Term Paper: Transference and Transference Love

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[. . .] According to Rockland, love transferences are almost ubiquitous. They only are seen as the products of psychotherapy or of psychoanalysis because the regressive process that is stimulated in psychoanalysis (less so in exploratory psychotherapy) "encourages increased conscious awareness of primitive, infantile transferences which are otherwise latent, though hardly inactive." He goes on to say the effects of the past are omnipresent: "We all contain within us the distorting prisms of our individual histories and internalized object images, which affect our perceptions of others." (Rockland, 1989; 104)

Rockland claims that there are three types of transference; the 'unobjectionable positive transference,' the 'mildly and moderately libidinized, positive transferences,' and 'the idealized, positive transference.' The first of these has been called 'mature transference' (Stone, 1961), and more recently has been thought of alongside the concept of a therapeutic alliance, or working alliance. However, even the unobjectionable positive transference have some libidinal and aggressive aspects. This is one reason why transference can be thought of as a form of love.

Moderately libidinized transferences, according to Rockland, are usually left untouched in supportive psychotherapy. They are powerful motivating factors in the relationship, underscoring both positive regard for the therapist and a wish to gain his or her love, or to emulate him or her. Such transferences are the most simmilar to conventional love, and provide the most effective motivation for catalytic change in psychotherapy; Rockland notes that they are particularly important in supportive psychotherapy. (Rockland, 1989; 106)

Such therapy consciously promotes this kind of transference; both unobjectionalbe and mildly libidinized transference are encouraged. For instance, if the patient is upset at the therapist, the therapist will ask 'what did I do to make you upset' instead of 'why do you feel upset,' as would an exploratory therapist. Such a relationship would have to be fostered in adherence with the strictest ethical standards; to encourage a patient to love her therapist is good for the therapist in that the patient is more receptive, however it is also good for the therapist in that it insures that the patient will continue to patronize his or her business. Rockland believes that such a relationship could be encouraged because: "respect for the therapist, admiration of the therapist, the feeling that the therapist is intelligent, skillful, and motivated to help the patient are all aspects of the mildly to moderately libidinized positive transferences that both keep the treatment going and give the therapist the ability to influence the patient and his or her behaviors." (Rockland, 1989: 107)

An extreme varient of transference exists in what Rockland calls "The idealizing positive transference." In this example, the patient idealizes the therapist. This is unacceptable in that it shifts the patient's locus of control to the therapist from him or herself. If the patient is prone to such actions, this is a problem in and of itself and counter-transferrance must be employed in order to break this compulsive behavior. As this is the product of the patient's history and attempt to use the psychoanalyst to fill pre-ordained roles, such an idealization can only result in failure as the psychoanalyst fails to fulfill those roles. Additionally, it can cause the patient to experience difficulty in his or her outside life. At such a point, transferrance becomes obsessive and is probably indicative of other obsessive behavior demonstrated by a patient.

To over-ride such notions, the therapist must instruct the patient to clarify what he or she thinks and feels and confront the patient with the nature of the therapeutic relationship and the therapist as a practitioner of psychoanalysis. The therapist then contextualizes the idealization by providing other examples of the patient's obsessive-compulsive behavior. The therapist might then illustrate how he or she isn't an example of the fantastic ideal that the patient has constructed.

Conventional psychology maintains that such dissociations are of immediate necessity when the patient makes the analyst an object of his or her sexual affections. This erotic transference is an attempt to turn a clinical relationship into an intimate and personal one, which undermines the therapist's ability to offer objective and proactive criticism. Although mild expressions can be ignored, consistent erotic transferences are corrosive and few analysts would be able to consistently operate in such an environment, as it tends to lead to the subjectification of the patient's problems.

Such transference can be responded to in the same manner as any idealization of the therapist, as it may result in enmity if it is not confronted. As with general idealistic notions, the patient must be guided to see these emotions in the perspective of his or her general experience with relationships. Parallels are drawn to simmilar instances in other professional relationships that the patient may have had. Erotic transferences may be common in histrionic or borderline patients who are prone to dramatic mood swings that characterize all of their relationships. Rappaport (1956), Blum 1994), Bolognini (1994), and others have also established several categories of transference-love, ranging from affection to perverse hostility. Three examples of transference which most resemble love are erotic, eroticized, and sexualized transference.

The erotic variant evokes the parent/child relationship and it is capable of recognizing the "as if" element described by Rockland that can eventually be referred back to the internal world of the patient. The eroticized transference mostly applies to borderline personalities; in such situations the therapist is idealized and also seen as persecuting. Such usually results in resistance and therapeutic goals are quickly sabotaged. A patient exhibiting sexualized may not only sabotage the treatment process but also attack the therapist, resulting in counter-transference. This is part of the reason why borderline patients are often referred to specialists. Sometimes it is possible for a patient to explore erotic love for the psychologist and also his or her feelings of jealousy and exclusion, and eventually to become aware of the true nature of the therapist's role.

Sue Johnson comments, "It is of the essence of the psychoanalytic process that transference-love in its erotic form should "undergo a transformation." In any of its manifestations -- be it compliance, hostility, seduction, identification -- it will always require that patient and therapist should go through the labours of maturation and mourning; and it is the therapist who must remain alert to the many vicissitudes. (Johnson, 1999: 149)

Some unconventional psychoanalysts use love as a form of therapy. Florence Rosiello, in Deepening Intimacy in Psychotherapy (1995) maintains that erotic love can be especially therapeutic in that many patients can only be healed through experiencing love. Mrs. Rosiello uses a variety of clinical examples to express her early experience with patients who developed erotic transference. Particularly of interest to her were the terminally ill, in that she found that terminally ill patients needed to feel loved in order to help them survive. Rosiello claims that her experience with AIDS patients "altered my understanding and clinical use of erotic dynamics between patients and therapist and began to view sexuality from a theoretical perspective that focused more on mutuality, including mutual emotional risk between patients and therapist." (http://www.florencerosiello.com/book.htm) McCartney (1966), was the best-known advocate of sexual relationship with patients, although such relationships were demonized as harmful to patients (Boas 1966; Marmor 1972b). McCartney quotes Boss's reasoning:

The female analysand begins to love the male analyst as soon as she becomes aware that she has found someone for the first time in her life who really understands her and who accepts her even though she is neurotic. She loves him all the more because the analyst permits her to fully unfold her real emotions within the safe relationship of the transference." In none of his writing does Boss put a limit on the extent to which the analysand should be allowed to go on expressing her needs.... I have found that 10 to 30% require some overt expression.... These patients not only want to think or talk about their relationship to the analyst, but also want to experience the newly discovered possibilities in the language of their emotions, as expressed by the body... (McCartney, 1966:228-29).

This contrasts completely with Freud's more apollonian approach to therapy; by engaging in a compassionate or actively erotic relationship with a patient, the nature of therapy changes altogether. Freud prescribed the use of 'sex surrogates,' which allows therapists to treat patients with sexual dysfunctions with a degree of relative objectivity.

In 1915 Freud wrote, in "Observations on Transference Love," "...Analytic technique requires of the physician that he should deny to the patient who is craving for love the satisfaction she demands. The treatment must be carried out in abstinence. By this I do not mean physical abstinence alone, nor yet the deprivation of everything that the patient desires, for no sick person could tolerate this. Instead, I shall state it as a fundamental principle that the patient's need and longing should be allowed to persist in her, in order that they may serve as forces impelling her to do work and to… [END OF PREVIEW]

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