Transference and Countertransference in the Light of Developmental Considerations

This article is aimed at the integration of the thinking of developmental psychoanalysis with the contribution of interpersonal psychoanalysis. Without obscuring the differences between these schools, we hope to gain some clarity on the issues raised in the treatment of borderline and narcissistic personality disturbances. This article centers around the therapeutic work done by one of the authors with a patient over a 10-year period.* The patient's reactions to her treatment and her condition are clearly spelled out in letters that she wrote during her treatment. These will be referred to in order to illuminate what took place from the patient's point of view. The evolution of the therapist's understanding of the concepts of transference and countertransference is discussed.

We subscribe to the view that transference is an expression of genuine needs that continuously elude satisfaction. In the therapeutic as in any other relationship, the patient expresses numerous unfulfilled needs. He requires help in recognizing the legitimacy of these needs, even in light of his adult status. He requires assistance in order to discover means that will bring him satisfaction of the needs. At the same time these means should not cause insufferable intrapersonal conflicts with the needs of more mature aspects of the self. A number of writers have pointed in this direction (1, 2, 6), and it has been made explicit by Guntrip, who wrote

it is relationship not analysis that is required, although it is still necessary to help the adult in the patient to understand what is going on, and we may call this analysis if we please. It is not analysis in classical terms… In classical Oedipal analyses the importance of a therapeutic relationship is not absent. It is merely not so conspicuous because the patient's need for it is not as great. With schizoid,

1. * The therapy was done by Benjamin Lapkin, and the pronoun “I” on the following pages refers to him. Jane Lury collaborated with Benjamin Lapkin

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1. * The therapy was done by Benjamin Lapkin, and the pronoun “I” on the following pages refers to him. Jane Lury collaborated with Benjamin Lapkin