Research Topics in Counselling Studies Essay Example

heightened under the therapy situation and often transferred to the therapist (Freud, 1912; Fenichel, 1945). In sum, transference could be viewed as that aspect of the therapist-client relationship that develops when significant relationships from the client’s past are re-capitulated and repeated, or “transferred” to the therapist (Freud, 1912; Strachey, 1934; Fenichel, 1945).

However, patients under therapy spend much of their time outside the therapy settings and also explore relationships with people other than their therapist during their time in therapy. Relationship with significant people in their lives may also have some transferential dimensions; however, the primary role ascribed to the curative function of the therapeutic transference - as the transference resulting from the client/practitioner relationship is known, as often meant that extra therapeutic transferences are relegated to the background.

Therefore, the research questions that will be developed and discussed in this paper include "how do therapists think about and use the material that emerges when patients describe transferential relationships outside of the therapy relationship the so-called extra-therapeutic transferences? Do they see clients' outside relationships in terms of the concept of transference? What theoretical concepts guide practitioners as they listen to clients' presentation of outside relationships?

Significance of the chosen Topic The centrality of the importance ascribed to therapeutic transferences has often meant that other forms of transferences are not properly recognised. For instance, though several theories provide thoughtful and useful guidance for practitioners on the recognition and use of transference in the therapy setting, very little is often said or written about the use and importance of extra-therapeutic transferences in practice. When discussed at all, within contemporary as well as traditional literature on transference, extra-therapeutic transference interpretations are

deemed less helpful than transference interpretations. They are often considered mistakes resulting from therapists missing or avoiding the "real" transferential implications in the material (Strachey 1934; Heimann 1956; Gill 1979; Wallerstein 1995)

Some authors even contend that when patients talk about outside relationships it is a defensive displacement of ideas or affect that belong in the transference—splitting, or resisting the experience of transference with the therapist because the experience might be painful or threatening. This opinion is best illustrated in Gill (1979) statement that “the most commonly recognized disguise [of transferential feelings towards the therapist] is by displacement [where] the patient’s attitudes are narrated as being toward a third party” (p.273).

The over-emphasis placed on therapist/client transference and transference interpretations as the key to therapy excludes from consideration the possible benefit to clients of talking with their therapists about outside relationships, having those transferences considered on their own terms, and gaining the benefit of insight and understanding derived from discussing and interpreting extra-therapeutic transferences, even though such experiences may have great immediacy for the client.

The implication of this tendency to view patients’ discussions of outside relationships as a manifestation of the therapeutic transference or as a form of resistance to treatment is that practitioners lack the appropriate theoretical guidance when they have to work directly with extra-therapeutic transference material. Therefore, by examining whether therapists consider outside relationships as phenomena to be worked with directly to address clients' views of themselves and their relationships or only as they relate to the primary therapeutic transference; and/or how therapists make use of extra-therapeutic transferences and whether they integrate it with their understanding of the concept of transference; a deeper theoretical

understanding of an important but undervalued therapeutic phenomenon - extra-therapeutic transference, could be achieved.

Therapeutic and Extra therapeutic Transference

Since the research question to be developed rest on the concept of transference, whether therapeutic or extra therapeutic, it is only reasonable to take a critical look at this underlying concept. Like most other aspects of psychodynamics and person centred therapy, the concept of transference could also be linked to Sigmund Freud. Freud observed how people read their present experiences through lenses that were shaped in the past. His understanding of transference began with recognizing it as “ a universal phenomenon of the human mind . .. [that] dominates the whole of each person's relations to his human environment" (1925, p. 76). Only gradually did Freud come to appreciate how the transference phenomenon, intensified by the structure and process of psychotherapy, becomes the key to therapy.

