Using the Transference in Psychotherapy PDF
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Using the Transference in Psychotherapy Using the Transference in Psychotherapy William N. Goldstein, M.D. Samuel T. Goldberg, M.D. A JASON ARONSON BOOK ROWMAN & LITTLEFIELD PUBLISHERS, INC. Lanham • Boulder • New York • Toronto • Plymouth, UK A JASON ARONSON BOOK ROWMAN & LITTLEFIELD PUBLISHERS, INC. Published in the United States of America by Rowman & Littlefield Publishers, Inc. A wholly owned subsidiary of The Rowman & Littlefield Publishing Group, Inc. 4501 Forbes Boulevard, Suite 200, Lanham, Maryland 20706 www .rowmanlittlefield.com Estover Road Plymouth PL6 7PY United Kingdom Copyright © 2004 by Jason Aronson First paperback edition 2008 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the publisher. British Library Cataloguing in Publication Information Available Library of Congress Cataloging-in-Publication Data Goldstein, William N. Using the transference in psychotherapy I William N. Goldstein, Samuel T. Goldberg. p.cm. Includes bibliographical references and index. l. Transference (Psychotherapy) 2. Countertransference (Psychology) 3. Psychotherapy. I. Goldberg, Samuel T. II. Title. RC489.T73G653 2004 616.89'14-dc22 2004004804 ISBN-13: 978-0-7657-0511-2 (pbk.: alk. paper) ISBN-10: 0-7657-0511-7 (pbk.: alk. paper) Printed in the United States of America ~TM '<!::!J The paper used in this publication meets the minimum requirements of American National Standard for Information Sciences-Permanence of Paper for Printed Library Materials, ANSl/NISO Z39.48-1992. Contents Introduction vii Part I: Historical Overview 1 1 The Old Model of Transference 3 2 The New Model of Transference 13 3 Countertransference 21 4 The Therapeutic Alliance 29 Part II: The Transference in Psychotherapy 35 5 Transference: The Old vs. The New 37 6 The Transference in Psychotherapy 43 7 Psychoanalysis and the Continuum of Psychotherapies 49 8 Projective Identification, Enactment, and The Transference 59 Part III: Clinical Vignettes 71 9 Love for the Therapist: Analytically Oriented Psychotherapy 73 10 Mr. B and Ms. G: Dynamically Oriented Psychotherapy 85 11 A Very Classical Case of Analytically Oriented Psychotherapy 95 12 Short Vignettes of Dynamically Oriented Psychotherapy 107 v vi Contents 13 Fully Developed Transference and Its Resolution in Psychoanalysis 117 References 143 Index 149 About the Author 153 Introduction This book provides both a historical and a contemporary overview of the con cept of transference, particularly as it relates to psychotherapy. It is written es pecially for students and mental health professionals at the early stages of their careers; yet it is also meant to be a useful reference for more experienced professionals. There are two dominant themes in this book: the "old" versus the "new" models of transference, and the role of transference in psychotherapy. Regard ing the former, the traditional-or classical-view of transference, termed the "old," is contrasted with a more modem relational view of transference, termed the "new." The old model views transference as a displacement offeel ings and thoughts (and defenses against these) from the important people of childhood to a relatively neutral, anonymous, and abstinent therapist. Trans ference here is based both on the actual and fantasized past, as experienced by the patient. The new model places more emphasis on the "joint creation" of the transference by patient and therapist. Here the therapist, like the patient, is viewed as a unique individual, with his own theory of how therapy works, his own idiosyncracies, his own conflicts, his own past, and his own strengths and weaknesses, all of which contribute to the unfolding of the transference. Thus the transference is seen to be jointly constructed between the two unique indi viduals. Implicit in this model is that the therapist need not be, and in fact, can not be, neutral, abstinent, and anonymous. Instead he is free to speak more openly and to participate in a more interactive and self-disclosing way. The au thors approach the transference from both models, the old and the new. Both perspectives are seen to have merits. While some patients do better with the old model and others with the new, many patients do well with either model. These and related issues are elaborated throughout the book. vii viii Introduction Regarding the theme of the role of transference in psychotherapy, this book compares two commonly used types of insight oriented psychotherapy. These two therapies are contrasted by their focus on the transference. In one, the transference is central; in the other, the transference is peripheral. The first, termed analytically oriented psychotherapy and modeled after psychoanaly sis, looks to the formation and resolution of the transference as the primary therapeutic agent. The second, termed dynamically oriented psychotherapy, downplays the role of transference in this regard. Dynamically oriented psy chotherapy emphasizes the formation and maintenance of a positive thera peutic or working alliance, and the use of that alliance to explore and gain un derstanding into the patient's conflicts without an active exploration of the transference. The difference between these two forms of psychotherapy, in addition to their applicability, is detailed in this book. These two forms of psychotherapy are seen to occur on a continuum of psychotherapy, with the most insight oriented approaches at one end of the continuum, and the most supportive approaches at the other end. This continuum, discussed in greater detail throughout this volume, includes psychoanalysis, analytically oriented psychotherapy, modified analytically oriented psychotherapy, dynamically oriented psychotherapy, and supportive psychotherapy. As background for these dominant themes, Part I of the book provides a historical framework. Chapter 1 begins with a historical overview of trans ference from the old or classical perspective. It starts with the work of Sig mund Freud, then moves to a brief selective summary of important subse quent literature on transference from a classical perspective. Included here are Melanie Klein, Strachey, Sterba, Anna Freud, Fenichel, Greenacre, Stone, Ar low, Brenner, Gray, and Busch. Continuing with the historical overview of transference, Chapter 2 focuses on the new perspective. It begins with the work of Merton Gill, transitional figure between the old model and the new, then proceeds with a selective review of some of the recent literature regard ing the new model. Included here are the relational movement and intersub jectivity, Hoffman, Renik, Aron, Greenberg, Stolorow, and Atwood. A section on selfobject transferences is included, as well as a look at the motivational system approach of Lichtenberg. The chapter ends with a section on the rele vance of the work of Fonagy on mentalization. Chapter 3 provides a histori cal overview of countertransference, beginning with the work of Sigmund Freud and including the Balints, Fenichel, Annie Reich, Little, Winnicott, Heimann, Racker, Sandler, Gabbard, and Jacobs. Chapter 4 focuses on the therapeutic alliance and includes the work of Sigmund Freud, Sterba, Zetzel, Greenson, Stone, and Brenner. Part II, "The Transference in Psychotherapy," addresses the main themes of the book, already elaborated. Chapter 5 details the old versus the new mod- Introduction IX els of transference. Chapter 6 compares analytically oriented psychotherapy (with its focus on transference) to dynamically oriented psychotherapy (where the transference is regarded as peripheral). Chapter 7 details the con tinuum of psychotherapies already mentioned, including psychoanalysis, an alytically oriented psychotherapy, modified analytically oriented psychother apy, dynamically oriented psychotherapy, and supportive psychotherapy. The concepts of projective identification and of enactment are somewhat elusive to many. Yet, these concepts are crucial to understanding the transference ac cording to a selected group of psychotherapists. With this in mind, Chapter 8 focuses on projective identification, enactment, and the transference. Part III is the clinical section of the book. Here a number of detailed cases are provided, graphically demonstrating how transference is addressed and dealt with in psychotherapy. Cases demonstrate analytically oriented psy chotherapy, dynamically oriented psychotherapy, and psychoanalysis. Al though many of the examples are those with more classical approaches, de tailed commentary on the old versus the new models is provided. Throughout this section numerous clinical items discussed in the book are demonstrated in action.
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