OF
TRANSFERENCE-COUNTERTRANSFERENCE
Introduced by: RICHARD J.KOSCIEJEW
Freud describes transference as both the greatest danger and the best tool for analytic work. He refers to the work of making the repressed past conscious. Besides these two implied meanings of transference, Freud gives it a third meaning: It is in the transference that the analysand may relive the past under better conditions and in this way rectify pathogical decisions and destines. Likewise three meanings of countertransference may be differentiated. It too may be the greatest danger and at the same time an important tool for understanding, an assistance to the analyst in his function as interpreter. Moreover, it affects the analyst’s behaviour; It interferes with his action as object of the patient’s re-experience in that new fragment of life that is the analytic situation, in which the patient should meet with greater understanding and objectivity than he found in the reality or fantasy of his childhood.
Although the concept of transference, from the point of view of definition, offers some semblance of evolutionary progression to something commanding wide agreement among psychoanalysts; the same cannot be said of countertransference. Definitions of countertransference have varied almost from the first discussions of it and there remains today widespread disagreement as to what the term comprises.
As Freud (1910) introduced the term in ‘The Future Prospects of Psychoanalytic Therapy’:
. . . We have begun to consider the ‘countertransference’ which arises in th e physician as a result of the patient’s influence on his unconscious feelings, and have nearly come to the point of requiring the physician to recognize and overcome this countertransference in himself . . . Anyone who cannot succeed in this self-analysis may without more ado regard himself as unable to treat neurotics by analysis.
On ‘Observations in Transference-Love’ Freud (1915) says of a patient’s tendency to fall in love with successive physicians.
To the physician it represents an invaluable explanation and a useful warning against any tendency to countertransference which may be lurking in his own mind. He must recognize that the patient’s falling in love is induced by the analytic situation and is not to be ascribed to the charms of his person . . . And it is always well to be reminded of this.
Freud continues, to warn against and attempt to influence the transference by partial gratification and then goes on to develop his well-known dictum that the treatment must be carried through in a ‘state of abstinence’.
On Jun e 3, 1923, at a meeting of the American Psychoanalytic Association, Adolph Stern read one of the first papers - if not the first - dealing extensively with the subject of countertransference which he defines as ’the transference that the analyst makes to the patient’ He continues:
Theoretically, the countertransference on the part of the analyst has the same origin as the transference in the part of the patient; namely, in the repressed, infantile material of the analyst. By the same law, it may manifest itself in any form that the transference does. Practically, however, owing to the previous training that the analyst has undergone, his theoretical knowledge and his actual clinical experience reduce considerably the field of activity of the countertransference in comparison with protean forms which the transference takes in patients.
Stern also differentiates libidinous from ego components in the countertransference and illustrates various unanalyzed problems in analysis that may give rise to countertransference difficulties.
Ferenczi and Rank, from whom Stern may well have drawn some of his ideas, add to the definition of countertransference:
The narcissism of the analyst seem suited to create a particularly fruitful source of mistakes, among others the development of a kind of narcissistic countertransference which provokes the person being analyzed into pushing into the foreground certain things which flatters the analyst and, on the other hand, into suppressing remarks and associations of an unpleasant nature in relation to him.
As noted, there is an explicit or implied difference in the concept of countertransference as simply a relation of the patient’s transference as distinguished from the analyst’s own transference to the patient for whatever reasons and arising from his own unresolved neurotic difficulties.
E. Glover (1927) devotes considerable space to the subject of countertransference in his published ‘Lectures on Technique in Psychoanalysis’. He distinguishes positive and negative countertransference well as countertransference and counterresistance. Both are refined for the most part in terms of relations to patient’s transference reactions, particularly in the transference neurosis, but other determinants in the psychology of the analyst and referred to. Glover adds little to the definition of countertransference, but presents a wealth of technical information.
Healy, Bronner, and Bowers (1930) seem to tread warily:
What is spoken of as ‘countertransference’ must also be reckoned with in connection with the analytic situation. By this is meant impulses on the part of the analyst to respond to the patient’s affectional trends. Schilder thinks that there is operative of an important psychological law regulating human relations and that the patient‘s feelings will of necessity call for complementary ones on the part of the analyst . . .
Reich (1933) does not define countertransference, but he does discuss countertransference problems, and assumes that they arise from the personal difficulties of the analyst.
Fenichel (1936) notes that little has been written about the important and practical subject of countertransference, nor does he undertake to define the term. An implied definition is found, however, in the following:
The analyst like the patient can strive for direct satisfactions from the analytic relationship as well as make use of the patient for some piece of ‘acting out’ determined by the analyst’s past. Experience shows that the libidinal strivings of the analyst are much less dangerous that his narcissistic needs and defences against anxieties. Little is said about this subject probably because nothing can act as a protection against such misuse of analysis except the effectiveness of the analyst’s own analysis and his honesty with himself.
What have present-day writers to say about the problem of countertransference?
Lorand writes mainly about the dangers of countertransference for analytic work. He also points out the importance of taking countertransference reactions into account fo r they may indicate some important subject to be worked through with the patient. He emphasizes the necessity of the analyst’s being always aware of his countertransference, and discusses specific problems such as the conscious desire to heal, the relief analyst may afford the analyst from his own problems, and narcissism and the interference of personal motives in clinical purposes. He also emphasizes the fact that these problems of countertransference concern not only the candidate bu t also the experienced analyst.
Winnicott is specifically concerned with ‘objective and justified hatred’ in countertransference, particularly in the treatment of psychotics, he considers how the analyst should manage this emotion; should he, for example, bear his hatred in silence or combinative skills to the analyst. Thus Winnicott is concerned with a particular countertransference reaction insofar as it affects the behaviour if the analyst, who is the analysand’s object in his re-experience of childhood.
