What is Transference in Psychotherapy?

I have discussed transference in prior articles (see my articles: Psychotherapy and the Positive Transference and Psychotherapy and the Erotic Transference).  I wanted to discuss transference in more detail in this article so that clients who are in therapy or thinking about going to therapy will have a better understanding of this concept.

What is Transference in Psychotherapy?

The concept of transference was originally developed by Sigmund Freud when he was developing psychoanalysis.  He described various forms of transference in psychotherapy, including the positive transference, negative transference, erotic transference, parental transference and so on.

Here is a simple explanation of transference for psychotherapy clients who might be curious:  Typically, transference occurs when the client unconsciously "transfers" feelings that s/he had during childhood from her primary caregiver to the current psychotherapist.

Since this phenomenon is unconscious on the client's part, s/he usually isn't aware that these old feelings are being superimposed on the relationship with the psychotherapist.

If the transference is positive, it usually means that the client and psychotherapist have a good therapeutic relationship and, in most cases, the therapy is going well.

If the transference is negative, it means that there is some conflict between the client and the psychotherapist or some obstacle in the therapeutic work, and the client has negative feelings about the therapist.

During the course of therapy, the client's transference can switch back and forth between positive and negative or other forms of transference.

Many clients aren't aware of the term "transference" because the term is a form of psychotherapy jargon, and most therapist would find a more accessible way of talking about the therapeutic relationship with the client without resorting to jargon.

But clients who are interested in psychotherapy and possibly thinking about becoming a psychotherapist will often read this term and wonder what it means.

Transference is not a phenomenon that is exclusive to psychotherapy.  We all experience various forms of transference all the time in our personal and work relationships.

For instance, if you resented your authoritative father as a child, you might unconsciously "transfer" the feelings of resentment from your father to your boss at work and develop a negative transference for your boss--regardless of whether your boss is authoritative or not.

This doesn't mean that you still don't resent your authoritative father.  It just means that your boss is a person who is in authority in your life, and regardless of whether your boss has an authoritative personality or not, on an unconscious level, you have similar feelings towards your boss (and possibly other authority figures) as you did (or do) towards your father (see the vignette in my article: Contemporary Psychotherapy: Redefining the Traditional View of "Resistance" in Therapy).

Similarly, if your boss unconsciously reminds you of your grandfather, who was kind to you, you might develop a positive transference for your boss without even realizing how your feelings for your boss are connected to your grandfather.

Many psychotherapy clients "fall in love" with their psychotherapists.  I put "fall in love" in quotes because they're not actually in love with the therapist.

Most of the time, their feelings are based on a fantasy of what it might be like to have a personal relationship with the therapist.

This fantasy might have nothing to do with what it might actually be like to have a personal relationship with the psychotherapist (see my article: Why Your Psychotherapist Can't Be Your Friend).

Clients who experience an erotic transference for their therapist often worry and feel ashamed of their feelings, but this is a common experience in therapy.  Usually, the erotic transference dissipates over time as the client gets a better sense of the therapist as a ordinary person, the client develops more objective feelings for the therapist, and the client finds other attainable love interests in the "real world."

Although transference is an important concept in psychotherapy, not all feelings towards your therapist are about transference and it's important to be aware of this.

For instance, if your psychotherapist has said or done something in therapy that bothers you, your feelings shouldn't be dismissed by the therapist as being only about transference.

The real issue between you and the therapist needs to be addressed (see my article: How to Talk to Your Psychotherapist About Something That's Bothering You in Psychotherapy).

In future articles, I'll discuss other forms of transference.

Conclusion
Everyone experiences transference in all kinds of relationships--not just their relationship with their psychotherapist.

Transference usually happens on an unconscious level.

If you're in therapy and you're uncomfortable with your transferential feelings for your psychotherapist, you can talk to your therapist about it.

Psychotherapists are usually open to talking about transference, and you'll probably feel better to get these feelings out in the open.

