The Developing Transference in Amnesia: Changes in Interpersonal Relationship, Despite Profound Episodic-Memory Loss

Recently there has been revived interest in the ability to learn emotion-related material—even material of great complexity—despite profound episodic amnesia. In psychoanalysis, this finding is especially important due to the possible role of such a dissociation in infantile amnesia and as a possible account of the neurobiological basis of the transference relationship. However, there have been few investigations of neurological patients with amnesia in psychoanalysis, and we are not aware of any published accounts of the development of the transference relationship in profound amnesia. In this paper, we briefly review the content of a series of psychoanalytic psychotherapy sessions of a profoundly amnesic patient, Mr. N, reported in unpublished form by Kaplan (1994). This patient showed changes in the content of his associations that appeared to be emotion-related, and he appeared able to learn from the dynamic interaction with the analyst, despite his inability to consciously recall previous encounters with the analyst or even to recognize her when they met for subsequent sessions. Such findings offer the opportunity for a better understanding of the neurological underpinnings of the transference relationship, including linking clinical psychoanalytic findings with a developing neuroscientific literature on this topic.