent–infant psychotherapy since the grandmother often represents both the mother’s mother and the child’s grandmother and offers a unique third position between mother and child. Three clinical vignettes illustrate how the grandmaternal transference may operate in this third position. In the first vignette, the therapist becomes in the transference a containing grandmother thereby facilitating maternal containment. In the second case, the therapist may be experienced as a differentiating grandmother able to help mother and infant with separation and individuation. In the third one, the therapist is transferentially experienced as a paternal grandmother who acts as a pseudo-father able to embody the paternal function. In each of these positions, the transference and countertransference – whether positive or negative – require that the therapist responds to rather than enacts the grandmaternal role. The three configurations of the grandmaternal transference have different clinical manifestations and offer different therapeutic ports of entry.     

An existential‐phenomenological counter‐theory of transference

The hypothesis of transference has become such a fundamental assumption for many therapeutic practitioners, that it is rarely questioned either in terms of its theoretical value or its function. This paper will critically examine the notion of transference from an existential‐phenomenological perspective and will argue the case for an alternative perspective. Further, it will seek to demonstrate that numerous and significant logical and applied problems arise with regard to the hypothesis of transference—problems which have a major negative impact upon the therapeutic relationship in general and upon the possibility of ‘encounter‘—or ‘meeting‘—between therapist and client. Finally, the paper will seek to show how, in many cases, the adoption of the hypothesis of transference can be seen as a defensive and power‐preserving (or enhancing) activity on the part of the therapist whose benefit to the client is, at best, questionable.     

The transference neurosis in Freud's writings

This paper reviews the evolution of the concept of transference neurosis in Freud's writings. It suggests that the language in which the concept of the transference neurosis is originally expressed by Freud includes an idea of the analyst as aggressively pursuing the analytic cure by waging a solitary battle against the patient's disease. With the representation of the death drive and the larger role accorded to sadism as its external manifestation in Freud's revised drive theory of 1920, the patient becomes the ally; resistance, in the sense of the conservative forces, not disease, in the sense of libidinal conflict, becomes the enemy. It is thus difficult to speak of a transference neurosis in the circumscribed way Freud originally meant it, and he ceased to use the term after 1926 rather than redefine it to fit his broader perspective. In this broader perspective, relative resolution of conflict replaced radical liberation of the patient from disease. That Freud did not redefine the term does not imply that he discarded it, or that we necessarily should. This paper suggests that Freud implied a functional distinction between transference as transforming agent and transference neurosis as result of that transformation. That distinction defines psychoanalytic cure in terms of the understanding of a symbolic transformation which is, through the transference neurosis, reexperienced as part of the psychoanalytic process.     

The threat of male-to-female erotic transference

Vignettes from an ongoing psychoanalysis with a patient, Michael, are presented to illustrate the various dimensions of the erotic transference at different phases of the treatment. The relation to power, the experience and expression of aggression, how these may be organized by gender, and the female analyst's countertransference are discussed as potentially fostering or inhibitory in the development of an erotic transference. Traditional sociocultural gender stereotypes kept alive in fantasy can cause female analysts to subtly foreclose the impending threat of an intense erotic transference with male analysands due to a fear of outwardly directed male aggression. It is suggested that the maternal/containing transference can be unconsciously fostered by both analyst and analysand to defensively avoid expression of the aggressivized erotic transference in its full intensity. Similarities and differences in cases of sexual boundary violations with opposite-gender pairings are discussed.     

Transference: current concepts and controversies

In this paper I have presented a brief outline of some of the more important issues regarding transference. To summarize I shall restate ten transference issues heretofore discussed: What should be included in the definition of transference? Should it be defined narrowly or broadly? In what ways can transference be usefully viewed in relation to reality? What merit is there in distinguishing the working alliance from transference? Should self and object transference be differentiated? Should transference neuroses be discriminated from transference reactions on the one hand and from transference psychoses on the other? In addition to sexual and aggressive transferences, should sexualized and aggressivitized transferences, respectively, be distinguished? How may transference be conceived of as a vehicle of cure and yet also as a resistance to cure? What is to be said for the relative merit of the "here and now" versus the "there and then?" What is the role of transference in relation to insight on the one hand and to the therapeutic object on the other? What are some of the basic issues in countertransference?     

Countertransference and reality

The psychoanalytic situation provides many opportunities for people to observe their analysts closely. These observations are inevitably woven into the fabric of patients’ transference experience. Because the observations can be uncomfortable for the analyst, there is a constant temptation to ignore or deny the plausibility of patients’ perceptions. They can be, and often are, quickly reinterpreted as derivatives of sexual or aggressive urges. Psychoanalytic drive theory, with its emphasis on impulse rather than observation as the force behind transference experience, can encourage counter‐transferential disclaimers and lead to blind spots. Some technical suggestions are offered to avoid this tendency and are based on a relational understanding of the nature of transference.     

