Monday, 3 July 2017

Defence Mechanisms from Freud to Klein







“In everyman, there is one part which concerns only himself and his contigent existencw, is properly unknown to anybody but himself, and dies with him. And there is another part through which he holds to an idea, which is expressed through him with an eminent clarity and of which he is a symbol.”  wilhem von Humboldt autobiographical fragments 1816

Anna Freud, in The Ego and The Mechanisms of Defence (1946), formulates the hypothesis that what the ego fears most is the return to a previous stage of fusion with the id, in case repression fails or instincts are too intense. In order to ensure the maintenance of the level of organization achieved, the ego has to protect itself from the invasion of instinctual demands (drives) of the id and from the return of the repressed contents.

   In fact, in the chapter "The Ego's Dependent Relations", in The Id and the Ego (1923), Freud says: "psychoanalysis is the instrument to enable the ego to achieve a progressive conquest of the id".

   Psychoanalysis aims at transforming greater amounts of what once belonged to the id into acceptable possessions of the ego, along with its main purpose of turning unconscious contents into conscious ones. Thus, the mind can find solutions that were previously unattainable to the immature ego.

My long term client Sonia, who is suffering from Schizoid effective disorder is particularly skilful at many of the following. She seeks to play off the psychiatric social worker against myself. If I challenge her on this she merely replies…well, we were not getting on well. If she is depressed see will use reaction formation for example to get angry with me to lift her mood using the angers as a means of transformation. I now can predict by her voice and general approach which of the basic five defence mechanisms she will use.

  The major defence mechanisms are the following:

1. Repression - the withdrawal from consciousness of an unwanted idea, affect, or desire by pushing it into the unconscious part of the mind.

2. Reaction formation - the fixation in consciousness of an idea, affect, or desire that is opposite to a feared unconscious impulse.

3. Projection - unwanted feelings are attributed to another person.

4. Regression - a return to forms of gratification belonging to earlier phases, due to conflicts arising at more developed stages.

5. Rationalization - the substitution of the true, but threatening cause of behaviour for a safe and reasonable explanation.

6. Denial - the conscious refusal to perceive disturbing facts. It deprives the individual of the necessary awareness to cope with external challenges and the employment of adequate strategies for survival as well.

7. Displacement- the redirection of an urge onto a substitute outlet.

8. Undoing - is achieved through an act, which goal is the cancellation of a prior unpleasant experience.

9. Introjection - intimately related to identification, aims at solving some emotional difficulty of the individual by means of taking into his personality characteristics of someone else.

10. Sublimation - part of the energy invested in sexual impulses is shifted to the pursuit of socially valuable achievements, such as artistic or scientific endeavour


  
   Just as we tend to assume that the world is as we see it, we naïvely suppose that people are as we imagine them to be. … All the contents of our unconscious are constantly being projected into our surroundings, and it is only by recognizing certain properties of the objects as projections or images that we are able to distinguish them from the real properties of the objects. and we always see our own avowed mistakes in our opponent. Excellent examples of this are to be found in all personal quarrels. Unless we are possessed of an unusual degree of self-awareness we shall never see through our projections but must always succumb to them, because the mind in its natural state presupposes the existence of such projections. It is the natural and given thing for unconscious contents to be projected. [“General Aspects of Dream Psychology,” ibid., par. 507.]

   Projection means the expulsion of a subjective content into an object; it is the opposite of introjection. Accordingly, it is a process of dissimilation, by which a subjective content becomes alienated from the subject and is, so to speak, embodied in the object. The subject gets rid of painful, incompatible contents by projecting them. [“Definitions,” CW 6, par. 783.]

   Projection is not a conscious process. One meets with projections, one does not make them. The general psychological reason for projection is always an activated unconscious that seeks expression. [“The Tavistock Lectures,” CW 18, par. 352.]

   It is possible to project certain characteristics onto another person who does not possess them at all, but the one being projected upon may unconsciously encourage it. This frequently happens that the object offers a hook to the projection, and even lures it out. This is generally the case when the object himself (or herself) is not conscious of the quality in question: in that way it works directly upon the unconscious of the projection. For all projections provoke counter-projections when the object is unconscious of the quality projected upon it by the subject. [“General Aspects of Dream Psychology,” CW 8, par. 519.]
   