From a subsequent flow of papers concerning countertransference in the analysis of neurotic patient, three recent articles are greatest relevance, that in 1951, Little noted that ‘unconsciously we may exploit a patient’s illness for our purposes, both libidinal and aggressive, and will quickly respond to this’.
In 1957, Schroff gave an account of the analysis of a man with a character disorder of which sexual acting some of the therapist’s unconscious impulses; and Schroff found, in his own work with the patient, that his countertransference problems influenced unfavorably the man’s acting out, until late in eventually successful analysis. This kind of mechanism incidentally, had been described in a paper in 1952 by Johnson and Szirek, in which these authors reported their finding of children’s acting out the patient’s unconscious antisocial impulses. Barchilion, in a paper of 1957 concerning ‘countertransference cures’, reported a number of examples of analytic ‘cures’ that he showed to be based precariously upon not only transference but also countertransference, and he commented that ‘in more extreme cases, the therapist forces the patient to act out his own unconscious solutions with little relevance to the patient’s needs.
Excessive acting out in the analytic situation would point to a blindspot in the analyst. What seems to happen in this situation is that the analyst happens to be similar in a personality difficulty to an authority figure of the patient’s, so both into a familiar pattern of reacting to each other without either one’s being aware of what is going on. Thus, for example, excessive acting out should always lead to th e analyst’ exploring his own contribution to the situation. Although, of course, we know that some patients tend to act out more than others - in their own right.
None the less the significance of the transference phenomenon impressed Freud so profoundly that he continued through the years to develop his ideas about it. His classical observations on the patent Dora formed the basis for his first formularies of this concept. He said, ‘What are transferences? They are the new editions or facsimiles of the tendencies and phantasies which are aroused and make conscious during the progress of the analysis; but they have this peculiarity, which is characteristic for their species, that they replace some early person by the person of the physician. To put it another way; a whole series of psychological experiences are revived, not as belonging to the past, but applying to the person of the physician at the present moment.
According to the Freudian view, the process of psychoanalytic cure depends mainly upon the patient’s ability to remember that which is forgotten and repressed, and thus to gain conviction that the analytical conclusion arrived at are correct. However, ‘the unconscious feelings strive to avoid the recognition which the cure demands’. They seek instead, emotional discharge, regardless of the reality of the situation.
Freud believed that these unconscious feelings, which the patient strives to hide, are made up of that part of the libidinal impulse that has turned away from consciousness and reality, due to the frustration of a desirous gratification. Because the attraction of reality has weakened, the libidinal energy is still maintained in a state of regression attached to the original infantile sexual objects, although the reasons for the recoil from reality have disappeared.
Freud stated that in the analytic treatment, the analyst pursued this part of the libido to its hiding place, ‘aiming always at unearthing it, making it accessible to consciousness and at last serviceable to reality’. The patient tries to achieve an emotional discharge of this libidinal energy under the pressure of the compulsion to repeat experiences over and again, rather than to become conscious of their origin. He uses the method of transferring to the person of the physician past psychological experiences and reacting to this, at times, with all the power of hallucination. The patient vehemently insists that his impression of the analyst is true for the immediate present, in this way avoiding the recognition of his own unconscious impulses.
Thus, Freud regarded the transference-manifestations as a major problem of the resistance. However, Freud said, ‘It must not be forgotten that they (the transference-manifestations) and they only, render the invaluable service of making the patient’s buried and forgotten love-emotions actual and manifest.’
Freud regarded the transference-manifestations as having two general aspects - positive and negative. The negative, he at first regarded as having no value in psychoanalytic cure and only something to be ‘raised’ into consciousness to avoid interference with the progress of the analysis. He later accorded it a place of importance in the therapeutic experience. The positive transference he considered to be ultimately sexual in origin, since Freud said, ‘To begin with, we knew none but sexual objects’. However, he divided the positive transference into two components - one, the repressed erotic component, which was used in the service of resistance; the other, the friendly and affectionate component, which, although originally sexual, was the ‘unobjectionable’ aspect of the positive transference, and was that which ‘brings about the successful result in psychoanalysis, as in all other remedial methods’ - Freud referred to the element of suggestion in psychoanalytic therapy.
At the moment, I should like to state that it would be a mistake to deny the value and importance of his formulations regarding transference phenomena. Nonetheless, I differ on certain points with Freud, but I do not differ with the formulation that early impressions acquired during childhood are revived in the analytical situation, and are felt as immediate and real - that they form potentially the greatest obstacles to analysis if unnoticed, and, as Freud put it, the greatest ally of the analysis when understood. Wherefore, I agree that the main work of the analysis consists in analyzing the transference phenomena, although I differ somewhat as to how this result is cure. Even so, it is my conviction that the transference is a strictly interpersonal experience. Freud gave the impression that under the stress of the repetition-compulsion the patient was bound to repeat the identical pattern, regardless of the other person, that I believe that the personality of the analyst tends to determine the character of the transference illusions, and especially to determine whether the attempt at analysis will result in cure. Horney has shown that there is no valid reason for assuming that the tendency to repeat past experiences time and again, having that he integrate with any given situation according to the necessities of his character structure.
Yet, among other things, I do want to mention a simple phenomenon, as described by Sherif, connected with the problem of the frame of reference. If you have a completely dark room, with no possibility of any light being seen, and you then turn on a small pinpoint of light, which is kept stationary, this light will soon appear to be moving about. I am sure a good many of you have noticed this phenomenon when gazing upon a single star. The light seems to move, and it does so, apparently because there is no reference point in relation to which one can establish it at a fixed place in space. It just wanders around. If, however, one can at the same time see some other fixed object in the room, the light immediately becomes stationary. Are a reference point having been established, and there is no longer any uncertainty, and vague wandering of the spot of light. It is fixed. The pinpoint of light wandering in the dark room is symbolic of the original attitude of the person to himself, undetermined, unstructured, with no reference point or points.