Getting Help in Therapy
If you're feeling stuck in your life or you're unable to overcome a problem on your own, you could benefit from attending psychotherapy (see my article: The Benefits of Psychotherapy).

Rather than suffering on your own, you owe it to yourself to get help from a licensed mental health professional (see my article: How to Choose a Psychotherapist).

Whether you need emotional support or if you need help overcoming psychological trauma, a skilled psychotherapist can help you overcome the obstacles that are keeping you from living a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist and I use Integrative Psychotherapy (see my article:  The Therapeutic Benefits of Psychotherapy).

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 or email me.

Developmental Trauma: The Client's Hopes and Fears in Psychotherapy

Clients often start psychotherapy with some degree of ambivalence--often a mixture of hope and fear.  The hope is that they will be able to work through their problems in therapy.  When clients come to therapy to deal with unresolved developmental trauma, the fear is that the psychotherapist might fail them, as they were failed in their earliest relationships with their parents, and they will be retraumatized (see my articles: Developmental Trauma: Living in the Present As If It Were the Past, Starting Psychotherapy: It's Not Unusual to Feel Anxious and Ambivalent,  Clients' Fears About Being Abandoned By Their Psychotherapist, Why It's Important For Psychotherapists to Provide Clients With Psychoeducation About Psychotherapy, and Developmental Trauma: Developing the Capacity to Put Words to Feelings and Sensations).

Developmental Trauma: The Client's Hopes and Fears in Psychotherapy

As I've mentioned in other articles, it's always important for the psychotherapist to establish a rapport with the client.  This is especially true when clients come to therapy to work through developmental trauma where they might have been neglected, abused or betrayed in some way. These clients often expect to be retraumatized in their personal relationships as well as in their client-therapist relationship.

Even when there seems to be a good therapeutic alliance between the client and the therapist, this rapport can be fragile and subject to sudden changes depending upon how vulnerable the client feels in a particular session, so the therapist needs to be aware that there can be these sudden changes.

If the client develops a positive transference to the psychotherapist and there is some misunderstanding, the client, who is ever vigilant for possible betrayal, can suddenly develop a negative transference when he thinks that the therapist is behaving in a similar way to his parents.

Many times this fear is unconscious on the client's part, and he might not know that he is reacting to the therapist as if the therapist was the parent who abused, neglected and betrayed him (this assumes that the therapist is really not being abusive, neglectful or betraying the client).

These ruptures are usually reparable if the therapist understands what's happening between her and the client and the client allows for the repair (see my article: Ruptures and Repairs in Psychotherapy).

Let's take a look at a fictional vignette that illustrates these dynamics:

Developmental Trauma: The Client's Hopes and Fears in Psychotherapy

Agnes

Agnes was in her early-30s when she began psychotherapy. 

During the consultation, Agnes explained to the therapist that she felt like she was "just drifting" in her life without purpose.  She said she felt "dead" inside.  She had a history of several unhappy romantic relationships and many unsatisfying dead end jobs, including her current job.  

Coming to therapy was her first attempt to explore these issues.  In the past, she considered attending psychotherapy, but each time she would dismiss this idea because she feared being betrayed in therapy.

But lately she felt so miserable and her friends were tired of hearing her complain.  Even when they were willing to listen, she didn't find them to be helpful.  She thought they didn't understand what she was going through and their suggestions were simplistic.  So, she decided to try therapy, hoping that she would feel better, but dreading that it would be another bad experience.  

She described her family history as "a nightmare."  Her father was a severe alcoholic, and her mother was in denial about the severity of the father's drinking.  She described her mother as being in her own "fantasy world" where everything was "rosy."  Even when her father lost one job after the next because of his alcoholism, her mother blamed the bosses for firing the father.  

As the older of two children, Agnes felt she had to contain all her worries by herself because her mother was unable to talk to her about Agnes' concerns.  

