Usefulness of Transference during Therapy

Transference is a simple term to describe the process of unconsciously transferring feelings. When therapy patients get involved in a regular treatment plan, especially one that involves a higher frequency of sessions per week, they often start having feelings about the therapist that are similar to feelings they had or have about other important people in their lives.

I talk about this with patients by explaining, “Sooner or later, you will have feelings about me that you have toward other significant people in your life.” This is useful because this phenomenon turns the therapy into a “living lab” where the patient’s old feelings and conflicts can be re-worked with the therapist in an alive and meaningful way, over and over again, leading to greater understanding of issues in the patient’s mind and improvement in his or her intimate relationships.

Here is a simple example of transference in therapy:

I was a few minutes late for a session with a patient, Ellie, who had started therapy about six months ago. I apologized when I opened the waiting room door. She said at once, rather brightly, “Oh, it’s no problem at all; these things happen.” I remained quiet and waited to hear what else Ellie might say. She started telling me about a friend she met for dinner last night.  Her friend “by chance” ran into difficulties and arrived late for their dinner together. After a brief silence, she told me in detail about her boss (a woman) being ten minutes late for an important meeting earlier that day. “Really created a problem with our client,” Ellie exclaimed.

I noted these two stories about people being late and keeping her and others waiting. I recapped that I had also been late today, but she had been very understanding and pleasant about my lateness. I then asked if that was her usual response to people being late or keeping her waiting.

Ellie looked surprised at my question, and then laughed in a slightly self-conscious way. She answered, “Well actually, no. Within myself, I feel hurt or annoyed, or both, about being kept waiting.”

I replied, “I’m heartened to hear that, but something kept you from sharing that with me, yes? I wonder what that might be about.”

After a longish silence, during which Ellie looked away, I saw tears rolling down her cheeks. I leaned forward and said, “Ah, I see something just made you feel very sad.”

Ellie responded in a broken voice, “My parents were so often late to pick me up from school, or from friends’ birthday parties. Everyone would be gone, but I would be sitting outside, alone. If I complained about it, my parents would blow up and accuse me of being spoiled and ungrateful. Why couldn’t I understand how much they had to do?”

I responded, “That’s really sad. It is so scary and painful for a kid to have to wait and then be scolded and berated for having feelings about it. So this is why you couldn’t feel free today to complain to me when I was late, lest I too get mad at you like your parents did. You are not sure yet that I could understand your feelings and take responsibility for my actions.”

This is a tiny example of the many interactions that take place between patient and therapist.  In sum, the patient’s life history and old relationships are re-experienced in therapy with an experienced, knowledgeable, and empathic therapist. The therapist conveys her understanding of these matters to the patient; in turn, the patient can emotionally understand the old hurts, childhood pain, fear of loss, or fear of retaliation from important people. This ultimately decreases the patient’s suffering and leads to a happier life.

Check our blog in the coming weeks for more tips and helpful articles.  At the Mel Bornstein Clinic, our goal is to offer a safe, confidential, and trustworthy treatment setting for all patients. For more information, please call Marla McCaffrey, LMSW at (248)851-7739.