Use of transference interpretations in dynamically oriented individual psychotherapy for patients with personality disorders

The use of transference interpretations in the individual treatment of patients with personality disorders is a controversial issue. Both expressive approaches that stress the importance of transference interpretations and supportive approaches that avoid interpretation of the transference have been advocated by dynamically oriented therapists. Literature is reviewed regarding recommendations for individual psychotherapy and the different views on interpretation of the transference. Available research that has attempted to illuminate the impact of these interventions is also summarized. Although the findings are limited by a number of methodological shortcomings, three implications have emerged. First, a strong therapeutic alliance is imperative for successful exploration of the transference. Second, transference-focused work should be balanced with supportive interventions. Third, the patient's quality of object relations and his or her ability to work within the transference should be considered. However, without further research to guide clinical decision making, clinicians will be left with a confusing array of recommendations and only their intuition.