Meetings of the New York Psychoanalytic Society

February 28, 1956. TRAUMA, DEPENDENCY, AND TRANSFERENCE. Max M. Stern, M.D.

Transference is studied by Stern as an ego function in the service of self-preservation. It is regarded as similar to the conditioned reflex which results from a physically traumatic situation. Transference is defined as a fixation to a previous situation displaced onto a substitute object which symbolizes the previous experience. It is an attempt at reparative mastery of the infantile sexual trauma. Trauma is defined as any occurrence resulting in a more or less lasting damage to the function of self-preservation. Primary trauma is a physiological condition characterized by a failure of internal homeostatic regulation in a situation of stress. Psychic trauma is any experience which elicits anticipatory repetition of previous primary traumata. Any threat of such repetition automatically produces a physiological homeostatic effect which is called primary defense. Primary defenses seem to be the precursors of psychic defenses. Infantile traumata are instrumental in creating transference by forcing a libidinal dependence and premature development of the mental apparatus, especially of symbolic thinking. Libidinal gratification is associated with protection against trauma. Stern feels that formation of the ego, relation to objects, and transference are simultaneous processes developing under the impact of trauma in a circular way, one re-enforcing the other. The fixation in transference is to the protective anxiety-reducing effect of libidinal dependence in situations of stress.

Fixation persists after danger is past because of later traumata, particularly those associated with pavor nocturnus. Stern ascribes far-reaching traumatic impact to such nightmares. He feels that the nightmare is not only an expression of psychopathology, but in itself produces psychopathology. Premature sexual stimulation contributes to the traumatization because of physiological immaturity. The trauma