THE RESONANT VOICE OF TRANSFERENCE
By: RICHARD J.KOSCIEJEW
Despite radical implications for theory of psychoanalytic techniques and others in a dialectical way, is often without awareness. Where these psychoanalysts disagree in their conceptual frame, create the recognition that analyst and patient cannot simply avoid having an impact on each other. Even so, we cannot be to remove obstructions from whether we have related this to our deliberate technical interventions or intentional aspects drawn upon the conceptual interactions. As for reasons that are useful and necessary to distinguish between theory of techniques, which the interconnectivity established through the conjunctive relationships have in relation of what seemed allowable for us to expand our knowledge of the complex and subtle factors that account for therapeutic action. This, however, can ultimately become the most effective basis for refining and developing our understanding of how best to serve of ourselves to advance the analytic situation and too aculeate more profound and very acute satisfactory depictions in the psychoanalytic engagements, no matter whatever our accountable resultants may be of our theoretical orientation.
An appreciation of the power of interactive forces in the analytic field not only challenges many traditionally held beliefs about the nature of therapeutic action. However, these take upon the requirement for us to recognize the untenability of the traditional view that analysts can be an objective source in the work. They have better to understand it, for example, where patients and analysts may express as a quantity that which the analyst is of a position to be an objective interpreter of the patient's experiential processes. That in this may reflect a form of collusive enactment and a convergence of the needs of both to see the analyst as an authority, and if the patient and analysts' both submit to needs to believe that the analyst is the omniscient other or the benevolent authority to which one can entrust ones' own. As the functional structure of the relationship might serve to obscure recognition of the fact that it is inclined to encourage the belief that, as once put, that wherever a coordinative system is complicating and hardens of its complexities, as recognized of the mind or brain, immediately 'indeterminacy' so then arises, not necessarily because of some preconditional unobtainability but holds accountably to subjective matters' from which grow stronger in obtaining the right prediction, least of mention, that so many things are yet to be known, in that the stray consequences of studying them will disturb the status quo, and of not-knowing to what influential persuasions do really occur between the protective cranial wall of vertebral anatomy. It is therefore that our manifesting awarenesses cannot accord with the inclining inclinations beheld to what is meant in how. History is not and cannot be determinate. Thus, the supposed causes may only produce the consequences we expect, this has rarely been more true than of those whose thoughts and interaction in psychoanalytic interrelatedness are in a way that no dramatist would ever dare to conceive.
In Winnicott (1969) has noted that there are times when 'analysers' can serve as holding operations and become interminable without any real growth occurring.
An interactive perspective also helps to clarify why in some instances the analysers 'abstinence' carriers as much risk of negative iatrogenic consequences as does active intervention. Although silence at time obviously can be respectful and facilitating, at other times it can be cruel and sadistic, or it can be based on fear of engagement, among a host of possible other meanings and equally attributive to the distributional dynamical functions.
An appreciation of interactive factors also allows us to consider that, to whatever degree the patient's perceptions of the analyst are plausible and even valid (Ferenczi 1933, Little 1951, Levenson 1973, Searles 1975, Gill 1982, Hoffman 1983), this may be due to the patient's expertise of stimulating precisely this kind of responsiveness in the analyst. The reverse is true as well thus, though patient and analyst each will have unique vulnerabilities, sensitivities, strengths, and needs, we must consider why such peculiarities have excited the particular qualities or sensibilities of either patient or analyst at a give moment and not at others. At any moment patient or analyst might be involved in some kind of collusive enactment (Racker 1957, 1959, Grotstein 1981, and McDougall 1979), they have held that their considerations explain of reasons that posit of themselves of why clinicians often seem to practice in ways that contradict their own shared beliefs and theoretical positions, least of mention, principles by way of enacting to some unfiltered dialectical discourse.
Yet, these differences, which occur within and between the diverse analytic traditions, in that an interactive view of the analytic field has some theoretical and technical implications that bridge all psychoanalytically perceptively which each among us cannot ignore. Its premise lies in the fact that we recognize that the analyst and patient cannot simply avoid having an impact on each other, even if both are totally silent, require us to realize that even if a treatment is productive or successful, we cannot be clear whether they have related this to our deliberate technical interventions or to aspects of the interaction that have eluded our awareness.
We have premised its owing intentionality that the recognition that analyst and patient cannot simply avoid having an impact on each other, even if both are totally silent, requires us to realize that even if some treatment is productive or successful, we cannot be clear whether we have related this to our deliberate technical interventions or to aspects of the interaction that have eluded austereness.
Psychoanalysts of diverse orientations increasingly have come to recognize that patient and analysts are continually influencing and being influenced by each other in a dialectical way, often without awareness. This has radical implications for abstractive views drawn upon psychoanalytic technique. Where these psychoanalysts disagree is in their conceptions of what the specific implications of an interactive view of the analytic field might be.
It is therefore that distinguishing between theory of technique is useful and necessary, which relates to what we do with awareness and intention, and theory of therapeutic action, which deals with what is healing in the psychoanalytic interaction whether or not it evolves from our ‘technique’: That recognizing this can allow us to expand our knowledge of the complex and subtler factors that account for therapeutic action. This can ultimately become the most effective basis for refining and developing our understanding of how best to use ourselves to advance the analytic work and to simplify more profound and incisive kinds of psychoanalytic engagement, no matter what our theoretical orientation.
An appreciation of the power of interactive forces in the analytic subject field not only challenges many traditionally held beliefs about the nature of therapeutic action, but also requires us to recognize the untenability of the traditional view that the analyst can be an objective participant in the work? It also helps us to grasp the extent to which presumably therapeutic interpretations, for example, can be ways of harassing, demeaning, patronizing, impinging on, penetrating, or violating the patient, or particular ways of gratifying, supporting, complying, among several of other possibilities. Where patient and analysts assume that the analyst can be an objective interpreter of the patient’s experience, this may factually reflect a form of collusive enactment and a convergence of the needs of both to see the analyst as an authority. If patient and analyst both have needs to believe that the analyst is the omniscient other or the benevolent authority to which one can entrust ones' own, the structure of the relationship might serve to obscure recognition of the fact that they are enacting such a drama. In this regard, Winnicott (1969) has noted that on that point are times when ‘analyses’ can serve as holding operations and become interminable, without any real growth occurring.
An interactive perspective also helps to clarify why sometimes the analyst’s ‘abstinence’ carries as much risk of negative iatrogenic consequences as does actively intervention. Although silence at times obviously can be respectful and facilitating, at other times it can be cruel and sadistic, or it can be based on fear of engagement, among a host of possible other meanings and contributing functions.
The contextual meaning of the patient’s free association also has to be reconsidered from such a perspective. Usually viewed as the medium of analytic work, free association may at times be a profound frame of resistance, and to avoid rather than engage in an analytic process. Alternatively it can reflect a form of compliance or collusion, conscious or unconscious, with the analyst’s needs, fears, resistances.
Amid the welter of competing or complementary theories that have characterized psychoanalyses over the century of its existence, the ideas of transference and the convictions very important in the therapeutic process are an unfiling theme. None of Freud's epochal discoveries - the power to the dynamic unconscious, the meaningfulness of the dream, the uniformity of intrapsychgic conflict - having been more heuristically productive or more clinically valuable than his demonstration that human regularly and inevitably repeat with the analyst and with other important figures in their current live patterned of relationship, of fantasy, and of conflict with the crucial figures in their childhood - primarily their parents?
Even for Freud, however, the awareness of this phenomenon and the understanding of its specific significance in the analytic situation itself came gradually. The flamboyant transference events in Breuer's patient Anna O and the unfortunate outcome in the patient of Dora served to consolidate in Freud's mind a view of transference as a resistance phenomenon, as an obstacle to the recollection of traumatic events that, in his view at the time, formed the true essence of the psychoanalytic process. Emphasis in this early period, thus, was on the 'management' of the transference, on finding ways to prevent its interference with the proper business of the analysis - recognizing, always, the inevitability of its occurrence. Freud was most concerned about the interferences generate by the 'negative' (i.e., hostile) and the erotised transference, the 'positive' transference he considered 'unobjectable,' the vehicle of success in the psychoanalysis.
Freud was also concerned to distinguish the analytic transference from the effects of suggestion in the hypnotic treatment he had learned in France, where he interdependently studying from Professor Charcot at the Salpêtrière hospital, and had been the forerunner of his own psychoanalysis technique. He, and his early followers and students, were at great pains to define the transference as a spontaneous product of the analytic situation, emerging from the patient rather than imposed by the analyst. Ultimately, Freud came to view as essentially for analytic cures the development of a new mental structure, the 'transference neurosis' - re-creation of the original neurosis in the analytic situation itself, with the patient experiencing the analyst as the object of his or her infantile wishes and the focus of his or her pathogenic conflicts. The crucial importance of the transference neurosis - it's very reality as a clinical phenomenon - has been and continues to be a matter of debate among psychoanalysts to this day.
Over the resulting decades several themes appear and reappear. One to which Freud alluded is that of the uniqueness versus the ubiquity of transference, is it a special creation of the analytic situation or is it an inevitable and universal aspect of all human relation? More central and perhaps more heated in the continuing debate, as the primary of transference interpretation in which Strahey called the 'mutative' effects of analysis - for example, whether such interpretations are simply more convincing than others or are the only kinds that are truly an effective therapy constitutionally begotten. Echoes of this debate have resounded through the years and to be perspectively descendable in most recent literary works. Finally, are all of the patient's reactions to the analyst in the analytic situations to be of counter-transference or do some partake of the 'real' 'non-neurotic' relationship or of the 'working alliance'?
It is only to mention, at the outset that resistance is, in certain fundamental references, an operational equivalent of defence, its scope is really far larger and more complicated. The thoughts of its nature and motivations on resistances to the psychoanalytic process use an array of mechanisms that sometimes defy classification in the way that fundamental genetically determined defences, derived from importantly and common developmental trends, can be classified. From falling asleep too brilliant argument, there is a limitless and mobile of devices with which the patient may protect the current integrations of his personality, including his system of permanent defences. In fact, Resistances of a surface, conscious type, related to individual character and to educational and cultural background, often present themselves are the patient’s first confrontations with a unique and often puzzling treatment method. While some of these phenomena are continuous with deeper resistances, a closer, and perhaps balancing equilibrium held in bondage to the mutuality within the continuity that we must meet others at their own level. All the same, it now leaves to a greater extent, the much-neglected faculty of informed and reflective common sense, and moves onto the less readily accessible and explicable dynamism, which inevitably supervene in analytic work, even if these initial surface Resistances have been largely or wholly mastered. Its submissive providences lay order to perfect connectivity, premising with which is the specific influence of the immediate cultural climate, stressed of the general attitude of many young people (Anna Freud 1968) toward the psychoanalytic process and its goals.
When Freud gave up the use of hypnosis for several reasons, beginning with the personal difficulty in inducing the hypnotic state and culminating in his ultimate and adequate reason - that it bypassed the essential lever of lasting therapeutic change, the confrontation with the repressing forces themselves - he turned to the method of waking discourse with the patient, in which insistence, with a sense of infallibility, accompanied by head pressure and release, were the essential tools for the overcoming of resistance (Breuer and Freud 1893-1895). Although the affording the unformidable combinations that are awaiting the presence to the future attributions in which the valuing qualities that allow us the privilege to have observed various forms of resistance ( in a general sense) before, as for example, inability to be hypnotized, ful in totality and a willful rejection of hypnosis, selective refusal to discuss certain topics under hypnosis, adverse reactions to testing for stances, it was the effectiveness of insistence in inducing the patient to fill memory gaps or to accept the physician’s constructions that reapproached of extending its lead, in that Freud was to a first and enduring formulation: Since effort
- psychic work - by the physician was required, a physical; evidently force, a resistance opposed to the pathogenic ideas, becomingly conscious (or being remembered), had to be overcome. They thought this to be the same psychic force that had initiated the symptom formation by preventing the original pathogenic ideas from achieving adequate affective discharge and establishing adequate associations - in short, from remaining or becomingly conscious. The motive for invoking such a force would be the abolition (or avoidance) of some form of physical distress or pain, such as shame, self-reproach, fear of harm, or equivalent cause for rejecting or wishing to forget the experience. Such are the appreciative attributions, in that the distributive contributional dynamic functions bestow the factoring understructure of the constellation of ideas, have already comforted us, yet, the later is clearly the ego and especially the character of it. It was thought important to show the patient that his resistance was the same as the original ‘repulsion’ which had initiated pathogenesis. The step later was short to the essential equivalent and permanent concept of defence at first repression. That is, though Freud gave tremendous sight to the effectiveness of the hand pressure manoeuver, he saw it essentially for distancing the patient’s will and conscious attention and thus simplifying the emergence of latent ideas (or images). From a present-day point of view, one cannot but think of the powerful transference excited by an infallible parental figure in a procedure only one step removed from the relative abdication of will. Consciousnessly involved in hypnosis, and that this quasi-archaic qualitative pattern of relationship was more important to effectiveness or failure than was the exchange of a psychic energy postulate by Freud. In this sense, the ‘laying on of hands’ granted its effect on attention, was probably even more significant in inducing transference regression than in the role that the great discoverer assigned to it.