   Through projection one can create a series of imaginary relationships that often have little or nothing to do with the outside world. The effect of projection is to isolate the subject from his environment, since instead of a real relation to it there is now only an illusory one. Projections change the world into the replica of one’s own unknown face. In the last analysis, therefore, they lead to an autoerotic or autistic condition in which one dreams a world whose reality remains forever unattainable. [“The Shadow,” CW 9ii, par. 17.]

   Projection also has positive effects. In everyday life it facilitates interpersonal relations. In addition, when we assume that some quality or characteristic is present in another, and then, through experience, find that this is not so, we can learn something about ourselves. This involves withdrawing or dissolving projections.

  So long as the libido can use these projections as agreeable and convenient bridges to the world, they will alleviate life in a positive way. But as soon as the libido wants to strike out on another path, and for this purpose begins running back along the previous bridges of projection, they will work as the greatest hindrances it is possible to imagine, for they effectively prevent any real detachment from the former object. [“General Aspects of Dream Psychology,” CW 8, par. 507.]


 
 The need to withdraw projections is generally signalled by frustrated expectations in relationships, accompanied by strong affect. But Jung believed that until there is an obvious discordance between what we imagine to be true and the reality we are presented with, there is no need to speak of projections, let alone withdraw them.

   Projection … is properly so called only when the need to dissolve the identity with the object has already arisen. This need arises when the identity becomes a disturbing factor, i.e., when the absence of the projected content is a hindrance to adaptation and its withdrawal into the subject has become desirable. From this moment the previous partial identity acquires the character of projection. The term projection therefore signifies a state of identity that has become noticeable. [“Definitions,” CW 6, par. 783.]

   Jung distinguished between passive projection and active projection. Passive projection is completely automatic and unintentional, like falling in love. The less we know about another person, the easier it is to passively project unconscious aspects of ourselves onto them.

   Active projection is better known as empathy – we feel ourselves into the other’s shoes. Empathy that extends to the point where we lose our own standpoint becomes identification. The projection of the personal shadow generally falls on persons of the same sex. On a collective level, it gives rise to war, scapegoating and confrontations between political parties. Projection that takes place in the context of a therapeutic relationship is called transference or countertransference, depending on whether the analysand or the analyst is the one projecting.

   In terms of the contra sexual complexes, anima and animus, projection is both a common cause of animosity and a singular source of vitality. When animus and anima meet, the animus draws his sword of power and the anima ejects her poison of illusion and seduction. The outcome need not always be negative, since the two are equally likely to fall in love. [“The Syzygy: Anima and Animus,” CW 9ii, par. 30.]

    For Melanie Klein two positions are both crucial and relevant to this essay.
The term 'paranoid-schizoid position' refers to a constellation of anxieties, defences and internal and external object relations that Klein considers to be characteristic of the earliest months of an infant's life and to continue to a greater or lesser extent into childhood and adulthood. Contemporary understanding is that paranoid-schizoid mental states play an important part throughout life. The chief characteristic of the paranoid-schizoid position is the splitting of both self and object into good and bad, with at first little or no integration between them.
    Klein has the view that infants suffer a great deal of anxiety and that this is caused by the death instinct within, by the trauma experienced at birth and by experiences of hunger and frustration. She assumes the very young infant to have a rudimentary although unintegrated ego, that attempts to deal with experiences, particularly anxiety, by using phantasies of splitting, projection and introjection.

   The infant splits both his ego and his object and projects out separately his loving and hating feelings (life and death instincts) into separate parts of the mother (or breast), with the result that the maternal object is divided into a 'bad' breast (mother that is felt to be frustrating, persecutory and is hated) and a 'good' breast (mother that is loved and felt to be loving and gratifying). Both the 'good' and the 'bad' objects are then introjected and a cycle of re-projection and re-introjection ensues. Omnipotence and idealisation are important aspects of this activity; bad experiences are omnipotently denied whenever possible and good experiences are idealised and exaggerated as a protection against the fear of the persecuting breast.

