Distortion is another word for transference in that we mis-read social cues based on past experiences and not based on current interactions. Barb comes to mind again. She is the 50ish year old woman who suffers from always feeling persecuted and treated poorly. She tells me that I “make her go to her appointments with me,” as if somehow I have that power over her. Her issue is that she attributes to me, as an authority figure, the power to condemn her if she does not coöperate. She fails to see that it is her decision to be in treatment, and it is her decision to stop or decrease the number of our sessions. How she managed to recreate her experience of feeling persecuted with me, is how Freud described this phenomena called transference. At first, he saw it as an obstacle to treatment, but over time, he came to “discover” that understanding the transference was the holy grail of treatment. In other words, if I can help Barb see how she makes her world play out such that she always feels boxed in, then I can help expand her mind such that she can see the situation in new and meaningful ways. Eventually, I believe, Barb will see me as someone who offers her a safe space to examine the inner workings of her mind, but for now, I am another persecutory figure who makes her life feel frustrating and that results in chronic feelings of anger. As we examine this repetition of feeling which occurs in my office, we can begin to understand how she unconsciously makes her life such that she feels she is a slave to other people, a repetition of childhood feelings of being a slave to her mother. As Freud said, we repeat in order not to remember, and so with Barb, understanding this repetition will take a great deal of time, because remembering her childhood feelings is going to feel deeply sad and despairing. The safety of our relationship allows for those feelings to bubble up, but it will still take time and care, on both of our parts, for her to allow herself to get there. Transference is a simple concept, but in the therapy room, it is complicated by very challenging feelings. Still, privileging the transference as the key to therapeutic gain is the concept, we, as mental health professionals, must hold on to, as this is where we need to guide treatment for psychic pain. I never tire of saying this, as the importance cannot be overstated.