What is important, in whatever way, is the establishment of a viable scientific and working idea of resistance to the therapeutic process as a manifestation of a reactivated intrapsychic conflict in a new interpersonal context. This in its essentials persists to this day in psychoanalytic work, in the concept of ego resistances.
At the same proven capability, as measuring with this development, less explicitly formulated but often described or inferred, was the marginal total rejecting or hostile or unruly attitude of the patient, sometimes evoking spontaneous antagonistic reactions in the physician. In occasional direct references in the early work and in the choice of figurative phraseology for years after that, Freud recognizes this ‘balky child’ type of struggle against the doctor’s efforts. One needs only recall Elizabeth von R., who would tell Freud that she was not better, “with a sly look of satisfaction” at his discomfiture (Breuer and Freud 1893-1895). When deep hypnosis failed with her, Freud “was glad enough that once, she refrained from triumphantly protesting ‘I am not asleep, you know, and cannot be hypnotized"; in this context that show with which this categorical type of resistance phenomenon that it represents the evolutionary whisper, though Freud and many others found it to come within the evolving gait of steps in a whisper, after-all, the advance of applied science was bringing to light curious new phenomena that, however hard men might try, would not be fitted into the existing order of things. All this is to encourage along the side of the paradigms of science to agree of it achievable obtainability through with of those has witnessed the impregnable future, least mentions, far and above is the first essentially forced finality to agree that fighting a great adventure in thought at lengths to come safely to shore is necessary, in this glare, the human figure has had to apply formally to be enlarged so that the brave stands which make for civic and academic freedom. It also taken to applicate the form to encourage the belief that, as nicely put, 'all men dance to the tune of an invisible piper. Because, we did not attest the big bang, but call its evolution of a particular type of ego-syntonic struggle with the physician that remains potentially important during any analysis by what the negative transference, whatever its particular nuances of motivation. This is, of course, a manifestly different phenomenon from the earnest effortful struggles of the cooperative patient whose associations fail to attend to him, or who forgets his dream, or who comes at the wrong hour, to his extreme humiliation. Still, in that respect is an important dynamic relationship between the two sets of phenomena.
Nonetheless, Freud made the analysis of resistance the central obligation of analytic work and proceeded from primitive beginnings, with rapidly increasing sophistication, both technical and psychopathologic, ideas that remain valid to this day; that conscious knowledge transmitted to the patient may have no, or an adverse, effect in the mobilization of what is similar or identical in the unconscious; that the repressing forces, the resistances, are more like infiltrates than discrete foreign-body capsules in their relation to preconscious associative systems; that the physician must begin with the surface and continue centripetally; that hysterical symptoms are more often serial and multiple than mononuclear, and the resistances participate in all productions and must be dealt with at every step of analytic work, and other matters of equal significance (Breuer and Freud 1893-1895).
Freud always maintained the central concept of resistance, and bequeathed it (reinforced later by the structural theory) to the generations of analysts who have followed him. Still, as the years went on, he elaborated the general scope of resistance far beyond the basic concept of intrapsychic defence, anticathexis that a great variety and range of mechanisms could impede the psychoanalysis as a recognizable process or, beyond this, making it ineffective or reverse expected therapeutic responses, or extend indefinitely the patient’s dependence on the analyst. When extended its direct equation with the anticathexis of defences, the variety of sources - not to speak of manifestations - of resistance multiplied rapidly. To remark upon the merely secondary realizations of illnesses (Freud 1905), under which the ‘external’ resistances are, for example, the hostility of the unmurmuring family line of treatment (Freud 1917), evenhandedly as the persistence of illness, with its detachment, superciliousness, and mechanical compliance as some weapons system for frustrating the analyst, as with the utterly troubled young girl (Freud 1920). The relevant sense of securing the symptomatic primary modes of perturbation conflict solution, and most crucially, the analysable obtainability of such subtly evolving concept of ‘transference-resistance,’ in its oscillating pluralistic sense, for example, (Breuer and Freud 1893-1895: Freud 1912, 1917). In his last writings, conspicuously in Analysis Terminable and Interminable (1937), in considering several possible factors in human personality that obstruct or render ineffectually the successful end of the analytic procedure, Freud offered a variety of psychodynamic considerations that could be fundamental in the extended or broadened concept of resistance: The question of the constitutional strength of instincts and their relation to ego strength; the problem of the accessibility of latent conflicts when undisturbed by the patient’s life situation (briefly but pointedly) the impingement of the analyst’s personality on the analytic situation and process; the existence of certain qualities of the libidinal cathexes - especially undue adhesiveness or excessive mobility; rigid character structure; the existence of certain sex-linked ‘bedrock’ conflicts that Freud regarded as biologically determined (insoluble penis envy in the female, and the male’s persisting conflict with his passivity). Finally and most formidable, there was the cluster of dynamism and phenomena that Freud, beginning in, Beyond the Pleasure Principle (1920) and The Ego and the Id (1923), attributed consistently and with deepening conviction to the operation of a death instinct. That is to say, to the ‘unconscious sense of guilt’ and demands the need for punishment, the repetition compulsion, the negative therapeutic reaction, and the more general operations of the need to suffer or to die or to seek outer or inner worldly concern. Yet, it remains an inexorable truth that the resistances underlying and hidden of representationally inherent cases or certain limitations implicit like psychoanalytic work, are moderately invincibly formidable, and cannot be disestablished by theoretical position any more than they can be thus created.
The varied clinical manifestations of resistance are dealt with extensively throughout Freud’s own writings, in many individual papers of other analysts, and in comprehensive works on analytic technique, for example, those of Fenichel (1941), Glover (1955), and more recently Greenson (1967) of which only makes a selective and occasional reference to their kaleidoscopic variety.
When free association and interpretation displaced hypnosis and derivative primitive techniques, the psychoanalysis as we now construe it came into being. To the extent that free association was the patient’s active participation, it was in this sphere that his ‘resistance’ to the new technique was most clearly recognized as such, cessation, slowing, circumlocution and a lack of informative or relevant content, emotional detachment, and obsessional doubt or circumstantiality became established as obvious impediments to the early (no longer exclusive but still radically important) topographic goals: To convert unconscious ideas largely via the interpretation of preconscious derivatives into conscious ideas. Only with time and increasing sophistication did fluency, even vividness of associative content, tendentious ‘relevancy’ itself evidently can, like over-compliant acceptance of interpretation, conceal and carrying out resistances that were the more formidable because expressed in such ‘good behaviour’.
One may define resistance (and in so doing include a liberal and augmenting paraphrase of Freud’s own most pithy definition [The Interpretation of Dreams 1900]) as anything of essentially intrapsychic significance in the patient that impedes or interrupts the progress of psychoanalytic work or interferes with its basic purposes and goals. In specifying ‘in the patient’ one is to imply as not underestimate the possibly decisive importance of the analyst’s resistances, to separate the ‘counterresistance’ as a different matter, in a practical sense, requiring separate study. One may concur, that as a generalized infraction forwarded of a direction with Glover’s statement (1955) that “however we may approach the mental apparatus there is no part of its function that cannot serve the purposes of mental defence and therefore give apparency during the analysis to the phenomena of resistances.” One may also concur with his formulation that the most successful resistances (in contrast with those employing manifest expressions) are silent, but disagree with the paradoxical sequel “. . . they might say that the sign of their existence is our unawareness of them.” For the absence of important material is a given sign, and becoming aware of such an absence is necessary, if possible.
Freud, in his technical papers and in many other writings, despite his reluctance in this direction did lay down the general and essential technical principles and precepts for analytic practice. We must note, however, that the clear and useful technical precepts are largely in that may be regarded as the ‘tactical sphere’, i.e., they deal with the manifest process phenomena of ego resistances. Other resistances, those largely contained in the ‘silent’ group, for example, detainment or unsuccessful symptomatic alteration, omission of decisive conflict material form free association or [more often] from the transference neurosis, inability to accept cancellation of the analysis, and allied matters. In that saying, the ‘strategic sphere’, relating to the depths of the patient’s psychopathology and personality structure and to his total reactions to the psychoanalytic situation, process, and the person of the analyst. Its use of the tern ‘strategic’ and ‘tactical’ differ from their user by others, for example, Kaiser (1934). While it is not to presume to offer simple precepts for the ready liquidation of the massive silent resistances, heedfully to contribute of something, however slight. To understanding them better and thus, potentially, to their better management but some of these considerations, for example, iatrogenic regression, as to context (1961, 1966). In the ‘strategic’ arena of resistance, so often manifested by total or relative ‘absence’, it is the informed surmise regarding the existence of the silent territory, by way of ongoing reconstructive activity, which is the first and essential ‘activity’ of the analyst. Beyond this mindfulness and subtle potentialities of the shaping and selection of interpretative direction and emphasis and the tactful indication of tendentious distortion or absence.
Because of a possible variety of factors, beginning with the estranging dissimulations that magnetism that the verbal statement of unconscious content puts into action of the analysts and patients alike (of itself is a frequent resistance or counterresistance) the priority of the analysis of resistance over the analysis of content, as discretely separate, did not readily come to its carry out quality. This might have been owing to the difficulties of dealing with more complicated resistances or developing an adequate methodology in this arena, or even the fact that an extensive interval over its timed and tactful reference to content (or its overall nature) sometimes seems the only way of mobilizing (reflexively) and thus exposing the corresponding resistance for interpretation and ‘working through’, an echo of Freud’s early, never fully relinquished diphasic process (1940).
Since this is not a technical paper, the admissive structural functionality, over which an extended discussion of the evolution of views on methods of resistance analysis, although substantiated functions has inevitably related such views to our immediate subject matter. Its mindful approaches that range from the strict systematic analysis of character resistances of Wilhelm Reich (1933) or the absolute exclusion of content interpretation of Kaiser (1934), to the special efforts toward dramatization of the transference of Ferenczi and Rank (1925) or Ferenczi’s own experiments with active techniques of deprivation and (on the other hand) the gratification of regressed transference wishes in adults (for example, 1919, 1920, 1930, 1931, 1932). Developments in ego psychology (for example, Anna Freud’s classical contribution on the mechanisms of defence [1936] brought the variety and importance of defence mechanisms securely into the foreground of analytic work, and the subsequential extent of which is widely accepted priority of defence analysis has rectified a great deal of the original [and not entirely inexplicable] ‘cultural cover with lagging’ in this describing importance, that if not exclusive, spheres of resistance analysis. Concomitant with a more widespread functional acceptance of the essentiality and priority (in principle) of resistance analysis over content interpretation, there is usually a more flexible view of the technical application of the essential precepts, permitting interpretive mobility, according to intuitive certainty or judgement between the psychic structures, according to Anna Freud (1936) principle of ‘equidistance’. Discrete specification may sometimes deal resistance with other than those apart from the intrinsic conceptual difficultly in the latter intellectual process, i.e., the specifying of a resistance without suggesting that against which it is directed (Waelder 1960). There is also a general broadening of the scope of interpretive method. Witness, for example, Loewenstein’s ‘reconstruction upward’ (1951) and Stone, having his own differently derived but often an allied conception, the ‘integrative interpretation’ (1951), both of which recognize that resistance may be directed ‘upward’ or against the integration of experience, than against the affirmative extent and exclusively infantile or against the past. Similar considerations are also reflected in Hartmann’s ‘principle of multiple appeal’ (1951).
It may, nonetheless be of note that while the emphasis on resistance in Freud’s early clinical presentations is overall proportionate to his theoretical statements, his methods of dealing with the concealed and more formidable resistances are not clear, except in certain active interventions, such as the magical intestinal prognosis in the “Wolf Man” (1918), or the ‘time limit’ in the same case, or the principle that at a certain point patients should confront phobic symptoms directly (1910), or the suggestion to transfer to a woman analyst, with the homosexual woman (1920). In these manoeuvres and attitudes it is recognized that (1) interpretation, the prime working instrument of analysis, may often reach an impasse in relation to powerful ‘strategic’ resistances, and (2) an implicit recognition that elements in the personal relationship of the analytic situation, specifically the transference, may subvert the most skilful analytic work by producing massive although ‘silent’ resistances to ultimate goals, and that sometimes where energetic elements are formidable, they may have to be dealt with directly and holistically, in the patient’s living and actual situation.
