Introductory lectures on psycho-analysis · Sigmund Freud
TWENTY-SEVENTH LECTURE TRANSFERENCE
It may be still comprehensible when a young woman who is unhappily married seems to be overwhelmed by a serious passion for her physician, if he is still unattached, and that she should be ready to seek a divorce and give herself to him, or, where circumstances would prevent this, to enter into a secret love-affair with him. That sort of thing, indeed, is known to occur outside psycho-analysis. But in this situation girls and women make the most astonishing confessions which reveal a quite peculiar attitude on their part to the therapeutic problem: they had always known that nothing but love would cure them, and from the beginning of the treatment they had expected that this relationship would at last yield them what life had so far denied them. It was only with this hope that they had taken such pains over the analysis and had conquered all their difficulties in disclosing their thoughts. We ourselves can add: ‘and had understood so easily all that is usually so hard to accept.’ But a confession of this kind astounds us; all our calculations are blown to the winds. Could it be that we have omitted the most important element in the whole problem?
And actually it is so; the more experience we gain the less possible does it become for us to contest this new factor, which alters the whole problem and puts our scientific calculations to shame. The first few times one might perhaps think that the analytic treatment had stumbled upon an obstruction in the shape of an accidental occurrence, extraneous to its purpose and unconnected with it in origin. But when it happens that this kind of attachment to the physician regularly evinces itself in every fresh case, under the most unfavourable conditions, and always appears in circumstances of a positively grotesque incongruity—in elderly women, in relation to grey-bearded men, even on occasions when our judgement assures us that no temptations exist—then we are compelled to give up the idea of a disturbing accident and to admit that we have to deal with a phenomenon in itself essentially bound up with the nature of the disease.
The new fact which we are thus unwillingly compelled to recognize we call TRANSFERENCE. By this we mean a transference of feelings on to the person of the physician, because we do not believe that the situation in the treatment can account for the origin of such feelings. We are much more disposed to suspect that the whole of this readiness to develop feeling originates in another source; that it was previously formed in the patient, and has seized the opportunity provided by the treatment to transfer itself on to the person of the physician. The transference can express itself as a passionate petitioning for love, or it can take less extreme forms; where a young girl and an elderly man are concerned, instead of the wish to be wife or mistress, a wish to be adopted as a favourite daughter may come to light, the libidinous desire can modify itself and propose itself as a wish for an everlasting, but ideally platonic friendship. Many women understand how to sublimate the transference and to mould it until it acquires a sort of justification for its existence; others have to express it in its crude, original, almost impossible form. But at bottom it is always the same, and its origin in the same source can never be mistaken.
Before we enquire where we are to range this new fact, we will amplify the description of it a little. How is it with our male patients? There at least we might hope to be spared the troublesome element of sex difference and sex attraction. Well, the answer is very much the same as with women. The same attachment to the physician, the same overestimation of his qualities, the same adoption of his interests, the same jealousy against all those connected with him. The sublimated kinds of transference are the forms more frequently met with between man and man, and the directly sexual declaration more rarely, in the same degree to which the manifest homosexuality of the patient is subordinated to the other ways by which this component-instinct can express itself. Also, it is in male patients that the analyst more frequently observes a manifestation of the transference which at the first glance seems to controvert the description of it just given—that is, the hostile or _negative_ transference.
First of all, let us realize at once that the transference exists in the patient from the beginning of the treatment, and is for a time the strongest impetus in the work. Nothing is seen of it and one does not need to trouble about it as long as its effect is favourable to the work in which the two persons are co-operating. When it becomes transformed into a resistance, attention must be paid to it; and then it appears that two different and contrasting states of mind have supervened in it and have altered its attitude to the treatment: first, when the affectionate attraction has become so strong and betrays signs of its origin in sexual desire so clearly that it was bound to arouse an inner opposition against itself; and secondly, when it consists in antagonistic instead of affectionate feeling. The hostile feelings as a rule appear later than the affectionate and under cover of them; when both occur simultaneously they provide a very good exemplification of that ambivalence in feeling which governs most of our intimate relationships with other human beings. The hostile feelings therefore indicate an attachment of feeling quite similar to the affectionate, just as defiance indicates a similar dependence upon the other person to that belonging to obedience, though with a reversed prefix. There can be no doubt that the hostile feelings against the analyst deserve the name of ‘transference,’ for the situation in the treatment certainly gives no adequate occasion for them; the necessity for regarding the negative transference in this light is a confirmation of our previous similar view of the positive or affectionate variety.
Where the transference springs from, what difficulties it provides for us, how we can overcome them, and what advantage we can finally derive from it, are questions which can only be adequately dealt with in a technical exposition of the analytic method; I can merely touch upon them here. It is out of the question that we should yield to the demands made by the patient under the influence of his transference; it would be nonsensical to reject them unkindly, and still more so, indignantly. The transference is overcome by showing the patient that his feelings do not originate in the current situation, and do not really concern the person of the physician, but that he is reproducing something that had happened to him long ago. In this way we require him to transform his _repetition_ into _recollection_. Then the transference which, whether affectionate or hostile, every time seemed the greatest menace to the cure becomes its best instrument, so that with its help we can unlock the closed doors in the soul. I should like, however, to say a few words to dispel the unpleasant effects of the shock that this unexpected phenomenon must have been to you.