The newborn infant probably perceives everything in a vague and uncertain way, including himself. Gradually, reference points are established, a connection begins to occur between hunger and breast, between a relief if bladder tension and a wet diaper between playing with his genitals and a smack on the hand. The physical boundaries and potentialities of the self are explored. One can observe the baby investigating the extent, shape, and potentialities of his own body, that he can hold his breath and everyone will get excited that he can smile and coo and people will be enchanted, or just the opposite. The nature of the emotional reference points that he determines depends on or upon the environment. By that still unknown quality called ‘empathy’ he discovers the reference points that help to determine his emotional attitude toward himself. If his mother does not want him, is disgusted with him, treats him with utter disregard, he comes to look upon himself as anything-to-be-disregarded. With the profound human drive to make this rational, he gradually builds up a system of ‘reasons why’. Underneath all these reasons is a basic sense of worthlessness, undetermined and undefined, related directly to the original reference frame. Another child discovers that the state of being regarded is dependent upon specific factors- all is well as long as one does not act spontaneously, as long as one can be just not of a separate person, as long as one is good, as the state of being good is continuously defined by the parent. Under these conditions, and these only, this child can feel a sense of self-regard.
Other people are encountered with the original reference frame in mind. The child tends to carry over into later situations the patterns he first learned to know. The rigidity with which these original patterns are retained depends upon the hidden nature of the child’s experience. If this has been of a traumatic character so that spontaneity has been blocked and further emotional developments has been inhibited, the original orientations will tend to persist. Discrepancies may be rationalize or repressed. Thus, the original impression of the hostile mother may be retained, while the contact with the new person is rationalized to fit the original reference frame. the new person encountered acts differently, but probably that is just a pose. She is just being nice because she does not know me. If she really knew me, she would act differently. Or, the original impressions are out of line with the present actuality, that they remain unconscious, but make themselves apparent in inappropriate behavior or attitudes, which remain outside the awareness of the person concerned.
The little child who grows more and more negativistic, because of injuries and frustrations, evokes more and more hostility in his environment. However, and this is important, the basic reactions of hostility on the part of the patents, which originally induced his negativism, are still there. Thus, the pattern does not change much in character - it just gets worse in the same direction. Those persons whose life experience perpetuate the original frames of reference, are more severely injured. Among the children, who has a hostile mother, may then have a hostile teacher. If, by good luck, he got a kind teacher and if his own attitude were not already badly warped, so that he did not induce hostility in this kind teacher, he would be introduced into a startlingly new and pleasant frame of reference, and his personality might not suffer too greatly, especially, if a kindly aunt or uncle happened to be around.
The profoundly sick people have been so early injured, in such a rigid and limited frame of reference, that they are not able to make use of kindliness, decency, or regard when it does come their way. They meet the world as if it were potentially menacing. They have already developed defensive traits entirely appropriate to their original experience, and then carry them out in completely inappropriate situations, rationalizing the discrepancies, but never daring to believe that people are different from the ones they early learned to distrust and hate. By reason of bitter early experience, they learn never to let their guard down, never to permit intimacy, least of mention, the death blow would be dealt to their already partly destroyed sense of self-regard. Despairing of real joy in living, they develop secondary neurotic goals which give a pseud-satisfaction. The secondary gains at first glance might seem to be what the person was really striving for - revenge, power and exclusive possession. Actually, these are but the expressions of the deep injuring sustained by the person. They cannot be fundamentally cured until those interpersonal relationships that caused the original injury are brought back to consciousness in the analytic situation. Step by step, each phase to the long period of emotional development is exposed, by no means chronologically; the interconnecting, overlapping reference frames are made conscious, those points at which a distortion of reality, or a repression of part of the self had to occur, are uncovered. The reality gradually becomes ‘undistorted’, the self refound in the personal relationship between the analyst and the patient. This personal relationship with the analyst is the situation in which the transference distortion can be analyzed.
In Freud’s view, the transference was either positive or negative, and was related in a rather isolated way to a particular person in the past. Justly, the transference is the experiencing in the analytic situation the entire pattern of the original reference frames, which include at every moment the relationship of the patient to himself, to the important persons, and to others, as he experienced them at that time, in the light of his interrelationships with the important people.
The therapeutic aim in this process is not to uncover childhood memories that will then lend themselves to analytic interpretation. Here, Fromm has pointed out, that psychoanalytic cure is not the amassing of data, either from childhood, or from the study of the present situation. Nor does cure result from repetition of the original injurious experience in the analytic relationship. What is curvature in the process, is that in tending to reconstruct with the analyst that atmosphere which obtained in childhood, the patient actually achieve something new. He discovers that of himself which has to be repressed at the time of the original experience. He can only do this in an interpersonal relationship with the analyst, which is suitable to such a rediscovery. To illustrate this point: If a patient had a hostile parent toward whom he was required to show deference, he has to repress certain of his own spontaneous feelings. In the analytic situation, he tends to carry over his original frame of reference, and again tends to feel himself to be in a similar situation. If the analyst’s personality also contains elements of a need for deference, that need will unconsciously be imparted to the patient, who will, therefore, still repress his spontaneity as he did before. True enough, he may act or try to act as if analyzed, since by definition, that is what the analyst is attempting to accomplish. But he will never have found his repressed self, because the analytic relationship contains for him elements actually identical with his original situation. Only if the analyst provides a genuinely new frame of reference - that is, if he is truly non-hostile , and truly not in need of deference - can this patient discover, and it is a real discovery, the repressed elements of his own personality. Thus, the transference phenomenon is used so that the patient will completely re-experience the original frames of reference, and himself within those frames, in a truly different relationship with the analyst, to the end that he can discover the invalidity of his conclusions about himself and others.