   This 'binary splitting' is essential for healthy development as it enables the infant to take in and hold on to sufficient good experience to provide a central core around which to begin to integrate the contrasting aspects of the self. The establishment of a good internal object is thought by Klein to be a prerequisite for the later working through of the 'depressive position’. A different kind of splitting, 'fragmentation', in which the object and/or the self are split into many and smaller pieces is also a feature of the paranoid-schizoid position. Persistent or enduring use of fragmentation and dispersal of the self-weakens the fragile unintegrated ego and causes severe disturbance. Sonia is continually splitting both myself and the psychiatrist. Whenever I try to help her have insight into her psychosis she will reply by telling me that the Psychiatrist knows more than I do. She does the same in reverse.
 
 Klein considers that both constitutional and environmental factors affect the course of the paranoid-schizoid position. The central constitutional factor is the balance of life and death instincts in the infant. The central environmental factor is the mothering that the infant receives. If development proceeds normally, extreme paranoid anxieties and schizoid defences are largely given up during the early infantile paranoid-schizoid position and during the working through of the depressive position.

   Klein holds that schizoid ways of relating are never given up completely and her writing gives the impression that the positions can be conceptualised as transient states of mind. The paranoid-schizoid position can be thought of as the phase of development preceding the depressive position as a defence against it and also as a regression from it.
Winnicott sees the ego as arising out of primitive threats to existence and developing a 'continuity of being', as afforded by the good-enough mother.
"The first ego organization comes from the experience of threats of annihilation which do not lead to annihilation and from which, repeatedly, there is recovery."  (Winnicott, 1956)
"With the care that it receives from its mother each infant is able to have a personal existence, and so begins to build up what might be called a continuity of being. On the basis of this continuity of being the inherited potential gradually develops into an individual infant. If maternal care is not good enough then the infant does not really come into existence, since there is no continuity of being; instead the personality becomes built on the basis of reactions to environmental impingement." (Winnicott, 1960)
Aggression in the child is seen as a natural part of development as they test out the limits of their personality. They kick and scream in rage. People who have not extended so in childhood may be repressed. Aggression also tests their environment and helps them to relate to it. Thus we may consider anti-social behavior and the blaming of refugees and the scrounger as a means of being noticed and almost is a cry to be held safe in a secure environment that the other is already seen to have.
"(1) Subject relates to object. (2) Object is in process of being found instead of being placed by the subject in the world. (3) Subject destroys object.  (4) Object survives destruction. (5) Subject can use object."  (Winnicott, 1969)
When the object is the mother, this is a very trying time for her. She acts as a 'container' for the child's aggression and, if maintaining calm, helps the child to get over the aggression.



Winnicott, and Klein
Klein saw psychic states operating at the level of unconscious phantasy and hence disconnected from the outside world. Winnicott took the view that you cannot consider the development of the child without taking into account the external environment, in particular in the varying interactions with parent figures.
He considered the detail of how the infant transitions from undifferentiated unity to independence and realization of the mother as a separate person. This is similar to Klein's depressive position. We may consider Klein`s position to be a more individual aspect of the more collective position of Winnicott, Sonia fears the world, she wishes both myself her Psychiatrist are both 2good enough parents” whom she plays against one another,

