Transference and countertransference are two fundamental terms in psychoanalysis. They are foundational in clinical practice and while they are two different concepts, transference and countertransference are clearly inseparable.
The patient-analyst interaction turns into in a space where the unconscious is allowed to circulate as freely as possible. This is where dynamics between the patient and the analyst can create transference and countertransference.
What is transference?
The term transference is not exclusive to psychoanalysis. It alludes to the idea of displacement or substitution of one place for another. You can see it in a doctor-patient or student-teacher relationship.
As for psychoanalysis, it is understood as recreating childhood fantasies, which will help the analyst diagnose potential problems. Transference means that a person superimposes something previous onto something current, with the goal of healing.
In the beginning, Freud considered transference as a huge obstacle in the therapeutic process. He considered it to be the patient resisting access to his unconscious thoughts and feelings. However, it didn’t take him long to realize that his role transcended that resistance.
This is how Freud describes transference as a paradoxical phenomenon in his 1912 paper Dynamics of Transference. Despite the fact it can be a source of resistance, it is fundamental for an analyst. He differentiates the positive type of transference — tenderness and love — from negative transference, which is full of hostile and aggressive feelings.
Contributions from other psychoanalysts on the concept of transference
After Freud, many papers have been written on the topic of transference. They’ve rethought the whole subject, at the same time comparing it to the original development of the phenomenon. They all agree that it is what happens in the relationship between the analyst and the patient during therapy.
According to Melanie Klein, it is a re-enactment of the patient’s unconscious fantasies. During analysis, the patient will evoke his psychic reality. He will use the analyst to relive unconscious fantasies.
According to Donald Woods Winnicott, the phenomenon of transference in analysis can be understood as a replica of the maternal bond. Hence the need to abandon strict neutrality. The way patients use the analyst as a transitional object gives another dimension to transference and interpretation. This is described in his 1969 paper “The use of an object“. Here he affirms that the patient needs the therapeutic link to reaffirm his existence.
As we said, the transfer has to do with the recreation of childhood fantasies by using the figure of the analyst. For this to happen, they must establish a transferential link.
To create the link, the patient first accepts his desire to work on what’s happening to him, then he meets with an analyst who is supposed to know something about what is happening to him. Lacan called him “Subject Supposed to Know“. This is how they reach first level of trust in the relationship, which will then pave the way for analysis.
However, on this journey there may be issues the analyst should be aware of and react to in a timely manner. The patient may show signs of falling in love with the therapist. They may make regular checks as to how attractive they are, and turn the analyst into their lover.
They may also fall into the trap of obeying the therapist unquestioningly. Another thing to watch out for are quick improvements without putting any work in. There are more subtle signs too, such as frequently being late to appointments or talking about other professionals too much.
Of course, the issues aren’t always just on the patient’s side. There may also be countertransferential manifestations. The analyst also has to be attentive to and to analyze himself. If the analyst starts to argue with the patient or have impulses to ask for favors, they should be very careful.
The analyst may start to dream about the patient and take excessive interest in them. Not keeping proper distance or and having intense emotional reactions related to the patient are also signs of danger.
What is countertransference?
Freud introduced the term countertransference in his 1910 paper “The future perspectives of psychoanalytic therapy“. He describes it as the analyst’s emotional response to stimuli that come from the patient. This emotional response is a result of its impact on the analyst’s unconscious feelings.
The analyst must be alert to it because they may become an obstacle to healing. Others, however, argue that everything felt in countertransference — the things that have nothing to do with the analyst — can be returned to the patient.
It may be that the feelings that the patient arouses in the analyst, after returning to the patient, generate greater awareness or understanding of what’s happening in the therapeutic relationship. It could be something that the patient hadn’t articulated until that moment.
For example, if the patient is reliving a childhood scene, the analyst may begin to feel sad. However, the patient could interpret it as rage. If the analyst then returns what he is feeling to the patient, then the patient can connect to the real emotion hidden behind the anger.
Relationship between transference and countertransference
On the one hand, we can define countertransference by its direction: the feelings of the analyst towards the patient. On the other hand, we can define it as a balance that serves as proof that a person’s reaction is not independent of what they receive from the other person. In this way, countertransference is related to what occurs in transference, and one influences the other.
Therefore, countertransference can be an obstacle if the analyst acts on it. He may let his feelings towards the patient carry him away — love, hate, rejection, anger, etc. In this case he would have broken the law of abstinence and neutrality that he should be abiding by. Instead of helping, he would be harming.
The patient tries to communicate his experiences. The analyst should only respond to what the patient says, not letting his own emotions influence what he says. The patient relives the fantasies and acts them out. He doesn’t do it consciously though, and that’s why interpretation plays a fundamental role in healing.
Functions of transference and countertransference
Analysis presupposes a transferential link from patient to analyst. This link between transference and countertransference is where emotions, unconscious desires, tolerances and intolerances will emerge.
Out of this transference relationship, the analyst will be able to make the necessary interventions. These may be interpretations, accusations, or ending the session. A transferential link is crucial to thorough analysis.
In the analytical relationship, the analyst must remain rigorously neutral. They must listen without letting their own emotions and life story affect things. The analyst has to become a kind of blank slate onto which the patient can transfer their unconscious thoughts and feelings.