That is to say, by this is not to mean to deny the correctness of Freud’s view of transference also acting as a resistance. As a matter of fact, the tendency of the patient to reestablish the original reference frame is precisely because he is afraid to experience the other person in a direct and unreserved way. He has organized his whole system of getting along in the world, bad as that system might be, on the basis of the original distortions of his personality and his subsequent vicissitudes. His capacity for spontaneous feeling and acting has gone into hiding. Now it has to be sought. If some such phrase as the ’capacity for self-realization’ is substituted in place of Freud’s concept of the repressed libidinal impulse, much is the same conclusions can be reached about the way in which the transference-manifestations appear in the analysis as resistance. It is just in the safest situation, where the spontaneous feelings might come out of hiding, that the patient develops intense feelings, sometimes of a hallucinatory character, that relate to the most dreaded of experience, that of the past. It is at this point that the hidden natures and the use by the patient of the transference distortions have to be understood and correctly interpreted, by the analyst. It is also here that the personality of the analyst modifies the transference reaction, a patient cannot feel close to a detached or hostile analyst and will therefore never display the full intensity of his transference illusions. The plexuity of this process, whereby the transference can be used as the therapeutic instrument and, at the same time, as a resistance may be illustrated by the following example: a patient had developed intense feelings of attachment to a father surrogate in his everyday life. The transference feelings toward this man were of great value in elucidating his original problems with his real father. As the patient became more and more aware of this personal validity, he found this masochistic attachment to be weakening. This occasioned acute feeling of anxiety, since his sense of independence was not ye t fully established. At this point, he developed very disturbing feelings regarding the analyst, believing that she was untrustworthy and hostile, although prior to this, he had successes in establishing a realistically positive relationship to her. The feelings of untrustworthiness precisely reproduced an ancient pattern with his mother. He experienced then at this particular point in the analysis in order to retain and to justify his attachment to the father figure, the weakening of which attachment had threatened him so profoundly. The entire pattern was elucidated when it was seen that he was re-experiencing an ancient triangle, in which he was contentiously driven to a submissive attachment to a dominating father, due to the utter untrustworthiness of his weak mother. If the transference character of this sudden feeling of untrustworthiness of the analyst had not been clarified, he would have turned again, submissively to his father surrogate, which would have further postponed his development of-independence. Nevertheless, the development of this transference to the analyst brought to light a new insight.
Freud felt that personality disorder called schizophrenias or paranoia could not be analyzed because the patient was unable to develop a transference to the analyst. In this view the real difficulty in treating such disorders is that the relationship is essentially nothing but transference illusions. Such persons hallucinate the original frame of reference to the exclusion of reality. Nowhere in the realm of psychoanalysis can one find more complicating and complex proof of the effect of early experience on the person than in attempting to treat these patients. Frieda Fromm Reichmann has shown in her work with schizophrenics the necessity to realize the intensity of the transference reactions, which have become almost completely real to the patient. And yet, if one knows the correct interpretations, by actually feeling the patient’s needs, one can over years of time do not the identical thing that is accomplished more quickly and less dramatically with patients suffering a less severe disturbance of their interpersonal relationships.
Another point with which Freud took the position that all subsequent experience in normal life is merely repetition of the original one. Thus love is experienced for someone today in terms of the love felt for someone in the past. As, perhaps, this is not exactly true: Yet the child who has not had to repress certain aspects of his personality enters into a new situation dynamically, not just as a repetition of what he felt, say, with his mother, but as an active continuation of it. That is to say, that there are constitutional differences with respect to the total capacity for emotional experience, just as there are with respect to the total capacity for intellectual experiences. Given this constitutional substratum, the child engages in personal relationships not passively as a lump of clay waiting to be molded, but most dynamically, bringing into play all his emotional potentialities. He may possibly find someone later whose capacity for response is deeper than his mother’s. If he is capable of the greater depths, he experiences an expansion of himself. Many later in life have met a ’great’ person and have felt a sense of newness in the relationship which is described to others as ’wonderful’ and which is regarded with a certain amount of extension of the self to a new horizon.
In considering the process of psychoanalytic cure, Freud very seriously discussed the relationship of analysis to suggestion therapy and hypnosis. He believed, that part of the positive transference could be made use of in the analysis to bring about the successful result. He said, ‘In so far we readily admit that the results of psychoanalysis rest upon a basis of suggestion, only by suggestion we must be understood to mean that which we, with Ferenczi, find that it consists of influence on a person through and by means of the transference-manifestations of which he is capable. The eventually independence of the patient is our ultimate object when we use suggestion to bring him into and carry out a mental operation that will necessarily result in a lasting improvement in his mental condition. Freud, elsewhere indicated very clearly, that in hypnosis, the relationship of the patient to the hypnotist was not worked through, whereas in analysis the transference to the analyst was resolved by bringing it entirely into consciousness. He also said, that the patient was protected from the unwitting suggestive influence of the analysis by the awakening of his own unconscious resistance.
We must deal, somewhat more in detail, with one phase of the analysis that can be called the, ‘plexuity of analysis’ and that preserves an important stage of the amalgation with academic psychology. The word ‘plexuity’ was first used by Kosciejew as the simplification of a complicated-complex psychological fact, to designate certain tendencies, characteristic for the person in question, or a related group of affect-coloured conceptions. This interpretation of the word, which was constantly becoming more comprehensive, and had thus come to have almost no meaning, was limited by those who described the unconscious repressed for its part of those group conceptions with its name by the analytical acceptance of ‘plexuities’. As the more subtle, labile, fluctuating process of cathexis in the psyche became accessible to research, the acceptance of such inflexible, separate mental components became more and again superfluous. They were to coherent, they could only be excited and displaced in toto, they were much too complicating, as more exact analysis showed to be treated as elements which could not be further reduced. However, in the newer works of Freud, this conception merely figures as the survival of a period since the creation of our meta-psychology.