Transference as defence

   The term "transference" as a meaning of resistance was firstly employed by Freud in 1985.1 It was considered an obstacle to the analytical process that prevented the access to residuals of the childhood sexuality that remained linked to "erogenous zones"; in a normal evolution, such links should be already disconnected.
   Some years later, in the classic Dora's case,2 Freud pointed out that the patient does not remember anything that is forgotten or repressed, but act it out, reproducing the repressed not as a recall, but as a repetitive and unconscious action. In the post-scriptum of this work, Freud3 conceptualizes transference saying that transferences "are new editions or facsimiles of the impulses and fantasies which are aroused and made conscious during the progress of the analysis; but they have this peculiarity, which is characteristic for their species, that they replace some earlier person by the person of the physician. To put it another way: a whole series of psychological experiences are revived, not as belonging to the past, but as applying to the person of the physician at the present moment. Some of these transferences have a content which differs from that of their model in no respect whatever except for the substitution. These then - to keep to the same metaphor - are merely new impressions or reprints. Others are more ingeniously constructed; their content has been subjected to a moderating influence - to sublimation, as I call it - and they may even become conscious, by cleverly taking advantage of some real peculiarity in the physician's person or circumstances and attaching themselves to that. These, then, will no longer be new impressions, but revised editions." So far, transference had been seen as a clinical phenomenon that could be an obstacle to treatment, later on, however, Freud4 referred to transference for the first time as a therapeutical agent, and observed that transference was not always an obstacle, it could have an important role in the process of understanding patients.
   The specific qualities of transference were assigned an additional meaning when the concept of "transference neurosis" was introduced.5 This concept emphasized the way how past relationships, which compose the neurosis, affect the patient's feelings towards the therapist. This concept was later widened, when Freud6pointed out that "the patient is compelled to repeat repressed contents as something from the present, instead of, as the physician should realize, remember it as something from the past". The theme of such reproductions, which arise with great and undesirable exactness, is some part of the children's sexual life and invariably is expressed through transference that takes place between patient and therapist. When one reaches such phase, we can say that the previous neurosis is replaced by a new one, the "transference neurosis." Repeating the past through transference is a consequence of the "repetition compulsion." The transference itself is only a fragment of repetition, which is a transference of the forgotten past not only from patient to therapist, but to all the other aspects of the present.
   The understanding of transference as a source of unconscious communication was very well developed by Melanie Klein.7 According to her, when the therapeutic relationship is set, the patient recalls feelings, conflicts and defences he or she experienced in the original situation. Klein understood transference as a reproduction of all primitive objects and objects relations internalized in the patient's psychology, followed by drives, unconscious fantasies and anxieties.
    According to Dewald,8 transference is defined as the displacement to an object from the present moment of all impulses, defences, attitudes, feelings and responses experienced with the first objects in life. Transference would be a repetition of situations whose origin rely in the past. Greenson9 defines transference as an unconscious process, as a repetition of an object relationship that took place in the past, usually with people who were important for the child's in his/her first years of life, unconsciously transferred to figures from the present.
   Therefore, by analysing the concept of transference under the light of different    authors, it can be defined as a set of unconscious expectations, beliefs and emotional responses that a patient carries to the therapeutic setting. Such responses are not necessarily based on who the therapist is or how he or she really acts, but on the persisting experiences that the patient has during his life with other important figures from the past.
   In 1915, Freud10 referred to the "transference love" as a serious difficulty in psychoanalysis as a very frequent situation in which the patient declares love for the doctor. Freud points out that the doctor must recognize that the patient's falling in love is not to be attributed to the charms of his own person. Freud intends to demonstrate how much the powers of nature are present in the transference phenomenon and also to call the doctor's attention to what he or she is managing, using the erotic transference to better understand the patient. In this work, Freud classified transference both as positive and negative. The positive transference is then referred to all drives and derivatives related to libido, especially feelings of affection and care, including erotic desires, provided that they have been sublimated under the form of non-sexual love and do not persist as an erotic link. On the other hand, the negative transference concerns the presence of aggressive drives and their derivatives, such as envy, jealous, voracity, destructiveness and intense erotic feelings.
   When approaching special types of transference, Sandler11 reported that there are patients who develop erotic transference and refuse to go on with the usual therapeutic treatment, they can reject interpretations that relate current feelings to the past and do not search further explanations for the meaning or cause of symptoms they had complained before. Sessions are used to express their love, gratification in the presence of the beloved, and pledges for having their "love" corresponded. Even though Freud10 acknowledged the resistance of transference, he warned therapists not to confound this reaction with true love, and at the same time he warned them against their attempts to repress patients' love. He said that "to urge the patient to suppress, renounce or sublimate her instincts the moment she has admitted her erotic transference would be, not an analytic way of dealing with them, but a senseless one. It would be just as though after summoning up a spirit from the underworld by cunning spells, one was to exorcize them down again to hell without having asked him a single question." This means it would be as disastrous for the patient to have her love fulfilled as suppressed.
