Shirah Vollmer MD

The Musings of Dr. Vollmer

Re-Posting: Analyzing The Transference: Critical or Over-stated?

Posted by Dr. Vollmer on July 18, 2013

“The ability to understand and handle transference is perhaps the single most important aspect of psychodynamic psychotherapy, and the subject that separates the truly skillful therapist from the adequate therapist,” says my local colleagues Drs. Thompson and Cotlove in their book, “The Therapeutic Process,” which by now, many of my readers have probably guessed,  I am reading in an effort to begin teaching my class tonight on psychoanalytic technique. With all due respect to my esteemed colleagues, this sentence disturbs me greatly. Understanding how the past impacts the present is the basis of psychodynamic psychotherapy. Transference is an inherent aspect of that inquiry. However, I do not think that one can identify any specific understanding which separates out the “skillful therapist from the adequate therapist.” Therapists have different skills to offer different patients. Each dyad brings out different material which, in turn, creates a different therapeutic process. The complicated nature of the patient/therapist relationship does not lend itself to focusing in on one aspect of the relationship. At the same time, I do agree that shedding light on issues in which past important and critical relationships are interfering with the present relationship may save a therapeutic relationship which is otherwise about to fail. These “transference interpretations” are what some colleagues call “high risk, high gain comments,” since they could make the patient feel humiliated in that they are repeating a past abusive relationship with their therapist, or it could make the patient develop deep insights into why difficult relationships are a pattern for them. I have a new class tonight. I hope I can make this distinction in a clear and meaningful way. The adage that if one wants to really learn, then one should teach, might be true. However, and I know I am a skeptic, I think that also depends on the students. Easily stated phrases always make me question. Our need for simplicity must fight with our desire to explore complexity. Exploring complexity wins when the stress is not too great. I hope my students will agree.

6 Responses to “Re-Posting: Analyzing The Transference: Critical or Over-stated?”

  1. Jon said

    Again, Shirah, your posts have me wax technical, or perhaps allow me the innate tendency to wax technical.

    Your phrase, “I think that also depends on the students” could be translated as a dependence on the “impedance match” between teacher and student. How well does the style with which you teach mesh with the way a particular student can learn? If the mesh is good, there is a good impedance match; if the mesh is not so good….

    “Easily stated phrases always make me question,” brings to mind a quote attributed to Einstein commonly given as “Everything should be made as simple as possible, but no simpler.” The phrases that you find easily stated may indeed be too simple. Indeed, this is really a simpler quote than what he actually said. The true quote of Einstein was a bit more complicated. On June 10, 1933 he stated in Oxford, “It can scarcely be denied that the supreme goal of all theory is to make the irreducible basic elements as simple and as few as possible without having to surrender the adequate representation of a single datum of experience.”

    All that said, I wish you the best of luck with tonight’s teaching. With luck it will be both rewarding and fun for all.

    • Shirah said

      You made me smile. You also bring up a theoretical gene, that which causes people, such as yourself to “wax technical”. Yes, simplicity is a good thing, provided it does not deny all of the complexities. Thanks.

  2. Shelly said

    Interesting. You state, “These “transference interpretations” are what some colleagues call “high risk, high gain comments,” since they could make the patient feel humiliated in that they are repeating a past abusive relationship with their therapist, or it could make the patient develop deep insights into why difficult relationships are a pattern for them.” What if a patient has difficulty with one particular therapist but not with others? Would you say that the issues deal with this patient’s relationship with his/her parents or with the therapist himself? Did transferrence simply not occur? In other words, could it be simply, that some therapists are less skilled in what they do and others are more skilled?

    • Shirah said

      If the patient has difficulty with one particular therapist and not with others, then there are two possibilities. One, is that the “difficult” therapist is stimulating important issues in the patient, or the “difficult” therapist is the wrong fit for the patient. Time helps to make this decision, as if relationships deepen, it is usually a good sign that although “difficult” the work is moving forward. Certainly, there is a range of skill level between therapists, and there is a range of skill level within an individual therapist. That is, therapists, generally speaking, get more skillful with more time doing psychotherapy, along with more life experience. Also, each patient “demands” a different skill set, so a skilled therapist for one person, may lack the necessary skills for another. Hence, choosing a therapist is a nearly impossible job, but one has to make the best decision possible, under very cloudy circumstances. Like dating, one has to rely on one’s gut instincts, which is complicated, because it is those gut instincts which may have got that person into trouble. This, is clearly, a subject for a future post. Thanks.

  3. Sunflower said

    “Our need for simplicity must fight with our desire to explore complexity.” What a powerful statement.

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