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Transference: a start

Psychoanalysis is not really about the Oedipus Complex after all

 


If you had just three or four papers to read in order to understand transference, among them should be Freud's Postscript to the ill-fated "Dora" case, Bird on "The hardest part of analysis," Luborsky on the basis for Core Conceptual Relationship Theme Therapy (CCRT) -- and for brilliant writing, one of the essays of Janet Malcolm on psychoanalysis (originally in the New Yorker). 

Or, you could read Hamlet.  Could it be more obvious? Polonius hidden behind a tapestry, stabbed by Hamlet, who mistakes him for his stepfather -- could there be a better image for transference?

But first, Freud:  Initially hysteria was supposed to be caused by childhood seduction. Later Freud concluded the seduction was usually imagined and that a displacement of sexual conflict to the symbolism of the body resulted in conversion reactions and other symptoms. Freud moved from treatment by hypnosis and abreaction (emotional purging) to 'free association,' the flow of which he repeatedly observed was impeded by resistance related to the transference.

Unconscious displacement of cognitions, affects, and defenses from early parental figures to later stand-ins potentially distorts all human relationships, but its interpretation in analysis (especially the patient's transference neurosis toward the analyst) is supposed to cure the unresolved 'infantile sexual neurosis' causing the adult 'psychoneurosis.'

Called Freud's "grandest clinical hypothesis" by Luborsky, transference has eight experimentally testable characteristics: (1) each patient has a predominant, specific and distinctive transference pattern (2) this pattern is based on early experiences with parental figures (3) the transference is activated in all important relationships (4) it distorts and impairs those relationships (5) it is consistently repeated throughout the patient's life (6) it also appears in the relationship with the therapist (7) it is only somewhat malleable, and (8) it is partly in the patient's awareness and partly kept out of awareness.

The literature on transference resistance begins as early as 1895, when Freud and Breuer were trying to understand failures in the treatment of Anna O's hysteria. In their published work they warned that a poor prognostic element in such cases occurs when the therapy is disturbed by the patient's overpowering fear of becoming a slave to treatment. Also they warned about negative feelings toward the analyst that emerged during the treatment.

What Freud and Breuer neglected to publish was that Anna O developed a psychotic transference to Breuer and a hysterical "pregnancy" with Breuer as the "father" of her child. This precipitated Breuer's panicky termination of therapy, his family's flight from town, and his abandonment of psychoanalysis as a career. Breuer and his wife then directly went on their "second honeymoon" in which they conceived a daughter that they named Dora. (Is it coincidence that Freud gave the name "Dora" to his most frustrating case?)

In fact the history of the elucidation of the transference is rooted in such disasters. Janet Malcolm writes 

Freud stumbled on the concept of transference while desperately casting about for an antidote to the epidemic of iatrogenic lovesickness that had spread through his practice in the 1890s. When, one by one, all of his women patients stopped doing the work of free association that they had at first enthusiastically taken up and began shyly and then importunely to declare their love for him he shrewdly surmised that it was not "the charms of my person" that were the cause of the disturbance but, rather, that the women were in a state of readiness to fall in love. . . . Freud's clearsightedness about the profound impersonality of romantic passion was not an original insight.... [w]here Freud's genius came into play was in his extension of the metaphor of unseeing, solipsistic passion to the whole of human interaction. It began to dawn on Freud that it is not only love that is blind -- all our feelings toward and ideas about one another are marked by a magnificent obliviousness to reality.

An obliviousness at times including Freud. Marcus approaches the case history of  "Dora" -- which he rightly calls "one of the great works of literature" -- by focusing the lens of literary criticism on the negative transference. "[A]s the account progresses, Freud has never been more inspired, more creative, more inventive; as the reader sees Dora gradually slipping further and further away from Freud, the power and complexity of the writing reach dizzying proportions."      p 71

At the center of Freud's "novel" there is the inescapable fact that almost every character (including at times the analyst) has betrayed Dora. After many gripping surprises and reversals, Dora, in an act of pure revenge, abruptly leaves Freud stunned behind his couch, gasping like a spurned lover. In a dramatic sense it is deeply satisfying. Dora's is an overdetermined conclusion that strikes out at her father, her mother, Herr and Frau K -- and, most of all, at Freud himself.

