Posted by pseudoname on April 10, 2006, at 12:56:19
In reply to still here :-), posted by pseudoname on April 10, 2006, at 10:32:54
(Possibly book-length. <chuckle>)
A couple times K has suggested that transference theory can be over-applied or isn't appropriate in interpreting all emotional problems. That sounds reasonable, but as far as I know, there isn't any scale or test for telling what is an appropriate situation to consider transference and what isn't. Gardernergirl also points out that not all emotions are transference, but there again, as far as I know, there is no test for telling what response is or isn't transferential.
Two candidates come up, but neither seems very good to me: intuition and therapeutic outcome.
Intuition about transference simply can't be evaluated. It isn't a naturalistic sort of “intuitive” inference like those we make when deciding whether someone's angry or lying. Those “intuitive” judgments can be tested in the laboratory and turn out sometimes to be reliable (like with sussing others' emotions) and sometimes not (detecting liars).
I personally found my analyst's appeals to his “gut” authority to be maddening. Intuition is often wrong, especially when there's no absolute standard to train it against. Intuition can be extremely valuable to humans in detecting subtle environmental cues, but when it does work in those situations it can also be backed up (later) by breaking down and referring to the environmental details that really *are* involved. In this way we can scientifically point to mouth/eyebrow correlations to show what makes a smile intuitively convincing.
That sort of scientific back-up is something the intuitive assessment of “transference” (etc) doesn't have, as far as I know.
I feel that therapeutic intuition is highly unreliable, meaning that different therapists have different intuitions. Studies running therapists head-to-head against each other diagnosing films of patient interviews showed very poor agreement in their intuitive judgments of things like transference. I personally think that the same therapist will have different intuitions about the same patient's transference on different days of the week because there's never anything that she can check her intuitions against in order to learn to make them better.
That leaves therapeutic outcome. I haven't looked for a study that isolates transference as a factor in therapy, but studies looking at psychoanalysis (in which transference theory is typically a big part) famously show dramatically poorer outcomes even than doing nothing. That doesn't blame transference theory itself, of course, but it doesn't look good.
Still, transference theory could be therapeutically *valid* (i.e., “work”) if the person improves due to its use, even if we can never say that transference of stored-up childhood emotions is really what's going on. Even if the idea of transference helps calm someone emotionally, that does not say that it's an accurate description of what's going on. Let me illustrate.
Consider Kleinian transference, which prominently involves The Breast. The hungry child sees himself as filled with badness and his mother's breast as filled with goodness. In suckling, the goodness in The Breast goes into the child and things are great for a while, until he's hungry again and then both resents and demands the goodness in The Breast. The child both hates and loves, rejects and needs The Breast, setting up a conflict played out in transference all the rest of his life.
Nice story, eh? Powerfully explanatory.
Consider a financially strapped guy who needs to ask his boss for raise. The guy feels he is highly deserving and should've gotten the raise from his rich, lazy boss long ago without asking. In a Kleinian interpretation, he sees himself as filled with weakness and passivity and insecurity and dependence — in short, with badness, just like when he was a hungry baby. He both hates and needs his boss, who can give him the goodness (money, promotion, etc) he both resents and loves.
He's emotionally all tied up in knots over this situation. He's too upset and afraid to approach his boss, yet he must in order to live. His Kleinian therapist explains the transference issues involving The Breast and voilà! The guy can approach his boss with a reasonable assertive request for a raise. Why? Because he no longer sees the boss as a threatening, all-powerful figure. He knows that the boss is really The Breast, and, heck, he's managed that type of situation since he was a baby.
Transferential awareness, the working-through, and cure.
Is Kleinian transference really going on? I really, really doubt it, despite the apparent therapeutic success. The pattern of behavior alleged here seems too specific to me, when we know that learning and mental connections are enormously complex and cross-referenced. This transference doesn't “look like” the behavioral changes we see in developmental biology, where early-stage responses drop off quite cleanly and naturally as mature adaptations appear.
But anyway I doubt that this sort of transference story-inspired courage will last the employed guy very long. The next insecurity problem he faces may not be so easily mapped onto the story of his infantile conflicts with The Breast.
To the extent that such transference stories *do* help, I think there is something else going on. And I think that the “something else” is what therapy and research should focus on. I think the therapeutic key here is that the guy acknowledges his fears and bad feelings and stops fighting them. His (I think mythical) explanation of transference allows him to relegate those feelings to a sort of sideline where he tolerates feeling them because he thinks they're not really related to any current *real* threats. They're left over from childhood. He can't do anything about them, so he feels them but ignores them and goes and asks his boss for a raise. I think THAT'S the therapy and that's what we should deal with more deliberately & directly.
poster:pseudoname
thread:628935
URL: http://www.dr-bob.org/babble/psycho/20060406/msgs/631392.html