   Erotic transferences can be manifested in different ways, following both the neurotic and psychotic patterns. Different authors have differentiated several forms of erotic transference. Bolognini12 described four types of erotic transference, with their respective dynamic origins and repercussions in the analytical relationship. The erotised transference would be predominantly based on a psychotic modality. The underlying fantasy in the transference erotization, which would have a defensive function, would be the fantasy of separation and abandonment, which will be an attempt to restore that state of narcissist fusion with the mother. The erotic transference would be based on a neurotic modality, and loving and affectionate transferences would be clinical manifestations that would correspond to a healthier and ameliorated behaviour. For many authors, the erotised transference is typical from borderline patients, very disturbed; in the erotic transference there is an excessive anguish to be loved by the analyst, with manifest and conscious demands of sexual gratification, which are direct, exaggerated and persistent.13,14 It expresses a very primitive mental functioning, in which the object is highly idealized and persecutory.
   According to Teixeira da Silva,15 and Blitzen, the erotised transference is a reflex of pre-genital conflicts in which aspects such as intense violence, fragility of the self and loss of the notion "as if" are predominant; the therapist is not "as if" he or she were the father or mother, the therapist is the patient's father or mother. There is a loss in the capacity of symbolizing, and the intensity of this loss shall represent the level of patient's regression. In the erotic transferences, the capacity of fantasizing is not lost, and the erotic demands remain in the level of fantasy, the analyst is an object of the patient's fantasy, different from the erotised fantasies, in which the therapist is a concrete object. Saul16 discusses the role of latent aggressiveness in situations of erotic transference. He points out that this type of transference is associated to real frustrations in relationships that took place in the early years of life, suggesting that hostility and rage triggered by such frustrations could be repeated in the relationship with the therapist. Transference love would be a way of protecting the physician from hostile feelings.
   Zimerman17 considers that two risks may follow the installation of erotised transference in the analytical field: one is that when the patient's demands are not satisfied by the therapist, the patient acts outside the analytical situation, sometimes acquiring some severe traces of malignity. The second possibility is equally malignant, it is when the therapy can end up perverting the transference, including the possibility of the therapist being involved in it.
  in the management of erotic transference, one should take into account that new editions of infantile conflicts result from unfulfilled desires that try to be accomplished in the context of the psychoanalytical treatment. It is the therapist's responsibility to show the reality to the patient, which can be made through a detailed analysis of transference/countertransference feelings of the dyad patient-therapist. When the therapist makes his or her interpretation, putting unconscious emotions into words, he opens the passage to the symbolic. When interpretation makes the unconscious conscious, it allows the libido to be at the self-disposal for healthier investments. It puts the patient in contact with reality and not with the fulfilment of a desire, as the patient requires. Moreover, if interpretation is employed correctly, it frequently reduces the desire and resistance inherent to the erotic transference.18 Elaborating the transference love implies elaborating the renouncement and the grief that usually follow the resolution of an oedipal situation. At the same time, the patient must learn that searching for the oedipal object would be a permanent aspect in all his or her love relationships. This does not mean do understand all future love relationships as resulting solely from the oedipal situation, but that the oedipal structure is present and affects the framework of love experiences.
   Freud,10 however, pointed out that there is "one class of women with whom this attempt to preserve the erotic transference for the purposes of analytic work without satisfying it will not succeed. These are women of elemental passion who tolerate no surrogates." He goes on saying that "with such people one has the choice between returning their love or else bringing down upon oneself the full enmity of a woman scorned. In neither case can one safeguard the interests of the treatment. One has to withdraw, unsuccessful; and all one can do is to turn the problem over in one's mind of how it is that a capacity for neurosis is joined with such an intractable need for love."
   For Kernberg,19 the most important technical issues in the management of erotic transfer are: first of all, tolerance with the development of sexual feelings towards the patient, either homosexual or heterosexual, which requires doctors' internal freedom so that they can use their psychological bisexuality. Then, the importance of systematically analysing the patient's defences against the complete expression of sexual transference, and the risk of becoming invasive through seduction; and finally, the physician's capacity of analysing the expression of transference love and his or her reactions to frustration, which will inevitably occur. The therapist's task would be to avoid talking about his countertransference feelings and integrate the understanding obtained with his or her countertransference with transference interpretations about the patient's unconscious conflicts.