Freud’s own interest in active techniques stimulated Ferenczi to extreme developments in this sphere (1912, 1920), later combined with his oppositely oriented methods of indulgence (1930). As time presses on, noninterpretative methods, particularly those involving gratifications of transference wishes, whether libidinal or masochistic, were set aside with increasing severity, in recognition of their contravention of the indispensability of the undistorted transference and the unique importance of transference analysis in analytic work. The same has been largely true of tendentious, selective instinctual frustrations (Ferenczi 1919, 1020). However, there is no doubt that the use of interpretive alternatives (sometimes suggests for the deliberate control of obstinate resistance phenomena in this spheric arena) has been sharpened by - partially coloured by - the earlier experiments in prohibition, whose transference implications were fully apparent at the time of their introduction. The type of active intervention introduced by Freud (the time limit, the confrontation of symptoms), confined in actuality to the sphere of the demonstrable clinical relationship, has retained a certain optional place in our work, although the potential transference meaning and impact of such interventions, with corresponding variations or limitations of effectiveness, are increasingly understood and considered. The broad general principle of abstinence in the psychoanalytic situation, stated by Freud in its sharpest epitome in 1919, remains a basic and indispensable context of psychoanalytic technique. The nuances of application remain open to, in fact to require, continuing study (Stone 1961, 1966).
In assent to important developments in ego psychology and characterology (for conspicuous examples, Anna Freud 1936, Kris 1956, Hartmann 1951, Loewenstein 1851, Waelder 1930, the principle factor in deepening, broadening, and complicating the conceptual problem of resistance, and thus modifying the strict latter-like sequential approach (Reich 1933) to the analysis of resistance ad content respectively, even in principle, has been the progressive emergence of transference analysis as the central and decisive task of analytic work. For, to state it over succinctly, and thus to risk some inaccuracy, the transference is far more than the most difficult tool of resistances and (simultaneously) an indispensable element in the therapeutic effort. Given the mature capacity for working alliance, it is the central dynamism of the patient’s participation in the analytic process and, while the proximal or remote source of all significant resistances, but those manifest phenomena originating in the conscious personal or cultural attitudes and experiences of the adult patient or those deriving from the inevitable cohesive-conservative forces in the patient’s personality, for which we must still summon briefly the Goethe-Freud ‘witch’, metapsychology (Freud 1937).
In relation to the ‘tactical’, i.e., process, resistances, an overall view of what is immediate and confronting for example, the threatening emergence of ego-dystonic sexual or aggressive material, may be adequate. All the same, to any casual access to what may be called the ‘strategic’ sphere of resistance. One must have a tentative working formulation of the total psychic situation in mind, including an informed surmise regarding large and essential unconscious trends. Such suggested procedure is, accessibly open to discussion on more than one scope, and it does involve one immediately in some basic epistemological problems of psychoanalysis. Unfortunately, we cannot become involved in this fascinating sphere of dialectic in this brief essay on a large subject nevertheless, in his early work Freud relied enthusiastically on his own capacity to fill primary gaps in the patient’s memory through informed inherences from the available data, and then, with an aura of infallibility, actively persuaded the patient to accept these constructions. However, with the further elaboration of psychoanalysis as process, in the sense of the increasing importance of free association, of the analyst’s relative passivity, and other characteristics of the process as we now know it, there have inevitably been some important modifications of the attitudes reelected in such procedures. While, as far as it had never been revised or revoked, Freud’s view that the resistances are operatives in every step of the analytic work, and knowing that there exists in many minds paradoxical mystiques to the effect that the patient’s free associations as such, unimpeded (and uninterpreted), could ultimately provide the whole and meaningful story of his neurosis, in the sense of direct information. This is, of course, manifestly at variances with Freud’s basic assumptions about the role of resistance, and the germane roles of defence and conflict in the origin of illness.
Nonetheless, in Freud’s, Recommendations (1912) is his advice against attempting to reconstruct the essentials of a case while the case is in progress. Such a reconstruction, here assumes, would be undertaken for scientific reasons. The caution, nevertheless, rests on both scientific and therapeutic grounds, on the assumption that the analyst’s receptiveness to new data and his capacity for evenly suspended attention would be impaired by such an effort. It is true, of course, that rigid preoccupation with an intellectual formulation can impair the capacities. Even so, it is also true that the ‘formulation’ or structuring of a case can and largely does go on preconsciously, in some references even unconsciously, and usually quite spontaneously. One must assume at the very least, that some such process reaches the analyst’s first perception of a ‘resistance’. Some have thought that Freud would have disagreed with using such a process. Still, its use, whatever the form, is a necessity, and, at times, it requires and should have the hypercathexis of conscious and concentrated reflection? One may, of course, assign the more purposive intellectual processes to periods outside hours, and thus better preserve the other equally important responses to the dual intellectual demand of psychoanalytic technique. The ‘voice of the intellect’, all the same, should not be deprived of this essential place in analytic work. It is well known that it must never be allowed to foreclose mobile intuitive perceptiveness or openness to unexpected data. Nor must ongoing formulations in the mind of the analyst be allowed to cram the spontaneity of the patient’s association. They should remain ‘in the analyst’s head’. To epitomize the technical situation: Strategic considerations require varying degrees of reflective thought, possibly outside hours. Except the perspectives and critiques they silently lend to understanding, they should not influence the natural and spontaneous, often intuitive, responses of the disciplined analyst to the never-ending variable nuances of his patient’s ‘tactics’. In relation to any category of clinical psychoanalytic problem. It is the structure of the transference neurosis and its unfolding, with the adumbrative material in characterology, symptom formation, personal and clinical history and the clues from specific data of the psychoanalytic process, taken as an ensemble, which provide the most reliable basis for general tentative reconstruction and thus for the understanding of resistances. While we must marshal our entire body of data, theory, and technology to see the transference neurosis as an epitome of the patient’s emotional life, our comprehension of it is nonetheless based essentially on something that is right before us. Again, the total ensemble is essential, and the objectively observable phenomena of the transference neurosis are of crucial and central valences.
In the background data, the large outlines of life history are uniquely important because they do represent, or at least strikingly suggest, the patient’s gross strategies of survival and growth, of avoidance and affirmation. One may infer that they will be invoked again in the conformation with the analyst, in his pluralistic significance. Some oversimplified and fragmentary illustrations are chosen in the occupational commitments with children and the mood in which they are carried out, with the general character of manifest sexual adaptation, can contribute to rational surmise about whether neurotic childlessness is based predominantly on disturbances of the Oedipus complex, on an original inability to achieve an adequate psychic separation from parent representations, or on the vicissitudes of extreme sibling rivalry. It must surely crystallize illnesses and analytic process if one knows that some patient lives, by choice, the breadth of an ocean removed from parents and siblings with whom there has been no evident quarrel, when this is not a crucial matter of occupational opportunity or equivalently important reality. Necessarily a male patient’s gross psychosexual biography helps us to understand which ‘side’ of the incestuous transference is more likely to be surfacing in his first paroxysm of heterosexual ‘acting out’. While it is true that dreams, parapraxes, and other traditionally dependable psychoanalytic material may dramatically reveal the ego-dystonic directions of impulse and fantasy life, and the specific nature of opposing forces, it is, only, the composite situation that historical and current picture that reveals the prevailing or alternative defences, the large-scale economic patterns, and the preferred or stable, i.e., most strongly over determined, trends of conflict solution.
Tactical problems of resistance were earliest observed largely in disturbances of free association, which, in frequent tacit assumptions, would, or in principle could, lead without assistance to the ultimate genetic truth. This truth was construed to be the awareness of previously repressed memory (or the acceptance of convincing and germane constructions). As time went on, in Freud’s own writing, terms of conative import appeared - such as ‘tendency’ or, more of vividly, ‘impulsiveness’. However, the critical etiological and (reciprocally) therapeutic importance of memory has, of course, never really lost its importance. For, while the recovery of traumatic memories, with an abreaction, is still dramatic in its therapeutic effect, for example, in war neuroses or equivalently civilian experiences and occasionally in isolated sexual experiences of childhood or adolescence, neuroses of isolated traumatic origin are rare in current psychoanalytic experience. Traumata is usually multiple, repetitive, often serving to crystallize, dramatize and fix (something even ‘covers’) more chronic disturbances, such as distortions or pathological pressures in the instinct life, against the background of larger problems of basic object relationships. Freud was already becoming aware of the complex structure of neuroses when he wrote his general discussion for the Studies on Hysteria (Breuer and Freud 1893-1895). Thus, to put it all too briefly, when structurized impulses or general reaction tendencies can truly be accepted for memory, i.e., as matters of the past, other than in a tentative explanatory sense, much of the analytic work with the dynamics of the transference neurosis has necessarily been accomplished. One does not readily give up a love or hatred, personal or national, only because one learns that it is based on a crushing defeat of the remote past.
The manifest communicative phenomena of resistance remain very important, just as the common cold remains important in clinical medicine. Morally justified in those of whom walk continuously among the corpsed of times generations, their circulatory momentum around the cross and forever finding its same death but it's comforting solice and refuge, from which, they dwell of the unknown infinity. It will never cease to be important to tell a patient that he is avoiding the emergence of sexual fantasies, that his blank silence covers latent thoughts about the analyst, or (in a measure more sophisticated) that apparent and enthusiastic erotic fantasies about the analyst conceal and include a wish to humiliate or degrade him. However, we can be better prepared, even for these problems, because of ongoing holistic reconstruction. Surely we are better prepared for the formidable resistances of patients who apparently do ‘tell all’ or even ‘feel all’, in a most convincing way and in all sincerity, yet may finish apparently thorough analysis without having touched certain nuclear conflicts of their lives and characters or, (more often) having failed to meet the transference neurosis, with a sense of affective reality. These instances, for instance refers to the instances described by Freud (1937) in which such conflicts remain dormant because current life does not impinge on them, but to those in which the ‘acting out’, in life or the solution in severe symptoms is desperately elected by the personality in apparently paradoxical preferences to the subjective vicissitudes of the transference neurosis (Stone 1966).
In brief, is a tentative formulation of the respective natures of the two peculiar and yet particular groups of resistance phenomena, ultimately and vestigially related and exists in varying degree in all analyses. It is, however, one or the other is usually important and is, in practical and prognostic sense, quite differently as: (1) Those progress to evidently large discernible impediments of the psychoanalytic process in its immediate operational sense. These are usual in the neuroses, in persons who have achieved satisfactory separation of the 'self' from the primary y object. Nevertheless, whose lives are disturbed by the residues of instinctual and other intrapsychic conflicts in relation to the unconscious representations of early objects and thus to transference objects. (2) Those that may be similarly manifested at times but maybe or even exaggeratedly free of them. Where the essential avoidance is of the genuine and effective e diphasic involvement in the transference neurosis, with regard too fundamental and critical conflicted, and thus of the potential relinquishment of symptomatic solutions and the ultimate satisfactory separation from the analyst. In this context, among other phenomena, there may be large-scale hiatuses in analytic material in the usual experiential sense, or there may be a striking absence of available and appropriate cues of connection with the transference, or failure, this complex of phenomena may repeat an original disturbance in ‘separation and individuation’ (Mahler 1965). Alternatively of other severe disturbances in early object relationships or related pregenital (particular oral) conflicts can have produced tenacious narcissistic avoidance of transference involvement, to facade involvement, or to the alternative of inveterate regressed and ambivalent dependency. Dependable and largely affirmative secondary identifications have usually not been achieved originally, and this phenomenon, related to basic disturbances of separation, contributes importantly to the variously manifested fears of the transference.
Intuitively, the phenomena of the two groups may overlap. There may be deceptively benign ‘aponeuroses’ in the more severe group. In the troublesome phenomenon of ‘acting out’, for example, one may deal with a transitory resistance to an emergent transference fragment, in some instances due to a delay of effective interpretation, or one may be confronted by a deep-seated, variably structuralized, and sometimes even ego-syntonic ‘refusal’ to accept the verbal mode of communication with an unresponsive transference parent in dealing with insistent disturbing and gross affects implored by impulsive unintelligibility.
