Dear Colleagues,

I've enjoyed the interesting discussion here about the nature of transference.
I think perhaps the greatest discovery of psychoanalysis is how people do
indeed construct a version of reality in accordance with their needs, wishes,
fantasies, etc., which extends to groups, cultures, and the "reality" (or
fantasy) of world politics and diplomacy.

Although "distortion" seems to fit the frequently radical nature of
transference, I think it's a term which is unnecessary and inaccurate;  (1) it
can be used to presuppose that the therapist/analyst's view of reality is
better or more accurate than the patient's, which can lead to subtle forms of
authoritarianism in therapy (2) reality and transference (fantasy) are not
necessarily mutually exclusive.   For instance, a patient may perceive his
therapist as overly rigid, a view that may even correspond to that of the
therapist's colleagues and friends;  however, what might be significant about
the patient's perception is why he is fixed on this idea, at the expense of
other aspects of the therapist's personality, and in this there may be
transference;  another patient might experience the same therapist
differently, or might be aware of a certain rigidity of the therapist but
might instead be irked by yet other aspects of the therapist's character.

And so, I've come to see and utilize transference in terms of "the patient's
'experience' of the therapist,"  without having to get into discussions or
debates with the patient about whether their experience is real versus unreal,
accurate versus inaccurate, which sounds like Gill's position on the face of
it.  Eric Gillette picked up on the solopsistic nature of this position, which
is one that I apply flexibly in my work;  which is to say that how a patient
views me is his/her choice based on a multitude of determinants, including my
presence and mannerisms, the latter which ought not be denied as having
influence on the matter.  The aspect of transference, however, has to do with
why THIS patient views my behavior in a particular way, whereas another
patient would view my same mannerisms and style quite differently; or why the
patient becomes fixed to certain aspects of my character or behavior, at the
expense of other aspects.

To be sure, a radical solopsistic approach in treatment also has its problems,
since when taken to an extreme it can undermine the patient's sense of reality
about his/her life, and can be used to deny that the therapist's or analyst's
behavior has any bearing or influence on the analytic process.  However, when
applied with sensitivity and tact, I think it offers the greatest potential
for unearthing the patient's motives for his/her view of Self and the outside
world, which is something the patient can do something about and change if
he/she wishes to do so, in contrast to changing the outside world.

All of the issues that others have discussed are ones which I routinely
grapple with.
I don't feel comfortable with either a radical solopsistic view of
transference or reality, but neither do I feel completely at ease with a view
which sees the therapist's behavior (or childhood experience for that matter)
as the "cause" of the patient's view of Self and of Others, in a linear sense,
as useful as the latter view may be at times, experientially speaking.  As
others have pointed out, however, arriving at a shared and mutually agreeable
vision of the patient's reality seems to be one of the  desireable features of
psychoanalytic therapy.

Do we construct reality from the outside in, the inside out, or both?  A
complex question which has tremendous implications for how to understand child
development, the psychoanalytic endeavor and psychoanalytic technique.  I
guess my tentative, working assumption, is that it's always BOTH, but that the
main (not exlusive) emphasis of psychoanalytic treatment is looking at what
the patient brings to the table (i.e. how his view of me is shaped by forces
inside of him), while being open about the influences which I bring to bear on
the process.

Regards,

David Mittelman, Ph.D.


In a message dated 98-05-22 09:12:03 EDT, James Duffy, Ph.D., wrote:

<<......First I disagree that if I assert that you are distorting reality then
I must be presupposing that reality is knowable......>>