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Transference: The Patient’s Love for the Therapist and an Answer to a Graduate Student’s Question

Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More

Some time ago, someone sent an E. Mail question to," Ask Dr. Schwartz," about her love for her therapist. Soon after, a bright and astute psychology graduate student read my response to the patient and asked the following excellent questions:

The patient:

"I’m in love with my therapist: Man; but how do I deal with the feelings I have, the love I feel for him? There’s nothing I want more than to be with him. And yet, I realize it can’t happen. How do I deal with this? Thank you for your advice."

My response to the patient may be found by clicking this link . It will be necessary to read my response in order to make sense of this essay.

Graduate Student’s Question:

"I am a graduate student in clinical psychology and I was hoping that you could clarify your response? I agree that feelings that clients have toward their psychologist is often transference. However, I was confused when you suggested that this feeling and the knowledge that it was inappropriate meant that the client knew that he or she was unlovable, perhaps that information was part of the correspondence that was not shared? Based on what was discussed, if I was this person’s therapist, I would also explore the possibility that he or she was afraid of getting injured in a romantic relationship and was using his or her feelings toward me as a way to not have to engage in a more appropriate peer relationship. Another possibility is that this person frequently chooses love interests that he or she feels have more power (likes to be the submissive partner, lower status partner in a relationship.) Yet another possibility is that he or she feels more safe with the therapist than in other relationships in his or her life. In this case he or she may be exploring scary emotional and romantic feelings in a safer environment. If you have more information about this person’s reason for attending therapy in the first place, maybe that would help me to understand your response? Thanks for participating in a venue to help people understand some of these complex psychological problems!"

My Answer to the Graduate Student and to All Readers:

My purpose here is not only to answer the student but to help people understand the complexity of psychotherapy and the human mind.

There are many definitions of transference . To keep the concept as simple as possible for our purposes here we will use the following definition of transference: Transference refers to the repetition of childhood experiences with parents, redirected onto the therapist today. In other words, feelings and desires felt towards the parents during childhood are redirected and placed onto the therapist. The transference is important for the therapist to understand, as it gives him a picture of what this patient experienced during childhood.

First, we must understand that there is very little we know about the individual who wrote the E. Mail. We have no way of knowing why this patient attended therapy in the first place. What we can deduce from what she writes is that her experience of love for the therapist, and her wish to be with him, is painful. The painful nature of her experience is surely due to the fact that she feels that it is hopeless to have her wishes realized. Perhaps and most likely, this is a depressed woman.

In terms of transference, it is possible that she experienced her love for her parents as frustrating and hopeless. Why? Perhaps they did not love her? Perhaps she was not allowed to love them or her love of them went unacknowledged and unappreciated? Perhaps she was made to believe that her love for her father was "inappropriate?" There is also a chance that she experienced loss as love from one or both parents as proof that she is unlovable. Children blame themselves for problems and not their parents. All of these and more are possible explanations but we do not have adequate information.

What we do know is that this patient now has a powerful transference relationship with the therapist. She loves her therapist and wants to be with him. She states that she knows that she "cannot be with him." Is this last sentence transference from the father or from both parents onto the therapist? If this is true then the experience of painful rejection is a repeat from the past. Similar to her thinking and feeling during her childhood, she concludes that she is not loveable and that is why the therapist "rejects her." In other words, what she experiences as rejection by the therapist, she probably experienced as rejection from her parents.

Again, it is common for children to blame themselves for most of the things that parents do, even when parents are being abusive toward the child and/or toward one another. In other words, it is not that the patient "knew" she was unlovable, but that she unconsciously experiences being unlovable when she is in relationships that end in disappointment or failure. The problem becomes "her fault," and not the fault of other people. She does not "know" any of this because the feelings of depression and self hate she experiences have unconscious causes rooted in her early past. The therapy provides a chance to work through and correct this self concept.

It is also true that if the patient was abused as a child, then the transference could be her expectation of repeated abuse at the hands of other people and of the therapist. When that does not happen, she comes to feel safe with the therapist. The therapist becomes a good object. However, he continues to refuse to "be with her," and she finds this intolerable. In this intolerable situation, she concludes that he does not make love to her because she is not worthy. Worse than that, he does not even beat her as her parents did when they abused her. Freud talked about this in his famous essay, "A Child is Being Beaten." The patient has learned to confuse love with being abused. This could be the source of her wanting to be in a relationship in which she is submissive. The therapist does not beat her and that is frustrating. In other words, it is not that she is avoiding being injured but that she is disappointed that the therapist does not beat her. All of these are examples of transference. However, in the case of this patient we can only make guesses.

The transference is enormously important in order for the patient to be able to move toward recovery. This person, in her love for the therapist, is experiencing a positive transference. The high regard the patient has for the therapist is the important ingredient that helps the therapist and patient move forward toward health as the patient’s misunderstandings are resolved.

The graduate student is absolutely correct in stating that this individual’s therapist should explore the various parameters of her feelings of love, depending on what the patient is presenting. So, for example, it is entirely possible that the patient wishes to be in a relationship in which she is submissive. If this is the nature of the transference, then it is entirely possible that this woman is using the safety of therapy to explore her romantic feelings without the risk of harm.

My suggestion to this patient in my E. Mail response was meant to convey the hope that some day she would be able to gratify her wishes for a romantic relationship with a safe person of her own choosing in the outside world. Of course, this response jumps way ahead of where she is at this point. Perhaps I should have just assured her that it is a good thing, although painful, that she has these feelings.

Today, psychologists, social workers, and psychiatrists to talk in terms of cognitive behavioral treatment and medication. Transference is based on psychodynamic and psychoanalytic psychotherapy and psychoanalysis. Therefore, there is a tendency to dismiss the importance of transference in the therapy. I think that is a mistake. In any type of psychotherapy transference is going to play a role and should be carefully examined by the therapist.

I want to thank the graduate student for her question and observation. I only hope that she and all readers can make sense out my attempt at explanations of some of these complexities. It is said that, "Excellence is not found in being the best, but in doing your best." I am not the best explainer, but I have done my best here!

Your comments, questions and observations are welcome and encouraged.

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