The most consistent thing would have been to do away entirely with this new useless rudiment of an earlier time, and to give up the terminology, which had become dear to most analysts, in favour of a better understanding. Instead of doing this, the whole of mental life was often regarded as a mosaic of such plexuities, and the analysis then carried out with the object of ‘analyzing out’ one complex after the other, or the attempt was make of treating the whole personality as a sum total of father-mother, brother and sister complexes. It was naturally easy to collect material for these, since every one has, of course, all the plexuities, that is, every one must, in the course of his development, somehow get on with the persons and object that surround him. The connected recounting of plexuity, or the attributes of these, may have its place in descriptive psychology, but not in the practical analysis of the neurosis, nor does it even belong in the psychoanalytic study of literary or ethno-psychological products, where it must undoubtedly lead to monotony in no way justified by the many-sidelines of the material, and scarcely tempered by giving preference, first to one and then to the other complex.
Although such a flattening out may have to be put up with at times, as unavoidable in a scientific presentation, one should not therefore transfer such a cramped interest into the technique. The analysis of plexuities easily misleads the patient into being pleasing to his analyst, by bringing him ‘complex material’ as long as he likes, without giving up any of his really unconscious secrets. Thus there came to be histories of illnesses In which the patient recounted memories, evidently fabricating them, in a way that never happens in unprejudiced analyses, and can only be looked upon as the product of such a ‘breeding of plexuity’. Such results should naturally not be used subjectively either to show the correctness of one’s own method of interpreting, or as theoretic conclusions, not yet as leading to any sort of evidence.
It happens particularly frequently that the associations of the patient were directed to the sexual factor at the wrong time, or that they remained stuck at this point, if as so often happens - he came to the analysis with the expectation that he must constantly talk exclusively of his actual or infantile sexual life. Aside from the fact that this is not so exclusively the case as our opponents think, permitting such an indulgence in the sexual often gives the patient the opportunity to paralyze the therapeutic effect of the privation he must undergo.
An understanding of the many-sided and important mental contents that underlie the collective name ‘castration complex’ was also not exactly furthered by bringing the theory of the complexes into the dynamics of the analysis. On the contrary, we are of the opinion that the premature theoretic condensation of the fact under the conception of the complex interfered with the insight into deeper layers of mental life. We believe that the full appreciation of that which the analytic practitioner has accustomed himself to finish off with the label castration complex, is still lacking, so that this attempt at an explanation should not lightly be regarded as the ultimate explanation of such varied mental phenomena and processes of the patient. We can, from the dynamic standpoint which is the only justifiable one in practice, often recognized in the forms of expression of the castration complex, so they manifest themselves in the course of the analysis, only one of the kinds of resistance that the patient erects against his deeper libidinal wishes. In the early stages of some analyses the castration anxiety can often be uncovered as an expression of the dread, transferred onto the analyst, as a protection against further analysis.
Technical difficulties arose also from the analyst’s having too much knowledge. thus the importance of the theory of sexual development constructed by Freud, misled some analysts to apply in a mistaken and over-dogmatic fashion in the therapy of the neuroses, certain systems of organization and autoeroticism, which first gave us an understanding of normal sexual development . In this searching for the constructive elements of the theory of sex, in some cases, the actual analytic task was neglected. These analyses might be compared to psychochemical ‘elements analyses’. Here, again, one could see that the theoretical importance did not always correspond to the value in the practical analysis. The technique need not methodically lay bare all the, . . .as it were, prescribed historic phases of the development of the libido, still less should the uncovering of all theoretically established details and gradations be used as a principle of healing in the neuroses. It is also practically superfluous to demonstrate all the original elements of a highly complicated ‘connection’, while missing the intellectual thread, which combines the few fundamental elements into new and varying phenomena. The same thing holds for the erotogenic zones as for the plexuity, for example the urethral or the anal erotic, and for the stages of organization the oral eroticism anal-sadistic and other pregenital phases, there can be no human development without all of these, but one must not in the analysis attribute to the importance, for the history of the illness, of which the resistance under the pressure of the analytic situation gives the illusion.
On closer observation a certain inner connection between ‘element analyses’ and ‘complex analyses’ could be recognize , insofar as the latter, in their attempts to plumb the psychic depths, struck upon the granite of the complexes and thus the work was spread out over the surface instead of going to the bottom. Such analyses then usually tried to make up for the lack of depth in the dynamics of the libido by an excursion into the theory of sex, and united rigid attributes of complexes with equally schematically treated principles of the theory of sex, whereas they missed just the play of forces that takes place between the two.
Such an attitude naturally led to a theoretical over-estimation of the factor of quantity, to ascribe everything to a stronger organ - eroticism, a point of view that resembled that of the pre-analytical school of neurologists - who blinded themselves to any insight into actual play of forces of the pathological cayuses by the catch words inheritance, degeneration, and disposition.
Since the theory of the instincts and also the sciences of biology and physiology have been called upon partly as a help in understanding mental phenomena, in particular since the so-called ‘pathoneurosen’, that is the neurosis on the organic level, the organ-neuroses, and even organic illnesses are treated psychoantically, disputes about border-line cases have taken place between psychoanalysis and physiology. The stereotyped translation of physiological processes into the language of psychoanalysis is incorrect. Insofar as one attempts to approach organic processes analytically the rules of psychoanalysis must be strictly adhered to, as one must try to forget, so to speak, one’s organic, medical and physiological knowledge and bear in mind only the mental personality and its reactions.
It was also confusing when simple clinical facts were at once combined with speculations about becoming, being, and duration and such deliberations treated like established rules in practical analysis, whereas Freud himself constantly emphasized the hypothetical character of his last synthetic works. Often enough such a wandering into speculation seems to have been a dodging of uncomfortable technical difficulty. We know how a desire to condense everything prematurely under a speculative principle can wreak vengeance from the point of view of technique (The Jungian theory).