   Initially, countertransference was also treated as an undesirable phenomena of the psychoanalytical treatment, just like transference. Freud20 coined the term countertransference defining it as a phenomenon that arises in the physician "as a result of the patient's influence on his unconscious feelings." As in the transference, Freud's first reaction was to consider it as something inadequate and disturbing that should be avoided. He says, with relation to the doctor, that "we are almost inclined to insist that he shall recognize this counter-transference in himself and overcome it."
      Later, Freud21 was already aware of the potential value of countertransference and recommended: The therapist "must turn his own unconscious like a receptive organ towards the transmitting unconscious of the patient ... so the doctor's unconscious is able, from the derivatives of the unconscious which are communicated to him, to reconstruct that unconscious, which has determined the patient's free associations."
   However, it was after the studies developed by Racker22 and Heimann23 that countertransference became an additional factor in the process of understanding the therapist's work. Racker22 considered countertransference as a set of therapist's images, feelings and impulses during the session that could happen in three different ways: a) as an obstacle; b) as a therapeutic instrument; and c) as a "field" in which the patient can really acquire a live experience, different from that he had originally. He also described two types of countertransference reactions: the complementary countertransference, when the analyst takes on the role of the patient's object; and the concordant countertransference, when the analyst takes on an aspect of the patient's personality (self, id and superego). Heimann23 describes the countertransference as the set of all physician's feelings towards the patient. He points out that the therapist can use the emotional responses to the patients' projections to understand them. For that end, the therapist must be able to keep his/her feelings for himself/herself, instead of discharging them as does the patient.
   Erotic transference usually causes some countertransference reactions in the therapist, and examining such reactions is important to understand the patient. Krenberg19 considers it is useful that the therapist is able to tolerate his/her sexual fantasies towards the patient, and must let an imaginary sexual relation happen in the narrative, mentally following the patient's erotic transference. This will allow him to progressively realize the ant libidinal, ant destructive and rejecting aspects that can be hidden in the patient's explicit erotic manifestation. According to this author, the analyst that feels himself/herself free to explore, in his/her own mind, the sexual feelings towards the patients will be able to assess the nature of the transference development and, thus, avoid the defensive negation of his own erotic response to the patient. The analyst must, at the same time, be able to examine the transference love without acting his countertransference out in what may be configured as a seductive approach.
   Teixeira da Silva15 draws attention to the role of the therapist's own treatment. He says that the "analyst's ideal didactic analysis would be that in which he/she could analyse with detail his/her pre-oedipal and oedipal aspects and overcome them to develop a natural and true relation with himself/herself. All this would be complementary to practice and theory. This author claims that there is no ideal analysis and that we must understand our work and clinical experience as an endless source of knowledge and development.
   There is a growing tendency in the psychoanalytical literature of works considering that transference and countertransference are influenced by the gender and vital cycle of the dyad involved in the analysis. The analyst's and patient's sexual identity does not only stimulate but create specific transference and countertransference resistance and difficulties.24 As to the erotic transferences, this is not different. Note, for example, that most of the psychoanalytical case reports involving erotic and erotised transferences is about female patients with male therapists.
   Teixeira da Silva,15 points out that both male and female therapists meet difficulties to realize transferences in which they have the role of the opposite sex. This author listed the different characteristics of transference in the therapeutic dyads according to the respective genders. In the male therapist and male patient dyad usually predominates, in the oedipal transference, the situation of an aggressive competition with the father, and, in general, the heterosexual impulses are not realized because they are displaced to external objects. The passive homosexual impulses, when aroused, are sources of great transference and countertransference resistances. In the female therapist and female patient dyad, the arousal of an intense erotization is more frequent, because the woman regresses more easily to a situation of fusion with the phallic mother, once the therapeutic situation corresponds to the original situation of the girl's development, in which she must firstly solve her erotic and homosexual development with her mother, then enter the positive oedipal phase, elaborate the Oedipus complex and establish her sexual identity. In the male therapist and female patient dyads the erotic transferences - or erotised transference - are more intense. In this situation, the therapist may find difficult to differentiate when the patient projects the rivalry and hostility against the oedipal mother of an anal regression against the frustrating object, that is, against the oedipal mother. In those dyads, when there is a homosexual desire towards the mother, it will be difficult for the therapist to identify it and separate it from the heterosexual desires concerning the father. In the female therapist male patient dyad, there would have an absence of erotised transferences due to the fear of the powerful pre-oedipal mother that generates anguishes of castration that interfere in the development of strong erotic desires for the oedipal mother.
