Transference in Psychotherapy

Transference was a cornerstone upon which psychoanalysis built its foundation for treatment upon.  There are several different understandings and definitions of transference within and outside the field, and the topic itself is hotly debated amongst clinicians.  Regardless of the definitions and understanding one uses of the concept– it is an important aspect of psychotherapy.  Transference is severely neglected in modern therapy of today, especially in behavioral sects like CBT and solution-focused therapies.  This neglect often leads to issues within the therapeutic relationship, and can prevent change and growth from occurring.  Having an understanding of transference is vital to all therapists.  

The two main understandings and interpretations of transference that I will concern you with today, are the traditional and the contemporary one.  The traditional one, that has evolved since, found its origins in Freud’s original work, as well as the work of the pioneering work of Pierre Janet.  Both Janet and Freud observed the phenomenon of transference with their patients, and did their best to make sense of what was happening.  Transference, in their understanding and conception, was the act by which a patient superimposes or transfers a relationship or person from their past into the current or present situation unfolding between them and the therapist.  Both Jane and Freud observed how patients would project their parental figures onto them as the analyst.  The patient would thus transfer properties, characteristics, attributes, beliefs, emotions, and events onto the therapist, from their personal history.  

Much debate and discussion arose out of the discovery of transference, and whether or not the phenomenon was useful or a hindrance in therapy and psychoanalysis.  Some believed that transference needed to be worked through, and that that in of itself was the therapeutic cure.  Freud went back and forth on this issue, and ultimately landed on transference needing to be worked through.  Others still believed that transference could not be worked through, and needed to be identified and then kept out of the treatment. Some ignored it completely, and denied that it had any place in treatment.  

Within this discourse, different types of transference were acknowledged and identified, such as mirroring, idealizing, positive, and negative transferences– among countless others.  While I will not identify a full list here, I will return to the various types in other blog posts.  Though, it is important to address positive and negative transference, to help elucidate the concept further.  

Positive transference refers to any positive aspects from the patient’s past or  idealizing projections brought to bear on the therapist or analyst.  A patient might have a sense of endearment or great admiration for their father, and through transferring that onto the therapist, admire and idealize or feel endeared toward them.  The process of transference is unconscious and often happening beneath the conscious awareness of the patient, and sometimes the therapist.  Negative transference, naturally took the shape of fear, anger, aggression, or avoidance of the therapist due to transferring traumatic material from the past onto the therapist in the present.  The patient may have had a terrifying or abusive caregiver, which they then might transfer onto the therapist– especially if they detect or perceive something reminiscent of that caregiver in said therapist.  This can often lead to re-enactments within the therapeutic relationship that need to be worked through– otherwise the treatment could be compromised and the relationship or patient could be harmed.  

Transference in therapy will look different based on each individual case.  Each person brings their own unique history and wounds into the consultation room, and this history will interact with the therapist and their own history.  Thus, the pairing of the therapist and patient creates a unique expression of that transference.  An individual who had a verbally abusive parent, might perceive more disapproval in the glances and facial expressions of their therapist, and act in accordance with this perception– perhaps out of fear or seeking approval or peacekeeping.  Another person who had an emotionally distant parent, might feel threatened and forced upon when their therapist overshares about themselves, or expresses a great amount of emotion and care towards them.  Understanding transference is deep work, and it’s alchemical in nature.  

The other understanding of transference, possesses a more open character.  Rather than thinking of transferne in those more narrow terms, contemporary thinkers define transference as all conscious and unconscious behaviors, attitudes, and affects from the person’s history that are brought into the therapeutic relationship.  This can be helpful in expanding what falls within the realm of transference, and makes it easier for clinicians to be able to understand expernitally and identify within their own therapeutic work with clients.  No longer does transference reside in the unconscious past brought to bear and transferred onto the present– it includes that which lies in awareness.  The difference between the two definitions lies in the inclusion of the conscious field of the patient, as well as the openness.

I’m not here to determine which definition is correct, only that they both have their usage and place within the field of psychotherapy.  I believe the truth lies somewhere in the middle between the open and more traditional understanding of transference.  While it may be useful to open the field to include many types of reactions and behaviors within the framework of transference, to help work though it– it might also muddy the waters of what is happening between patient and therapist.  And it might be counterproductive to distinguish between positive and negative transferences, as all transference is important to work through and understand how the past is getting repeated in the present.  Regardless, transference is an important aspect of psychoanalysis and psychotherapy.  For further reading, check my recommended reading list and other blogs on the topic.  

James Nole