Her mother would minimize Agnes' fears by telling Agnes that she was being "dramatic" or a "worry wort."  Agnes' brother, who was 10 years younger than her, didn't understand what was going on, so Agnes felt alone and she suffered from terrible anxiety.

From the time she was a child, she worried about things going wrong.  Even when things were going relatively well, she worried that there could be a sudden downturn and she would be devastated.

She was offered jobs that were commensurate with her education and skills, but she never felt confident enough to accept them.  Instead, she took low level, low paying because they didn't cause her to feel such fear and anxiety.

When she recently turned 31, she had a sudden awakening that she didn't want to just "drift" in life any more.  She wanted to get married and have a family, but she was afraid to date because her prior relationships were so awful.  

She also wanted to work in a more interesting job because she was bored at her current job.  Money wasn't an issue because her father left her a trust fund when he died, but she feared that one day when she was older that she would look back on her life and have many regrets because she was too afraid to take risks.

Recently, a family friend, who knew of Agnes' advanced education and skills, offered Agnes what she  considered to be her "dream job."  But she was highly ambivalent about taking it.  She feared that if she didn't do well, she wouldn't be able to face the family friend or her mother and brother.

So, her dilemma was whether she should stay in her current, boring job where she was underemployed or if she should take the risk and accept the family friend's job offer.

Agnes also talked about coming to therapy as being a "risk."  She chose her psychotherapist based on a recommendation from her primary care doctor, but she feared that the therapist would be another disappointment in a long line of disappointments throughout her life.

Given all of Agnes' fears about therapy, she and her therapist decided that they would take it slow.  Agnes' preference was to deal with the career issue first since she had to give her family friend an answer soon.

During their sessions together, Agnes went back and forth as to what she wanted to do about the job offer.  In one session, she said she planned to take the job.  In another session, she changed her mind and said she was too afraid to take the risk.

As they talked about her need to make a decision and how difficult this was for her, Agnes' therapist helped Agnes to see the connection between her early history and her fear of taking what she perceived to be a big risk.

Agnes began to understand how overwhelmed and emotionally neglected she was as a child since neither parent was able to be emotionally supportive.

It was understandable that Agnes, who felt so insecure about most things since she was a child, would also be fearful of making a change in her career.  She had little confidence in her decision making process in part because she was so invalidated as a child (see my article: Growing Up Feeling Invisible and Emotionally Invalidated).

After a few weeks, Agnes expressed feeling comfortable in therapy.  She felt that her therapist understood her and was emotionally supportive.  

Soon after that, Agnes told the family friend that she would accept the job.  At first, she was relieved that she made a decision and she was no longer going back and forth in her mind.  

But shortly afterwards, she was overcome with anxiety and fear:  Was she taking on more than she could do?  Would she disappoint the family friend?  If she didn't succeed, would she feel like a failure in front of family and friends?

Whenever Agnes spoke with her therapist about her decision, she felt better.  She was almost defiant about "showing" her mother that she could do better.  She also knew that she could leave the job if it didn't work out and no one needed to know what happened.  

But she continued to ruminate about her decision, going back and forth in her mind even though she had already told the family friend that she accepted the position.  Her rumination caused her to lose sleep because she was so worried.

One day, Agnes showed up at her psychotherapist's office on the wrong day.  When her therapist saw her in the waiting room, she called Agnes into her office to talk to her for a moment and to let her know that her appointment was for the next day.  She explained that she couldn't see Agnes today because she already had other clients scheduled.

At that point, Agnes became furious.  She insisted that her appointment was for that day, and she blamed the therapist for being confused, "I knew I couldn't trust you.  You're just like my parents--so unreliable.  I knew you would betray me.  I don't think you're the right therapist for me" and with that she stormed out of the office.

Agnes' therapist called Agnes that evening after she saw her other clients.  When Agnes answered the phone, she sounded calmer.  She told her therapist that she realized afterwards that she was the one who was confused about the day, and she apologized.