Freud (1925), pointed out that everything said in the analytic situation must have some coefficient of reflection to the situation in which it is said. This is, of course, consistent not only with reflective common sense but also with the theory of transference and the current view of the central position of the transference neurosis in analytic work. Furthermore, despite his earliest view of the ‘false connection’ as pure resistance (Breuer and Freud 1893-1895) and the continuing high opinion of this aspect of transference, Freud early established the (non-conflictual) positive transference as the analyst’s chief ally against resistances. So, he never stretched out in his appreciation of the primitive driving power of the transference and its indispensable function of conferring a vivid and living sense of reality on the analytic process (Freud 1912). However, in past commination, the transfer is the central dynamism of the entire psychoanalytic situation, and the transference neurosis provides the one framework which give essential and accessible form to the potentially panpsychic scope of free association (Stone 1961, 1966). In this frame of reference the irredentist drive to reunion with the primal mother, as opposed to the benign processes of maturation and separation, underlies neurotic conflict in its broadest sense and is the basis of what is called the ‘primordial transference’, whose striving renewed physical approximation or merger. Speech, which is the veritable stuff of psychoanalysis, serves as the chief ‘bridge’ of mastery for the progressive somatic separations of earliest childhood. The ‘mature transference’, in continuum, alternative and contrast, is that series and complex of attitudes contingent on maturation and benign predisposing elements of early object relationships (conspicuously, the wish to be understood, to learn, and to be taught) that enables increasing somatic separation in a continuing affirmative context of object relationship, as later reelected in the psychoanalytic situation. In this interplay, speech - our essential working tool - plays as these oscillating, curiously intermediates roles, ranging from the threat of regression in the direction of its primitive oral substrate to it is ultimately purely communicative-referential function linked with insight (Stone 1961, 1966).
Nonetheless, the origin of the ‘transference’ as we usually perceive it clinically, and as the term is traditionally employed, is in the primordial transference. Be it essentially the classical triadic incestuous complex or an oral drive toward incorporation or toward permanent nursing dependency or a sadomasochistic and shriving toward a parent, it will be re-experience in the analytic situation, in good part in regressive response to its derivations (Macalpine 1950), and produce the central, and ultimately the most formidable, manifest resistance, the transference-resistance.
The ‘transference-resistance’, while sometimes used in varying references, meant originally the resistance to effective insight into the genetic origins and prototypes of the transference, expressed in the very fact of its emergence (originally, the ‘false connection’ described by Freud [Breuer and Freud, 1893-1895]). Afterwards, as the transference became established in its own autochthonous validity, the same resistance could be viewed as an obstruction to genetic understanding of the transference, and thus putatively to its dissolution. Alternatively, such dissolutions (using this word in a relative and pragmatic sense) are contingent on much germane analytic work, on analysis of the dynamics of the attitude as represented in the transference neurosis, on working through, and on complicated and gradual responsive emotional processes in the patient (Stone 1966). Nevertheless, this genuine genetic insight is indispensable for the demarcation of the transference from the real relationship and for the intellectual incentive toward its dissolution within the framework of the therapeutic alliance.
While to the ‘resistance to the awareness of transference’ the confrontations of patients are characterized by the immediate emergence of intense (even stormy) transference reactions, most patients experience these emergent altitudes as essentially ego dystopia, except in the sense of the attenuate derivatives that enter (or vitiate) the therapeutic alliance or in the sense of chronic characterological reactions that would appear in other parallel situations, however superficial and approximate the parallel might be.
The clinical actuality of emergent transference requires analysis in its usual technical sense, including the prior analysis of defence. Transference may appear in dreams long before it is emotionally manifest; in parapraxes, in symptomatic reactions, in acting out within the analytic situation, or - most formidable - in acting out in the patient’s essential life situation. Except in cases of dangerous acting out, or very intense anxiety or equivalent symptoms, which can form emergencies, the technical approach involves the same patient centripetal address to the surface prescribed for analysis and its comprising it. However, as for this, it would suggest a modification of the classical precept that one does not interpret the transference until it becomes a manifest resistance. At this point, the interpretation is obligatory. The resistance to awareness should be interpreted, and its content brought to awareness, when the analyst believes that the libidinal or aggressive investment of the analyst’s person is economically a sufficient reality to influence the dynamics of the analytic situation and the patient’s everyday life situation.
Stripping the matter of nuances is useful, reservations, and exceptions, for clarity in an essential direction. The avoidance of awareness of transference derives from all of the hazards that accompany consciousness: Accessibility of the voluntary nervous system, therefore heightened ‘temptation’ to action; heightened conflict in relation to the sanctions and satisfactions of impulse materialization; the multiple subjective dangers of communication of "I-you" impulses and wishes or germane fears to an object invested with parental authority; heightened sense of responsibility (in that way, guilt) connected with the same complex, and, very far from least, the fear of direct humiliating disappointment - the narcissistic would have rejection or, perhaps worse of all, no affective response, the avoidance of this helplessness of impact, plays and important part. There is also the exceedingly important fact that the transference conflicts remaining outside awareness retain their unique access to autoplastic symptomatic expression, in compact and narcissistically omnipotent, if painful, solution, without the direct challenge and confrontation with alternative (and essentially ‘hopeless’) solutions.
Why, then, if such fears weigh heavily against the analytic effort and the ultimate therapeutic advantage of awareness, does the patient cling tenaciously to his views of the analyst and the system of wishes connected with this view, once it has become established in his consciousness? In the earliest view, where the cognitive elements in analysis were heavily preponderant, not only in technique but also in the understanding of process, such clinging to transference attitudes was thought to be, since the essence of subjective matters' amounted of what was significantly the essential goal of the analytic effort and was thought to be, itself, the essential therapeutic mechanism. Still, why is the patient not willing, like the historian Leaky’s dinner partner, to ‘let bygones be bygones’? Unless one accepts this aversion to recall or reconstruction, a preference for ‘present pain’, as a primary built-in aversion, in its self of an unexplained fact of ‘human nature’, one must look further. Yet, on the person of the patient might informally reject these elements of ‘insight’ because they vitiate or diminish both the affective and cognitive significance of this central object relationship, which is a current materialization of crucial unconscious wish and fantasy, originally warded off. If it is to be given up, why was it pried out of its secure nest in the unconscious? Such resolution is always felt, at least incidentally, as an attack on the patient’s narcissism and on his secure sense of self, secondarily reestablished. Moreover, to the extent that there is a genuine translation of the subjectively experienced somatic drive elements into verbal and ideational terms related to past objects, there is an inevitable step toward separation from the current object that parallels the original and corresponding development movement.
An essential dynamic difference from the past lies in the different somatic and psychological context in which the renewed struggle is fought. Old desires, old hatreds, old irredentist urges toward mastery, have been reawakened in a mature and resourceful adult, in certain spheres still helpless subjectively but no longer literally and objectively, a fact of which he is also aware. It was pointed out by Freud (1910) that this great quantitative discrepancy between infant conflict and adult resources make possibly and eases therapeutic change, through insight. In many important respects, this remains true. However, the remorseless dialectic of psychoanalysis again asserts itself. Truly effective insight requires validating emotional experience, which is only rarely achieved through recollections alone. The affective realities of the transference neurosis are necessary (now and again, inevitable), and with this experience comes the renewal of the ancient struggle, in which, with varying degrees of depth, the maturity and resources of the analysand often play a role at valiance with his capacity fort understanding. This is true not only of the subjective quality and experience of his striding but of the resources which support his resistances, in either phase of the transference involvement. Whether the wish is to seduce, to cling, to defeat and humiliate, to spite, or to win love, mature resources of mind - sometimes of body - may be involved to start this purpose, including what may occasionally be an uncanny intuitiveness regarding the analyst’s personal traits, especially his vulnerabilities?
The persistence of old desires for gratification and the urge to consummate them, or the given urges to restore and maintain an original relationship with an omnipotent (and omniscient) parent, are intelligible to everyday modes of thought. That the transference, like the neurosis itself, may also entail guilt, anxiety, flustration, disappointment and narcissistic hurt are another matter. If it gives so much trouble, why does it reappear? Freud’s latter-day explanation involved the complex general theory of primary masochism and the repetition compulsion. One cannot, in a brief discussion, reach a disputation that has already occasioned voluminous writing. In ultimate condensation, the operational view to which are the elements to be understood, as perhaps, of (1) accompanying the renewed unregenerate drive for gratification of previously warded off wishes, whether libidinal or aggressive, based on the presentation of an actual object who bears significant functional ‘resemblances’ to the indispensable parent of early childhood, in a climate and structure of instinctual abstinence, and
(2) based on the latent alternative urge to understand, assimilate, perhaps alters parental response, or otherwise master poignantly a painful situation as they were experienced in state of relative helplessness in the past. Both may be viewed as independent of adult motivations, although the power of the first may at times importantly subserve such motivations, and the second may often be phenomenologically congruent with them. Implicit in both, in contrast with the experienced plasticities and varieties of mature ego development, is the persistent and a continuous theme of adhesion to the psychic representation of the decisive original parent figure or a perceptually variant substitute. Still, it is profoundly important against original separation from the primal mother, with its potential phase specifications, as opposed to the powerful urges toward independence development, providing the underlying basis for developmental and later, neurotic conflict, that these conflicting tendencies, in the sense of the profundity that of them provide a certain parallel to the Thanatos-Eros struggle that assumed a decisive role in Freud’s final contributions. In a recent study of aggression (Stone 1971), examined Freud’s views on this subject. Although - in a paradox - by which the existence of a profound ‘alternative’ impulse to die at least conceptually tenable and susceptible to clinical inferential support, it is the conviction of those, that from both observation and inference, that aggression as this is an essential instrumental phenomenon (or can serve self-preservation and sexual impulses alike, and that it is thus, in its original forms, pitted against a postulated latent impulse to die, as it is against external threats to life. These urges and instrumentalities find primal organismic expression and experience in the phenomenon of birth and the immediate neonatal period, the biological prototype of all subsequent specifications, elaborations, and transmutations of the experience of separation. At the very outset the ‘conflict’ may find expression in the delay of breathing or, shortly after that, in the disinclination of suck. There is thus an intertwining of the two conceptions of basic conflict. It may characterize that 'time' will validate Freud’s latter-day views of the fundament of human conflict. For the time being, however, it has to the presents that are an empirically more accessible and a heuristically more useful view of the ultimate human intrapsychic struggle. Thus the originally unmastered or regressively reactivated struggle around separation, revived by developmental conflict, would in this schema represent the ‘bedrock’ of ultimate resistances, although never - at least in theory - utterly and finally insusceptible to influence. If we assume that the vicissitudes of object relationships, initiated by the special relationship of the human infant of his family, are fundamental in the accessible process of personality (thus, structural) development and thus of neuroses, and that, in ‘mirror images’. The transference and thus the transference-resistance has a comparable strategic position in the psychoanalytic process, can we extend these assumptions inti the detailed technical phenomenology of process resistance in its endless variety of expression? Yet it remains that this extension is altogether valid.
What is more, is whether or not one thinks of it as ‘motivation’ in its usual sense, one can without extravagance postulate and even more intense cohesiveness at the first signal of that stimulus that contributed to the establishment of the organization and its basic strategies in the first place, i.e., the analyst as transference object. In the subjective good sense, the regressive trend of the transference, by the total structure of the psychoanalytic situation (i.e., the basic rule of free association and the systematic deprivations of the personal relationship) confronts the patient with one who has perceived ultimately as his first and an all-important object, the prototypical source of all gratification, all deprivation, all rejection, all punishment - the object involved in the primordial serial experience of separation (Stone 1961). This may seem an exaggeratedly magniloquent way to view a practitioner who puts himself in a seating position, usually in an armchair, listens, tries to understand, and then interprets, when he can, toward a therapeutic end. To a large portion of the adult's patient’s personality, the ‘observing’ portions of his ego, the portion that enters the therapeutic alliance, that is just what he is and that of what he should remain. To another portion, largely unchanged from its past, sequestered in the unconscious but influential although in derivative and indirect ways, he is a formidable object. It is in this field of force that, along with the drive toward better solutions, the range of clinical transferences as we know they are awakened. As, the entire efforts to translate the patient’s view of drives for reunion and contact, whether libidinal or aggressive, into genuine language, insights and voluntary control (or appropriate conative accomplishment elsewhere) is ‘resisted’. As it was originally, as an expression (or at least precursors) of separation, thus repeating aspects of the original developmental conflict. It is, however, it also true that the later and clinically more accessible vicissitudes of childhood create more accessible resistances within the postulated Metapsychological context created by the infant-mother relationship. Such changes as those patients in whom the phenomena of general the unity or approximations have been largely renounced, not only as a physical fait's accompli in perceptual and linguistic fact but also with deployment of the cathexis among other essential intrapsychic representations. These changes remain subject to regression or to the primary investment of certain phase strivings, conspicuously the Oedipus complex, in an excessive libidinal or aggressive cathexis. Such strivings, paradigmatically the incest complex, are in themselves the narrowed, potentially adaptive, maturational expressions of the basic conflict arouse by separation. If the analyst, to this infantile portion of the patient’s personality, an indispensable parent because cognition is, in this reference, subordinate to drive, it follows that the analyst becomes the central object in the complicated infant system of desires, needs, and fears that have previously been incorporated in symptoms and character distortion. The patient must, furthermore, tell these ‘secrets’ to the very object of a complex of disturbing impulses. This is a new vicissitude, not usually encountered in childhood and guarded forthwith. Even within the patient’s own personality, by the very existence of the unconscious. Ordinarily, he does not even have to ‘tell himself’ about them, in the sense that he is to a considerable degree identified with his parents, originally in his ego, then, in a punitive or disciplinary sense, in his superego? To be sure, the adult ‘observing’ portion of his personality, except where matters of adult guilt, embarrassments, or shame interfere, usually cooperates with the analyst. It can at least try to maintain the flow of derivative associations, which give the analyst material for informed inferences. The tolerant and accepting attitudes of the analyst tested by patients' rational and intuitive capacities, evened more decisively his interpretative activity, which suggestively an unredeemed child in the patent that he, ‘knows’ (or at least surmises) already, ‘gradually overcome the patient’s far of his own warded-off material and finally the fear of is frank expression'.
