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In a clinical study the author describes how patients produce different defenses against superego conflicts as related to the analyst. Different strata have to be 'built up' to bring out the deep, basic meaning of the transference neurosis. In practically every case, Racker has found elements that appear to be psychotic, such as paranoid mechanisms and manic and depressive aspects of the transference. Only at the end of treatment is synthesis of the personality possible.
The author also finds a relationship between resistance and transference, and discusses the dynamics of the transference. He describes particular situations in individual cases where the technique applied had to accord with the special mechanism displayed by the patient at the particular time. In other words, different pathological stratifications in resolving the transference neurosis are necessary. One of his conclusions is that what the patient fears most is his inability to love—that is, to obtain a libidinal attachment with a satisfactory object in one or any of the different stages of the evolution of the transference. Basically, fear of loving is paramount as the patient feels that loving is a destructive act—to love is to expose oneself and to end up being abandoned. This threatens the dissolution or the dismembering of the ego; therefore, the imago of a good object that the patient might wish to eat or suck may turn out to be dominant—an object that might laugh at, humiliate, deceive, or take advantage of him. 'The sadism of this imago of the object is only a reflection of the patient's own pain—of the patient's own self-destructive feelings projected onto the analyst as a means of frustration or erotic rebuff from the analyst.'
Racker is aware that this masochistic situation appears in practically every patient. In some cases he has been able to demonstrate with transference material that it is not only the superego that is projected onto the analyst but any elements that until the