During the course of Agnes' therapy, there were several more similar incidents.  Whenever an incident occurred, Agnes was sure that her therapist had betrayed her in some way.  

But when she calmed down and she and her therapist were able to talk calmly, Agnes realized that she had misjudged the situation and that her fear of being betrayed was always just under the surface waiting to erupt.

As Agnes and her therapist were able to repair their relationship after each incident, Agnes became more trusting of her therapist.  As time went on, these incidents decreased and there was more time between each incident.

In the meantime, Agnes was doing well at her new job.  This gave her more confidence, although she was still afraid sometimes that she would fail.  

When Agnes was ready and she felt more stable in her relationship with her therapist, she and her therapist began to work on her developmental trauma using EMDR therapy (see my articles: What is EMDR Therapy? and  How EMDR Therapy Works: EMDR Therapy and the Brain).

Developmental Trauma: The Client's Hopes and Fear in Psychotherapy

Over time, she was able to work through her traumatic childhood so that the trauma didn't continue to get played out in her adult life.

As she felt more comfortable and secure, she also started dating again, and she felt more hopeful about being in a long-term relationship.

Conclusion

People who have experienced developmental trauma often expect to be abused, neglected, disappointed or betrayed in some way in their adult relationships.

Many people, who have unresolved developmental trauma, tend to be vigilant so they won't be caught off guard when the disappointment comes.  Even when things are going relatively well in their life, their fears can dominate their emotions.

Clients with developmental trauma usually come to therapy hoping that they will find relief from their problems, but many of them also dread that their therapist will betray them in some way.  

Even if the client with developmental trauma develops a positive transference with the therapist, even a minor misunderstanding can cause the client to regress to feeling suspicious and fearful again.

Under these circumstances, there can be many incidents of ruptures and repairs between the therapist and the client--if the client will allow the repair.  Some clients just leave therapy precipitously and never allow for the repair (see my article: When Clients Leave Psychotherapy Prematurely).

But if the client and therapist can work on repairing the relationship, this is healing for the client because her childhood experience was usually that there were no repairs, only ruptures, so seeing that ruptures in therapy can be repaired is healing for the client.

Over time, if the client stays in therapy, a consistently positive relationship can develop between the client and the psychotherapist and can create an opening to develop other positive relationships.

Getting Help in Therapy

One of the most difficult things for many clients with developmental trauma to do is to come to therapy (see my article:  The Benefits of Psychotherapy).

For these clients, balancing hope and fear can be challenging.

Clients with developmental trauma often come to therapy when the emotional pain they're experiencing is greater than their fear.

Over time, if the client and the therapist are a good match, these issues can be worked through in therapy and the unresolved developmental trauma can be gradually resolved (see my article: How to Choose a Psychotherapist).

If the issues that I've described in this article resonate with you, you owe it to yourself to find a skilled psychotherapist who has experience working with developmental trauma.

Once you are free from your traumatic history, a huge emotional burden will be lifted from you.  It can improve how you feel about yourself, your outlook for the future, and your relationships.  

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article:  The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

I have helped many clients to work through their traumatic experiences so they can live more fulfilling lives.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

The Effects of Parental Transference in Therapy

In my earlier articles, I've discussed different types of transference that clients develop in therapy, including Psychotherapy and the Positive Transference and Psychotherapy and the Erotic Transference: Falling "In Love" With Your Therapist.  In this article, I'm focusing on another common form of transference, the parental transference.

The Effects of Parental Transference in Therapy

As I've mentioned in my prior articles, developing transference isn't limited to therapy.  People form transferential feelings in other relationships, including with mentors, teachers, a supervisor, in a relationship with a spouse or romantic partner, and so on.

Transference is usually unconscious--at least, at first.  Over time, the client and therapist usually become increasingly aware of the transference and can use the transferential feelings in therapy as part of the therapeutic work.

What is Parental Transference?
The parental transference often develops where the client experiences the therapist as either a maternal or paternal figure.  Often, this has nothing to do with age.  A therapist can be younger than a client and still evoke a parental transference.

