What’s your position in the transference?

transferenceIn my own psychoanalytic training, this is a question that’s often been asked of me.  Psychoanalysts believe that transference is when the patient acts towards someone – often the therapist – as if they were a figure in the patient’s past.   So, when a patient feels unloved, criticised, intruded upon or neglected, we might ask ourselves ‘who am I to them?’.

Countertransference, is the therapist’s feelings about the patient.  Note that they can be responses to a perceived transference, and ways of defending against these – e.g. I feel inadequate when a patient feels criticised by me, so I try to make it up to them, to repair the ‘rupture’.

To our patient that tells us that they feel criticised, a more Kleinian approach would be to ‘tell’ the client what you think they’re doing.  Something like ‘you see me as your mother, who always used to criticise you, so when I point things out to you, you feel criticised like you used to then’.  A more contemporary approach would be to invite the patient to critique the beliefs that result in them feeling criticised.  Maybe like ‘what does it mean to you that you feel criticised?’.  The latter intervention avoids stepping into and elaborating the fantasy on behalf of the patient, and invites them instead to consider what the word means to them, and where there beliefs about it might come from.  Much less chance of the patient feeling criticised by this kind of response!

This illustrates two different positions in the transference – the Kleinian, where the therapist acts out the transference, then analyses it.  The contemporary, where the therapist uses the transference to analyse it as a symbolic ‘third term’, something about the patient’s mind (and the language they use to talk about it) that can be looked at by them both, rather than something ‘going on’ in the relationship between them.

Check out this handy webpage to read a little more about transference and working with it: http://cbtvspsychodynamic.com/transferenceexamples.html

Dr Russel Ayling

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