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작성자  simonshin 작성일  2016.11.16 14:26 조회수 1416 추천 0
 신현근 박사 강의안 - 전이와 역전이  
첨부파일 : f1_20161116142615.pdf

과목현대 갈등 이론 (Modern Conflict Theory)

주제:  Transference and Countertransference

내용:  강의안 전이와 역전이

교재:  Brenner, C. (1982). The Mind in Conflict. New York: International Universities Press.

 1.       Traditional views

1.1.    Transference is a concept which is, in the mind of every analyst, firmly connected with the analytic situation.

1.2.    Analysts are generally agreed that transference can develop fully only in the setting of an analysis and many insist that analysis is not really analysis unless a patient develops a full-blown transference neurosis, although, admittedly, there is no generally accepted definition of what a full-blown transference neurosis is.

1.3.    Still, all agree that the development of transference, that transference as a phenomenon in psychic life, stands in a special relation to psychoanalysis as therapy and to psychoanalytic situation.


2.       Brenner’s  views

2.1.    Wishes for gratification, anxiety, depressive affect, defense, and superego derivatives, all originating in early childhood, play major roles in every object relation of later childhood and adult life.

2.2.    It is true that a patient’s relation to the analyst is profoundly influenced by childhood wishes, i.e., by childhood drive derivatives, and the conflicts they gave rise to.

2.3.    It is true that in an analytic situation the wishes and conflicts of early childhood are transferred to the analyst.

2.4.    It is not true, however, that there is anything unique or special about such a transference.

2.4.1.Every object relation is a new edition of the first, definitive attachments of childhood.

2.4.2.A patient’s relation to his or her analyst is no exception.


3.        It is not even true that in the relation of patient to analyst the importance of childhood wishes and conflicts is of greater relative importance than it is in other human relations.

3.1.    Transference is ubiquitous.

3.2.    It develops in every psychoanalytic situation because it develops in every situation where another person is important in one’s life.


4.       What is unique about transference in psychoanalysis is not its presence, but the way it is dealt with.

4.1.    In an analytic situation, an analyst responds to a patient’s transference in a way that is unique.

4.2.    An analyst analyzes a patient’s transference instead of responding to it any other way.

4.3.    It is analysis of the transference that is unique to analysis, not transference itself.


5.        Freud’s views

5.1.    When a repressed sexual wish or impulse of childhood is aroused during analysis, the patient, instead of remembering what he or she felt at the time and to whom the feeling was directed, applies it to the analyst as a current wish.

5.2.    He recognized that transference of wishes occur in every analysis and, for that matter, in the nonanalytic treatment of every patient suffering from hysteria.

5.3.    Freud distinguished between transference and normal object relations.

5.4.    The normal outlet for sexual wishes, Freud believed, is in sexually gratifying object relations or in sublimation.

5.5.    Only the sexual wishes of childhood which repression has rendered incapable of gratification appear in therapy as transferences.

5.5.1.Freud saw transference as one of pathological phenomena properly subsumed under the heading, return of the repressed.

5.5.2.He did not believe it to be an example of a normal object relation, as I maintain it is.


6.       Another of Freud’s views on transference

6.1.    Another of Freud’s views on transference, worth noting, was that there are mentally ill patients whom the very nature of their psychopathology has rendered incapable of developing a true, analytic transference.

6.2.    Analyzable psychoneuroses, which were thought to be hysterias and obsessional neuroses, were grouped together as the transference neurosis, while the others, which included severe depressions and other types of psychosis, were called the narcissistic neurosis.

6.3.    One might say that, according to Freud, transference characterizes only the pathology of psychoneurosis (Note: “Psychoneurosis” may be replaced by “transference neurosis”).

6.3.1.For sicker patients it is impossible; for the normal it is unnecessary.


7.       Historical overview

7.1.    Freud first conceived transference to be a manifestation of the id.

7.1.1.He saw transference as an expression of repressed childhood sexual wishes or drive derivatives.