There are, then, three broad aspects of the relationship between resistance and transference. Assuming technical adequacy, the proportional importance of each, one will vary with the individual patient, especially with the depth of psychopathology. First, the resistance awareness of the transference and its subjective elaboration in the transference neurosis; second, the resistance to the dynamic and genetic reductions of the transference neurosis and ultimately the transference attachment itself, once established in awareness; third, the transference presentation of the analyst to the ‘experiencing’ portion of the patient’s ego, as id object and as externalized super-ego simultaneously in juxtaposition to the therapeutic alliance between the analyst in his real function and the rational ‘observing’ portion of the patient’s ego. These phenomena give intelligible dynamic meaning to resistances ordinarily observed in the cognitive-communicative aspects of the analytic process. These are the process or ‘tactical’ resistances, largely deriving from the ego under the pressure or threat of the superego.
As for this, the word ‘working through’ was sometimes, as Freud made mention (1914), that the structure yields only when a peak manifestation of resistance has apparently been achieved. The patient appears to require time, repetition, and a sort of increasing familiarity with the forces involved for real change to occur. In addition, Freud originally thought of the energy transactions as having some relation to the phenomenon of an abreaction in the earlier methods. One is impressed with the insistent recurrence of transference effects, conspicuously irrational anger in essentially rational patients, as though the structuralized tendency from which they derive can be directorially based on repetitive re-enactment and gradual reduction of effect. Since circumscribed symptom formations equivalent forms of neurotic suffering (and gratification) play an ongoing and inevitable economic role in the psychoanalytic situation and process, apart from having usually been the basis for its initiation, one might assume that they bear an important relationship to working through. Even when extinguished short of fear or long since under the influence of the transferee, their continued latent existence (or potentialities) is opposed to the vicissitudes of the current transference neurosis or it through which gradual relinquishment via working. This is true whether one thinks of the symptom in the quasi-neurophysiological sense of Breuer’s early formation of pathways of ‘lowered resistance’ (Breuer and Freud 1893-1895) or in a more empirical sense as a perennially seductive regressive condensation of impulse, gratification, and punishment, a useful and well-grounded concept, allied with the struggle against separation, is the relationship of working through to the process of mourning (Freud 1917).
While from the adult point of view the gratifications may be small and the crucial change for the worse, the symptom is nevertheless autoplastic, narcissistic in an isolated sense, already structuralized, and subject too no outside interference (except by the analysis), an expression of localized infantile omnipotent fantasy, however large or small this fantasy kingdom may be. Similarly, considering unconscious processes administering both the challenges and sanctions of the world of reality, and from the temporary disruptive intrusions of new elements into the narcissistically invested conscious personality organization. In working through, there is the diphasic and arduous problem of restoring original or potential object cathexes' in the transference neurosis, reducing their pathological intensities or distortions, and the deploying them in relation to the outer world. One may thus think of ‘working through’ as opposed to the renewal, symptom formation and as repeating some postulated vicissitude of one of the earliest conceptions of ‘transference’, the infantile transition from autoerotism to an object of love (Ferenczi 190-9). In this sense, the clinging to the incestuous object, represented in the clinical transference, would represent an intermediate process.
There is thus a tenacious reluctance of the ‘observing’ ego, might seduce the involved portion from its inveterate clinging to the actual transference object or to its autoplastically equivalent symptomatic representation. The postulated two portions of the ego (Freud 1940, Sterba 1934 in different references) are, after all, ‘of the same blood’ to put it mildly, and the urge to reunion in integrated function, the libidinal (synthetic) bonds, is quite strong. This affinity between ego divisions may, of course, take an opposite and adverse turn, a triumph of the ‘resistance’. As to instances of chronic severe transference regression, where the adult segment of the ego is ‘pulled down’ with the other and remains recalcitrant to interpretative e effort (Freud 1940). While this is, often contingent on the depth of manifest or latent illness, it may be simplified by iatrogenic factors, such as excessive and superfluous derivation in inappropriate and essentially irrelevant spheres. With these considerations, of whose importance is increasingly convincing with the passage of time.
Mentioning it is important, even if briefly, that certain special factors, sometimes extrinsic to analysis as such, may indefinitely prolong apparent satisfactory analyses. Real guilt, for example, may not be faced. Emotional distress based on real-life problems may not be confronted and accepted as such. A person of the type described by Freud (1916) as an ‘exception’, who feels of himself as having been abused by the fortune of fate, even if in other respects not more ill than others, may consciously or unconsciously reject the psychoanalytic discipline or the instinctual renunciation derived from its insights. Fixed and unpromising life situations or organic incapacities may permit so little current or anticipated gratification that the attractiveness of the regressive, aim-inhibited analytic relationship is strongly in comparison with the barrenness of the extraanalytic situation. The last general consideration is, of course, always an essential (if silent) constituent of the psychoanalytic field of force, especially in relation to the dissolution of the transference-resistance (Stone 1966). Or alternatively more accessibly, the ‘rules of procedures’ of analysis itself may be consciously or unconsciously exploited by the patient. He may, in ‘obedience’ to a traditional rule, delay certain decisions to the point of absurdity, invoking the analytic work in support of his neurosis and sometimes in contempt of important obligations in real life. Financial support t of the analysis by someone other than the analysand can provide a basis for chronic, concealed ’acting out’. Usually, the analysis itself can, on occasion, become a lever for subtle erasion of obligations, vicissitudes, and contingent gratifications of everyday life, and thus, paradoxically, become a resistance to its on essential goals and purposes. It may become too much like the dream, to which it bears certain dynamic resemblances (Lewin 1954, 1955). The analyst’s perceptive and tactfully illuminating obligation is no less important in these spheres than in other sectors of his commitment.
It is sometimes thought that by the ‘mature transference’ is meant, inflects the ‘therapeutic alliance’ or a group of mature ego functions that enter such an alliance. Now, there is sone blurring and overlapping the conceptual edges in both instances, but the concept as this is largely distinct from either one, as it is from the primitive transference. Either the concept is thought by others to comprehend a demonstrated actuality is a further question, that this question, is, of course, only to follow on conceptual clarity. In other words, the purposeful nonrational urge is not dependent on the perception of immediate clinical purposes, a true ‘transference; in the sense that it is displaced (in current relearnt form) from the parent of early childhood to the analyst. Its content is nontransitional but largely nonsenual (sometimes transitional, as in the child’s pleasure in so-called dirty words) (Ferenczi 1911) and encompasses a special and does not misuse spheric object relationship? : The wish to understand, and to be understood, the wish to be given understanding, i.e., teaching, specifically by the parent (or later surrogate), the wish to be taught ‘controls’ in a nonpunitive way, corresponding to the growing perception of hazard and conflict, and very likely to an implicit wish to provide with and taught channels of substitutive drive discharge. With this, there might be a wish, corresponding as the element in Loewald’s ascription (1960) by therapeutic process, to be seen as for one’s developmental potentialities by the analyst. However, the list could be extended into many subtleties, details, and variations. However, one should not omit to specify that, in its developments, it would include the wish for increasing accurate interpretation and the wish to ease such interpretations by providing sad adequate material: Ultimately, of course, by identification, to participate for being of its interpreter. The childhood system of wishes that underlie the transference is a correlate of biological maturation, and the latent (i.e., teachable) autonomous ego functions appearing with it (Hartmann 1939). However, there is a drive like quality in the particular phenomena that disqualifies any conception of the urge as identical with the functions, no one who has at any time watched a child importunes engendering questions, or experiment with new words, or solicit her interest in a new game, or demand storytelling or reading, can doubt this. That this finds powerful support and integration in the ego identification with a loved parent is undoubtedly true, just like the identification with an analyst toward whom a positive relationship has been established. That functional pleasure’ particates, certain ego energies perhaps, very likely the ego’s urge to extend its hegemony in the personality (Waelder 1936), however, the drive element, even the special phase patterns and colourations, and with it the importance of object relations, libidinal and aggressive, for a special reason. For just as the primordial transference seeks to into separation, in a sense to prevent object relationships as we know then ‘mature transference’ tends toward separation and individuation (Mahler 1965) and increasing contact with the environment, optimally with a large affirmative (increasing neutralized) relationship toward the original object, toward whom (or her surrogates) a different system of demands is now increasingly discrete. The further consideration that has to emphasize the drive like elements in these attitudes as integrated phenomena, as example of ‘multiple function’ than as the discrete exercise of function or functions, is the conviction that there is continuing dynamic relation of relative interchangeability between the two series, at least based on the responses to gratification, a significant zone of complicated energid overlap, possibly including the phenomenon of neutralization. That the empirical ‘interchangeability’ is limited, but this in no way diminishes its decisive importance. In the psychoanalytic situation, both the gratifications offered by the analyst and the freedom of expression by the patient are much more severely limited and concentrated practically entirely (in as much as the day is demonstrable sense) in the sphere of speech, on the analyst’s side, further, in the transmission of understanding.
Whereas the primordial transference exploits the primitive aspects of speech, the mature transference urges seek the heightened mastery of the outer and inner environment, a mastery to which the mature elements in speech contribute importantly. Likewise, the most clear-cut genetic prototype for the free association-interpretation dialogue is in the original learning and teaching of speech, the dialogue between child and mother. It is interesting that just as the profundities of understanding between people often include - ‘in the service of the ego’ - transitory interjections and identification, the very word ‘communication’ represents the central ego function of speech, is intimately related etymologically, even in certain actual usages, to the word chosen for that major religious sacrament that is the physical ingestion of the body and blood of the Deity. Perhaps, this is just another suggestion that the oldest of individual problems does, after all, continues to seek its solution in its own terms, if only in a minimal sense and in channels so remote as to be unrecognisable.
The mature transference is a dynamic and integral part of the ‘therapeutic alliance’, along with the tender aspects of the erotic transference, evens more attenuated (and more dependable) ‘friendly feeling’ of adult type, and the ego identification with the analyst. Indispensable, of course, are the genuine adult need for help, the crystallizing rational and intuitive appraisals of the analyst, the adult sense of confidence in him, and innumerable other nuances of adult thought and feeling. With these giving a driving momentum and power to the analytic process - always by it’s very nature in a potential course of resistance - and always requiring analysis, is the primordial transference and its various appearances in the specific therapeutic transference. That is, if well managed, not only a reelection of the repetition compulsion in its baleful sense, but a living presentation from the id, seeking new solutions, ‘trying again’, so to speak, to find a place in the patient’s conscious and effective life, has important affirmative potentialities. This has been specifically emphasized by Nunberg (1951), Lagache (1953, 1954), and Loewald (1960), among others. Loewald (1960) has recently elaborated very effectively the idea of ‘ghosts’ seeking to become ‘ancestors’, based on an earlier figure of speech of Freud (1900). The mature transference, in its own infantile right, provides some unique quality of propulsive force, which comes from the world of feeling, than the world of thought. If one views it in a purely figurative sense, that fraction of the mature transference that derives from ‘conversion’ is like the propulsive fraction of the wind in a boat navigating through close-haulage away from the wind: The strong headwind, the ultimate source of both resistance and propulsion, is the primordial transference. This view, however, should not displace the original and independent, if cognate, origin of the mature transference. To cohere to the figure of speech a favourable tide or current would also be required. It is not that the mature transference is itself entirely exempt from analytic clarification and interpretation. For one thing, like other childhood spheres of experience, there may have been traumas in this sphere, punishments, serious defects or lack or parental communication, listening, attention, or interest. Overall, this is probably far more important than has previously appeared in our prevalent paradigmatic approach to adult analysis, even taking into account the considerable changes die to the growing interest in ego psychology. ‘Learning’ in the analysis can, of course, be a troublesome intellectualizing resistance. Furthermore, both the patient’s communications and his reception and use of interpretations may exhibit only too clearly, as sometimes with other ego mechanisms, their origin in and tenacious relation to instinctual or analytic dynamism, greediness for the analyst to talk (rarely the opposite), uncritical acceptance (or rejections) of interpretations, parroting without actual assimilation, fluent, ‘rich’, endlessly detailed associations without spontaneous reflection or integration, direct demands for solution of moral and practical problems entirely within the patient’s own intellectual scope, and a variety of others. Discriminating it between the use of speech by an essentially instinctual demand and an intellectual may not always be easy or linguistic trait, or habit, determined by specific factors in their own developmental sphere. However, the underlying essentially genuine dynamism remains largely of a character favourable to the purposes and processes of analysis, as it was the original process of maturational development, communication, and benign separation. Lagache (1953, 1954) comments that on the desirability of separating the current unqualified usage. ‘Positive’ and ‘Negative’ transference, as based on the patient’s immediate state of feeling, from a classification based on the essential affect on analytic process. In the latter sense, the mature transference is usually, a ‘positive transference’.
A few remarks about clinical considerations in the transference neurosis and the problem of transference interpretation, may be offered at this given directions held within time. The whole structural situation of analysis (in contrast with other personal relationships), its dialogue of frees association and interpretation, and its deprivation as to most ordinary cognitive and emotional interpersonal dispensing tends toward the separation of discrete transference from one another with defences, in character or symptoms, and with deepening regression, toward the re-enactment of the essentials of the infantile neurosis in the transference neurosis. In additional relationships, the ‘cooperative’ outlook - gratifying, aggressive, punitive, or in other ways abounding with responsibly, and the open mobility of search for alternative or greater satisfaction - put activities of profound dynamic and economic influence so that the only extraordinary situation or transference of pathologically comparable both, occasion comparable repression.
It is a curious fact that whereas the dynamic meaning and importance of the transference neurosis have been well established since Freud gave this phenomenon a central position in his clinical thinking, the clinical reference, when the term is used, remains variable and ambiguous. For example, Greenson, in his paper of 1965, speaks of it as appearing “when the analyst and the analysis become the central concern in the patient’s life.” Yet, to specify certain aspects of Greenson’s definition, for the term ‘central’ is justifiable, in that the term would apply to the analyst’s symbolic position in relation to the patient’s experiencing ego (Sterba 1934) and the symbolically decisive position that he correspondingly assumes in relation to the other important figures in the patient’s current life. Although the analysis is in any case, and for many reasons, exceedingly important to the seriously involved patient, there is a free-observing portion of his ego, as involved, but not in the same sense as that involved in the transference regression and revived infantile conflicts. There is, of course, always the integrated adult personality, however diluted it may seem at times, to whom the analysis is one of many important realistic life activities. Rarely, although it unavoidably does occur, that the analysis factually thrives of importance to other major concerns, attachments, and responsibilities of the patient’s life, and, perhaps, it is not as desirable that this should occur. On the other hand, if construed with proper attention to the economic considerations, the idea is important both theoretically and clinically. In the theoretical direction, we are to assume that there is a continuing system of object relationships and conflict situations, most important in unconscious representations but participating often in all others, deriving in a successive series of transferences from the experiences of separation from the original object, the mother. In this sense, the analyst is substantially, the uniquely important portion of the patient’s personality, the portion that ‘never grew up’, a central figure. In the clinical sense, its importance is felt of the transference neurosis as outlining for us the essential and central analytic tasks, provided by the informatics adjacencies of currents of relative fugaciousness and demonstrability, a secure cognitive base for analytic work. By its inclusion of the patient’s essential psychopathological processes and tendencies in their original functional connections, it offers in its resolution or marked reduction, the most formidable lever for an analytic cure. The transference neurosis must be seen in its interweaving with the patient’s extra-analytic system of personal contacts. The relationship to the analyst may influence the course of relationships to others, in the same sense that the clinical neurosis did, except that the former is alloplastic, proportionally exposed, and subject to constant interpretations. It is also an important fact that, except in those rare instances where the original dyadic relationship appears to return, the analyst, even in strictly transference spheres, cannot be assigned all the transference roles simultaneously. Other actors are required. He may at times oscillate with confusing rapidity between the status of mother and father, but he usually predominantly in one of these roles for long periods, someone else representing the other. Moreover, apart from ‘acting out’, complicate and mutually inconsistent attitudes, anterior to awareness and verbalization, may require the seeking of other transference objects: Husband or wife, friend, another analyst, and so forth. Children, even the patient’s own children, may be invested with early strivings of the patient, displaced from the analysis, to permit the emergence or maintenance of another system of strivings. Physicians, of course, may encouragingly be more aware of in their patients and their own strivings, mobilized by the analysis, even experience the impulses that they would wish to call forth in the analyst. Transference interpretation therefore often had inescapably had some sorted paradoxical inclusiveness, which is an important reality of technique. There is another aspect, and that is the dynamic and economic impact of the intimate and actualized dramatis personae of the transference neurosis on the progress of the analysis as such and on the patient’s motivations, and his real-life avenues for recovery. For the person in his milieu may fulfill their ‘positive’ or ‘negative’ roles in transference only too well, in the sense that an analyst motivated by a ‘blind’ countertransference may do the same. Apart from their roles in the transference drama, which may ease or impede interpretative effectiveness, they can provide the substantial and dependable real-life gratifications that ultimately ease the analysis of the residual analytic transferences, or their capacities or attitudes may occasion an over-load of the anaclitic and instinctual needs in the transference, rendering the same process far more difficult. In the most unhappy instances, there can be a serious undercutting of the motivations for basic change.
There is also the fundamental question of the role of the transference interpretation, is but nonetheless, the variances reserved as to details and emphasis on the other important aspects of the therapeutic process, in that, there are still many to whom, if not in doubt regardless the quality value of transference interpretation, are inclined doubts their uniqueness and to stress the importance of economic considerations in determining the choice about whether transference or extratransference (In a sense, the necessarily ‘distributed’ character of a variable fraction of transference interpretation), there is the fact that the extra analytic life of the patient often provides indispensable data for the understanding of detailed complexities of his psychic functioning, because of the sheer variety of its references, some of which cannot be reproduced in the relationship to the psychoanalyst. For example, there is not repartee (in the ordinary sense) in the analysis. This way the patient handles the dialogue with an angry employer may be importantly revealing. The same may be true of the quality of his reaction to a real danger of dismissal. There are not only the realities’ not also the ‘formal’ aspects of his responses. These expressions of his personality remain important, though his ‘acting out’ of the transference (assuming this was the case) may have been even more revealing and, of course, requiring transference interpretation. Furthermore, these expressions remain useful, if discriminating and conservatively treated, even if they are inevitable always subject to that epistemological reservation, which haunts so much of the data as placed in the analytic situation. Of course, the ‘positive’ transference simplifies intensified interpretations, but it is what might render their enabling capabilities that the abling of the patient’s acceptably to listen into them and directly take them seriously.
In an operational sense, it seems that extratransference interpretations cannot be set aside or underestimated. However, the unique effectiveness of transference interpretations is not by that disestablished. No other interpretation is free, without reason. Of considering unlikely introduced apart from not substantially knowing the ‘other person’s’ involvement in a feel deep affection for, quarrelling, criticism, or whatever is being hoped-for. No other situation provides for the patient’s combinational sense of cognitive acquisition, with the experience of complete personal tolerance and acceptance, that is implicit in. an interpretation made by an individual who is an object of the emotions, drives or even defences, which are active at the time. There is no doubt that such interpretations must not only (in common with all others) include personal tactfulness but also must be offered with special care as to their intellectual reasonableness, in relation to the immediate context, lest they defeat their essential purpose. It is not too often likely that a patient who had just been jilted in a long-standing love affair and id suffering exceedingly will find useful an immediate interpretation that his suffering is because the analyst does not reciprocate his love, although a dynamism in this general sphere may be ultimate shown, and acceptable to the patient. On the other hand, once the transference neurosis is established, with accompanying subtle (sometimes gross) colourations of the patient’s story, transference interpretations are indicative, for, if all of the patient’s libido and aggressions are not, in fact, invested in the analyst, he has at least an unconscious role in all important emotional transactions, and if the assumption is correct, that the regressive drive, mobilized by the analytic situation, acceding the directorial restoration of a single all-encompassing relationship, specified pragmatically in the individual case by the actual attained level of development, then there is a dynamic factor at work, importantly meriting interpretation as such, to the extent that available material supports it. This would be the immediate clinical application of the material regarding a ‘cognitive lag’.
Freud’s first formal reference to transference (Breuer and Freud 1893-1895) set the tone for all that followed. In discussion resistance and obstacles too effective cathartic (analytic) work, he offers as one possibility that ‘the patient is frightened at finding that she is transferring into the figure of the physician the distressing ideas that arise from the content of the analysis . . . Transference onto the physician takes place through a ‘false connection’. Freud then offers an example of a woman who developed a hysterical symptom based on her wish many years earlier (and now relegated to the unconscious) that the man she was talking to at the time might slowly take the initiative and gives her a kiss. He then described how, toward the end of one session, a similar wish came up within the patient toward himself - Freud. The patient was horrified and unable to work in the next hour, and obstacle to the therapeutic work that was removed once Freud had discovered its basis and pointed it out to the patient. In her response, the patient could recall the pathogenic recollections that accounted for her reactions to Freud the unconscious wish, according to Freud, had become conscious but was linked to the person based on a false connection by the transference,
Importantly, the present of issues is the finding that Freud’s monumental discovery of transference was founded upon his realization that his patient’s conscious fantasy about him was based on an earlier experience with another man. This displacement from an earlier figure (in later writings this person would often be linked to the patient’s father or other childhood figure) was seen as having no foundation in the analyst’s behaviours and as based entirely on the patient’s inner wish. Freud repeatedly characterized such responses as the real for the patient though unfounded in the actualities of the analytic relationships.
Once, again, in his well-known postscript to the case of Dora, Freud (1905) showed an appreciation of the unconscious basis for transference, though he maintained as his clinical reference point some type of conscious allusion to a reaction toward the analyst. Freud defined transference as a special class of mental structures that for the most parts are unconscious. Descriptively, he identified them as; untried additions or facsimiles of the impulses and phantasies that are suspensefully made conscious during the progression of the analysis. . . . They replace some earlier person by the person of the physician. Freud stared that some transferences differ from their earlier models in no way except the substitution of the physician for the earlier figure. He abstractively supposed of these to be new impressions or reprint, but stated that other transferences are more ingeniously constructed and have been subjected to a modifying influence he termed sublimation, the implication was that these transferences took advantage of some real peculiarity in the physician’s person or circumstance and attached themselves to that factor. These transferences he considered revised editions. Through transference, the past of the patient is revived as belonging to the present. Even with the patient Dora, the main transference was seen as a replacement for her father with Freud, and much of this found expression through conscious comparisons such as her question about whether Freud was keeping secrets from her as had her father. Other manifest concerns that Dora expressed in her relationship with Freud were traced to the relationship with Herr K.
Throughout his discussion, Freud maintained the clinical view of transference as involving some direct reference to himself as the analyst. While he clearly stated that transference structures are largely unconscious, his evidently stressed on the role of unrecognized displacement s and an unawareness with the patient of intrapsychic and genetic sources of her direct responses to the analyst. It is this peculiarity of the conceptualization of transference - a recognition of its unconscious basis, which is seldom specified in any detail, and a simultaneous maintenance of the ides that it is expressed through direct references to the analyst - that has contributed too much uncertainty in this area.
Freud and others have treated manifest and conscious fantasies about the analyst as if they represented either the direct awareness of a fantasy influencing the patient’s psychopathology or the breakthrough of as previous unconscious fantasy or memory, originally attached to an earlier figure. This has caused considerable confusion; for all practical purposes, conscious fantasies about the analyst and defences against them have been taken as the substance of the patient’s transference neurosis, while the role of the unconscious fantasies has been neglected.
