More about the co-creation of transference

In teaching and learning more about the co-creation of ‘transference’ in our Intro to Psychoanalytic Concepts I course, we used papers by Fosshage and by Slochower to further our discussion. While Fosshage helped the class rethink anonymity and abstinence from a more contemporary view, and nicely explicated a more contemporary idea of transference as an organizing activity from the classical displacement model of transference, the candidates and I agreed that the distinction between pathological and non-pathological forms of transference may not add to our clinical experience. Regardless of its form, we agreed that transference is always co-created.

A lovely example came, again, from a candidate. The candidate described that her patient had insulted her, the analyst’s, competence, then the patient additionally complained that the analyst was a ‘blank screen.’ The candidate-analyst found it “harder to hear” that she was viewed by her patient as not so human (capable of feeling) than to hear she was not so skilled as a therapist. The candidate then explained to her peers [who had heretofore failed to see the co-creation of the patient’s latter comment] how she, the therapist, had “refused the discomfort” of the insult to her competence and so had remained unmoved. “I did not feel my anger” so “my answer was not human.” The patient, having expected hurt or anger, or some response, and having read -right brain to right brain-  the therapist’s dissociation from uncomfortable human feeling, then complained about the ‘blank screen.’  

This segued nicely into Slochower’s paper where we see Slochower on the cusp of struggling to recognize her own contribution to the patient’s ‘hateful’ness, and struggling to ‘wear the attributions’ of incompetence, manipulativeness, and greed as she negotiates with her patient an attempt at a mutual understanding. A second candidate noted aloud how Slochower’s interrogation of ‘Why would I want to do that?” nonetheless leads to a deeper revelation about the patient’s fears: “Obviously, to get as much money from me as possible.” Slochower gives us an illustrative case example of just how very hard it is for analysts to see our own contribution and acknowledge it to patients and, thus, validate the patients’ experience of us. This is one way our patients are our best supervisors.

Fosshage, J.L. (1994). Toward Reconceptualising Transference: Theoretical and Clinical Considerations. Int. J. Psycho-Anal., 75:265-280.

Slochower, J. (1992). A Hateful Borderline Patient and the Holding Environment. Contemp. Psychoanal., 28:72-88.