Meetings of the Psychoanalytic Association of New York

October 16, 1967. TRANSFERENCE AND STRUCTURE. Harold Blum, M.D.

Dr Blum defines transference as a repetition that depends on an archaic regressive state of both structure and function, in which there is a utilization of the primary process and projection. Early descriptions of positive or negative transference in terms of drive investment were oversimplifications; later structural studies revealed complexities in affective states. While analysis does not create transference, it permits its observation and promotes its concentration on the person of the analyst; there is a new neurotic function in which the analyst takes the place of the original objects in the patient's emotional life.

In contrast to the spontaneous appearance of transference phenomena, and as differentiated from the floating or initial transference, the development of the transference neurosis is partially dependent on the analysis of initial resistances and defenses. But, depending on structural aspects, there are limits to the transformation of transference phenomena into a transference neurosis. A positive transference involving basic trust is essential for the formation of both a therapeutic alliance and a manageable transference neurosis. Structural considerations are paramount (Hartmann, Kris) as in the participation of the autonomous ego in the controlled regression of an analyzable transference neurosis.

Waelder noted three views of transference in the history of analysis: 1, obstacle to treatment; 2, most important vehicle of treatment; 3, opportunity for direct influence. There is a difference between resistance to awareness of transference and its infantile source, and transference purely as resistance. The latter concept was replaced by analysis of resistance and content within the transference—the focus of analysis rather than the hindrance. The resulting affective conviction then furthers the mastery of resistance through insight. Blum noted that the transference neurosis is