27TH CONFERENCE: THE TRANSFER (398-406)
Sigmund Freud (1917)
Summary:
In a number of forms of neuroses such as hysterias, states of anguish, and obsessive neuroses, psychoanalysis has shown succe ss
in addressing repression, uncovering resistances, and making the unconscious conscious. This process involves an internal struggle
between old repressive motives and new ones that seek to resolve the conflict in favor of the patient.
However, there are other forms of illness, such as paranoia, melancholy, and dementia praecox, where these techniques fail to
eliminate resistance or reverse repression. Despite the intellectual capacity of these patients, something in their psyche seems
immune to psychoanalytic treatment, raising doubts about the necessary conditions for therapeutic success in each case.
As we continue to deal with our hysterical and neurotic obsessives, we soon encounter a second startling fact for which we were
not prepared. Over time, we notice that these patients behave in a particular way towards us. Despite having calculated all the
driving forces involved in the cure, something unevaluated seems to have seeped into that calculation. This new, unexpected
element manifests itself in several ways, which I will describe below.
This new and unexpected phenomenon is multifaceted, but I will first describe its most frequent and understandable forms of
manifestation.
We noticed that the patient, initially focused on finding a way out of his pathological conflicts, develops a particular interest in the
person of the doctor. For a while, the treatment of the patient is very pleasant, and shows gratitude and courtesy, whi ch creates a
favorable opinion of the doctor. However, this positive period does not last indefinitely.
At one point, the patient begins to show a lack of interest in the treatment and difficulty following directions. This sugges ts a
resistance that hinders therapeutic progress. In investigating the cause of this disturbance, we discovered that the patient has
transferred intense feelings of tenderness to the physician, which go beyond what is justified by the therapeutic relationshi p.
How this tenderness manifests itself and the goals it pursues depend on the individual circumstances of both participants. Fo r
example, if the patient is a young woman and the doctor is a young man, it may seem like a normal crush. However, this situation
may conceal an underlying disturbance in the patient's capacity to love.
On the other hand, even in cases where there is no obvious attraction, some married or single patients manifest an intense passion
for the doctor, believing that only through love can they heal. This confession surprises the medical team and raises questio ns
about whether crucial aspects of the therapeutic approach have been overlooked.
As we immerse ourselves in experience, it becomes increasingly difficult to deny this shameful amendment to our scientific ri gor.
What may initially seem like a contingent obstacle, alien to the purposes of analytic cure, reveals itself as a recurrent phenomenon
deeply rooted in the very nature of the disease.
We identify this phenomenon as transference, which consists of the projection of feelings onto the person of the doctor, alth ough
we do not consider that the therapeutic dynamics justify its emergence. Rather, we believe that these affections were latent in the
patient and were transferred to the physician during treatment. Transference can manifest as an intense claim for love or in more
attenuated forms, such as the desire to be accepted paternally or the pursuit of an idealized friendship.
Transfer is not limited to female patients; It is also observed in male patients, with similar intense ties with the doctor and
tendencies towards overvaluing their qualities. In the case of men, the manifestations of transference tend to be more subtle, with
a higher prevalence of sublimated forms and fewer direct sexual demands. In some cases, transference can even manifest itself in
hostile or negative ways, which may initially be surprising, but reflects the complexity of this phenomenon.
Let us clarify that transference arises from the beginning of the treatment and for a time powerfully drives the therapeutic work.
While this transference works in favor of analysis, we do not need to pay attention to it. If, however, it becomes resistance, we
must recognize that it modifies the relationship to healing under two opposite conditions: when tender feelings are so eviden t
that they generate an inner resistance, and when they manifest as hostile rather than tender emotions.
Importantly, transference, whether tender or hostile, poses an initial threat to the cure, but it can become your best instru ment.
We overcome transference by demonstrating to the patient that his or her feelings do not originate in the present situation o r are
1
Made by MatyBuda
Sigmund Freud (1917)
Summary:
In a number of forms of neuroses such as hysterias, states of anguish, and obsessive neuroses, psychoanalysis has shown succe ss
in addressing repression, uncovering resistances, and making the unconscious conscious. This process involves an internal struggle
between old repressive motives and new ones that seek to resolve the conflict in favor of the patient.
However, there are other forms of illness, such as paranoia, melancholy, and dementia praecox, where these techniques fail to
eliminate resistance or reverse repression. Despite the intellectual capacity of these patients, something in their psyche seems
immune to psychoanalytic treatment, raising doubts about the necessary conditions for therapeutic success in each case.
As we continue to deal with our hysterical and neurotic obsessives, we soon encounter a second startling fact for which we were
not prepared. Over time, we notice that these patients behave in a particular way towards us. Despite having calculated all the
driving forces involved in the cure, something unevaluated seems to have seeped into that calculation. This new, unexpected
element manifests itself in several ways, which I will describe below.
This new and unexpected phenomenon is multifaceted, but I will first describe its most frequent and understandable forms of
manifestation.
We noticed that the patient, initially focused on finding a way out of his pathological conflicts, develops a particular interest in the
person of the doctor. For a while, the treatment of the patient is very pleasant, and shows gratitude and courtesy, whi ch creates a
favorable opinion of the doctor. However, this positive period does not last indefinitely.
At one point, the patient begins to show a lack of interest in the treatment and difficulty following directions. This sugges ts a
resistance that hinders therapeutic progress. In investigating the cause of this disturbance, we discovered that the patient has
transferred intense feelings of tenderness to the physician, which go beyond what is justified by the therapeutic relationshi p.
How this tenderness manifests itself and the goals it pursues depend on the individual circumstances of both participants. Fo r
example, if the patient is a young woman and the doctor is a young man, it may seem like a normal crush. However, this situation
may conceal an underlying disturbance in the patient's capacity to love.
On the other hand, even in cases where there is no obvious attraction, some married or single patients manifest an intense passion
for the doctor, believing that only through love can they heal. This confession surprises the medical team and raises questio ns
about whether crucial aspects of the therapeutic approach have been overlooked.
As we immerse ourselves in experience, it becomes increasingly difficult to deny this shameful amendment to our scientific ri gor.
What may initially seem like a contingent obstacle, alien to the purposes of analytic cure, reveals itself as a recurrent phenomenon
deeply rooted in the very nature of the disease.
We identify this phenomenon as transference, which consists of the projection of feelings onto the person of the doctor, alth ough
we do not consider that the therapeutic dynamics justify its emergence. Rather, we believe that these affections were latent in the
patient and were transferred to the physician during treatment. Transference can manifest as an intense claim for love or in more
attenuated forms, such as the desire to be accepted paternally or the pursuit of an idealized friendship.
Transfer is not limited to female patients; It is also observed in male patients, with similar intense ties with the doctor and
tendencies towards overvaluing their qualities. In the case of men, the manifestations of transference tend to be more subtle, with
a higher prevalence of sublimated forms and fewer direct sexual demands. In some cases, transference can even manifest itself in
hostile or negative ways, which may initially be surprising, but reflects the complexity of this phenomenon.
Let us clarify that transference arises from the beginning of the treatment and for a time powerfully drives the therapeutic work.
While this transference works in favor of analysis, we do not need to pay attention to it. If, however, it becomes resistance, we
must recognize that it modifies the relationship to healing under two opposite conditions: when tender feelings are so eviden t
that they generate an inner resistance, and when they manifest as hostile rather than tender emotions.
Importantly, transference, whether tender or hostile, poses an initial threat to the cure, but it can become your best instru ment.
We overcome transference by demonstrating to the patient that his or her feelings do not originate in the present situation o r are
1
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