transference as mistaken identity

January 6, 2019

Thinking About Transference in a New Way

Transference — erotic and otherwise — is worth an unconventional look.

What past events push one toward an unconscious like or dislike of his therapist? What previous learning does the patient now misapply to a stranger who offers help?

A child reacts to his parents based on reiterated experience. If the adults are pleasant and welcoming, his sentiments tend toward the benign. If the guardian’s proximity signals rash criticism, irrational outbursts, or inappropriate physical contact, he associates them with troubled, private states of mind and feeling.

The young one’s mood changes even in anticipation of adult attention. Looking forward to mom or dad’s return home from work can trigger joy or fear. Repeated signals of happiness or trouble will be learned. When an alcoholic overseer opens a beer can, the internal stir tells the child what might soon happen.

The scene or place connected to a wound matters. The familiar location informs a sensitive offspring of potential discomfort. A bedroom, for example, causes alarm if sexual abuse tends to occur there. The boy or girl’s emotional alteration becomes automatic. Conscious thought isn’t necessary.

We are thus conditioned by neglectful or abusive parents. The brain is a predictor, foreseeing danger. Our time at home trained us to notice subtle warning signs of mistreatment. High alert occurs in proximity to anyone resembling those who inflicted the injury, as if we are wearing glasses enlarging false positive features of menace. The distorting lenses sometimes govern how we see employers, friends, and lovers. Youthful coping mechanisms kick into gear.

A trauma survivor’s life is one of constant reliving.

What characteristics of the therapist contribute to this? First, counselors are most often older than the patient, just as the mom and dad were senior to him. The treating professional has an advantage of authority and power in the relationship, as guardians do. He also sets rules and requires their fulfillment. Payment is expected, rather like the home stipulation to do your chores, or else.

The doctor creates the schedule and determines the length of the session. If you wanted more intimacy with your parent, you might be frustrated by your provider’s boundaries. If you never felt special in the family, the doctor’s full caseload reminds you of growing up without status. You are one of a crowd, not first in line.

A clinician needn’t do anything remarkable to provoke a facsimile recreation of a historical script he never read. As if by magic, he arranges the set for the client’s long-running drama. The latter’s well of resentment, love, sadness, and yearning reveal themselves act by act.

A considerate and wise healer gives all his attention, looks in your eyes, and accepts you without judging. You know little about his life. His imputed resemblance to the rejecting sire allows you a mirage-like new chance at the love you never won. He assumes the form of the imagined caretaker you didn’t have, now come to life.

Transference is a kind of disguise, a costume the unknowing client applies to his doctor, who is taken for someone else. The apparel designer’s imagination fills him with qualities belonging elsewhere.

A risk exists here: the mistaken identity can overwhelm the therapist’s capacity to interpret it and refer it back to the initial source.

If this sounds like a guarantee of a bad outcome, however, it isn’t.

Once you accept the idea of transference, you may begin to actively catch the triggered emotions as they develop (or soon after) and work on their underlying cause: the ancient shadow of old relationships and the need to grieve them.

An erotic transference must be more tactfully managed. Tender feelings, romantic or not, are problematic even when unmentioned. While their connection to the past is identical to more common transferential moments, the universal hope for a sainted parent or perfect mate adds a layer of complexity to emotional resolution.

In each case, if your counselor does not overreact to your unhappiness, resentments, or thirst for unique closeness, your imbedded responses should lessen: they will be extinguished or unlearned with time. Likewise, the ability to recognize the difference between your doctor and early custodians is a first step toward doing the same with bosses, companions, and suitors.

People will be recognized more as they are, less similar to Halloween characters. Improved life choices and increasing ease of intimacy becomes possible.

Life and therapy offer us endless challenges. Muhammad Ali, a man who knew a bit about contests inside and outside the ring, offered this advice:

I hated every minute of training, but I said,
‘Don’t quit. Suffer now and live the rest of your life as a champion.’

——

The first and last images above are both untitled painting by V.S. Gaitonde, the last from 1953. The middle work is called Painting No. 1, 1962, by the same artist.

December 16, 2017

Is Erotic Transference Ever the Thing We Call Love?

Erotic transference is troublesome. Counselors are trained to view its occurrence in one way only: a counterfeit of real love. Sexual feelings toward the therapist are pathologized, made into a kind of specimen for microscopic examination rather than something more basic. Is there another way? Are a patient’s affection and desire for the counselor ever no different than the early stages of romance? Perhaps we therapists go too far in making something unusual of a thing we might otherwise call love.