7.2.    Much later A. Freud and Fenichel called attention to what they called defense transferences, i.e., to the role of defense in transference.

7.3.    As for the role of the superego in transference, once the concept of superego was introduced by Freud (1923), it rapidly became a commonplace observation, even an obvious one, that patients often attribute to the analysts the guilt or moral condemnation they themselves feel for their own thoughts and actions.

7.4.    Thus the role of drive derivatives, of defense, and of superego functioning in one or another example of transference has gradually become apparent.

7.5.    What was not appreciated until recently, however, is that every one of these components of conflict plays a role in every example of transference.


8.       A case

8.1.    The patient was a woman in her mid-twenties.

8.1.1.A striking feature of her behavior during the second year of her analysis was the frequency with which she argued with me.

8.2.    The patient soon realized that arguing with me in analysis was like arguing with her father during her adolescence.

8.2.1.For one thing, it gratified both aggressive and libidinal drive derivatives.

8.2.2.It was intended both to defeat and humiliate me in a special way and to gratify her wish for sexual intercourse with me.              If her father lost her temper, if he shouted at her, swore, and was otherwise unreasonable, she would feel triumphant.              That the quarreling with me also gratified the sexual wishes she had unconsciously cherished for her father in her adolescence was made clear somewhat later, when she became aware, after yelling at me angrily, rushing out of my office in tears, and locking herself in the lavatory, that she felt like masturbating.

8.2.3.Another meaning of the patient’s arguing with me had to do with anxiety and depressive affect, both of which, like the drive derivatives expressed in and gratified by arguing, had their origins in her oedipal period.              Her anger at me, as at her father, for not showing h preference she longed for, and her consequent desire to take revenge by besting me in an argument was a defensive reaction that minimized the castration depressive affect caused by her not having a penis.

8.2.4.Defensive function of all the aspects of arguing with me is obvious.              Being angry minimized or eliminated depressive affect, the content of which was both castration and loss of love.              It did so by opposing her wishes to possess my penis, to have a baby from me, and to be my beloved wife.              When she argued with me, she could belittle such wishes, ignore them, or put them comfortably in the past.              In addition, her troublesome wishes, her fears, and her misery were all displaced and disguised in their transference manifestation of arguing with me, as they had been in adolescence when she argued with her father.              She argued with me not to avoid feeling castrated and humiliated, but because it seemed to her I was trying to ram down her throat something that was untrue.              Or she was angry and argued, she believed, because I provoked her by my insolent, condescending manner, or tone of voice, or both.

8.2.5.Arguing had superego aspects as well.              All through childhood the patient was guilty about wanting what did not belong to her or what she felt more that her share.              This attitude had pervaded her relationship with father during her oedipal phase as well as thereafter.              She was guilty at wanting me all to herself and was remorseful when she felt she had me.              To feel that I was provocative, ungiving, contemptuous of her, or otherwise disagreeable represented punishment and penance she unconsciously felt she deserved and must have if she was to be forgiven by mother and other rivals.              Thus her bitterness and most cherished reproaches concerned my refusal to advise her how to help the members of her family – mother and sibling – who were the surviving rivals of her childhood.

8.3.    The illustration just offered has to do with but one feature of my patient’s transference.

8.3.1.The point I wished to illustrate is that every transference manifestation is a compromise among all the components of psychic conflict.


9.       It is useless and potentially misleading to ask about any transference manifestation whether it is gratifying, defensive, or self-punitive, i.e., whether it derives from id, ego, or superego.

9.1.1.One must understand in advance that a transference manifestation is a compromise among all three.

9.1.2.The question is never, “Is this a drive derivative, transferred to an analyst?” or “Is this transference of defense?”

9.1.3.The correct question is always, “What defensive functions this transference manifestation serve, what drive derivatives does it gratify, and in what ways is it a manifestation of superego functioning?”

9.1.4.At a particular time one or another component may be more readily identified than others, but all are invariably present.