While Freud and other analysts have at times stressed the critical role of unconscious fantasy constellations in the development of neurosis, in their actual clinical work conscious fantasies are often taken at face value and held responsibly for the patient’s illness. Some of this contradiction has been rationalized away with the idea that these conscious fantasies represent direct breakthroughs of previously unconscious fantasies, a position adopted despite the acknowledgment in other contexts (Arlow 1969, Brenner 1976) that defences and resistances are always at work and that pure breakthroughs are extremely either rare or nonexistent (the conscious product is always a compromise and always contains some degree of disguise).
While this view pats-lip service to the idea of nondistorted reactions by the patient, there has been virtually no consideration of his continuous, essentially sound functioning, or of his conscious and unconscious interventions. This is in keeping with the overriding stress on pathological unconscious fantasies in the etiology of neuroses and in transference, to the neglect of unconscious perceptions and introjects, a factor neglected to this day.
Most of what Freud had to say about unconscious fantasies and derivatives appeared in papers unrelated to technique and transference. In an important contribution in 1908, Hysterical Phantasies and Their Relation to Bisexuality, he specifically identified the role of unconscious fantasies in symptom formation, borrowing heavily from his insights into dreams. Freud had discovered that hysterical symptoms are based on fantasies that represent the satisfactions of wishes. He noted, however, that these fantasies can be conscious or unconscious initially, but that the critical factor in neurosogenesis is the presence of an unconscious fantasy expressing itself through hysterical symptoms and attacks. Freud felt that at times these unconscious fantasies can quickly be made conscious and that both the conscious and the unconscious fantasy may be some derivative of a formally conscious fantasy, suggesting by that the disguise involves the unconscious rather than the conscious fantasy. In this early use of the concept of derivatives, then, it was no the conscious fantasy that was the derivative of the underlying fantasy, but the reverse.
But, nonetheless, his paper on the dynamics of transference, Freud (1912) described transferences as based on a stereotyped plate that is constantly repeated - repeated afresh - during a person’s life. The underlying fantasias were seen as partly accessible to consciousness, and as partly unconscious. Transference, then, is the introduction of one of these stereotypical plates into the patient’s relationship with the analyst.
It was also that Freud stated that when associations fail or become blocked. They have become connected with the analyst. Freud stressed the role of unconscious complexes in psychopathology and suggested that they are represented consciously and that their roots in the unconscious have to be traced out. The key to analysis is the distortion of pathogenic material expressed through the patient’s transference.
In Remembering, Repeating, and Working Through, Freud (1914) saw transference as involving repetitions of the past in the actual relationship with the analyst. In stressing, once, again, the extent to which the patient experiences these transferences as real and contemporize, Freud again used the term transference to refer to direct reactions to the analyst. In his paper on transference love (1915) Freud is clearly alluding to conscious erotic wishes and fantasies about the analyst. He stated that he was discussing situations in which women patients declare their love for a male analyst and make direct demands for the return of his love, using such demands as resistances. Similar thinking is revealed in An Outline of Psycho-Analysis, (1940), in which Freud discusses how the patient sees the analyst as a reincarnation of figures from his childhood, and transfers feelings and reactions based on this prototype. Freud was to escape an understanding by which, once, again attributive to positive and negative attitudes toward the analyst, and the plastic clarity with which patients experience such transferences.
The clearest evidence for Freud’s clinical definition of transference appears in his presentation of the opening phase of the analysis of the Rat Man (1909). The note’s of Freud decanting of this example, to reveal that with one exception, each time Freud used the term transference he was calling a conscious knowing fantasied illusion about himself or his family unit of measure. Persistently, Freud would attempt to identify the genetic basis for these transferences, largely, the main unconscious aspect was the mechanisms of displacement. It followed, then, that resistance, and in particular transference resistance, became defined as efforts by the patient to avoid the expression or realization of conscious fantasies about the analyst, and that the term could be extended to include unconscious avoidance as well. This is a reminder that the definition of resistance depends largely on the definition of transference - that is to say, that Freud took allusions toward an outside person as displacements from himself, and from ‘the transference’. In this context, it is well to recall that Freud’s original definition o acting out (Freud 1905) alluded to behaviours, directed toward the analyst, such as Dora’s flight from analysis, and to a lesser extent as to natural actions involved with other persons.
Freud’s narrow view of transference concerning direct references to the analyst is also reflected in one of his rare comments on the nature of material from patients’ (Freud 1937). In discussing the kinds of material that patient’s put at the disposal of analysts for recovering lost pathogenic memories. Freud refers to dreams, free association, the repetition of effects, actions performed by the patient both inside and outside the analytic situation, and the relation of transference that becomes established toward the analyst. In addition, his archaeological model of repressed unconscious memories can be seen to imply the discovery of previously repressed fantasies integrated as though it were also to leave room for fragmented representations. Finally, we may note a comparable comment by Freud in the Outliner (1940): “We gather the material for our work from a variety of sources - from what communication has been made a reduction by giving us by the patient and by his free associations, from what her shows us in his transference, from what we reason out by interpreting his dreams and from what he betrays by his slips or parapraxes.”
Moreover, Freud leaned toward the divorce of his discussion of the transference neurosis and transferences from his consideration of the nature of psychopathology. In keeping with this trend, his discussion of the nature of unconscious fantasies and processes, and of derivative communication, appeared primarily in two metaphysical papers - Repression (Freud 1915) and The Unconscious (Freud 1915). In both papers he was concerned with communication between the unconscious mind and the preconscious or conscious mind? He noted that this takes place by means of derivatives that express and represent unconscious instinctual impulses. He also pointed out that unconscious fantasies can be highly organized and logical even thought outside the awareness of the patient, suggesting again the possibility of the direct breakthrough of such fantasy material. In these writings, it is the unconscious fantasy that expresses itself consciously through derivatives as substitute formations such as symptoms or preconscious thought formations. What has been repressed, Freud noted? Can become conscious only if it is sufficiently disguised? On this basis, unconscious fantasies can be appeared in a patient’s free association (the reference to free association rather than to transference), through remote and distorted derivative expressions. These are substitute formations that include the return of the repressed, the repressed instinctual impulses modified by defensive operations such as displacement.
Let it be said, that Freud left considerable room for uncertainty regarding his conceptualization of transference. Theoretically, he implied that transferences are based on unconscious fantasias and memories derived from experiences and brought into play in the relationship with the analyst. He himself never applied his insights into the nature of derivative comminations to the subject of transference. As a result, his clinical referent for transference remained throughout his writings that of a direct reference to the analyst. While he acknowledged the important role of unconscious processes and contented the analyst at face value and to understand them as direct representations displaced from the past. A major contradiction by that unfolded. In that Freud correctly understood neuroses to be based on unconscious fantasy constellations, including unconscious transference fantasies, and yet he worked analytically with the patient’s conscious fantasies toward himself as analyst. Freud’s contention that sometimes unconscious fantasies break through unmodified into conscious awareness is clearly insufficient justification for this approach. There is abundant clinical evidence that unconscious fantasy constellations are always expressed through derivative formations, and that even when elements of the underlying unconscious fantasy break through in unmodified form - or are recovered through interpretation - there always remains an additional cloak-and-dagger element. Further, at the point of realization of an undisguised unconscious fantasy, it seems likely that its own expression would be itself function as a disguised and defensive derivative of a different and still repressed unconscious fantasy (Gill 1963).
The failure by analysts to maintain the essential definition of transference - as based on an unconscious fantasy constellation expressed, almost without acceptation, through derivatives - has led to many mistaken formulations regarding the nature of psychopathology, the analytic process itself, and the techniques of the psychoanalyst and psychotherapist. In their discussion of neuroses, analysts have consistently maintained and documented the thesis that psychopathological syndrome is based on unconscious processes and contents - fantasy constellations. It seems evident, that analytic work with manifest fantasies per se cannot provide access to, or interpretations of, these unconscious constellations.
The need to clarify the contextual significance of ‘transference’ and what it serves to achieve, or prevent, or avoid, and becomes apparent. For example, relating to the analyst based on some preconceived fantasy, rather than as the person he or she is, can function to prevent the possibility of engaging meaningfully and experiencing the anxiety a more mutual and intimate engagement might arouse.
An appreciation of interactive factors also allows us to consider that, to whatever degree the patient’s perceptions of the analyst are plausible and eve valid (Ferenczi, 1933; Little, 1951; Levenson, 1972; Searles, 1975; Gill, 1982; Hoffman, 1983), this may be due to the patient’s expertise at stimulating precisely this kind of responsiveness in the analyst. The reverse is true as well. Thus, though patient and analyst each will have unique vulnerabilities, sensitivities, strengths, and needs, we must consider why particular qualities or sensitivities of either patient or analyst are begun at a given moment and not at others. At any moment patient or analyst might be involved in some find of collusive enactment (Racker, 1957, 1968; Levenson, 1972, 1983; Sandler, 1976, Bion, 1967, 1983; Ogden, 1979; Grotstein, 1981; McDougall, 1979). These considerations to illuminate why clinicians often seem to practice in ways that contradict their own stated beliefs and theoretical positions.
The powerful impact of unwitting communication between patient and analyst is, of course, one reason the analyst’s countertransference experience can be a source of vital data about the patient and may become the ‘key’ to understanding aspects of the interactions that might otherwise remain impenetrable (Heimann, 1950).
An appreciation of interactive factors also requires us to reconsider what makes up analytic ‘mistake’. In this regard Winnicott (1956, 1963) has expressed the views that there are times when our patients need us to fail. In the end the patient uses the analyst’s failure, often quite: Small ones, perhaps manoeuverer by the patient: The operative factors are that the patient now hates the analyst for the failure that originally came as an environmental factor, outside the infant’s area of omnipotent control, that is now staged in the transference. So in the end we succeed by failing the patient’s way. This is a long distance from the simple theory of cures by corrective experience (Winnicott, 1963)
From-Reichmann (1939, 1950, 1952), has emphasized that at times the analyst’s mistakes may become the basis for a ‘golden (analytic) opportunity’. From this vantage point we might consider that how an analyst deals in the accompaniment with wished, in that he or she has in possession of some inevitable fallibility that maybe on of the defining aspects of his or her techniques.
An appreciation of interactive considerations thus requires us to rethink important issues of technique and the question of how we define ‘analysis’. It also requires us to consider that the pattern’s so-called ‘analyzability’ may depend on the nature of the analyst’s participation than has previously been recognized. The dilemma is how to move into a new mode of thinking about clinical technique that is not beset by the inherent limitations of traditional thinking or by those of more radical new perspectives.
The unformidable combinations of others before have thought that the psychoanalytic situation and process as such have a general unconscious meaning, which reproduces certain fundamental aspects of early developments. For example, in Greenacre and in 1956 Spitz offered ideas of the psychoanalytic situation and of the origins of transference, based largely on the mother-child relationship of the first months of life. Greenacre used the term ‘primary transference’ (with two alternatives). As far as the ideas of Greenacre and Spitz emphasize the prototypic position of the first months of life, as reproduced in the current situation, there are subtle but important differences from the view presents. Nacht and Viderman in 1960 extended related ideas to their conceptual extreme, requiring metaphysical terminology. One can readily understand the regressive transference drive set up by the situation as having such general direction, i.e., toward primitive quasi union, a reservation that Spitz accepted and specified, in response to Anna Freud. It is te activation of this drive and its opposing cognate that underlies the construction of the psychoanalytic situation, which is seen primarily as a state of separation, of ‘deprivation-in-intimacy’.
With the prolonged and strictly abstinent contact of the classical analytic situation, there is inevitably for the patient, some growing and paradoxical experience of cognitive and emotional deprivation in the personal sphere, the cognitive and emotional modalities in certain respects overlapping or interchangeable, in the same sense that the giving of interpretations may satisfy to varying degree either cognitive or emotional requirements. The patient, also renounces the important expression of a locomotion. If developed beyond a certain conventional communicative degree, even gesture or other bodily expressions tend, by interpretive pressure, to be translated into the mainstream of oral-vocal-auditory language. The suppression of hand activity, considering both its phylogenetic and ontogenetic relation to the mouth (Hoffer 1949), exquisitely epitomizes the general burdening of the function of speech, regarding its latent instinctual components, especially the oral aggressions.
From the objective features of this real and purposive adult relationship, one may derive the inference that “its representational advance presents of unintentional consciousness, one of disguising itself in its primary and most extensive impact, the superimposed series of basic separation experiences in the child’s relation to his mother." In that, the analyst would represent the mother-of-separation, as differentiated from the traditional physician who, by contrast, represent the mother associated with intimate bodily care. This latent unconscious continuum-polarity eases the oscillation from ‘psychosomatic’ reactions and proximal archaic impulses and fantasies, up to the integration of impulse and fantasy life within the scope of the ego’s control and activities (Stone 1961).