For those unfamiliar with the topic, I’d suggest you read my 2015 essay before proceeding. The psychoanalytic view of erotic transference refers to its infantile nature, an unrealistic and intense quality of “wanting” presumably not found in other romantic attachments. The contrast with non-clinical love is emphasized more than the likeness.

What I wrote in 2015 reflected the field’s accumulated wisdom and the observations of countless practitioners who recognized the amorous gaze of the patient across the room: the look that signaled “I only have eyes for you.” The allegedly misplaced affection is a common therapeutic occurrence, marked down because of its commonness and the clinician’s need to guide the process toward a therapeutic end, not a romantic one.

I am not talking about the extreme of erotic transference, where desire becomes obsession and stalking. Within the less acute expression of feelings, however, I would include those patients who profess their love (or keep it secret), say their genitals lubricate (or, for men, become erect) in session; offer themselves in words, dress to seduce, and bring suggestive gifts to the doctor. All these happened in my practice. They happen in every practice.

More than rejection frustrates such clients. They can feel discounted, their yearning made into another treatment issue to be worked on, worked through, and worked-over. They are told their emotions will likely disappear even if those stirrings are the most enlivening experience in their lifetime. The therapist’s intellectualization of the heart-throb and heartache makes the matter of the client’s heart a conundrum for the doctor’s head. The patient and practitioner then operate in two universes: the former feeling the issue, the latter thinking about it, unless he reciprocates the patient’s sentiments.

My profession considers erotic transference a kind of mistaken identity due to your history and because of the nature of treatment. A sensitive and wise healer gives all his attention, looks in your eyes, and accepts you without judging. You know little about his personal life. You automatically infer qualities in him for which you have no evidence, unconsciously imagining he is like the loving parent you never had (for example). He seems to fill a vast, cavernous, lonely gap in your heart. All true, but not so different from other infatuations.

Perhaps we would do better to recognize that love often depends on what we don’t know about the other, not only what we do. How many people understand the partner well before they fall in love? Many questions have not been asked – may never be asked and answered by words or observation. This is true in the extreme for young people, where the right questions are not yet known. They do not even know themselves. Hormones rule the day.

Counselors also should admit – especially in this day of therapists’ websites describing their practices, listing credentials and schools attended, and maybe even including a blog (!) – that we aren’t the blank slates we believe ourselves to be. Unless seated behind the reclining patient’s pillowed head, we have always had a physical presence, tone of voice, a smile, laughter, and movement. No, the client is not dealing with a shadow or computerized speech.

In almost all fresh attractions, aren’t the fantasy, the newness, and imagination what it means to be in any romantic, early-stage love? Throw in uncertainty, idealization and physical urging. These are among the most magical and wondrous qualities of romance. Over the long haul it can be argued that loyalty, devotion, kindness, respect, similar interests, proportion, compatible values, pulling together, and shared experience are more important, but they do not send a shiver down the spine.

Devotion does not levitate, no matter however precious and essential.

Therapists are not the only people about whom one experiences transference (or stimulus generalization). Has not a new person reminded you of someone else in your past? Think for a moment:

  • Bosses, teachers, the next door neighbor.
  • The neighborhood bully, father and mother figures.
  • Political leaders.
  • Mentors, the people we instinctively dislike, and those we are automatically drawn to.

If I am right, the therapeutic management of transference requires a different kind of sympathy, more recognition for the genuine nature of what is in the patient’s heart and the sensual pulse in her being. This will be difficult for the therapist, rather like dealing with someone who says “I love you” outside the controlled atmosphere of his sealed-off office; with its sex-discouraging moat, doctor-patient ethical boundaries, and the requirement of therapeutic distance.

All this suggests that the process of her “getting-over” erotic transference may not only be a matter of uncovering the mistaken identity nature of feelings more properly attached to other people and earlier times, and releasing emotions derived from past relationships. The unrequited love then demands grieving not unlike other lost loves. Perhaps such grief-work can only be managed with a different therapist, although – one hopes – after the remaining treatment goals have been accomplished.

Though many counselors know better, those who believe the mistaken identity only happens in the office need to think again. The same patient who falls for you might already have fallen for others who reminded her of a loved one, with as little ability to look past the transferential aura to the truth of who her partner really was.

One more thought. Should therapists give a written warning to all their new clients?

BEWARE! YOU MIGHT FALL IN LOVE WITH ME!!!

If you are laughing for more than a few seconds, begin reading again at the top.

—

The first (undated) photo, School Cafeteria, was taken by the Adolph B. Rice Studios and comes from the Library of Virginia. The following picture of Swimmers Annette Kellerman and C.M. Daniels was taken in 1907 by G.G. Bain and is the property of the Library of Congress. Both are sourced from Wikimedia Commons.