There are some differences between how the therapeutic relationship is con- ceptualized by classical analysis and current relational analysis. The classical analyst stands outside the relationship, comments on it, and offers insight- producing interpretations. In contemporary relational psychoanalysis, the therapist does not strive for a detached and objective stance. Instead, the par- ticipation of the therapist is a given, and he or she has an impact on the client and on the here-and-now interaction that occurs in the therapy context (Alt- man, 2008). Contemporary psychoanalytic theory and practice highlights the importance of the therapeutic relationship as a therapeutic factor in bringing about change (Ainslie, 2007). Through the therapeutic relationship “clients are able to fi nd new modes of functioning that are no longer encumbered by the neurotic confl icts that once interfered with their lives” (p. 14). According to Lu- borsky, O’Reilly-Landry, and Arlow (2008), current psychodynamic therapists view the emotional communication between themselves and their clients as a useful way to gain information and create connection.
Transference is the client’s unconscious shifting to the analyst of feelings and fantasies that are reactions to signifi cant others in the client’s past. Trans- ference involves the unconscious repetition of the past in the present. “It re- fl ects the deep patterning of old experiences in relationships as they emerge in current life” (Luborsky et al., 2008, p. 46). The relational model of psychoanaly- sis regards transference as being an interactive process between the client and the therapist. A client often has a variety of feelings and reactions to a thera- pist, including a mixture of positive and negative feelings. When these feelings become conscious, clients can understand and resolve “unfi nished business”
from these past relationships. As therapy progresses, childhood feelings and confl icts begin to surface from the depths of the unconscious. Clients regress emotionally. Some of their feelings arise from confl icts such as trust versus mistrust, love versus hate, dependence versus independence, and autonomy versus shame and guilt. Transference takes place when clients resurrect from their early years intense confl icts relating to love, sexuality, hostility, anxiety, and resentment; bring them into the present; reexperience them; and attach them to the analyst. For example, clients may transfer unresolved feelings to- ward a stern and unloving father to the analyst, who, in their eyes, becomes stern and unloving. Angry feelings are the product of negative transference,
but clients may also develop a positive transference and, for example, fall in love with the analyst, wish to be adopted, or in many other ways seek the love, acceptance, and approval of an all-powerful therapist. In short, the analyst be- comes a current substitute for signifi cant others.
If therapy is to produce change, the transference relationship must be worked through. The working-through process consists of an exploration of unconscious material and defenses, most of which originated in early child- hood. Working through is achieved by repeating interpretations and by explor- ing forms of resistance. It results in a resolution of old patterns and allows cli- ents to make new choices. Effective therapy requires that the client develop a relationship with the analyst in the present that is a corrective and integrative experience. By experiencing a therapist who is engaged, caring, and reliable, clients can be changed in profound ways, which can lead to new experiences of human relationships (Ainslie, 2007).
Clients have many opportunities to see the variety of ways in which their core confl icts and core defenses are manifested in their daily life. It is assumed that for clients to become psychologically independent they must not only be- come aware of this unconscious material but also achieve some level of freedom from behavior motivated by infantile strivings, such as the need for total love and acceptance from parental fi gures. If this demanding phase of the therapeu- tic relationship is not properly worked through, clients simply transfer their in- fantile wishes for universal love and acceptance to other fi gures. It is precisely in the client–therapist relationship that the manifestation of these childhood motivations becomes apparent.
Regardless of the length of psychoanalytic therapy, traces of our childhood needs and traumas will never be completely erased. Infantile confl icts may not be fully resolved, even though many aspects of transference are worked through with a therapist. We may need to struggle at times throughout our life with feelings that we project onto others as well as with unrealistic demands that we expect others to fulfi ll. In this sense we experience transference with many people, and our past is always a vital part of the person we are presently becoming.
It is a mistake to assume that all feelings clients have toward their thera- pists are manifestations of transference. Many of these reactions may have a re- ality base, and clients’ feelings may well be directed to the here-and-now style the therapist exhibits. Not every positive response (such as liking the therapist) should be labeled “positive transference.” Conversely, a client’s anger toward the therapist may be a function of the therapist’s behavior; it is a mistake to label all negative reactions as signs of “negative transference.”
The notion of never becoming completely free of past experiences has signifi cant implications for therapists who become intimately involved in the unresolved confl icts of their clients. Even if the confl icts of therapists have surfaced to awareness, and even if therapists have dealt with these personal issues in their own intensive therapy, they may still project distortions onto clients. The intense therapeutic relationship is bound to ignite some of the un- conscious confl icts within therapists. Known as countertransference, this phe- nomenon occurs when there is inappropriate affect, when therapists respond
in irrational ways, or when they lose their objectivity in a relationship because their own confl icts are triggered. In a broader sense, countertransference in- volves the therapist’s total emotional response to a client. Hayes (2004) refers to countertransference as the therapist’s reactions to clients that are based on his or her unresolved confl icts. Gelso and Hayes (2002) indicate that research has shed light on specifi c causes of countertransference within the therapist such as confl icts revolving around the therapist’s family experiences, gender roles, parenting roles, and unmet needs.