Changes in psychoanalytic ideas: transference interpretation

Interpretation of the transference is central to all psychoanalytic models. Definitions of transference and transference interpretation have changed greatly during the past half-century, influenced by major movements in philosophy, advances in psychoanalytic research and theory, and changes in our understanding of Freud. This paper suggests that historical, relatively simple, concepts of the transference as the reproduction in the present of significant relationships from the past do not adequately meet current clinical and theoretical demands. Modernist views of the transference emphasize as additional sources of transference responses, the role of the analytic background of safety, the constant modification of unconscious fantasy and internal representations, and the interactive nature of transference responses, with important interpersonal and intersubjective components. It is suggested that the evolving modernist views of transference and transference interpretation permit a fuller accounting for transference phenomena and open the way for better informed interventions. A brief discussion of the issue of psychological "truth" and "distortion" as applied to transference phenomena is presented. The themes are illustrated with clinical vignettes.     

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.     

The working alliance is St. Stephan's cathedral. Epistemological considerations of the Heinrich Deserno lecture, "Analysis and the working alliance" (1990)]

With the term "working alliance", as it was discussed by R.R. Greenson in noted publications, an understanding of work was introduced that corresponds with the dominant contemporary idea of work as a purely instrumental and technical process which is alien to the original "spirit" of Freudian Analysis. The author shows that psychological work, which in analysis is carried out cooperatively by analyst and analysand, needs transference to be successful, a transference with the help of which the analysand is able to discuss and specify his unconscious psychological conflicts. In Greenson's understanding the working alliance--supposedly neurosis-free--appeals to the rational part of the ego and introduces a normative understanding of reality. The transference relationship, by contrast, gives room to those psychic forces which refuse to obey the authority of the ego and its tendencies to conventionalize and suppress unconscious material.     

The analyst's awkward gift: balancing recognition of sexuality with parental protectiveness

The author describes the many roles that the analyst is called upon to fulfill in the transference during the course of an analysis. The loving transference is distinguished from the erotic transference and the erotized transference. Repetition is discussed, as is narcissism, especially in the light of clinical situations in which oedipal issues take center stage. Four brief clinical examples are presented.     

Patient's sleep on the analytic couch

Published reports about sleep on the couch have primarily emphasized its preoedipal (especially oral) determinants and defensive purposes. A detailed case is presented in which sleep became the central symptom of the transference neurosis. The primary determinants of the symptom were from the phallic-oedipal stage of development. Like other symptoms, the sleep symptom was a reliving of earlier experiences and was analyzed primarily through the transference. The analytic data from the case are used to illustrate resistance as an ally in the psychoanalytic process.     

An ego psychology-object relations theory approach to the transference

This paper summarizes an ego psychology-object relations theory and its application to psychoanalytic technique, particularly to the analysis of the transference. The relative importance of verbal, nonverbal, and generally relational "channels" of communication in patients with differing degrees of transference regression is examined. The use of countertransference reactions in formulating transference interpretations is reviewed. The relations between unconscious meanings in the "here-and-now" and unconscious meanings in the "there-and-then" are explored in the transferences of patients with varying degrees of severity of psychopathology. Differences with other theoretical approaches are highlighted throughout.     

What''s right and what''s wrong with transference theories

This paper examines the Transference Theory of causation, developed originally by Aronson (1971) and Fair (1979). Three difficulties for that theory are presented: firstly, problems associated with the direction of transference and causal asymmetry; secondly, the case of persistence as causation, for example where a body's own inertia is the cause of its motion; and thirdly the problematic notion of identity through time of physical quantities such as energy or momentum. Finally, the theory is compared with the Conserved Quantity Theory (Dowe 1992c), and it is shown that that account embodies the modifications that the transference theory needs to adopt.     

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.     

Primal seduction, matricial space and asymmetry in the psychoanalytic encounter

Wishing to highlight the asymmetric dimension that characterizes ethics as 'responsibility toward the other' in Levinas's philosophy, the author presents as an introduction three related concepts of Levinas's thinking: the caress, the face, the saying. Following some poetic narrative reflections offered as 'interlude' moments, the author seeks to bring together her concept of 'matricial space' inspired by Levinas's conception of ethics and the Laplanchian concept of 'primal seduction', both based on asymmetry. She suggests adding to Laplanche's proposition of two kinds of transference (filled-in transference and hollowed-out transference) a third kind: the matricial-space transference. She argues that together with the hollowed-out transference, which is related to the primal seduction, the matricial-space transference, which relates to the matricial position in the parent/analyst, is provoked by the analyst. If the hollowed-out transference assures the moving-on of the analysis, the matricial-space transference, in combination with the hollowed-out transference, is prerequisite for transformation to occur and may be deciphered specifically in 'impasse' situations, at what she coined 'subjectal moments'. As a conclusion, while insisting on the need for asymmetry in the analytic encounter, she suggests the existence in the human neonate of a need for ethics, and she questions the origin of the human capacity to be responsible toward the other. She illustrates her argument using clinical material from her own work alongside that of other authors.     

A Farewell to Countertransference

The "discovery" of countertransference provided a much-needed corrective to the one-sided view of transference and a patient's pathology. Even if its usefulness in the development of psychoanalysis was indisputable, its days are numbered. When I present my clinical work at conferences, I am often asked questions about my countertransference. These questions contain numerous assumptions that are challenged in this paper. Treatment is discussed from a self psychological perspective to highlight the therapeutic value of enabling the patient to engage a selfobject transference. The concept of "projective identification" is also challenged. Systems theory, in which the therapeutic relationship is understood as a co-construction between therapist and patient, is proposed as a more effective model to deal with the issues formerly included under transference-countertransference.