It is also a mistake, while neglecting the individual, in the explanation of the symptoms, to make cultural and phylogenetic analogies at once, no matter how fruitful the latter might be in themselves. The overestimate of the actual factors led to an anagogic prospective interpretation, which was useless so far as the pathologic fixation were concerned. The adherents of the ‘anagogic’, as well as some of those of the ‘genetic’ school, in their interest in the future and in the past, neglected the present condition of the patient. and yet almost all of the past, and everything that the unconscious attempts, insofar as it is not directly conscious or remembered (and this occurs extremely seldom), expresses itself in actual reactions in relation to the analyst or to the analysis, in other words, the transference to the analytic situation.
The requirements of the Breuer-Freud catharsis that the affects, displace upon symptoms, should be led back directly to the pathologic memory traces, and at the same time brought to a discharge and bound again proved to be unrealizable, that is, it succeeds only in the case of incompletely repressed, mostly preconscious memory material as in the case of certain derivatives of the actual unconscious. This itself, the uncovering of which is the chief task of the analysis, since it was never ‘experienced’ can never be ‘remembered’, one must let it be produced on the ground of certain indications. The mere communication, something like ‘reconstruction’, is itself not suited to call forth affect reactions: Such information glides off from the patients without any effect. They can only convince themselves of the reality of the unconscious when they have experienced - mostly after they have frequently experienced - something analogous to it in the actual analytic situation, that is, in the present. The new insight into the topography of mental life and the functions of the separate depth levels gives us the explanation for this state of affairs. The unconscious repressed material has no approach to motility, nor to those motor innervations in the sum total of which the affect discharge consists, the past and the repressed must find their representative factors in the present and the conscious (preconscious) in order that they may be affectively experienced and develop further. In contrast to the stormy abreaction one could designate the unwinding bit by bit of the affects in analysis as a reactional catharsis.
In general, that affects in order to work convincingly must first be revived, that is actually present and that what has not affected us directly and actually must remain mentally ineffective.
The analyst must always take into account that almost every expression of his patients springs from several periods, but he must give his chief attention to the present reaction. Only from this point of view can he succeed in uncovering the roots of the actual reaction in the past, which means changing the attempts of the patient to repeat into remembering. In this process be need pay little attention to the future. One may quietly leave this care to the person himself who has been sufficiently enlightened about his past and present mental strivings. The historic, cultural and phylogenetic analogies also need, for the most part, not be discussed in the analysis. The patient need hardly ever, and the analyst extremely seldom, occupy himself with this early period.
At this place we must consider certain misunderstandings about the enlightenment of people who are being analyzed. There was a phase, in the development of psychoanalysis, in which the goal of the analytic treatment consisted in filling the gaps in the memory of the patient with knowledge. Later recognizes that the neurotic ignorance proceeded from the resistance, that is from not wishing to know, and that it was this resistance that had to be constantly uncovered and made harmless. If one proceeds thus the amnesic gaps in the chain of memories fill themselves in, for the most part automatically, for the other part with the help of sparse interpretations and explanations. The patient therefore learns nothing more and nothing other than what he needs, and in the quantity requisite to allay the predominating disturbances. It was a fatal mistake to believe that no one was completely analyzed who had not been theoretically familiarized with all the separate details of his own abnormality. Naturally it is not easy to set a boundary line up to which the instruction of the patient should be carried. Interruption of the correct analysis by formal courses of instruction may satisfy both the analyst and the patient, but cannot effect any change in the libido-attitude of the sick person. A further result of such instruction was that without noticing it, one pushed the patient into withdrawing himself from the analytical work by means of identifying himself with the analyst. The fact that the desire to learn and to teach creates an unfavourable mental attitude for the analysis is well known but should receive much serious attention.
At times one heard from analysts the complaint that this or that analysis failed on account of ‘too great resistances’ or a too ‘violent transference’. The possibility in principle of such extreme cases is admitted; we do find ourselves at times confronted with quantitative factors, which we , must in no way practically underestimate, since they play an important part in the final; outcome of the analysis, as well as in its causes. But the factor of quantity, so important in itself, can be used as a screen for incomplete insight into the play of forces that finally decide the kind of application and the distribution of those very quantities. Because Freud once uttered the sentence, ‘Everything which impedes the analysis work is resistance.’ one should not, every time the analysis comes to a standstill, simply say, ‘this is a resistance’. This resulted, particularly in patients with an easily aroused sense of guilt, in creating an analytic atmosphere in which th y, so to speak, were fearful of making the ‘faux pas’ as having a resistance, and the analyst found himself in a helpless situation. One evidently forgot another utterance of Freud’s, namely, that the analysis we must be prepared as to meet the same forces, which formerly caused the repression as ’resistance’, as soon as one sets to work to release these repressions.
Another analytical situation that one was also in the habit of labeling incorrectly as ‘resistance’ is the negative transference, which, from its very nature, cannot express itself otherwise than as ’resistance’ and the analysis of which is the most important task of the therapeutic activity. One need, of course, not be afraid of the negative reactions of the patient for they constitute, with iron necessity, a part of every analysis. Also the strong positive transference, particularly when it expresses itself in the beginning of the cure, is only a symptom of resistance that requires to be unmasked. In other cases, and particularly in the later stages of an analysis, it is an actual vehicle for bringing to light desires that have remained unconscious.
In this connection an important rule of psychoanalytic technique must be mentioned in regard to the personal relation between the analyst and the patient. The theoretic requirements of avoiding all personal contact outside if the analysis mostly led to an unnatural elimination of all human factors in the analysis, and thus again, to a theorizing of the analytic experience.
