It is true that patients’ personal histories are the crux of psychotherapy, but if they tell their stories without the presence of transference, they will not be healed. (Transference is also fun to observe in everyday life as you catch yourself transferring onto others, and being transferred upon.)
In a nutshell transference means, “Everybody you meet reminds you of someone you’ve met before.” I know how nutty that sounds, but bear with me. We humans are a collection of accumulated experiences going all the way back to our childhood when we began to “meet” people. Mom, Dad, siblings, other relatives, friends, neighbors, teachers, shopkeepers, coaches, clergy, etc. Add to this the numerous people we meet as adults, including those on television, the radio, in movies and in literature. All of these people, especially ones met early, will color future relationships.
When we meet someone new, our past experiences with that “kind” of person prompts us to immediately begin making judgments about him or her. Acting like a computer, our mind begins collating stored data from our pasts and we will instantly start assuming things about the person we just met. He, or she, will “re-mind” us of someone else.
There are dozens of features about a person that will spark transference, such as gender, age, name, body structure, facial structure, skin color, eye color, hairstyle, smile, clothing, ethnic appearance, and “where they’re from.” (For instance, everybody knows all New Yorkers are obnoxious. If you’ve lived out West you know that all Texans are, too.)
Other, not-so-obvious triggers will be smell, size and shape of the hands, sound of voice, jewelry worn (or not), over-all projection of self esteem (or lack of). Also contributing to transference will be the environment in which we meet a person such as in church, on a ranch, at a bar, at a baseball game, a PTA meeting, in prison, wherever. Learning a person’s occupation will strongly contribute to the transference. By the way, transference is not “projection.” With transference we ascribe the attributes of others onto someone. With projection we ascribe our own. But I’m being picky.
I had a male patient “Frank” who told me he was first attracted to his wife because of her smile. “Her teeth and lips were exactly like my favorite aunt’s,” he said. Frank fell in love with his wife the moment they met, immediately transferring all sorts of attributes to her that were like his aunt’s. As he learned over time few were accurate, but by then it was too late. They’d gotten married, had two kids, and he now wanted a divorce. This situation happens often. You know the old saying, “First impressions are lasting impressions.” Fewer old sayings are more accurate because of the phenomenon of transference.
Another old expression is: “The things you say when you’re drunk are what you really mean.” This may be correct in some instances, when the booze has just begun to act, but if you are really hammered and say things to a loved one that is hurtful, transference is probably the culprit. This is especially true when married people harangue each other while under the influence of alcohol. Because marriage is the ultimate transference relationship, those hurtful, hateful things that you really didn’t mean, and are so sorry about later, were most likely things you wanted to say years ago to your parent of the opposite sex. The booze weakened your ego, the person you are today, and you wound up in a regressed, childlike state saying things to a spouse you never could have said as a kid to a parent ... but wanted to.
If there was ever a Doubting Thomas about the existence of transference, all Thomas would have to do is be a fly on the wall of an analytic session. He would hear the patient ascribe to the analyst (who naturally becomes a parental figure) all manner of beliefs, thought processes, wisdom and experiences that often do not apply. In most cases, where the sex of the analyst and analysand are different, Thomas would witness the analysand “fall in love” with the therapist. (This sometimes happens when analyst and analysand are the same gender, also.) It never ceased to amaze me how much patients thought they knew about me due to the transference. They certainly didn’t know enough to fall in love with me, but that happened almost every time as they transferred feelings for a significant person from their past onto me. Transference, therefore, from a psychotherapy standpoint is not to be discouraged. It is a necessary dynamic.
Knowing that my patients love for me had nothing to do with me gave me objective knowledge of their needs, wants, fears and hopes so I could better do my job creating a picture of their unconscious minds. The patients resurrected their flawed “love object” from the past and placed that creation onto me. They made me someone else, someone from their early years who had not done the job properly. I became a “wished for” parent. To them I was no longer their analyst, I had become their mom or dad (it could shift back and forth), and with this dynamic in place much of the early damage could be worked through and corrected.
It could be corrected because they transferred me into their parental figure. But I did not respond to them as that person had responded. I was responding as that person should have responded so many years ago. By making me into someone else, they underwent what’s called a “Corrective Emotional Experience.” This second time around they got it right. The patients now received the “new” mom or dad’s undivided attention, concern, empathy, and (in their minds’) love — like parents are supposed to give. The fact that shrinks are paid money for dispensing attention, concern, empathy, and love does not, curiously, screw up the process.
Patients must make the shrink a transference figure if they are to get better, but they don’t have to work at this. It will happen naturally and it matters not if patient and therapist are of the same or opposite sex. Transference is the single most important aspect of psychotherapy. Incidentally, some mental health workers discourage transference when it shows itself. These are the same people who call their patients “clients.” They are counselors, not psychotherapists. O’Douls versus Guinness Stout.