What went wrong with the case...was something to do with the transference.... [and Freud] was in fact just beginning to learn about this therapeutic phenomenon.... [The Dora paper is] the first really important one about it to have been written.... On Dora's side the transference went wrong in several senses. In the first place there was the failure on her part to establish an adequate positive transference to Freud. She was not free enough to respond to him erotically -- in fantasy -- or intellectually -- by accepting his interpretations: both or either of these being prerequisites for the mysterious 'talking cure' to begin to work. And in the second, halfway through the case a negative transference began to emerge, quite clearly in the first dream....      p 75

So psychoanalysis comes full circle -- from the revenge of Hamlet to the revenge of Dora. Much of his psychology Freud absorbed from Shakespeare. From Hamlet's inexplicable viciousness toward Ophelia to Dora's transference to Freud, psychoanalysis -- explicitly or implicitly -- springs from the deepest well of the Western canon:  That would be Shakespeare.

Suppose the greatest play of the greatest psychologist must contain forerunners of key psychoanalytic concepts (if those concepts are in fact true). And if it's a valid concept, the "magnificent obliviousness" called transference must be in the play -- its characters, its plot, its poetry. Now, if you are like most people, you will not at first spot any transference. It seems to be nowhere obvious. But over time, experience with the play lights up the so-called 'problems' that have long intrigued the English-speaking world. For the riddle of transference, might we not take Hamlet as a start? Here is a list of its puzzles, in no particular order, dashed off to illustrate how rich and varied they are: 

           'Who's there?' Do the guards and Horatio see the Illusion as the soul of Hamlet's father?

            Is Horatio from Denmark or a visitor? Why and when, really, did he come to Elsinore?

            Is Fortinbras a reckless adolescent or a competent leader fit to inherit the throne of Denmark?

            How is Hamlet 'melancholy'? Does he want to die? Does he really need to feign madness? Is he really mad?

            He tells Rosencrantz and Guildenstern he no longer exercises, so why does he tell Horatio he exercises daily?

            How old is 'young Hamlet'? If he's 30 (as implied in the Graveyard scene) why is he still a student?

            Did Hamlet really want to be king?  Just how angry is he at the election/ usurpation of Claudius?

            Is Claudius really a drunk? Does Hamlet himself know why he doesn't kill Claudius when he has the chance?

            Why is Hamlet so angry at Gertrude? Why is he so contemptuous of Polonius? Why is he so cruel to Ophelia?

            Don't both the Dumb Show and the Mousetrap depict Claudius's murder of the King? Isn't one redundant?

            Why does Claudius not react to the Dumb Show's accusation but, seconds later, he reacts to the play?

            What do the Court and others in the audience think is the reason for Claudius's aborting the performance?

            Why is Hamlet so attached to Horatio? When they first meet at Elsinore, why does Hamlet barely recognize him?

            How does he mistake Polonius behind the arras for Claudius when he's just left Claudius at prayer?

            Why can't Gertrude see the Ghost? How can she describe Ophelia's death when she wasn't there?

            What is the dramatic function of the fool Yorick, Hamlet's childhood companion?

            Why does Hamlet return from the sea much changed? Where does his fatalism come from?

            Isn't the timing of Fortinbras's arrival at Elsinore just a bit too coincidental?


To begin with 'the problem of problems,' Hamlet's procrastination, Freud had his own answer: the Oedipus Complex. But scores of papers and books over the past century refute it. What if Freud missed the larger point? What if many of these problems are ultimately traceable to transference? Might this magnificent obliviousness be a key to the problems in Hamlet ? It's a question worth asking.


Bird B. Notes on transference:  universal phenomenon and hardest part of analysis. J Am Psychoanal Assoc 1972;20:267-301
 
Luborsky L,  Mellon J, Cohen KD, van Ravenswaay P, Hole AV,  Childress AR, Ming S, Crits-Christoph P. A verification of Freud’s grandest clinical hypothesis:  the transference. Clin Psychology Rev 1985;5:231-246
 
Malcolm J. The patient is always right. [Review of M. M. Gill's Analysis of transference]. NY Rev Books 1984;31(December 20):13-18, http://www.nybooks.com/articles/5622
 
Marcus S. (1993). Freud and Dora:  story, history, case history. In Essential papers on literature and psychoanalysis. E Berman, ed. New York, New York University 1993: 36-80. (Original 1974)http://www.nybooks.com/articles/5622

Winnicott DW. On transference (1956). In Essential papers on transference, AH Esman ed. New York, New York University 1990: 246-251
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