From this point of view, some practitioners all too readily failed to attribute that importance to a change in the person of the analyst, which results from the interpretation of the analysis as a mental process, the unity of which is determined by the person of the analyst. A change of analysts may be unavoidable for outer reasons in rare, exceptional cases, but we believe that technical difficulties - in homosexuals, for example - are not simple to be avoided by the choice of an analyst of the opposite sex. For in every correct analysis the analyst plays all possible roles for the unconscious of the patient; it only depends upon him always to recognize this at the proper time and under certain circumstances to make use of it consciously. Particularly important is the role of two parental images - father and mother - in which the analyst actually constantly alternatives (transference and resistance).
It is not an accident that technical mistakes occurred of frequently just in the expression of transference and resistance. One was easily inclined to let oneself be surprised at these elementary experiences in the analysis and strangely enough forgot just here the theory that had been incorrectly pushed into the foreground in the wrong place. This may also be due to subjective factors in the analysis. The narcissism of the analyst seem suited to create a particularly fruitful source of mistakes: Among others the development of a kind of narcissistic counter-transference that provokes the person being analyzed into pushing into the foreground certain things that flatter the analyst and, on the other hand, into suppressing remarks and associations of an unpleasant nature in relation to him. Both are technically incorrect, he first, because it can lead to an apparent improvement of the patient in only intended to bribe the analyst and in this way to win a libidinal counter-interest from him. The second because it keeps the analyst from the necessity of noticing the delicate indications of criticism, which mostly only venture forth hesitantly, and help the patient to express plainly or to abreact them. The anxiety and the sense of guilt of the patient can never be overcome without this self-criticism, requiring a certain overcoming of himself on the part of the analyst; and yet these two emotional factors are the essentials for bringing about and maintaining the repression.
Another form under which technical inaccessibility hid itself was an incidental remark of Freud’s to the effect that the narcissism of the patient could set limits to the degrees to which he could be influenced by the analysis. If the analysis did not progress well, one consoled oneself with the thought that the patient was ‘too narcissistic’. And since narcissism forms a connecting link between ego and libidinal strivings in all normal, as well as abnormal, mental processes, it is not difficult to find proofs in his behaviour and thoughts of the narcissism of the patient. Particularly one should not handle the narcissistically determined ’castration’ or ‘masculinity’ complexes as they set the limits for analytic solution.
When the analysis struck upon a resistance of the patient one often over-looked to what extent a pseudo-narcissistic tendency was brought into the question. The analyses of people who bring a certain theoretic knowledge a great deal of what one was theoretically inclined to scribe to narcissism, is actually secondary, pseudo-narcissistic and can continue analysis be completely solved in the parental relationship. Naturally it is necessary in doing this to take up analytically the ego-development of the patient, as it is in general, necessary in the analysis of the resistance to consider the up-to-now much-too-neglected analysis of the ego, for which Freud has recently given valuable hints.
The newness of a technical point of view introduced by Ferenczi under the name of ‘activity’ resulted in some analysts, in order to avoid technical difficulties, overwhelming the patient with commands and prohibitions, which one might characterize as a kind of ‘wild activity’. This, however, must be looked upon as a reaction to the other extreme, to holding too fast to an over-looked upon as a reaction to the other extreme, to holding too fast to an over-rigid ‘passivity’ in the matter of technique. The latter is certainly sufficiently justified by the theoretic attitude of the analyst who must at the same time be an investigator. In practice, however, this easily leads to sparing the patient the pain of necessary intervention, and to allowing him too much initiative in his associations as well as in the interpretation of his ideas.
The moderate, but, when necessary, energetic activity in the analysis consists in the analyst’s taking on, and, to a certain extent, really carrying out those rules that the unconscious of the patient and his tendency to flight prescribe. By doing this the tendency to the repetition of earlier traumatic experiences is given an impetus, naturally with the goal of finally overcoming this tendency by revealing its content. When this repetition takes place spontaneously it is superfluous to provoke it and the analyst can simply call forth the transformation of the resistance into remembering (or plausible reconstruction).
These last purely technical remarks lead back to the often-mentioned subject of the reciprocal effect of theory and practice.
I do not mean by this to deny the correctness of Freud’s view of transference also acting as a resistance. As a matter of fact, the tendency of the patient to reestablish the original reference frame is precisely because he is afraid to experience the other person in a direct and unreserved way. He has organized his whole system of getting along in the world, bad as that system might be, on the basis of the original distortions of his personality and his subsequent vicissitudes. His capacity for spontaneous feeling and acting has gone into hiding. Now it has to be sought. If some such phase as the ‘capacity for self-realization’ is substituted in placing Freud’s concept of the repressed libidinal impulse, much the same conclusion can be reached about the way in which the transference-manifestations appear in the analysis as resistance. It is just in the satisfactory situation, where the spontaneous feeling might come out of hiding, that the patient develops intense feelings. Sometimes of a hallucinatory character, that relates to most directed experiences of the past. It is at this point that the hidden natures and the use by the patient of the transference distortion have to be understood and correctly interpreted , by the analyst. It is also, that the personality of the analyst modifies the transference reaction. A patient cannot feel close to the character hostile analyst and will therefore never display the full intensity of his transference illusions. The complexity of this process, whereby the transference can because as the therapeutic instrument and, at the same time, as a resistance may be illustrated by the following example, in his everyday life. the transference feelings towards this were of great value and elucidating his origin problems with his real father. As the patient became more and more aware of his own personal+ validity, he found this narcissistic attachment to be weakening. This occasional acute feeling of anxiety, since his sense of independence was not yet fully established. At that point, he developed very disturbing feelings regarding the analyst, believing that she was untrustworthy and hostile, although proof to this, he had succeeded in establishing a realistically positive relationship to her. The feelings of untrustworthiness precisely reproduced an ancient pattern with his mother, he experienced them at this particular point in the analysis in order to retain and to justify his attachment to his father figure, the weakening of which attachment and threatened him so profoundly. The entire pattern was elucidated as when that which he had driven to a submissive attachment to a dominating father, due to the utter untrustworthiness of his real mother. If the transference character of this sudden feeling of untrustworthiness of the analyst had not been clarified, he would have further postponed his development of independence. Nevertheless, the development of this transference to the analyst brought to light a new insight .
