Transference and Countertransference

The concepts of transference and countertransference, together with that of transference neurosis, properly belong to the theory and practice of psychoanalysis. In Sigmund Freud’s original formulations they were inextricably intertwined with his propositions about the determinants of development and neuroses, and they have very limited meaning outside that framework. Where they are so used, their meanings derive from a simple attribution of current client behavior to events in the client’s past.

Freud’s Definition of Transference

Freud’s earliest discussion of transference was in the case of Dora, whom he saw late in 1900. After interpreting some of her behavior toward him as a repetition of her behavior toward her father, he said that transferences were “new editions or facsimiles of the impulses and phantasies which are aroused and made conscious during the progress of the analysis [and] replace some earlier person by the person of the physician. To put it another way: a whole series of psychological experiences are revived, not as belonging to the past, but as applying to the person of the physician at the present moment” (Freud, 1905, p. 116). Here Freud did not tie transference to any complex theory of neurosis, and in his further discussion of the case he did not go beyond the proposition that neuroses are based on repressed sexual ideas.

The first theoretical context in which Freud formulated the notion of transference was in his unpublished correspondence between 1897 and 1901 with Wilhelm Fliess, after Freud partially (and secretly) abandoned the proposition that neuroses were due to repressed memories of perverse childhood sexual experiences—the so-called seduction theory. In place of the apparently real seduction memories that Freud claimed to have discovered, Freud now substituted the notion of a perverse childhood sexual drive that generated the same oral, anal, and genital sensations as the supposed real seduction, and which provided the basis of childhood fantasies from which the symptoms of neuroses formed. Thus Dora’s late recall of the smell of smoke as part of her dream was actually determined by the repressed oral component of her childhood sexual drive being directed into a longing for a kiss from the cigar-smoking Freud (as well as her attempted seducer) rather than to its original object, her father, who also smoked.

For Freud, Dora’s transference was explained entirely within this early theory of childhood sexuality, and his explanation became even more complete in his fully developed sexual theory. In it, the oral, anal, and genital components of the childhood sexual drive pass through a phylogenetically determined series of stages at any of which there can be some degree of fixation and perverse choice of object. Together with abnormalities in the associated ego and superego structures, these processes contribute causally to later adult neuroses, determining their symptoms as well as the content of the transferences and the transference neurosis.

Transference Neurosis and Its Resolution

The term transference neurosis refers to the temporary neurosis created in psychoanalysis as the revived, but unconscious, sexual feelings and object choices of the patient’s past are transferred on to the analyst. Freud introduced the concept in 1914 when discussing patients whom he believed were rejecting his interpretations and avoided remembering past repressed unconscious conflicts, but unconsciously repeated behaviors based on them. In 1920, he extended the meaning to include what he saw as the patient’s compulsion to repeat earlier, unpleasant experiences that helped to maintain the neurosis.

Although in one sense an artificial creation of the analytic situation, Freud came to believe the transference neurosis was an inevitable revival of the earlier infantile neurosis in which the basic neurotic symptoms were reproduced in a simplified and more readily identifiable form. By reconstructing the patient’s past, the transference neurosis could be used therapeutically. In this sense, Freud regarded the resolution of the transference neurosis as a necessary condition for the cure of the ordinary or adult neurosis. He was generally optimistic that it would yield to psychoanalytic intervention although, as an unconscious resistance, it could sometimes interfere with that aim.

Freud first mentioned countertransference in 1910 as the constellation of feelings aroused in the psychoanalyst by the patient from the analyst’s unconscious complexes and internal resistances. He gave no formal definition, but characterized it negatively and said it required a deep, continuous, and productive self-analysis if the psychoanalyst was to be successful. The negative effects of countertransference were later regarded so seriously that Freud’s requirement of a self-analysis was extended to requiring a personal analysis as part of analytic training.

Identifying the Phenomena

Although Freud’s definitions may be clear enough, studies by psychoanalysts have shown that there is little agreement among them about the manifestations of transference, and hence of transference neurosis and countertransference. The cause of this disagreement is that there is no behavior that, simply by itself, can be said to constitute transference (or countertransfer-ence). To count as a manifestation of transference, whatever the patient has expressed emotionally, verbally, or in other ways has to be interpreted within a developmental context constructed by the treating psychoanalyst. The lack of agreement among the multitudinous reinterpretations of Dora’s identifications and dreams provides a good example of the problem. Each reinterpretation was made from the same set of “facts” Freud described, but the lack of agreement on the developmental context meant there could be no agreement on what counted as transference. It seems impossible for other analysts to comprehend fully the particular developmental context constructed by a colleague. The same point explains the lack of agreement in those few studies of transference manifestations that are judged by a panel of analysts examining audio- or videotapes of a patient’s behavior over a number of sessions.

