Shirah Vollmer MD

The Musings of Dr. Vollmer

Idealizing Transference

Posted by Dr. Vollmer on January 22, 2013

 

“This (idealizing) transference expresses the need for a calm, strong, wise and reliable therapist whose ‘properties’ and presence can be made use of by the patient in order to foster of sense of safety, self-esteem, and well being; self-worth and value are enhanced in the glow of the idealizing transference,” says Mark Thompson MD and Candace Cotlove MD in their book entitled “The Therapeutic Process”.   Becky, forty-four, a psychiatrist, glows when she speaks about her therapist, Doctor Holzberg. Her tone makes me think that she is speaking of a passionate love relationship, but she will tell you that she loves her husband and her three children very much and she did not seek psychotherapy because she was feeling unloved or unloveable. Becky, also known as Dr. S. has seen Dr. H. for over three years and she has yet to feel she has had a difficult session or a disappointment. “Could you be idealizing him?” I ask Becky, in casual conversation, as it is hard for me to believe that any psychiatrist, any psychotherapist,  does not present frustrations and grievances during the course of a treatment.  Becky is not sure, but she responds astutely. “Idealization prevents further growth, so if I am, then I have a pretty shallow relationship with him,” she says, hitting my point head on. Glowing reports about a psychotherapist are always suspect, given that too positive a point of view might suggest that the narcissism in the therapist does not allow for the relationship to have its fair share of interpersonal struggles and minor ruptures. It is through these struggles that relationships deepen and people grow internally. The trained ear tries to separate the need for the “perfect therapist” from the “good enough” therapist who provides support and trust, within the framework of divergent points of view. The “perfect therapist” may have too high of a need to be loved to allow for enough discourse. Given that, it is hard to plunge into therapy, as too great an endorsement may suggest a very self-centered therapist. The layers of meaning are endless. Diving in takes great courage.

6 Responses to “Idealizing Transference”

  1. Jon said

    Idealization can be understood as a limit of perfection of ideals. Thus, there can be many ways of simplifying the messy real world into ideals – be it an ideal gas from physical chemistry or an ideal or perfect therapist in psychotherapy. In physical chemistry the ideal gas is a very useful first step in understanding the behavior of real gasses. In psychotherapy, the ideal therapist can be seen as someone who captures the therapeutic process to the tee. That said, in engineering, a standard concept is that better unnecessary in the light of good enough. This implies that it is not worth the resources to make something better than something that can do the job as is. Here the situation is even deeper, as a better therapist may indeed not be ideal but one that instigates the “struggles that relationships deepen and (let) people grow internally.” Indeed the layers of meaning are many.

    • Shirah said

      Thanks, Jon. You nailed it. Engineers get the job done, with “good enough” resources. There is a place for idealization, on the road to acceptance of human foibles. As with science, the ideals teach us a lot, but we need the engineers to get us going at a reasonable cost. Limitations need to be acknowledged, no matter what realm we are talking about.

  2. Shelly said

    I have to disagree with you. A perfect therapist, from a patient’s point of view, would be one that a patient would feel most comfortable with and feels is best helping him or her. The therapist is not necessarily narcissistic in that the patient feels a perfect fit with the therapist, that he or she understands the inner world of the patient and is in sync with the angst and nuances of daily life for the patient. I don’t really think it has anything to do with the ego of the therapist at all, nor idealizing the therapist or the relationship one has with him or her. It has to everything to do with the process one has with the therapist and the work one is doing together. I realize that many times the patient, in his need to feel loved or lovable, may ‘stroke’ the ego of the therapist and may say, “You are the perfect therapist,” whereby the therapist is highly flattered and feels good about himself and the patient is rewarded with a closer, more binding “loving relationship” with the therapist. However I would hope that in real life the therapist would recognize that the patient is really saying, “We have such a good and fulfilling therapeutic relationship.”

    • Shirah said

      I am not sure we disagree, Shelly. Some therapists deal with the “idealization” in a way which seasons the feeling with a sense of humility and a watchful eye, whereas other therapists take this “idealization” to stroke their own egos and thereby inhibit further internal development in the patient. The issue is not that idealization is a problem, but rather the issue is how long that phase lasts. As therapy recapitulates development in many ways, children need to idealize their parents, but come adolescence, they need to get a more realistic view of them in order to separate and become their own person. As parents need to allow this to happen, so do therapists.

      • Shelly said

        Does transference have to happen? Is this a part of the therapeutic process? What if it never comes about?

        • Shirah said

          Transference is ubiquitous as past is always layered under the present. Whether it is part of the therapeutic process is a decision that the therapist makes. If it is never discussed, deep work can still happen, but one might argue that the “holy grail” of deep work is missing. Thanks.

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