The Therapist: Transference
Having discussed the mechanisms of therapeutic change in group therapy, the tasks of the therapist, and the techniques by which the therapist accomplishes these tasks, I turn in this chapter from what the therapist must do in the group to how the therapist must be. Do you, as therapist, play a role? To what degree are you free to be yourself? How "honest" can you be? How much transparency can you permit yourself?
Any discussion of therapist freedom should begin with transference, which can be either an effective therapeutic tool or a set of shackles that encumbers your every movement. In his first and extraordinarily prescient essay on psychotherapy (the final chapter of Studies on Hysteria [ 1895]), Freud noted several possible impediments to the formation of a good working relationship between patient and therapist. 1 Most of these could be resolved easily, but one stemmed from deeper sources and resisted efforts to banish it from the therapeutic work. Freud labeled this impediment. Transference, since it consisted of attitudes toward the therapist that he believed had been "transferred" from earlier attitudes toward important figures in the patient's life. These feelings toward the therapist were "false connections "--new editions of old impulses.
Only a few years passed before Freud realized that transference was far from an impediment to therapy; if used properly, it could be the therapist's most effective tool. 2 What better way to help the patient recapture the past than to allow him or her to reexperience and reenact ancient feelings toward parents through the current relationship to the therapist? Furthermore, the intense and conflicted relationship often developing with the therapist, which he termed the transference neurosis, was amenable to reality testing; the therapist could treat it and, in so doing, simultaneously treat the infantile conflict. Considerable evolution in psychoanalytic technique has occurred over the last half-century, but, until recently, certain basic principles regarding the role of transference in psychoanalytic therapy have endured with relatively little change: