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This presentation concerns the “multilateral transference relationship,” a specific and complex transference configuration that evolved in the psychoanalytic psychotherapy of a woman with a primitive and archaically organized personality disorder. The patient commenced her treatment on referral from Dr. Rotenberg to Dr. S. Silverman,** who has treated her since 1988 in individual psychoanalytic therapy. She was referred for concurrent analytic group psychotherapy with Dr. R. in 1989. The term, “multilateral transference relationship” refers to the complex treatment relationships that evolved, as therapeutic attempts were made to respond to this patient's clinical state in a manner that was “optimally responsive” (Bacal, 1985a) for her, and which allowed the treaters to live with the treatment in a relatively comfortable manner. Ease of regression and the patient's capacity to descend precipitously into the depths of the “basic fault” (Balint, 1952) were urgent clinical problems from the outset of treatment. This paper represents a narrative history of our own questions and the kind of thinking that led to our own interventions.
For a variety of reasons, many of which arose from the evolving clinical need of the patient, the patient's treatment surround, or “holding