Within this structure, the critical function of speech is seen in a similar perspective, as a continuous telescopic phenomenon ranging from its primitive meanings as physiological contact, resolution of excess or residual primitive oral drive tensions, through the conveyance of expressive or demanding or other primitive communications, on up to its role as a securely established autonomous ego function, genuinely communicative in a referential-symbolic sense. To the extent that an important fraction of human impulse life is directed against separation from birth onward, the role of speech, which develops rapidly as the modalities of actual bodily intimacy are disappearing or becoming stringently attenuated (Sharpe 1940), has a unique importance as a bridge for the state of bodily separation. In the instinctual contribution to speech, considering it as a phenomenon of organic or maturational ‘multiple function’ (Waelder 1936), the cannibalistic urges loom large; they, and more manifestly, their civilized cognates (partially, derivative?), Introjection tracings and their preserving capabilities for re-emergence as such, always. In such view, the most primitive and summary form of mastery of separation, fantasized oral incorporation, is in a continuous line of development with the highest form of objective dialogue between adults. The demonstrable level of response of the given patient, in this general unconscious setting, will be determined (in ideal principle) by his effectively attained level of psychosexual development and ego functioning in its broadest sense and by his potentiality for regression.
Advances in our understanding of the therapeutic action of the psychoanalysis should be based on deeper insight into the psychoanalytic process. By ‘psychoanalytic process’ is to mean the significant interactions between patient which ultimately leads to structural changes in the patient’s personality. Today, after more than fifty years of psychoanalytic investigation and practice, we can appreciate, if not to understand better, the role which interaction with environment plays within the core organizational formation, development, and continued integrity of the psychic apparatus. Psychoanalysis ego-psychology, based on a variety of investigations concerned with
Ego-development, has given us some tools to deal with the central problem of the relationship between the development of psychic and interaction with other psychic structure, and of the connexion between ego-formation and other object-relations.
If ‘structural changes in the patient’s personality’ mean anything, it must mean that we assume that ego-development is resumed in the therapeutic process in the psychoanalysis. This resumption of ego-development is contingent on the relationship with a new object, the analyst. The nature and the effects of this new relationship are under what should be the fruitful attempt to correlate our understanding of the significance of object-relations for the formation and development of the psychic apparatus with the dynamics of the therapeutic process.
Problems, however, of essentially established psychoanalysis theory and tradition concerning object-relations the phenomenon of transference, the relations between instinctual drives and ego, and concerning the function of the analyst in the analytic situation, have to be dealt with, least of mention, it is unavoidable, for clarification to those who think of a divergent repetition from the cental theme to deal with such problems. Thus and so, the existent discussion is anything but a systematic presentation of the subject-matter. Therefore, in continuing further details of attempting to suggest modifications or variations in techniques, but the psychoanalytic changes for the better understanding of therapeutic action of the psychoanalysis in that it may lead to changes in technique, as anything of such clarification may entail as a technique is concerned should be worked out carefully and is not the topic but its psychometric test?
While the fact of an object-relationship between patient and analyst is taken for granted, classical formulations concerning therapeutic action and concerning the role of the analysts in the analytic relationship do not reflect our present understanding of the dynamic organization of the psychic apparatus, and not merely of ego. In that, the modern psychoanalytic ego-psychology that expressed directly or indirectly, as far more than an additional psychoanalytic theory of instinctual drives. It is however the elaboration of a more comprehensive theory of the dynamic organization of the psychic apparatus, and the psychoanalysis are in the process of integrating our knowledge of instinctual drives, gained during earlier stages of its history, into such a psychological theory. The impact of psychoanalytic ego-psychology has on the development of the psychoanalysis, in that is to suggest that ego-psychology be not concerned with just another part of the psychic apparatus, given but a new continuum to the conception of the psychic apparatus as an undivided whole.
In an analysis, one is to think that we have opportunities to observe and investigate primitively and more advanced interaction-processes, that is, interactions between patient and analyst that leads to or from steps in ego-integration and disintegration. Such interactions, or integrative (and disintegrative) experiences, occur often but do not often as such become the focus of attention and observation, and go unnoticed. Apart from the difficulty for the analyst of self-observation while in interaction with his patient, there is a specific reason, stemming from theoretical bias, why such interactions not only go unnoticed but are frequently denied. The theoretical bias is the view of the psychic apparatus as a closed system. Thus the analyst is seen, not as a co-actor on the analytic stage, on which the childhood development, culminating in the infantile neurosis, is restaged and reactivated in the development, crystallization and resolution of the transference neurosis, but as a reflecting mirror, even if of the unconscious, and characterized by scrupulous neutrality.
This neutrality of the analyst is required (1) in the interest of scientific objectivity, to keep the field of observation from being contaminated by the analyst’s own emotional intrusions, and (2) to guarantee an unformed mind for the patient’s transferences. While the latter reason is closely related to the general demand for scientific objectivity and avoidance of the interference of the personal equation, it has its specific relevance for the analytic procedure as such in as far as the analyst is supposed to function not only as an observer of certain precess, but as a mirror that actively reflects back to the patient the latter’s conscious and particularly his unconscious processes through communications. A specific aspect of this neutrality is that the analyst must avoid falling into the role of the environmental figure (or of his opposite) the relationship to whom the patient is transferring to the analyst. Instead of falling into the assigned role, he must be objective and neutral enough to reflect back to the patient what role the latter has assigned to the analyst and to himself in the transference situation. Nevertheless, such objectivity and neutrality now need to be understood more clearly as to their meaning in a therapeutic setting.
It is all the same that ego development is a process of increasingly higher integration and differentiation of the psychic apparatus and does not stop at any given point except in neurosis and psychosis: although it is true that there is normally a marked consolidation of ego-organization around the period of the Oedipus complex. Another consolidation normally takes place toward the end of adolescence, and further, often less marked and less visible, consolidation occurs at various other life-stages. These later consolidations - and this is important - follow periods of relative ego-disorganization and reorganization, characterized by ego-regression. Erickson has described certain types of such periods of ego-regression with subsequent new consolidations as identity crises. An analysis can be characterized, from this standpoint, as a period or periods of induced ego-disorganization and reorganization. The promotion of the transference neurosis is the induction of such ego-disorganization and reorganization. Analysis is thus understood as an intervention designed to set ego-development in motion, be it from a point of relative arrest, or to promote what we conceive of as a healthier direction or comprehensiveness of such development. This is achieved by the promotion and use of (controlled) regression. This regression is one important aspect under which the transference neurosis can be understood. The transference neurosis, in the sense of reactivation of the childhood neurosis, is set in motion not simply by the technical skill of the analyst, but by the fact that the analyst makes himself available for the development of a new ‘object-relationship’ between the patient and the analyst. The patient having a tendency to make this potentially new object-relationship into an old, on the other hand, its total extent from which the patient develops ‘positive transference’ (not in the sense of transference as resistance, but in the sense in which ‘transference’ carries the whole process of an analysis). He keeps this potentiality of a new object-relationship alive through all the various stages of resistance. The patient can dare to take the plunge into the regressive crisis of the transference e neurosis that brings him face to face again with his childhood anxieties and conflicts, if he can hold to the potentiality of a new object-relationship, represented by the analyst.
We know from analytic s well as from life experience that new spurts of self-development may be intimately connected with such ‘regressive’ rediscoveries of oneself as may occur through the establishment of new object-relationships, and this means: New discovery of ‘objects’. Seemingly enough, new discovery of objects, and not discovery of new objects, because the essence of such new object-relationships is the opportunity they offer for rediscovery of the early paths of the development of object-relations, leading to a new way of relating to objects and of being and relating to ones' own. This new discovery of oneself and of objects, this reorganization of ego and objects, is made possible by the encounter with a ‘new object’ which has to possess certain qualification to promote the process. Such a new object-relationship for which the analyst holds himself available to the patient and to which the patient has to hold on throughout the analysis is one meaning of the term ‘positive transference’.
What is the neutrality of the analyst? Its significance branches the intangible quantification upon stemming from the encounter with a potentially new object, the analyst, which new object has to possess certain qualifications to be able to promote the process of ego-reorganization implicit in the transference neurosis. One of these qualifications is objectivity. This objectivity cannot mean the avoidance of being available to the patient as an object. The objectivity of the analyst has reference to the patient’s transference distortions. Increasingly, through the objective analysis of them, the analyst overcomes not only a potentiality but the subjective expanding activities available are of a new object, by eliminating in stages impediments, represented by these transferences, to a new object-relationship. There is a tendency to consider the analyst’s availability as an object merely as a device on his part to attract transference onto himself. His availability is seen as to his being a screen or mirror onto which the patient projects his transference, which reflects them back to him as interpretations. In this view, at the ideal endpoint of the analysis no further transference occurs, no projections are thrown on the mirror, the mirror having nothing now to reflect, can be discarded.
This is only a half-truth. The analyst in actuality does not reflect the transference distortions. In his interpretations he implies aspects of undistorted reality that the patient begins to grasp the successive sequence as the transferences are interpreted. This undistorted reality is mediated to the patient by the analyst, mostly by the process of chiselling away the transference distortions, or, as Freud has beautifully put it, using an expression of Leonardo da Vinci, ‘per via di levare’ as, insomuch as of sculpturing, not ‘per via di porre’ as, in producing a painting. In sculpturing, the figure to be created comes into being by taking away from the material: In painting, by adding something to the canvas. In analysis, we bring out the true form by taking away the neurotic distortions. However, as in sculpture, we must have, if only in rudiments, an image of that which needs to be brought into its own. The patient, in such a way he contributes of himself to the analyst, and provides rudiment infractions of such a continuous image of fragmented fluctuations imbedded by distortion - an image that the analyst has to focus in his mind, thus holding it in safe keeping for the patient to whom it is mainly lost. It is this tenuous reciprocal tie that represents the germ of a new object-relationship.
The objectivity of the analyst regarding the patient’s transference distortions, his neutrality in this sense, should not be confused with the ‘neutral’ attitude of the pure scientist toward his subject of study. Nonetheless, the relationship between a scientific observer and his subject of study has been taken as the model for the analytic relationship, with the following deviation: The subject, under the specific conditions of the analytic experiment, directs his activities toward the observer, and the observer expresses his findings directly to the subject with the goal of modifying the findings. These deviations from the model, however, change the whole structure of the relationship to the extent that the model is not representative and useful but, in earnest, very much misleading. As the subject directs his activities toward the analyst, the latter are not integrated by the subject as an observer: As the observer expresses his findings to the patient, the latter are no longer integrated by the ‘observer’ as a subject of study.
While the relationship between analyst and patient does not possess the structure, scientist-scientific subject, and is not characterized by neutrality in that sense by the analyst, the analyst may become a scientific observer to the extent to which he can observe objectively the patient and himself in interaction. The interaction itself, however, cannot be adequately represented by the model of scientific neutrality. Using this model is unscientific, based on faulty observation? The confusion about the issue of countertransference relates to this. It hardly needs to be pointed out that such a view in no way denies or reduces the role scientific knowledge, understanding, and methodology play in the analytic process, nor does it have anything to do with advocating an emotionally-charged attitude toward the patient or ‘role-taking’. In that a showing attempt to disentangle the justified and requirement of objectivity and neutrality from a model of neutrality that has its origin in propositions that may be untenable.
One of these is that therapeutic analysis is an objective scientific research method, of a special nature to be sure, but falling within the general category of science as an objective, detached study of natural phenomena, their genesis and interrelations. The ideal image of the analyst is that of a detached scientist. The research method and the investigative procedure in themselves, carried out by unspecified scientists, are said to be therapeutic. It is not self-explanatory why a research project should have a therapeutic effort on the subject of study. The therapeutic effect appears to have something to do with the requirement, in analysis, that the subject, the patient himself, gradually becomes an associate, as it was, in the research work, that he himself becomes increasingly engaged in the ‘scientific project’ which is, of course, directed art himself. We speak of the patient’s observing ego on which we need to be able to rely to a certain extent, which we attempt to strengthen and with which we collaborate among ourselves. We encounter and make to some functional applicability of what is known under the general title, ‘identification’. The patient and the analyst acknowledge the fact for being equally increasing to the evolving principles that govern the political nature as deployed to the accessorial evolution for a better and mutually actualized understanding, if the analysis proceeds, in their ego-activity of scientifically guided self-scrutiny.
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