The parental transference can be either positive or negative or it can alternate between positive and negative at different times in the same therapy.

When a client's parent is deceased, the parental transference can be especially powerful and often provides an opportunity for a client to work through unresolved feelings toward the parent.

When an adult client has unmet childhood needs, it's not unusual for him or her to develop a parental transference towards the therapist.

The counterpart of transference is the therapist's countertransference.  If the therapist is psychodynamically trained, s/he is usually aware of the client's transference and any countertransferential feelings s/he might have towards a client.

Just as a client can develop a parental transference, a therapist can also develop countertransferential feelings towards the client.  In that case, the therapist has parental feelings towards the client.

A Fictionalized Vignette
Let's look at a fictionalized vignette to illustrate how the parental transference can play out in therapy and how it can be worked through.

John
John came to therapy because he felt anxious around his new director at work.

Although he was successful in his career, he had developed anxiety-related symptoms when the new director replaced the former director, who had retired.

John had a very good relationship with his former director, Joe.  Joe was a mentor and helped John to move up in the company.  Even though John maintained contact with Joe, he missed their talks and his Joe's easygoing style.

John's new director, Nina, came from another company.  She had a reputation for being very talented and innovative in their field.

When John first met Nina, he felt that their meeting went well enough, so he couldn't understand why he felt uneasy with her.  There was nothing objective that John could pinpoint that could explain his anxiety around her.

Even though Nina praised his contribution to a big project and let him know that she was pleased with his work, John was anxious about falling short of her expectations.  No matter how he tried to convince himself that there was no objective reason why he should feel this way, his anxiety increased over time, which is why he came to therapy.

Initially, John was able to form a good therapeutic alliance with his therapist.  But, after a few weeks, he began to worry about how she saw him.  He worried that he wasn't being "a good patient" in therapy because he couldn't figure out why he was anxious around his new director.

The Effect of Parental Transference in Therapy

John's therapist assured him that they were just at the beginning of their exploration of his problem, they would explore this together, and she had no expectation that he would figure it out on his own.

Objectively, John knew that therapy is a collaborative process and that clients aren't expected to determine the underlying cause of their problems.  But, on an emotional level, he felt he was falling short in therapy and that his therapist would soon feel disappointed in him, if she wasn't already disappointed.  He couldn't understand why he felt this way.

Transferential Feelings Are Often Unconscious

As John and his therapist explored his family background, it soon became apparent what was happening at work as well as in his therapy.

As an only child, John grew up feeling closer to his father than his mother.

Whereas John and his father spent a lot of time together camping, going to sporting events and building models, John spent relatively little time with his mother.  She spent long hours at the office and on weekends she was involved in community events.

Whenever John spent time around his mother, he was acutely aware of how impatient she was with him.  She tended to be aloof and critical of him.  John felt like he was a disappointment to his mother, so he felt anxious whenever he was around her.

After John's father died, when he was eight, he missed his father a lot.  He spent many hours alone in his room.  Dinner time with his mother was a lonely affair because she hardly talked and when she did, she would criticize John for falling short in some way.  As a result, John felt like a failure and that he never met up to her expectations.

As his therapist talked to John about parental transference, John began to understand his relationships with Joe and Nina and how he had unconsciously superimposed his parental relationships on them.

John realized Joe was like his father.  Joe was warm, generous and kind, just like John's father.  He also spent time helping John to develop in his career, and he had nurturing qualities similar to John's father.  So, it was easy to see how John would form a positive paternal transference towards Joe.

But Nina was nothing like his mother.  Even though Nina was different than his mother, she was still an authority figure, similar in nature to how a mother is an authority figure in a child's life.  Unconsciously, he kept waiting for her to morph into his mother.  As time went on, John's anxiety increased because of his unconscious anticipation.

