

Transference In Psychotherapy: Helpful or Harmful?

Discover How Transference Is Used In Psychotherapy

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Although history has demonstrated the value of psychotherapy in a range of psychiatric disorders, comprehending how psychotherapy works is still beyond complete understanding. One currently debated topic is the use of transference in psychotherapy. Contention surrounding the concept of transference is centered on instances where a patient in therapy develops strong feelings of attraction to her therapist. These feelings, in the world of psychotherapy, are viewed as part of the healing process. However, to a patient, transference in psychotherapy can be confusing and sometimes patients are convinced that the feelings are not part of the therapy, but are sincere.

What is Transference?
Transference is characterized by the unconscious redirection of feelings from one person to another. The phenomenon happens when a patient begins to transfer feelings to their therapist, whether they are positive or negative. For example, the patient may begin to look at the therapist as if the therapist were their father, transferring feelings for their real father to their therapist.

Conversely, when the therapist transfers his or her own unconscious feelings to the patient during a therapy session, it is known as countertransference. Countertransference is also periodically used to define situations where the therapist literally takes on the suffering of his patient.

History of the Concept
The concept of transference originated with Sigmund Freud during his collaborative work with Joseph Breuer in the 19th Century. The pair worked with a patient known as Anna O while seeking treatment for patients with hysterical symptoms. Freud and Breuer believed that bringing the patient’s repressed thoughts into consciousness could cure her.
But, when Anna O embraced and kissed Breuer at the end of an analytic session, her analysis was brought to an abrupt stop. While Breuer abandoned his pursuit of psychoanalytic investigation and treatment, Freud persevered, learning from the experience and continuing his studies.

Freud eventually formulated a theory that began with Breuer’s experience, where he distinguished between positive transference of affectionate feelings and negative transference of hostile feelings. He linked those feelings to experiences that originated from early infantile experiences. Freud came to argue that the work between patient and doctor was played out almost wholly in the transference relationship. But the main use of transference with which Freud was engrossed, was its ability to make the patient’s hidden and forgotten impulses transparent and accessible to analysis.

Since then, the concept has been further developed and more recently transference has been described as a framework where the patient has fantasies and expectations of the analyst. The patient places the analyst in a varying role that may change between sessions, or even within a single session. Basically, the main characteristic of transference in the world of psychotherapy is when a patient transmits feelings to his or her therapist, which actually apply to someone in his or her present life or past.
How is Transference Used?
Transference is used in psychotherapy to help patients work through past traumas. For example, a child who has been severely abused by a parent may undergo transference by perceiving the therapist as a parent. Because the child might expect this role to be negative or harmful, recovery of abuse could be possible when the therapist does not abuse the child. Alternatively, the therapist uses the child’s transference to supply what his or her parent did not – a safe, accepting relationship.

In this case, the therapist may endure strong feelings of anger from the patient, which can be helpful to the patient because it allows him or her to express feelings that he or she could not express in an abusive setting. Expressing these feelings could give her a feeling of relief, as if she had actually confronted her own parents.

More commonly, however, transference is of a romantic nature – not limited to relationships between client and therapists of the opposite sex. Although transference is no indication of homosexuality, a patient with a same sex therapist could experience terrible confusion regarding romantic feelings toward their therapist.

Usually the role of lover is projected onto the therapist because the therapist is oftentimes the only person in a patient’s life totally invested in the patient, who also views him or her without judgment.
Although transference can create confusing and difficult feelings, discussion with the therapist can be helpful and healing, and in due course could assist in moving the patient out of the transference state into a place where those romantic feelings can be relocated back to the patient’s partner or spouse.

What is the Controversy About?
Transference is extremely controversial and debated in the world of psychotherapy. While some therapists overstate its uses, others deny its purpose altogether. Why is transference so contentious? For example, if a client has strong feelings for his or her therapist, typical psychoanalytic doctrine automatically labels the phenomenon as “transference”. Under this definition, the patient’s feelings are not really about the therapist; instead, these feelings describe how the patient feels about other people who are, or have been, significant in his or her life.

The dispute within the world of psychotherapy surrounds this question: how can anyone know whether these feelings would not have occurred outside of the patient-doctor relationship? If the patient sincerely believes that she would have fallen in love with her therapist had they met in a social setting, how could it be proved that she is wrong?

Harmful Effects of Transference
While many therapists use transference as a technique for psychotherapeutic rehabilitation, there are problems that can arise because of transference. Some therapists may transfer their own feelings onto the client – a phenomenon known as countertransference. In the realm of the doctor-patient relationship, the patient may generally do anything the therapist asks, including sexual behavior.
Transference can become an especially sensitive issue if the therapist has a dual relationship with the patient. Therapists cannot always completely avoid social relationships with their patients. In these cases, it is likely that the therapist will have patients who experience transference reactions towards them.

Transference reactions can also develop during therapy even if the therapist does not have a dual relationship with his or her client. If transference does develop, it can cause the patient to experience difficulties with other patients and therapists even after the therapy has ended.

Furthermore, when a patient and therapist have a transference relationship, the patient could cease to look upon the therapist as a safe person to talk to. He or she might begin to withhold information during a session, and if the sessions do not go well, the therapist may not have the information he or she needs in order to help correct the problem.

Transference is Normal, But be Aware
Although it is vital to recognize transference as a normal stage of therapy, if a therapist appears to reciprocate romantic feelings or attempts to initiate a sexual relationship, this therapist is no longer helpful to the patient. In fact, therapists can do considerable harm to their patient when this occurs.

However, in most cases therapists can use transference as a stage of therapy to help a patient determine a more healthy view of key relationships with romantic partners or family members. While these feelings can be confusing and difficult, especially when the patient is married and those feelings seem unfaithful or seem to conflict with marriage vows, the patient should not feel guilty for having these feelings.
It helps to remember that transference feelings are those that a person has or wishes to have with a spouse or partner. While discussion of these feelings can be awkward, these discussions can ultimately be used as an instrument to reach a healthy state of mind in respect to relationships with central people in one’s life.

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