It is critical that therapists become aware of the countertransference so that their reactions toward clients do not interfere with their objectivity. For exam- ple, a male client may become excessively dependent on his female therapist.
The client may look to her to direct him and tell him how to live, and he may look to her for the love and acceptance that he felt he was unable to secure from his mother. The therapist herself may have unresolved needs to nurture, to foster a dependent relationship, and to be told that she is signifi cant, and she may be meeting her own needs by in some way keeping her client dependent.
Unless she is aware of her own needs as well as her own dynamics, it is very likely that her dynamics will interfere with the progress of therapy.
Not all countertransference reactions are detrimental to therapeutic prog- ress. Indeed, countertransference reactions can provide an important means for understanding the world of the client. Hayes (2004) reports that most re- search on countertransference has dealt with its deleterious effects and how to manage these reactions. Hayes adds that it would be useful to undertake systematic study of the potential therapeutic benefi ts of countertransference.
Gelso and Hayes (2002) contend that it is important to study and understand all of the therapist’s emotional reactions to the client, which fi t under the broad umbrella of countertransference. According to Gelso and Hayes, coun- tertransference can greatly benefi t the therapeutic work, if therapists study their internal reactions and use them to understand their clients. Ainslie (2007) also agrees that the therapist’s countertransference reactions can pro- vide rich information about both the client and the therapist. Ainslie states that the contemporary understanding of countertransference “has broadened signifi cantly to include a range of feelings, reactions, and responses to the client’s material that are not seen as problematic but, on the contrary, are viewed as vital tools to understanding the client’s experience” (p. 17). What is critical is that therapists monitor their feelings during therapy sessions, and that they use their responses as a source for understanding clients and help- ing them to understand themselves.
A therapist with a relational perspective pays attention to his or her coun- tertransference reactions and observations to a particular client and uses this as a part of therapy. The therapist who notes a countertransference mood of irritability, for instance, may learn something about a client’s pattern of being demanding. In this light, countertransference can be seen as potentially useful if it is explored in therapy. Viewed in this more positive way, countertransfer- ence can become a key avenue for helping the client gain self-understanding.
What is of paramount importance is that therapists develop some level of objectivity and not react defensively and subjectively in the face of anger, love,
adulation, criticism, and other intense feelings expressed by their clients. Most psychoanalytic training programs require that trainees undergo their own extensive analysis as a client. If psychotherapists become aware of symptoms (such as strong aversion to certain types of clients, strong attraction to other types of clients, psychosomatic reactions that occur at defi nite times in thera- peutic relationships, and the like), it is imperative for them to seek professional consultation or enter their own therapy for a time to work out these personal issues that stand in the way of their being effective therapists.
The client–therapist relationship is of vital importance in psychoanalytic therapy. As a result of this relationship, particularly in working through the transference situation, clients acquire insights into the workings of their un- conscious process. Awareness of and insights into repressed material are the bases of the analytic growth process. Clients come to understand the asso- ciation between their past experiences and their current behavior. The psy- choanalytic approach assumes that without this dynamic self-understand- ing there can be no substantial personality change or resolution of present confl icts.
Application: Therapeutic Techniques and Procedures
This section deals with the techniques most commonly used by psychoana- lytically oriented therapists. It also includes a section on the applications of the psychoanalytic approach to group counseling. Psychoanalytic therapy, or psychodynamic therapy (as opposed to traditional psychoanalysis), includes these features:
• The therapy is geared more to limited objectives than to restructuring one’s personality.
• The therapist is less likely to use the couch.
• There are fewer sessions each week.
• There is more frequent use of supportive interventions—such as reassur- ance, expressions of empathy and support, and suggestions—and more self-disclosure by the therapist.
• The focus is more on pressing practical concerns than on working with fantasy material.
The techniques of psychoanalytic therapy are aimed at increasing awareness, fostering insights into the client’s behavior, and understanding the meanings of symptoms. The therapy proceeds from the client’s talk to catharsis (or ex- pression of emotion) to insight to working through unconscious material. This work is done to attain the goals of intellectual and emotional understanding and reeducation, which, it is hoped, leads to personality change. The six basic techniques of psychoanalytic therapy are (1) maintaining the analytic frame- work, (2) free association, (3) interpretation, (4) dream analysis, (5) analysis of resistance, and (6) analysis of transference. See Case Approach to Counseling and Psychotherapy (Corey, 2009, chap. 2), where Dr. William Blau, a psychoana- lytically oriented therapist, illustrates some treatment techniques in the case of Ruth.