Properly conducted psychoanalysis works wonders between same or different genders but I believe the ideal situation is when the therapist and patient are not the same gender. This dynamic is a natural re-creation of the Oedipal Conflict, that final phase of personality development. It is the source of much mental illness. The early analysts in Europe believed all mental illness stemmed from Oedipal problems. Oedipus, if you have forgotten your mythology, unknowingly killed a man who was his father and wound up, unknowingly, marrying his mother.
The Oedipal conflict shows itself when children, around age 5, become enamored with their parent of the opposite sex. A mini-sexual attraction accompanies it. This is a natural part of the process of growing emotionally. The way parents are supposed to handle this is to gently, but firmly, push the child away from themselves and back to the parent of the same sex who is the proper one to identify with. On paper this sounds easy, but most parents mess it up, either by giving in to the child’s wishes or by being too harsh in rebuffing the child’s overtures.
I have a theory that the reason so many marriages fall apart after seven years (the seven-year itch) is because parents can’t handle the reverse of Oedipus, which is also present. Their first child is in the Oedipal stage of development and getting “feelings” toward the parent of the opposite sex but so, too, is that parent getting “feelings” toward their son or daughter. As horrible and inconceivable as that sounds, those feelings are present. Most parents are unaware this is natural and consider the feelings, and the thoughts that accompany them, to be abominable. These feelings, I believe, can break up a marriage.
Unfortunately no one told parents it’s natural to see and appreciate the sexuality and sensuality of their children and to understand the accompanying thoughts. What is abominable is if they are acted upon. The terror of succumbing to their base desires becomes too overwhelming so the parent splits — making up a bunch of socially acceptable reasons and being only vaguely aware of why he, or she, really wanted out of the marriage.
Oedipus, like so many psychoanalytic principals, sounds like total nonsense to most people and that is understandable. Feelings and their associated thoughts that are in our unconscious minds frequently defy logic, reason, common sense, and even goodness itself. They call into question religious teachings and morality. Nonetheless they are present and no one is immune from them. Let me tell you a story.
Our house had always been a magnet for our sons’ friends. They knew I was a shrink, and as they got into their teens they sometimes asked me to listen to one of their “really weird” dreams. I was happy to do this, being careful to comment on only the least embarrassing parts of the dream. Almost all of their dreams were loaded with Oedipal material.
One time “Ted” told me a dream which ended with him and a movie star standing at the edge of the Grand Canyon. They were holding hands, obviously lovers or soon to be. The movie star’s initials were the same as Ted’s mother’s — something which never occurred to Ted. He asked me to interpret the dream. I told him it was a standard, very normal Oedipal dream and pointed out that the initials were his mother’s. “It doesn’t mean I am going to marry a movie star?” he asked.
“Sorry, Ted,” I replied.
Ted, my sons Alex and Zack, and two other teenagers left the house and drove to Atlanta. Later Alex told me what happened. In the car they talked about the dream and Ted said that he thought I was a smart man, but I sure was wrong about all that Oedipal crap. There was a few seconds of silence and then Ted, thinking he was changing the subject, said, “You guys know that new kid in school, Tom Dean? Have you seen his mother? She sure is a hotty!” The other kids howled with laughter.
A male shrink and female patient, or vice versa, is probably the ideal to correct the patient’s Oedipal problems (the stage is set), and like the relationship between parent and child the love between therapist and patient can indeed go both ways. Therapists do sometimes “fall in love” with their patients via the phenomenon of “counter transference.” Like a wise parent, the therapist must never ever act out sexually or seductively with a patient. If he does so, he should be put into prison, charged with two offenses: 1) Sexual child abuse, 2) Fraud.
I am serious. Prison. To violate a patient’s trust, even though the patient may have initiated the desire for sex, is to violate the entire psychotherapeutic process and to make fraudulent use of the transference. This is a mortal sin, but I am sorry to say that, like incest, it happens a lot. The long-lasting effects on patients is devastating. If a patient is a victim of sexual activity from a therapist, he or she should call the police. If the therapist did it to them, he (or she) will be doing it to others.
Because psychotherapy is so very intimate, it is frequently tempting to cross the line between talking and feeling ... and action. Most shrinks I know have normal levels of libidinal energy but they must keep it in check when dealing with patients.
But we are human.
When a patient of the opposite sex discusses sexual needs, activities and fantasies, the therapist is listening with that “third ear,” and sensuality, which would normally be present, is not. The atmosphere is best described as professionally friendly. In 30 years as a psychoanalyst, I was sexually turned on by patients only twice. Both times I got caught off guard.
Durango is a small town. After a few years of practicing it was virtually impossible for me to go to a restaurant, grocery store, church or tavern without encountering a patient. In my three years between marriages I frequented a bar called The Solid Muldoon. One night I was approached by a woman patient whom I had seen for her first session earlier that day.
