Therapist as teacher

This essay will chart the course of the development of a psychoanalytic technique known as transference. Transference, in classical Freudian psychoanalysis, will be defined and explained in relation to other psychoanalytic phenomena, particularly repression and resistance. The relevance of transference as a therapeutic tool will then be discussed in accompaniment to answering the question “Why interpret transference?” Lastly, an overview of the fostering of transference within contemporary psychoanalysis will be provided as well as a short analysis of transference in cyberspace.

The rejection of hypnosis and the adoption of free association In 1895, Breuer and Freud published ‘Studies on Hysteria’, which compiled several important case studies the colleagues had developed through their analytic work. For both doctors, this book marked an important move away from hypnosis, which had begun to prove itself as an unreliable tool within analysis (Freud, 1910).

It was Breuer’s patient, Anna O., who contributed to the development of ‘the talking cure’ or ‘chimney sweeping’, both terms that she herself had invented (Freud, 1910; Breger,2000). This procedure aided the removal of hysterical symptoms by the patient’s ability to describe the event, which was connected to the onset of hysteria, ‘in the greatest possible detail’ (Breuer and Freud,1893-1905).

“Bertha was a woman of great intelligence and creativity, and she was a genuine collaborator in the invention of psychotherapy…Breuer, who had no taste for the role of authority, was open to this collaboration and he gave her the credit as co-inventor of the cathartic method” (Breger, p.105). Freud, however, who took precedence in choosing names for his younger brother and his own children (Breger,2000), adopted the technique, made it his own and called it ‘free association’.

Therapist as teacher

Psychoanalysis is a causal therapy that, as it’s mode of attack, employs techniques that remove causes rather than symptoms (Freud, 1916-7). Using the technique of free association, the therapist interprets, discovers and communicates the material within the patient’s unconscious to the patient’s conscious. Once the patient is conscious of the cause of these neurotic symptoms, they can actively begin to resolve the conflict.

The analyst must discover and show the patient how to make what is unconscious become conscious. The analyst’s knowledge of the patient’s unconscious is not equal to the patient’s. Freud advises that the analyst’s knowledge must run beside the patient’s rather than acting as a replacement. To explain this interaction between roles, Freud uses the metaphor of a student looking through a microscope, who can only see and, therefore, make sense of what is there with the help of the teacher’s guidance and rules. At first, the patient is either an eager student, who accepts and follows the principles of psychoanalysis, or a hostile subject, who rejects the therapist’s interpretations and advice.

Freud does describe a third type of ‘student’, that who is indifferent to the process of analysis. Freud identifies the third type as paranoics, melancholics or sufferers of dementia praecox, these are ‘narcissistic neuroses’ and remain unaffected by psychoanalytic procedures. Psychoanalysis does have the potential to cure those subjects who have developed hysteria, anxiety hysteria or obsessional neurosis. These three illnesses are termed as ‘transference neuroses’ because, according to Freud, they are susceptible to transference (Freud, 1916-7).

Transference: a therapeutic tool Freud learned from his colleague that within the ‘talking cure’, Anna. O had developed “powerful feeling and wishes” (Esman, 1990, p.3) toward Breuer. Anna. O had claimed she was pregnant with Breuer’s child and though this revelation had caused Breuer himself much distress (Freud,1935; Breger,2000) Freud began to review the incident as an aid to the therapeutic treatment, “Psychoanalytic treatment does not create transferences, it merely brings them to light like so many other hidden psychical factors” (Freud, 1905, p.117, emphasis in original).

Freud stressed that these feelings are a spontaneous product of the analytic situation and placed ultimate importance on the analyst’s ability to ‘manage’ this phenomenon, lest it should destroy the treatment (Freud, 1912). Freud believed that as the unconscious material is made conscious, there is a revival of the original pathogenic conflict and “…the libido (whether wholly or in part) has entered on a regressive course” (Freud, 1912) due to unsatisfied libidinal impulses (Strachey, 1990).

The nature of the analysis must then be one of detection; the libido must be exposed from its place of hiding. This is not an easy task and the forces, which originally caused the libido to regress, now strongly resist the work of the analysis. Instead of remembering, the patient follows a path of repetition and begins to ‘act out’ the old conflict within the present situation. Freud states that the illness must be treated “… not as an event of the past, but as a present-day force” (Freud, 1914, p.151).

The patient remembers the old conflict by repeating or ‘acting out’ within the therapeutic situation, transferring infantile feelings linked to the past onto the analyst. Through the figure of the doctor, the patient’s libidinal anticipatory ideas, socially unacceptable unconscious wishes and desires, can achieve cathexis (Freud, 1912). With resistance, there may come a period of deterioration as “new and deeper-lying instinctual impulses” (Freud, 1914,p.153) come to the fore. The analyst must awaken the patient from his state of repetition by uncovering and exposing the resistance and, therefore, eliminating the transference since “…the part transference plays in the treatment can only be explained if we enter into its relations with resistance” (Freud,1912).

The transference allows for an artificial illness, called ‘transference neurosis’, to replace the original illness and in this way, the therapist can access and revise the original and unsuccessful method, which was used to deal with the libido’s rejection of reality. Freud argued that this transference of feelings, which he owed to the patient, could ‘facilitate’ the therapeutic process if they are interpreted rather than ignored or rejected (Freud,1912).

The analyst must distinguish whether feelings are affectionate or hostile in nature. The dyadic nature of transference calls for two separate processes of interpretation. Affectionate behaviour is classed as positive transference and hostile behaviour as negative transference. Positive transference occurs when the patient …

“Breuer went on to extend this therapy. At one point in her illness, for a period of weeks, Anna O. declined to drink and would quench her thirst with fruit and melons. One evening, in a state of self-induced hypnosis, …

In psychoanalysis a therapist would have a patient lie on a couch, relax and talk freely about their past, childhood, dreams, personal experiences and memories that they feel are affecting them while the therapist takes notes and tries to interpret …

Paul Briquet introduced one concept in his work, Traite de l’Hysterie that was published in 1859. “Briquet regarded hysteria as a “Neurosis of the Brain” in which a variety of unpleasant environmental events acted upon the “affective part of the …

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