10.   Transference neurosis

10.1.                     The term transference neurosis is a tautology.

10.2.                     The concept is anachronism.

10.3.                     A transference manifestation is dynamically indistinguishable from a neurotic symptom.

10.4.                     To call it neurotic or to call the totality of transference a neurosis is to add a word without adding meaning.

10.5.                     Transference is enough.

10.6.                     Nothing is gained by expanding the term to transference neurosis.


11.   Erotic transference

11.1.                     Freud said that when an analytic patient expresses sexual desires for her analyst, whether these be spoken or unspoken, the analyst must understand two things. 

11.1.1.    The first is that such erotic wishes are not a tribute to his charm.          They are transference.

11.1.2.    The second is that such wishes are invariably in the service of resistance.          A patient who is in love with her analyst, said Freud, has fallen in love to avoid analyzing.

11.2.                     To speak of an erotic transference today, however, is using a confusing misnomer.

11.3.                     Transference always includes among its components both libidinal and aggressive drive derivatives.

11.3.1.    It always includes childhood sexual wishes.

11.4.                     One should not think or speak of an “erotic transference” as though there were some other kind.


12.   Positive transference or negative transference

12.1.                     Neither should we speak of positive or of negative transference.

12.2.                     One can speak appropriately of manifestations of negative or positive transference feelings or of negative or positive transference wishes, or both, in an analysis.

12.3.                     Transference as a whole, however, is never simply positive or negative.

12.4.                     It is always ambivalent, as decades of analytic experience attest.


13.   Benign positive transference

13.1.                     Benign positive transference, a term also introduced by Freud, is another concept which is best discarded.

13.2.                     In the light of transference as a compromise formation, benign transference is at best a poor name for whatever aspects of transference help, at the moment, to further the work of analysis.

13.3.                     As Stein pointed out, it often happens that the very manifestations of transference which are helpful at one time during an analysis are formidable resistances at another.

13.4.                     Not all helpful transference manifestations are positive.


14.   Regression

14.1.                     The role of regression in the development of transference in psychoanalysis should be reevaluated.

14.2.                     The transference manifestations are not increasingly infantile because transference, in and of itself, entails regression.


15.    Lack of transference

15.1.                     To assert that a patient does not or cannot develop a transference is to assert an impossible.

15.2.                     Transference is ubiquitous.

15.2.1.    It develops in every psychoanalytic situation, not because of the unique features of the situation, but because it develops in every situation where another person is important in one’s life.

15.2.2.    Every object relation expresses the drive derivatives of childhood and the conflict to which they have given rise.

15.3.                     Whatever a patient’s reaction to the analyst may be, whether it is readily analyzed or impenetrable to one’s best efforts, it is a compromise formation arising from conflicts of childhood origin.


16.   Countertransference

16.1.                     An analyst’s relation with each patient is also determined, genetically and dynamically, by childhood drive derivatives and the conflicts to which they gave rise.

16.2.                     What is called countertransference in psychoanalysis are manifestations of the ubiquitous phenomena in the analyst’s reactions to the patient.

16.2.1.    Transference and countertransference are indistinguishable dynamically and genetically.

16.3.                     Manifestations of transference in an analysis are analyzed rather than dealt with or responded to in other ways.

16.3.1.    Manifestations of countertransference are not analyzed with the patient’s participation or, at any rate, they should not be.

16.4.                     Patients usually seek analysts for therapy, while analysts see patients as a matter of vocational choice.

16.4.1.    The practical importance of transference is its analyzability, i.e., its accessibility to analysis.

16.4.2.    The practical importance of countertransference is whether it interferes with psychoanalysis or whether it assists the process.

16.5.                     What is of great importance here is that transference and countertransference are compromise formations.

16.6.                     The practical value of transference lies in its being analyzed.

16.6.1.    The practical value of countertransference is that it facilitates analysis by promoting an analyst’s ability to analyze.

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