Transference II
Resistance to the awareness of transference happens frequently because:
a. Both therapist and patient fear this will belittle the significance of events in outside life
b. Anxieties about the here and now dominate
c. Fear of inflating one’s self importance
d. All of the above.
d. Discomfort is easy to make working in the transference AVOIDED
Patients in this state of mind are more likely to hear an interpretation realistically instead of using it to do something.
What is the depressive position?
“My landlord charges too much for rent” seems like a possible transferential communication.
True or False: Gill believes that these transference manifestations are infrequent and very sporadic at the beginning of the therapy.
False. Gill feels that this fails to recognize the pervasiveness of the patient’s associations and of the many indirect allusions to the transference. Being alert to this pervasiveness is important.
In Gill’s paper ‘The Analysis of the transference,’ he quotes Freud saying that "once resistances are overcome, these should appear relatively without difficulty."
What are memories?
This kind of repair is a defense because the person tries to make things better without ever really feeling sad, guilty, or responsible. It is usually done toward less important people, who are seen as beneath them and under their control.
What is manic reparation?
Betty Joseph found that focusing on individual associations a therapist will likely be:
a. Making interpretations that only address the adult part of the patient
b. Ignore the need to get the underlying assumptions out in the open.
c. Staying within the comfort of staying with ‘the material.’
d. All of the above.
d. Joseph found that transferences are constantly moving and changing. The bed-rock of the personality is not addressed which is found in the pressures brought to bear which comprise “The Total Situation.”
WHY attempt to focus and work in the transference?
Unconscious repetition allowing for opportunity to cultivate deep understanding of a person’s unconscious inner world (without doing this according to Minnick you ‘don’t have a patient’).
Allowing for what is talked about ‘outside’ to be experienced and understood in the context of a therapeutic relationship. Here we can bring first hand vital understanding and intervention.
One of these seeks to resurrect the beloved object "exactly as before", whereas the other begins with the sorrowful recognition that the object has been wounded and may never be the same.
What is the difference between manic and true reparation?
Gill surmises that reading Freud’s case histories has skewed analytic technique towards:
a. Seduction theories that emphasize infantile sexuality components
b. Genetic interpretations “because you felt your father was harsh” variety.
c. An understanding of the difficulty in making ‘here and now’ interpretations.
d. Analyst as reinforcing superego tendencies in a patient.
b. Genetic interpretations seem to be an easier ‘go to,’ which may be helpful at times, but also manage to keep the transference as a less emotionally laden situation.
What is a major contributing factor to why even psychoanalytic psychotherapists themselves resist attempting interpretations having to do with the ‘here and now’ in a session.
a. Fear their supervisor will disapprove
b. Uncertainty about the accuracy of the interpretation
c. The ‘heat’ of the situation feels too intense.
d. Not wanting to make their patient feel uncomfortable.
c and d. Also to not make themselves feel uncomfortable.
Klein describes two emotional states that even exist in infancy that are particularly destructive to introjecting the good mother (and continue to interfere with the reciprocity of loving relationships throughout life). What are they?
GREED AND ENVY.
In greed, there is never satisfaction. Greed leads to exploitation, and is increased by anxiety. In envious states, in envy, the suspicion that when one is frustrated the mother is deliberately withholding, kept for her own benefit. The envious response is to spoil the good, so others won't be able to enjoy....this leads to a spoiled object, without a good object to internalize, no gratitude can be found.
Gill describes the essential need to encourage the expansion (or even identification!) of the transference by focusing on:
a. Dream content.
b. Slips of the tongue or parapraxis.
c. Acting out that encompasses a wide range of motor behavior.
d. Attitudes, feelings, and intentions.
d. Repetition is often not acted out in motor behavior, and the implicit expression of transference can be found in attitudes, feeling states, and intentions and then brought into a more explicit awareness. Investigation of the ATTITUDES ascribed to the therapist is key.
What is a common defense used for these conscious or unconscious attitudes, feelings, or behaviors that emerge towards the figure of the therapist?
Displacement is commonly used. Interpreting these ‘disguises’ will help to identify and expand the transference.
Manic reparation can never be completed, because if it were complete, the object fully restored would again become lovable, esteemed, and free from THIS.
What is the manic person's omnipotent control and contempt?
Alongside what the patient is saying, focus on the shifts of THIS, according to Betty Joseph, is what will bring understanding and to real psychic change.
What is HOW the therapist is actively being used? WHO am I, WHAT are they doing with me, and WHY.