Beyond Transference and Interpretation

In this paper I shall attempt to clarify some of the controversial issues raised in previous publications on the 'real' or 'non-transference' relationship between the patient and the psychoanalyst (see Greenson, 1967); (Greenson & Wexler, 1969), (1970). I shall also try to demonstrate the importance of interventions other than interpretation as a necessary ingredient for the creation and maintenance of a productive analytic atmosphere. These statements are not meant to cast doubt upon the central role of the interpretation of transference and resistance for psychoanalytic therapy. However, I, along with a growing number of other psychoanalysts, contend that the technique of 'only interpreting', and the belief that all interactions between patient and analyst are transference phenomena, stifle or distort the development of the patient's transference neurosis and block his capacity to develop realistic object-relationships. 'Reality-relatedness proceeds always a bit ahead of, and makes possible, the progressive evolution and resolution of the transference …' (Searles, 1965). I shall use clinical examples to illustrate these points.

A 27=year-old woman, Mrs K., sought analysis because she felt out of things, numb, 'gone', like a zombie. She had been raised by a warm and promiscuous alcoholic mother, who married four times and never stayed married longer than three years. Mrs K. had recently married an older man, and it was the failure of her supposedly happy marriage to resolve her inner numbness that motivated her to come for psychoanalytic treatment. In the third year of her analysis Mrs K. became pregnant and shortly thereafter her husband unexpectedly died. We analysed at great length the many anxieties stirred up by the thought of bringing a fatherless baby into the world. We also analysed how the foetus inside became good or bad, beautiful or deformed, destructive or destroyed. This depended on her internal body