John and his therapist also discussed how his anxiety towards her was similar to his anxiety around his mother.  Even though he and his therapist had a non-hierarchical relationship and she was nothing like his mother, he still feared that his therapist would be disappointed in him, similar to how his mother was disappointed in him.

As they continued to explore these feelings, John realized that his problems in romantic relationships often involved his fear that his partner would become disappointed with him.  He realized how this hindered him in terms of starting and maintaining relationships.

As John and his therapist continued to work together, John became aware that he had unresolved trauma related to the loss of his father and his unmet childhood emotional needs with his mother (see my article: What is Child Emotional Neglect?)

He and his therapist did inner child work to mourn what he didn't get as a child, especially after his father died, and to nurturing that younger part of him that felt unloved (see my article: Nurturing Your Inner Child).

Further exploration about his parental transference towards his director and his therapist helped John to differentiate his feelings for his mother and his feelings for his director and therapist.

It also helped John to distinguish who his mother was when he was growing up and who she was now.  He realized that his mother had softened over the years and that she had become a warmer, kinder person with age.

The more John was able to make the differentiation between his mother from his childhood from his mother now, the better he felt.

Working Through Transference and Feeling Confident

Rather than doubting himself, John began to feel confident at work and at ease with his director.

He felt comfortable with his therapist.

Conclusion
Transferential feelings are a normal part of life, whether they occur in therapy, at work or in other important relationships.

Transference is usually unconscious so, initially, people believe that whatever they're feeling about a person is directly related to the person and not affected by earlier feelings.

Psychotherapy offers an opportunity to work through transferential feelings as well as resolve unmet childhood needs and unresolved loss and trauma.

Getting Help in Therapy
Transferential issues are difficult to work through on your own.

Transferential feelings are often entrenched, enduring and can last a lifetime if you don't seek help.

Not all therapists work with transference, so if you think that your problems are related to transference (whether this involves transference in a relationship or at work), find out if the therapist that you plan to consult with has been trained psychodynamically (see my article: How to Choose a Psychotherapist).

About Me
I am a licensed New York City psychodynamically-trained psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Psychotherapy and the Idealized Transference

In my last blog article, I discussed the erotic transference in psychotherapy. I also discussed the the overall meaning of transference in psychotherapy as well as transference in our daily lives outside of therapy sessions. In this blog post I will focus on the idealized transference in psychotherapy and how it can enhance treatment in many cases.

Psychotherapy and the Idealized Transference

What is the Idealized Transference in Everyday Life?
As with the erotic transference, most of us have experienced the idealized transference at some point in our lives. Examples of the idealized transference would include the idealization that a student might feel for a favorite teacher, a church member's idealization of a minister, or a young person's idealization of a political candidate (e.g., John F. Kennedy in the 1960s or Barack Obama in the last presidential election).

As with any idealization, there is usually some distortion with the idealized transference because no one can be perfect, ideal or even very good 100% of the time. There are bound to be times when the person who is being idealized will be off the mark. Depending upon the strength of the idealization and how much the person feels the need to put the idealized person on a pedestal, he or she will often rationalize the idealized person's mistakes in order to maintain this person on the pedestal.

What is the Idealized Transference in Psychotherapy?
Similar to any idealization, the idealized transference is usually more about the client's need to see the therapist as being all good or all powerful or always right, especially if the client is coming to treatment with a history of abuse or neglect or feelings of low self worth about him or herself.

How Does the Idealized Transference Form in Psychotherapy?
Every experience of the idealized transference will be different. Very often, if the psychotherapist maintains good boundaries, the client often doesn't know very much about the therapist, especially at the beginning of treatment. If the therapist is empathic and caring, he or she will provide a safe emotional "holding environment" for the client. All of this increases the likelihood that the client will develop a positive transference (he or she has good feelings about the therapist and the work they are doing together) and, in many cases, will idealize the therapist.