She had been sitting at the bar with another young woman. Both, by the way, were very attractive. She came over to my table and sat down next to me, and said, “Our session today was great. I feel so much better already. I want to do something special for you.” She told me that she and her girlfriend decided they’d rent a room at the General Palmer House Hotel next door, take me with them and “Show you the time of your life.”
I was totally blindsided. I thanked her for the offer, told her I couldn’t do that and would explain why not at our next session. She laughed and said, “If you change your mind let us know” and went back to the bar. I watched the baseball game on TV until things settled down and got the hell out of there. Don’t ask me who was playing.
On another occasion I came out of a session with “Sylvia,” another very attractive patient. She was 45 years old and from a foreign country with a very different culture than ours. This had been our fourth session. She had been resistant to therapy and the candidness and intimacy that is necessary for it, but during this session she began to let her defenses down, and I felt good about her new-found trust. As I was standing at the counter putting her next appointment in the logbook, she came up behind me and tapped me on the shoulder. I turned around and she put her arms around my neck and thrust her pelvis into mine. She had taken her top off and was not wearing a bra. “Let’s go back to that couch of yours,” she said.
Shocked, I put my hands on her shoulders and gently, but firmly, pushed her away. “Sylvia, we can’t do this,” I said, “Please put your top back on.” I turned around to give her privacy and she left the building, slamming the door behind her.
I doubted she’d be back for the next session but I was wrong. She marched in and sat down, angry and sullen. She told me I had insulted her. I explained to her about transference and counter-transference and told her I simply couldn’t have sex with a patient. It was the biggest taboo in my profession. She glared at me. I then segued into talking about morality, specifically adultery. She was married. She continued to glare, making me feel foolish. Although the words I said were correct, their affect was terribly lame. I felt like a child talking to a worldly adult.
“Our time together will not continue,” she finally said with a touch of sadness. “If we do not make love. I can not be intimate with you on the spiritual level and not physical. It is my culture.”
“But we are both married,” I said. “What does your culture say about cheating on your spouse? In my culture, my religion, that’s a sin.”
“The only sin is allowing your spouse to know about it. Then he is hurt. Hurting someone’s feelings is a sin. If no one knows about it, no one is hurt and there is no sin.” Her tone now soft. Her eyes sincere. “Come to me,” she said and The thought of making love to this beautiful, mysterious woman who was beckoning to me caused the clinical barriers of psychotherapy to fly out the window. We were now a man and a woman. I thought about making some Oedipal interpretation about her wish to make love to her father, that I was his replacement, but that would have sounded even dumber than what I had already said. Besides she was much older than me. I was not going to her nor was I terminating the session. She was now making the rules. I had lost control of our time together.
“I’m sorry, Sylvia, as much as I would like to make love to you, and I really would, my culture, religion and profession forbids it.”
“Then we both lose,” she said and walked out of my office, gently closing the door.
Shortly after this, my marriage broke up and I’d heard that hers did also. I thought of calling her, but another rule of therapy prohibited that: “Once a patient — always a patient.” (Nuts.) I never saw her again but I’ve thought about her, both psychoanalytically and in other ways. Yes, therapists are human.
During our final session, after four years of in-depth analysis, “Janet” asked a question which I’d never heard before. “Tell me, Jim, what really cured me. Psychoanalysis or your love for me?”
This is an example of transference. I did not love Janet. True, I was fond of her and she felt that. But her concept of my emotional attachment to her far exceeded reality. In her mind I had become the loving father that she never had. She needed that dynamic to make her well and her question was rhetorical. I didn’t answer it. Janet and I had been through her hell together and she was now ready to live her life without regularly scheduled meetings with me. We had been approaching this final session for a few months and she knew my door would remain open should she need further treatment. This was standard “termination” procedure.
At the door of my office she paused, turned around, and said, “I know you think it was psychoanalysis, Jim, but I think it was your love. But it doesn’t matter.” She left and I never saw her again.
Transference is an all-pervasive element in human life. It is active not only when we pick a mate but also as we choose our friends and enemies. It has an effect on where we shop, what TV programs we watch, what we read, and who we vote for. It will determine, for sure, whom we hire and maybe whom we fire. Because we are an on-going compilation of experiences with others, transference affects all current and future experiences. It is a potent component of human nature. When we meet new people if we pause and listen, we will hear our unconscious mind immediately providing data about them. It’s an easy way to experience the unconscious at work.
Waynesville resident Jim Joyce’s memoir, Use Eagles if Necessary, is being published in weekly installments in The Smoky Mountain News. Each week we begin a chapter in our print edition and then put the entire chapter on our Web site. All previous chapters are available online. The book can be purchased at rockpublishing.com/eagles.htm, and may be ordered through bookstores after May 31.