After all, we must not forget that this illness of the patient’s which we undertake to analyse is not a finally accomplished, and as it were consolidated thing; but that it is growing and continuing its development all the time like a living thing. The beginning of the treatment puts no stop to this development; but, as soon as the treatment has taken a hold upon the patient, it appears that the entire productivity of the illness henceforward becomes concentrated in one direction—namely, upon the relationship to the physician. The transference then becomes comparable to the cambium layer between the wood and the bark of a tree, from which proceeds the formation of new tissue and the growth of the trunk in diameter. As soon as the transference has taken on this significance the work upon the patient’s recollections recedes far into the background. It is then not incorrect to say that we no longer have to do with the previous illness, but with a newly-created and transformed neurosis which has replaced the earlier one. This new edition of the old disease has been followed from its inception, one sees it come to light and grow, and is particularly familiar with it since one is oneself its central object. All the patient’s symptoms have abandoned their original significance and have adapted themselves to a new meaning, which is contained in their relationship to the transference; or else only those symptoms remain which were capable of being adapted in this way. The conquest of this new artificially-acquired neurosis coincides with the removal of the illness which existed prior to the treatment, that is, with accomplishing the therapeutic task. The person who has become normal and free from the influence of repressed instinctive tendencies in his relationship to the physician remains so in his own life when the physician has again been removed from it.
The transference has this all-important, absolutely central significance for the cure in hysteria, anxiety-hysteria, and the obsessional neurosis, which are in consequence rightly grouped together as the ‘transference neuroses.’ Anyone who has grasped from analytic experience a true impression of the fact of transference can never again doubt the nature of the suppressed impulses which have manufactured an outlet for themselves in the symptoms; and he will require no stronger proof of their libidinal character. We may say that our conviction of the significance of the symptoms as a substitutive gratification of the Libido was only finally and definitely established by evaluating the phenomenon of transference. Now, however, we are called upon to correct our former dynamic conception of the process of cure and to bring it into agreement with the new discovery. When the patient has to fight out the normal conflict with the resistances which we have discovered in him by analysis, he requires a powerful propelling force to influence him towards the decision we aim at, leading to recovery. Otherwise it might happen that he would decide for a repetition of the previous outcome, and allow that which had been raised into consciousness to slip back again under repression. The outcome in this struggle is not decided by his intellectual insight—it is neither strong enough nor free enough to accomplish such a thing—but solely by his relationship to the physician. In so far as his transference bears the positive sign, it clothes the physician with authority, transforms itself into faith in his findings and in his views. Without this kind of transference or with a negative one, the physician and his arguments would never even be listened to. Faith repeats the history of its own origin; it is a derivative of love and at first it needed no arguments. Not until later does it admit them so far as to take them into critical consideration if they have been offered by someone who is loved. Without this support arguments have no weight with the patient, never do have any with most people in life. A human being is therefore on the whole only accessible to influence, even on the intellectual side, in so far as he is capable of investing objects with Libido; and we have good cause to recognize, and to fear, in the measure of his narcissism a barrier to his susceptibility to influence, even by the best analytic technique.
The capacity for the radiation of Libido towards other persons in object investment must, of course, be ascribed to all normal people; the tendency to transference in neurotics, so-called, is only an exceptional intensification of a universal characteristic. Now it would be very remarkable if a human character-trait of this importance and universality had never been observed and made use of. And this has really been done. Bernheim, with unerring perspicacity, based the theory of hypnotic manifestations upon the proposition that all human beings are more or less open to suggestion, are ‘suggestible.’ What he called suggestibility is nothing else but the tendency to transference, rather too narrowly circumscribed so that the negative transference did not come within its scope. But Bernheim could never say what suggestion actually was nor how it arises; it was an axiomatic fact to him and he could give no explanation of its origin. He did not recognize the dependence of ‘suggestibility’ on sexuality, on the functioning of the Libido. And we have to admit that we have only abandoned hypnosis in our methods in order to discover suggestion again in the shape of transference.
But now I will pause and let you take up the thread. I observe that an objection is invading your thoughts with such violence that it would deprive you of all power of attention if it were not given expression. “So now at last you have confessed that you too work with the aid of suggestion like the hypnotists. We have been thinking so all along. But then, what is the use of all these roundabout routes by way of past experiences, discovering the unconscious material, interpreting and retranslating the distortions, and the enormous expenditure of time, trouble, and money, when after all the only effective agent is suggestion? Why do you not suggest directly against the symptoms, as others do who are honest hypnotists? And besides, if you are going to make out that by these roundabout routes you have made numerous important psychological discoveries, which are concealed in direct suggestion, who is to vouch for their validity? Are not they too the result of suggestion, of unintentional suggestion, that is? Cannot you impress upon the patient what you please and whatever seems good to you in this direction also?” What you charge me with in this way is exceedingly interesting and must be answered. But I cannot do that to-day; our time is up. Till next time, then. You will see that I shall be answerable to you. To-day I must finish what I began. I promised to explain to you through the factor of the transference why it is that our therapeutic efforts have no success in the narcissistic neuroses.
I can do it in a few words, and you will see how simply the riddle is solved, and how well everything fits together. Experience shows that persons suffering from the narcissistic neuroses have no capacity for transference, or only insufficient remnants of it. They turn from the physician, not in hostility, but in indifference. Therefore they are not to be influenced by him; what he says leaves them cold, makes no impression on them, and therefore the process of cure which can be carried through with others, the revivification of the pathogenic conflict and the overcoming of the resistance due to the repressions, cannot be effected with them. They remain as they are. They have often enough undertaken attempts at recovery on their own account which have led to pathological results; we can do nothing to alter this. On the basis of our clinical observations of these patients we stated that they must have abandoned the investment of objects with Libido and transformed object-Libido into Ego-Libido. By this we differentiated them from the first group of neurotics (hysteria, anxiety, and obsessional neurosis). Their behaviour during the attempt to cure them confirms this suspicion. They produce no transference, and are, therefore, inaccessible to our efforts, not to be cured by us.
Text from Project Gutenberg, public domain in the United States.