Freud’s view of the so-called narcissistic neuroses, was felt that personality disorders called schizophrenia or paranoia could not be analyzed because the patient was unable to develop a transference to the analyst. However, in that the real difficulty in treating such disorders is that the relationship is essentially nothing but transference illusions. Such persons hallucinate the original frame of reference to the exclusion of reality. Nowhere in the realm of psychoanalysis can one find more complete proof of the effect of early experience of the person than in attempting to treat these patients. Frieda Fromm Reichmann has shown in her work with schizophrenics the necessity to realize the intensity of the transferee reactions, which have become almost completely real to the patient. And yet, if one knows the correct interpretation, by actually feeling the patient‘s needs, one can over years of time do the identical thing that is accomplished more quickly and less dramatically with patients suffering a less severe disturbance of their interpersonal relationship.
Another point of interest is that Freud had taken the position that all subsequent experience in normal life is merely a repetition of the original one. Thus, love is experienced for someone today in terms of the love felt for someone in the past. Perhaps, in believing that this is not exactly true, the child who has not had to repress certain aspects of his personality enters into a new situation dynamically, not just as a repetition of what he felt, say, with his mother, but as an active continuation of it, in that of believing that there are constitutional differences with respect to the total capacity for emotional experience, just as there are with respect on the total capacity for intellectual experiences. Given this constitutional substratum, the child engages in personal relationships not passively as a lump of clay waiting to be molded, but most dynamically, bringing into play all his emotional potentialities. He may possibly find someone later whose capacity for response is deeper than his mother’s. If he is capable of a greater depth, he experience s an expansion of himself. Many later in life have met a ‘great’ person and have felt a sense of newness in the relationship which is described simply as otherwise ‘wonderful’ and which is regarded with a certain amount of awe. This is not a ‘transference’ experience, but represents a dynamic extension of the self to a new horizon.
In considering the process of psychoanalytic cure, Freud very seriously discussed the relationship of analysis to suggestion therapy an hypnosis. He believed, that part of the positive transference could be made use of in the analysis to bring about successful result. He said, ‘In so far we readily admit that the results of psychoanalysis rest upon a basis of suggestion, only by suggestion we must be understood to mean that which we, with Ferenczi, find that it consists of influence on a person through and by means of the transference-manifestations of which he is capable. The eventual independence of the patient is our ultimate object when we use suggestion to bring him to carry out a mental operation that will necessarily result in a lasting improvement in his mental; condition’. Freud elsewhere indicated very clearly that in hypnosis, the relationship of the patient to the hypnotist was not worked through, whereas in analysis the transference to the analyst was resolved by bringing it entirely into consciousness. He also said that the patient was protected from unwitting suggestive influence of the analyst by the awakening of his own conscious resistance.
Even so, Freud describes transference as both the greatest danger and the best tool for analytic work. He refers to the work of making the repressed past conscious. Besides these two implied meanings of transference, Freud gives it a third meaning: It is in the transference that the analysand may relive the past under better conditions and in the way rectify pathological decisions and destinies. Likewise three meanings of countertransference may be differentiated. It too, may be the greatest danger and at the same time an important tool for understanding, an assistance to the analyst in his function as interpreter. Moreover, it affects the analyst’s behaviour. It interferes with his action as object of the patient’s re-experience in that new fragment of life that is the analytic situation, in which he found in the reality or fantasy of his childhood.
Lorand writes mainly about the dangers of countertransference for analytic work. He also points out the importance of taking countertransference reactions into account, for they may indicate some important subject to be worked through with the patient. he emphasizes the necessity of the analyst’s being always aware of his countertransference, and discusses specific problems such as the conscious desire to heal, the relief analysis may afford the analyst from his own problems, and narcissism and the interference of personal motives in clinical purposes. He also emphasizes the fac t that these problems of countertransference concern not only the candidate but also the experienced analyst.
Heimann deals with countertransference as a tool for understanding the analysand. The basic assumption is that the analyst’s unconscious understands that of his patient. This rapport on the deep level comes to the surface in the form of feelings that the analyst notices in response to his patient, in his countertransference. The emotional response of the analyst is frequently closer to the psychological state of the patient than is the analyst’s conscious judgment thereof.
Little discusses countertransference as a disturbance to understanding and interpretation and as in influence the analyst’s behaviour with decisive effect upon the patient’s re-experience of his childhood. She stresses the analyst ‘s tendency to repeat the behaviour of the patient’s parents and to satisfy certain needs of his own, not those of the analysand. Little emphasizes that one must admit one’s countertransference to the analysand and interpret it, and must do so not only in regard to ‘objective’ countertransference reactions (Winnicott) but also to ‘subjective ‘ ones.
Annie Reich is chiefly interested in countertransference as a source of disturbance in analysis. She clarifies the concept of countertransference and differentiates two types; ‘Countertransference in the proper sense’ and the ‘analyst’s using the analysis for acting-out purposes’. She investigate s the cause of these phenomena, and seeks to understand the conditions that lead to good, excellent or poor results in analytic activity.
Gitelson distinguishes between the analyst’s ‘reactions to the patient as a whole’ (the analyst’s ‘transference’) and the analyst’s ‘reactions to partial aspects of the patient (the analyst’s ‘countertransference’). He is concerned also with the problem of intrusion of countertransference e into the analytic situation, and states that, in general, when such intrusion occurs the countertransference should be dealt with by analyst and patient working together, thus agreeing with Little.
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