No matter how non-hierarchical or egalitarian the therapist is in treatment, there is still a power differential between therapist and client with the therapist being in the more powerful position. This occurs, in part, because the therapist sets and maintains the treatment frame with regard to time and fees. It also occurs because the therapist is considered "the expert" that the client comes to see. All of this feeds into the transference, whether the transference is positive, negative, eroticized or idealized.

This is not a matter of therapists creating the idealized transference and pretending that they're something that they're not. In fact, if therapists did this, in most cases, it would be counterproductive because most clients would see through any deliberate efforts to create an idealized transference. And in the particular case of a narcissistic therapist, who might actually believe in his or her perfection or an idealized self, most clients would sense the inauthenticity of this as well.

Rather, when the idealized transference occurs, it's usually a naturally-occurring phenomenon that stems from the client's need to idealize the therapist, often without even realizing it.

As discussed in my previous blog article, transference can form quickly, especially if a client is coming for multiple sessions per week, and the client is emotionally vulnerable and has the need to be with a therapist who is "perfect." For many clients, having someone that listens intently to them and is empathic might be a new and much-needed experience.

There are many issues that can affect transference, including treatment ruptures, where the therapist unintentionally makes a mistake that might be hurtful. These ruptures can usually be repaired if the therapist is willing to admit that he or she made a mistake. Often, it the rupture is handled well by the therapist, this can strengthen the therapeutic alliance between client and therapist, especially if the client grew up in an environment where the parents were unable to acknowledge mistakes. However, treatment ruptures is a topic for a future blog post.

What Are the Advantages of the Idealized Transference in Psychotherapy?If we think of psychotherapy as being a treatment with a beginning, middle and end phases, the idealized transference usually forms at the beginning and/or middle stages of treatment.

This is a period of time, if treatment is going well, when clients often internalize their therapists to the point where, even outside treatment sessions, when faced with problems or decisions, clients can ask themselves, "What would my therapist say about this?" At that point, the therapist becomes a sort of auxiliary mind that the client can call upon internally for support and wisdom. This is a normal, natural part of treatment when it's going well.

Being able to internalize the idealized therapist usually allows clients to make positive changes in their lives.

The following fictionalized scenario, which is a composite and not about any one client, will illustrate these points:

Ted:
Ted was in his early 30s when he began attending psychotherapy for longstanding depression. His feelings of low self worth kept Ted from excelling in a career, and he was unable to form intimate, romantic relationships with women.

For years, Ted tried reading self-help books and going to workshops to overcome his depression, but nothing helped, and he knew now that he couldn't change his depression on his own.

Ted had never attended psychotherapy before, so he didn't know what to expect, and he felt anxious and ambivalent on the day of his first appointment. He almost cancelled the appointment, but he knew that he couldn't manage his feelings of low self worth on his own any more. In the past, he rationalized to himself that he didn't need therapy because he never felt suicidal so, in his mind, his depression wasn't so bad. But as time passed and he continued to feel stuck in his life, he knew he needed professional help.

During his first session, he was surprised that he actually felt comfortable and he was able to talk relatively easily to the therapist. He liked the therapist and also felt very comfortable in the office. He discussed his family history, including how depressed and anxious his parents were when he was growing up. He also talked about how critical his father was and how his father made him feel that he couldn't do anything right. He knew that his parents did the best that they could but, as an only child, he felt alone and lonely. He excelled at school, hoping to get his parents' love and approval, but they were too preoccupied with their own lives to pay attention to Ted.

By the time Ted went away to college, he went from being a "straight A" student in high school to being an average student in college. He had given up trying to please his parents, and he had such a poor sense of self that he didn't care about how he performed in college. He also felt socially inept, so he hardly attended any social activities. And when he did, he felt awkward and shy. He dated a few women, who took the initiative of asking him out, but nothing ever came of these dating relationships.

After Ted graduated college with a major in psychology, he took the first job that he could find as a sales clerk in a clothing store. He was bored and, on some level, he knew that he was underemployed, but he lacked the self confidence to get a job that was commensurate with his education.