Freud initially thought the patient's dreams and free associations in analysis would be sufficient to cure neurotic patients. Repressed conflicts, which the therapist interpreted, would move analysis towards cure through insight. Other than the positive transference that helped create trust and rapport, when transference phenomena arose, Freud thought of them as resistances or obstacles to treatment. The unexpected termination of Dora’s treatment in 1901 opened Freud's eyes to the importance of attending to the transference. He concluded that his failure to analyze Dora's transferential reactions to him had led to a premature termination of her analysis (Freud, 1909, 1925).

Although other types of transference may be present, the most relevant for Freudian treatment is the “transference neurosis” (Freud, 1914). The less important are, first, the general and positive type of transference that Freud understood

to occur in any doctor-patient relationship, involving a feeling of trust that facilitates therapeutic progress. The second is a “transference reaction” that Bird (1972), in a later elaboration of Freud’s theory, described as "the means of displacing feelings and attachments from one object to another, and of repeating the past in the present” (p.281).

The transference reaction is distinguished from the complex, and particularly Freudian notion, called the transference neurosis, an artefact of the psychoanalytic process. According to Freud the transference neurosis is the defining characteristic of a successful analysis. During the psychoanalytic process a transference neurosis would emerge when the analyst becomes the object of transferred sexual and aggressive feelings once reserved for the patient’s parents. Conflicts from the core of the patient's neurosis would become activated within the relationship to the therapist. As the transference neurosis is played out with the analyst and interpreted, the patient becomes aware of internal conflicts previously kept from consciousness.

After Freud, several theorist and researchers elaborated on the techniques of transference. However, the hallmark of psychoanalytic techniques is the interpretation of transferences. Basch (1980) contend that "interpretation involves the explanation of the meaning of behaviour in terms of past or present relationships". He further posited that interpretations may apply to resistances, defences, wishes or fantasies, warded-off impulses, superego reactions, identifications, and similar matters, where unconscious meaning attaches ton manifest thought (Basch, 1980; Stone, 1981).

On the other hand, Bibring (1954) identified a hierarchy of five 'basic therapeutic principles'. He referred to suggestion, abreaction, manipulation (by which he meant the mobilisation or redirection of emotional systems in order to expose the patient to new experiences), insight through clarification, and insight through

interpretation. In his view, the interpretive process, as opposed to an interpretation per se, may include a number of these steps. Furthermore, Bibring (1954) went ahead to explain how each of the techniques within his hierarchy resulted in particular types of changes in the patient:

Thus suggestive techniques result in suggestion (in the sense of induced irrational beliefs) [e.g. to help the patient face reality]; abreactive techniques bring about relief from acute tension through emotional discharge; manipulative measures correspond to a number of curative agents which may be outlined under the general heading ‘learning from experience’; and finally the techniques of clarification and interpretation which produce the corresponding types of insight which we propose to call insight through clarification and insight through interpretation. (1954, p.746)

In other words, interpretation as a useful tool in making use of transference is the practitioner’s way to convey his or her understanding of the client to the client. This understanding develops through the therapist’s introspection, intuition, and empathy, together with his or her cognitive and rational gathering and organizing of data from the patient’s history and productions in the therapy setting.

From this understanding, interpreting the transference resulting from the client/therapist relationship might just be as important for the therapeutic process as concretely examining the resulting from the patients' emotional relationship with his/her significant others, although, there is dearth of literature to support this stand. What follows is an exploration of the arguments for the usefulness and otherwise of extra therapeutic transference to the therapy settings, in contemporary literatures.

However, it is only fair to state here that several authors have questioned the exclusive emphasis placed on client-therapist transference. Halpert (1984) reports that

"It is impossible to do analysis purely on the basis of transference without attention to current conflicts and realities and without reconstruction of the past in which the transference is rooted" (1984, p. 142); while Blum (1983), observing that the relationship between the transference and the extra transference is exceedingly complex and stressing the ‘complementarity’ and synergy of working with the extra transferences as well as the transference to the therapist; states that "A 'transference only' position is theoretically untenable and could lead to an artificial reduction of all associations and interpretations into a transference mould and to an idealised folie a deux" (Blum, 1983, p. 615).