Psychoanalysis Part I – Transference and Countertransference

via minddisorders.com   

Psychoanalysis can be described as a curative method based on complete verbalization of thoughts and free associations method in a context that will allow patients to overcome their repressed memories or thoughts.

We can say that psychoanalysis is a specific technique to investigate the mind. The novelty of Freud’s discoveries came with the acknowledgement of how important the unconscious processes were. He stated that they behave differently than conscious processes as the influence of this part of our mind can make us reach conflicting mental states.  

Some of the characteristics of psychoanalysis are:

•      it is a long term therapy method, even today despite the vast amount of short term therapies.    Psychoanalysts believe that there is a need for a long term therapy as their method will modify the      patient’s personality to be able to eliminate the symptoms completely;
•  Psychoanalysis searches for the cause and it is not based on eliminating just the symptom;
•   it is a non-directive type of psychotherapy;
•   it uses specific methods;
•   it explores transfer and counter-transfer;

Transference and Countertransference in Psychoanalysis

Psychoanalysis is not just a strictly intellectual process where the patient talks and the therapist analyses, it is a relationship where affectivity plays an important role. This is why transfer is so important.  At first Freud considered that transference can be an impediment during therapy but he later discovered that it is actually essential.

The patient transfers feelings towards the therapist, feelings that they may have for their brothers, sisters, mothers, etc.; it is considered to be a reenactment of a childhood relationship. Defined shortly, transference is unconscious redirection of feelings from one person to another. For example, a person could despise somebody who resembles in some way their ex-lover. During psychoanalytical therapy transference is explored, a method that is not used in other therapies. As transference often appears when there is an emotional connection, it can be an important concept in finding the cause for mental distress, so transfer is also stimulated during psychoanalysis.

This relationship is important for two reasons: it helps the therapist search for childhood models and identify particularities that define the patient’s relationships with the ones around them. This bond between the patient and therapist will help the patient overcome their resistances as the patient will feel the need to please the therapist, as they feel protected and supported.

Countertransference is also important, although it is quite a controversial term. It wasn’t discovered at the beginning of psychoanalysis. It can be defined as an unconscious affective reaction of the therapist in relation to their patient. During the 60’s countertransference started playing a big role during therapy.

Resistance is another concept used in this therapeutic approach and can be defined as a phenomenon when the patient completely disagrees with their therapist and fights back any type of interpretation. However, this is just a type of resistance that can be easily seen during therapy but it can manifest itself in other ways such as: being late or not coming at all to the therapy sessions, developing new symptoms, falling asleep during the psychotherapy session, or eventually, leaving the therapy process completely.  Psychoanalysts believe that patients develop resistances because they cannot face what lies in their unconscious.

Also, there’s another approach on transference and countertransference that is offered in Adlerian psychotherapy. The patient’s transference is pointed out and explained as an obstacle to cooperation and improvement. On the other hand, experimenting countertransference would suggest that the therapist needs to continue their personal therapy and training to overcome such tendencies in the future.

The Psychoanalytical Space

The place and atmosphere where the therapy is conducted also plays an important role during psychoanalysis; those who still practice classic psychoanalysis choose to have a simple space with a couch, no paintings or decorative items, an armchair and a small table. Obviously, this is not the exact description as everybody chooses to decorate and design their office the way they want but it should give you some perspective on how a psychoanalyst’s office should look like.

The therapy is usually done with the patient lying on the couch and the therapist behind him; this helps the patient with their projections and verbalize things easier.  

Freud And His Controversial Theories

Freud’s studies about the unconscious had deep impact on the 20th century though. He was born in Austria in 1856 and studied medicine in Vienna. He revolutionized psychiatry by developing psychoanalysis and this “speech therapy” replaced some medicine and electric shocks that were used as treatment. Freud was also an exceptional writer, winning the Goethe Prize in 1930.

Freud’s basic idea was the fact that human behavior is greatly influenced by sexual desire, which he considered present in humans from early childhood. He argued that dreams, like neurosis, were a disguised desire and the key to understanding behavior.

He is also known for dividing the human mind into: id, ego, and superego. The id is the primitive part of our mind, where instincts like sexual desire or hunger exist. Ego is the rational self and superego is the moral element that tries to inhibit the ego with culpability.

Sublimation, Oedip’s complex or “guilt complex” are just a few of the concepts Freud came up with and are still used in psychology today. 

One idea that managed to make feminists really angry was the one regarding childhood molesting. Freud argued that his molested female patients were imagining everything. He also had the Penis Envy theory which was about the envy women felt because they had castration anxiety. He suggested that when they are 3-5 years old, girls distance themselves from their mothers and devote their affections to their fathers because they realize that they have no penis. Unconsciously, girls believe that their mothers are responsible for their missing penis. 

Another controversial idea was the one regarding religion. For Freud, religion was an expression of neuroses and distress and also a way to control the Oedipal complex, feel fulfillment, and an attempt to gain control over the outside world. He believed that all religions were mass deceit but also added that no religious person would ever recognize that. This was probably one of his most controversial statements and it brought him even more fame.

He wrote: “A religion, even if it calls itself a religion of love, must be hard and unloving to those who do not belong to it."

His idea about death was also very unusual for that time. He considered that humans have an instinct of death that manifests itself through a need to destroy oneself.

There were no experimental studies proving that Freud’s methods worked better than the ones used by other psychiatrists at the time and soon he became less and less popular. This was a dramatic experience for Freud and he was convinced that his adversaries were mentally ill. He wrote to his friend Carl Jung that he was treating his reluctant colleagues the same way as he treated his patients. 

When he reached his forties, Freud started believing that he would die at the age of 51. He started being depressed and having more and more medical problems, so he began self analysis. The major breakthrough of his self analysis was the fact that he felt a lot of hostility towards his father and that he had sexual feelings towards his mother when he was about two or two and a half years old. He experimented with cocaine and considered it to be a great treatment. He also smoked a lot and believed that it helped him concentrate more, which eventually gave him cancer; he committed suicide with the help of a fellow doctor when his pain was unbearable.

Freud might have been an unusual character but his concepts and ideas are still widely used today and his “speech therapy” is the basis of many psychological approaches.

Further reading and references:
http://allpsych.com/psychology101/ego.html
http://www.iep.utm.edu/freud/
http://en.wikipedia.org/wiki/Sigmund_Freud
http://psychology.about.com/od/sigmundfreud/p/sigmund_freud.htm