I’ve been spending a lot of time over on Shrink Rap these days – they have some great stuff if you get a moment to check it out. What drew me back again was a post that I read a few weeks back on transference and its role in the therapeutic relationship. Many approaches to therapy view transference as an important part of the process; others do not. It’s come a long way since Freud and the focus on erotic transference – now it may include the full range of client reactions to the therapist that reflect prior relationship experiences.
To acknowledge the existence of transference, I think you have to acknowledge the healing power of the therapeutic relationship as well. I mentioned this idea in the post on unconditional love. And I’m not just talking about the general lift in mood that comes from having someone listen empathically for an hour each week; while this is certainly important, I feel like there’s a lot of value in taking it to another level and purposefully using the relationship between therapist and client as a tool.
Dinah from Shrink Rap questions this approach. She says:
My sense is that for the average patient with a psychiatric problem, focusing on the therapeutic relationship in a major way probably does not make people better. I don’t usually do it, and people still seem to heal.
I agree with her thought that misdirected focus on transference can be narcissistic on the part of the therapist and unhelpful for the client. And I have certainly seen clients heal without relationship-heavy therapy. I’ve also had the experience of it being very powerful to use the therapeutic relationship as a live, “in-the-moment” experience of a client’s difficulties. An example that comes to mind is the fearful or anxious “people pleaser” client who gets walked all over. Before long the tendency to please will show up in the therapeutic relationship, maybe by scheduling at a time that’s not convenient for the client. I may say to a client, “I get the sense right now that you’re putting my needs ahead of your own, which sounds familiar. I’m aware that it makes me unsure of whether you’re being genuine, which keeps me from totally trusting you…and I bet others in your life might be reacting the same way. Let’s see what may be pulling you to do that.” By working with these issues in a (hopefully) safe therapeutic relationship, clients can have a healing experience that often can’t happen in unsafe “real world” relationships.
I’ll admit that I tend to view client issues as rooted in relationship, so it’s easy for me to sing the praises of relationhip-based interventions. That said, there’s some very interesting stuff (see work by Louis Cozolino, Daniel Siegel, and many others) coming out these days on the neurobiology of attachment, the impact of early relationship wounds on our developing brains, and the possibilities for healing them through a healthy relationship. At the risk of sounding like a psycho-geek, it’s kind of exciting 🙂
I’d be interested to hear from therapists and clients alike who’ve had experience with transference (and counter-transference) in therapy.
Happy early Thanksgiving,