The Reality of the Psycho-Analytic Relationship and Situation in the Handling of Transference-Resistance1

The kind of cases I would like to discuss are, in the main, patients with severe neurotic character disturbances. The subject is that delicate relationship between the real relationship between patient and analyst, and the intense transference relationship which usually develops in psycho-analytic therapy. My thesis, which I would like to illustrate with clinical material and discuss theoretically, is that a real, reparative relationship must be developed and cultivated in psycho-analysis with these patients, so that character transference resistances may be handled in the earlier stages of therapy, and later regressive transferences, or the transference neurosis, may be fostered and eventually resolved before becoming an unworkable transference-resistance. Further, there may also be reality aspects of the normal, expectant psycho-analytic relationship which may prove a hindrance to the development of a reparative, real relationship; which must be developed in order to have a working (Greenson, 1965) or therapeutic alliance (Zetzel, 1956) to handle earlier and later transference resistances. A further corollary is that unless sufficient attention is paid to both the real and transference aspects of the paradoxical psycho-analytic relationship with severe neurotic patients, grave difficulties arise. I would like to add parenthetically that much that I am outlining already occurs in what I believe to be good analytic work, but that I have rarely seen it discussed well conceptually in the psycho-analytic literature.

My main case illustration is that of Martha who came to me in her early 20s from a socially prominent Mid-Western family. Early familial relationships consisted of a social-form driven mother, unresponsive and un-empathetic to her daughter and sons, her character consisting much more of ground than figure, similar to Vieulliard's painting of the artist's mother fading into the wallpaper at the Modern Museum in New York City. This relationship was some