Ted had a few close friends, but he had not dated anyone in over a year, and he felt lonely.

After he was in therapy for a couple of months, Ted began to admire his therapist. He really liked that his therapist listened to him attentively and that he was also so empathic with Ted and seemed to understand him. Ted had never experienced this before. He felt that his therapist cared about him, and he looked forward to his sessions.

Ted imagined that his therapist was everything that Ted was not. He didn't know anything about his therapist's personal life because they focused on Ted in their sessions, but he imagined that his therapist was happy in a relationship and successful in his private practice. He imagined that his therapist was everything that Ted wanted to be in his own life.

Without realizing it, Ted began to change the way that he dressed so that it was similar to his therapist's appearance.

He also liked looking at his therapist's book shelves, and he was fascinated by all the psychology books. Ted used to enjoy reading psychology but, other than self-help books, he stopped reading scholarly psychology books. But when he noticed his therapist's books, he felt more curious and open again, and he started taking out these same books from the library, and this re-ignited his interest in psychology.

Whenever he encountered problems outside of treatment, Ted asked himself what his therapist might say. And, when he spoke to friends, he often spoke highly of his therapist to them.

Step by step, Ted began making changes in his life. After about six months, Ted began to feel a sense of optimism again. He was beginning to see a glimmer of a possible future for himself. He began having thoughts about going to graduate school for psychology or clinical social work. Just having these thoughts was surprising to him. This was the beginning of an upward spiral for Ted.

As he talked to his therapist about his thoughts about going to graduate school, his therapist encouraged him to explore various possibilities. Ted began to fantasize that he might have his own psychotherapy private practice one day.

About a year later, Ted began attending social work graduate school. He continued in therapy and he often spoke to his therapist about his internship. It was during this internship that Ted realized that he didn't like seeing clients one-on-one as much as he had anticipated.

This was a surprising disappointment to him. He discovered that he really liked his community organizing classes. There seemed to be two primary groups at his university, those who wanted to go into psychotherapy private practice and those who were passionate about community organizing.

Ted began forming friendships with the students who wanted to be community organizers. He liked their ideas and their passion. He also felt that he could help many more people if he became a community organizer than if he became a psychotherapist and worked with people one-on-one.

This made him wonder why his therapist became a psychotherapist and not a community organizer. It was the first time that Ted began to have some doubts as to whether he wanted to be just like his therapist (or as he imagined his therapist to be). This made him feel a little sad because, until then, he thought of his therapist as being "perfect."

Ted was able to discuss this with his therapist, including the sadness that he felt about it. At first, he was hesitant to tell his therapist that he had some doubts about him for his career choice. But what came out of these discussions was very important: Ted was beginning to see his therapist as a person and not as an idealized figure. He was also beginning to see himself as a separate person from his therapist who could have his own feelings and ideas.

Over time, Ted was able to achieve some balance in his feelings and perceptions about his therapist. He still liked his therapist and found their sessions to be very valuable to him, but he no longer idealized his therapist and he felt comfortable with that. Along the way, he also developed more confidence in himself, and he began a relationship with a woman that he met in his social work program.

A year after Ted became a community organizer and he and his girlfriend moved in together, he successfully completed treatment. During the final stage of treatment, Ted and his therapist reviewed their work together and Ted had a sense of how far he had progressed. He also knew that he could return to see his therapist in the future.

As demonstrated above, the idealized transference is often useful in helping clients to make positive changes in their lives during the initial and middle stages of treatment. The client uses his or her own idealized fantasies and projections about the therapist to make personal changes.

There are times when the idealized transference is not resolved because the client has a need to maintain that view of the therapist. Not only is this true about clients coming into therapy, but it is often true of psychoanalytic students at institutes, some of whom never lose their idealized view of their psychoanalysts. But, once again, this is another topic.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR therapist who works with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist

To set up a consultation, call me at (917) 742-2624 during business hours or email me.