Resolution Of Traumatic Transference: Two Cases

IWOULD LIKE TO DISCUSS THE RESOLUTION of traumatic transference in analytic work with patients who have dissociative symptoms, and to suggest a technical modification of interpretation that allows for repair of the dissociated aspects of the self. I will argue that standard analytic technique based on a model of inner conflict as the basis for symptoms can actually be harmful and disruptive in work with these patients, if it imposes certain meanings prematurely. Interpersonal theory provides a more effective framework for understanding such dynamics, since it describes the development of the self through interaction with others, and may help to avoid the implication that abuse is the patient's fault.

By traumatic transference I mean a kind of transference in which the patient "unconsciously expects that the therapist, despite overt helpfulness and concern, will covertly exploit the patient for his or her own narcissistic gratification" (Spiegel, 1986, p. 72). That is, the transferential pattern is based on the patient's expectation of misuse of power by the parental or authoritative figure in the relationship. This dynamic leads to a replaying in all forms, in the analytic arena suspended in time and space, of some of the nastiest behaviors of the species. To be fully healed, and especially to be able to claim appropriate power for him or herself, the patient-victim-survivor may need to try out how it feels to be the abuser, as well as the victim (Davies & Frawley, 1992). In complement to the roles assumed by the patient, even the most well-intentioned analyst will be experienced as abusing his or her power at some point, and will certainly feel like, and possibly even be, the patient's victim at others. Herman (1992) describes how this happens.

The patient scrutinizes the therapist's every word and gesture, in an attempt to protect herself from the hostile reactions she expects. Because she has no confidence in the therapist's benign intentions, she persisten