The problem posed by theoretical context in identifying transference manifestations is also seen in the two main groups of empirical studies of the phenomenon, those by Lester Luborsky and his colleagues and by Susan Andersen and hers. Both note the considerable lack of agreement among psychoanalysts in defining the concept before outlining their own criteria for identifying transference. Using recordings of psychoanalytic therapy sessions and adopting a general psychoanalytic framework, Luborsky’s group arrived at agreement on the presence of consistent and recurrent patterns of relationships between childhood and adult behaviors (Core Conflict Relationship Themes). They take these recurrent patterns to confirm Freud’s “grandest clinical hypothesis”—that of transference—even though the relationships are not necessarily based on repressed unconscious instinctual wishes. At best, their concepts of transference are fairly bland translations of Freud’s. Andersen and her colleagues explicitly differentiated their concept of transference from the drive-structure assumptions on which Freud’s is based. They do not assume that repression is involved and merely endorse the simple premise that aspects of past relationships may be replayed in present ones.

Transference and Countertransference outside Psychoanalysis

As almost any textbook on counseling will attest, transference and countertransference are given different meanings and accorded differing degrees of importance in systems of counseling and psychotherapy other than psychoanalysis. Only in those psychotherapies explicitly basing some of their theoretical notions on Freud’s does one tend to find the concepts being used with similar meaning.

On the other hand, in those systems of therapy and counseling where little emphasis is placed on the contribution of specific childhood factors to adult maladjustment, transference, transference neurosis, or countertransference are not discussed. This is not necessarily because of a lack of knowledge of these concepts. Aaron Beck and Albert Ellis, for example, both trained as psychoanalysts before developing their own approaches, but virtually dismiss transference. Beck gave a role to childhood experience, but claimed that discussing parents is not always necessary and that transference can be dealt with in the first 5 minutes, whereas Ellis directed the whole of the client’s attention to current matters. Transference does find some limited place in Carl Rogers’s client-centered counseling, the progenitor of many modern approaches. According to Rogers, although transference attitudes may develop, the combination of the time-limited nature of his form of counseling and the accepting environment in which it takes place prevents transference relationships proper from developing. John Shlein, a contemporary follower of Rogers, argued that the therapist’s invocation of transference was a means by which counselors avoided personal responsibility for the effects they had on their clients. Note, however, that the reference of the concept of transference here is to simple behavior rather than the theoretically based understanding proposed by Freud.

In much of the counseling literature there is a similar simplification of countertransference, so if it is discussed at all, it is as the ordinary emotional reactions of the counselor to the client. It ranges from discussions of liking or not liking the client to the more serious issue of the erotic attraction of the counselor or therapist to the client. But, whether the effect of the latter is simply to cloud the counselor’s judgment or to cause a much more serious ethical violation by involving the counselor with the client sexually, it seems neither necessary nor desirable to invoke the explanatory armamentarium of Freudian theory.

References:

Berk, M. S., & Andersen, S. M. (2000). The impact of past relationships on interpersonal behavior: Behavioral confirmation in the social-cognitive process of transference. Journal of Personal and Social Psychology, 79, 546-562.
Freud, S. (1953). Fragment of an analysis of a case of hysteria. In J. Strachey (Ed. & Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 7, pp. 1-122). London: Hogarth Press. (Original work published 1905)
Laplanche, J., & Pontalis, J.-B. (1973). The language of psychoanalysis. (D. Nicholson-Smith, Trans.). London: Hutchison. (Original work published 1964)
Luborsky, L., & Crits-Christoph, P. (1998). Understanding transference: The Core Conflictual Relationship Theme method (2nd ed.). Washington, DC: American Psychological Association.
Macmillan, M. (1997). Freud evaluated: The completed arc. Cambridge: MIT Press.
Shlien, J. M. (1987). A counter-theory of transference. Person-Centered Review, 2, 15-49.
Wood, A. B. (1951). Transference in client-centered therapy and in psychoanalysis. Journal of Consulting Psychology, 15, 72-75.