Table Of ContentUsing the Transference
in Psychotherapy
Using the Transference
in Psychotherapy
William N. Goldstein, M.D.
Samuel T. Goldberg, M.D.
A JASON ARONSON BOOK
ROWMAN & LITTLEFIELD PUBLISHERS, INC.
Lanham • Boulder • New York • Toronto • Plymouth, UK
A JASON ARONSON BOOK
ROWMAN & LITTLEFIELD PUBLISHERS, INC.
Published in the United States of America
by Rowman & Littlefield Publishers, Inc.
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Copyright © 2004 by Jason Aronson
First paperback edition 2008
All rights reserved. No part of this publication may be reproduced,
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without the prior permission of the publisher.
British Library Cataloguing in Publication Information Available
Library of Congress Cataloging-in-Publication Data
Goldstein, William N.
Using the transference in psychotherapy I William N. Goldstein, Samuel T.
Goldberg.
p.cm.
Includes bibliographical references and index.
l. Transference (Psychotherapy) 2. Countertransference (Psychology)
3. Psychotherapy. I. Goldberg, Samuel T. II. Title.
RC489.T73G653 2004
616.89'14-dc22
2004004804
ISBN-13: 978-0-7657-0511-2 (pbk.: alk. paper)
ISBN-10: 0-7657-0511-7 (pbk.: alk. paper)
Printed in the United States of America
~TM
'<!::!J The paper used in this publication meets the minimum requirements of American
National Standard for Information Sciences-Permanence of Paper for Printed Library
Materials, ANSl/NISO Z39.48-1992.
Contents
Introduction vii
Part I: Historical Overview 1
1 The Old Model of Transference 3
2 The New Model of Transference 13
3 Countertransference 21
4 The Therapeutic Alliance 29
Part II: The Transference in Psychotherapy 35
5 Transference: The Old vs. The New 37
6 The Transference in Psychotherapy 43
7 Psychoanalysis and the Continuum of Psychotherapies 49
8 Projective Identification, Enactment, and The Transference 59
Part III: Clinical Vignettes 71
9 Love for the Therapist: Analytically Oriented Psychotherapy 73
10 Mr. B and Ms. G: Dynamically Oriented Psychotherapy 85
11 A Very Classical Case of Analytically Oriented Psychotherapy 95
12 Short Vignettes of Dynamically Oriented Psychotherapy 107
v
vi Contents
13 Fully Developed Transference and Its Resolution
in Psychoanalysis 117
References 143
Index 149
About the Author 153
Introduction
This book provides both a historical and a contemporary overview of the con
cept of transference, particularly as it relates to psychotherapy. It is written es
pecially for students and mental health professionals at the early stages of
their careers; yet it is also meant to be a useful reference for more experienced
professionals.
There are two dominant themes in this book: the "old" versus the "new"
models of transference, and the role of transference in psychotherapy. Regard
ing the former, the traditional-or classical-view of transference, termed the
"old," is contrasted with a more modem relational view of transference,
termed the "new." The old model views transference as a displacement offeel
ings and thoughts (and defenses against these) from the important people of
childhood to a relatively neutral, anonymous, and abstinent therapist. Trans
ference here is based both on the actual and fantasized past, as experienced by
the patient. The new model places more emphasis on the "joint creation" of the
transference by patient and therapist. Here the therapist, like the patient, is
viewed as a unique individual, with his own theory of how therapy works, his
own idiosyncracies, his own conflicts, his own past, and his own strengths and
weaknesses, all of which contribute to the unfolding of the transference. Thus
the transference is seen to be jointly constructed between the two unique indi
viduals. Implicit in this model is that the therapist need not be, and in fact, can
not be, neutral, abstinent, and anonymous. Instead he is free to speak more
openly and to participate in a more interactive and self-disclosing way. The au
thors approach the transference from both models, the old and the new. Both
perspectives are seen to have merits. While some patients do better with the
old model and others with the new, many patients do well with either model.
These and related issues are elaborated throughout the book.
vii
viii Introduction
Regarding the theme of the role of transference in psychotherapy, this book
compares two commonly used types of insight oriented psychotherapy. These
two therapies are contrasted by their focus on the transference. In one, the
transference is central; in the other, the transference is peripheral. The first,
termed analytically oriented psychotherapy and modeled after psychoanaly
sis, looks to the formation and resolution of the transference as the primary
therapeutic agent. The second, termed dynamically oriented psychotherapy,
downplays the role of transference in this regard. Dynamically oriented psy
chotherapy emphasizes the formation and maintenance of a positive thera
peutic or working alliance, and the use of that alliance to explore and gain un
derstanding into the patient's conflicts without an active exploration of the
transference. The difference between these two forms of psychotherapy, in
addition to their applicability, is detailed in this book. These two forms of
psychotherapy are seen to occur on a continuum of psychotherapy, with the
most insight oriented approaches at one end of the continuum, and the most
supportive approaches at the other end. This continuum, discussed in greater
detail throughout this volume, includes psychoanalysis, analytically oriented
psychotherapy, modified analytically oriented psychotherapy, dynamically
oriented psychotherapy, and supportive psychotherapy.
As background for these dominant themes, Part I of the book provides a
historical framework. Chapter 1 begins with a historical overview of trans
ference from the old or classical perspective. It starts with the work of Sig
mund Freud, then moves to a brief selective summary of important subse
quent literature on transference from a classical perspective. Included here are
Melanie Klein, Strachey, Sterba, Anna Freud, Fenichel, Greenacre, Stone, Ar
low, Brenner, Gray, and Busch. Continuing with the historical overview of
transference, Chapter 2 focuses on the new perspective. It begins with the
work of Merton Gill, transitional figure between the old model and the new,
then proceeds with a selective review of some of the recent literature regard
ing the new model. Included here are the relational movement and intersub
jectivity, Hoffman, Renik, Aron, Greenberg, Stolorow, and Atwood. A section
on selfobject transferences is included, as well as a look at the motivational
system approach of Lichtenberg. The chapter ends with a section on the rele
vance of the work of Fonagy on mentalization. Chapter 3 provides a histori
cal overview of countertransference, beginning with the work of Sigmund
Freud and including the Balints, Fenichel, Annie Reich, Little, Winnicott,
Heimann, Racker, Sandler, Gabbard, and Jacobs. Chapter 4 focuses on the
therapeutic alliance and includes the work of Sigmund Freud, Sterba, Zetzel,
Greenson, Stone, and Brenner.
Part II, "The Transference in Psychotherapy," addresses the main themes
of the book, already elaborated. Chapter 5 details the old versus the new mod-
Introduction IX
els of transference. Chapter 6 compares analytically oriented psychotherapy
(with its focus on transference) to dynamically oriented psychotherapy
(where the transference is regarded as peripheral). Chapter 7 details the con
tinuum of psychotherapies already mentioned, including psychoanalysis, an
alytically oriented psychotherapy, modified analytically oriented psychother
apy, dynamically oriented psychotherapy, and supportive psychotherapy. The
concepts of projective identification and of enactment are somewhat elusive
to many. Yet, these concepts are crucial to understanding the transference ac
cording to a selected group of psychotherapists. With this in mind, Chapter 8
focuses on projective identification, enactment, and the transference.
Part III is the clinical section of the book. Here a number of detailed cases
are provided, graphically demonstrating how transference is addressed and
dealt with in psychotherapy. Cases demonstrate analytically oriented psy
chotherapy, dynamically oriented psychotherapy, and psychoanalysis. Al
though many of the examples are those with more classical approaches, de
tailed commentary on the old versus the new models is provided. Throughout
this section numerous clinical items discussed in the book are demonstrated
in action.