   There are a number of other authors that also made important contributions for the understanding of the issue. Lester,25 for example, stressed that the male patient anxiety towards the female therapist as a phallic pre-oedipal powerful and castrating mother can blur and inhibit the expression of sexual feelings towards the therapist as an oedipal mother, which will account for the few cases reporting this situation in the dyad female therapist and male patient. The author also observed that the passivity engendered by regression in the analytic therapy is dystonic to his active male sexual role. Such point of view was not corroborated by
 Gornick.26 He thought that, for certain male patients, it would be much more difficult to be passive and dependant than expressing sexual feelings, which would make men to defend themselves from such feelings, developing erotic feelings towards the therapist in an attempt to restore the sense of male domination.
   Pearson27 points out that the erotic transference is more frequent in women as a form of transference, while men would resist against any form of conscience of an erotic transference. Usually, men would displace their erotic feelings towards the therapist to a woman out of the therapy setting, because recognizing such desires would threaten his sense of autonomy. Person also considers that the erotic transference in women is more frequently a desire for love, whilst in men it is a sexual desire.
   The management of erotic transference can pose some difficulties, which can be compared to hostile and paranoid transferences, once they can block the therapist's analytical capacity, at least temporarily.
   According to Meurer,28 such situations challenge the therapist's capacity, demanding a high level of integration with the self, free fluctuating attention and free perceptive sensitivity to be able to detect, acknowledge and interpret what happens in the transference and countertransference. In the erotic transference, the patient is expected to externalize once more his or her intense infantile desire of loving and being loved, and his or her permanent neurotic willingness to fulfil oedipal love frustrations and obtaining unrestricted and exclusive love from the mother-father therapist. A delicate issue is the possibility, and even necessity, of using countertransference to identify the nature of feelings and fantasies present in the transference. Thus, countertransference does not need to arise as an obstacle but as a factor to understanding. As a consequence, the patient's transference will not be only resistance and drawback, but also a valuable form of communication, which will bring contributions to treatment.
   Wallerstein,29 in an analysis of the "Observations on transference love"10 stresses that Freud: 1) Identified the high prevalence of erotic feelings evoked in the psychoanalytic treatment and the "dangers" of such feelings; 2) observed that a small part of patients would develop a form of transference love that would act as very intense resistances and could not be analysable; and 3) established the main technical foundations to cope with such transferences, as the rule of abstinence and neutrality.
   The fact that erotic transference is a common process that can cause technical difficulties when being managed was always stressed in the psychoanalytical literature. Following the basic principles of psychoanalysis postulated by Freud, acknowledging the phenomenon of resistance and adequately using countertransference are necessary conditions for understanding and solving it, which brings precious benefits for the patient's treatment.

  The therapist's personal treatment is a fundamental instrument, which can make him able to understand his own psychological functioning and the processes that take place in the patient's mind, as well as the mechanisms that influence the erotic transference and countertransference phenomena. Other required resources can be learning through clinical and theoretical seminars, selected readings and individual supervising.
   According to Zimmerman,17 although the patient has an absolute conviction and determination in his game of seduction, in his or her inner deep he is afraid the analyst makes some mistakes, as remaining cold, indifferent and distant from the patient's appeals and erotic fantasies; getting disturbed and defensively replacing interpretation by criticisms, accusations, moral lessons and apology to good behaviour; the patient can even have repressive actions that include the fear of having the treatment interrupted, use of medication or being referred to other professional; and the real possibility of the therapist getting involved in a sexual intimacy, which would characterize a total perversion of transference and of the psychoanalytical process.










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Klein, M. (1946).  Notes on some schizoid mechanisms.  International Journal of Psychoanalysis, 27, 99-110.

Klein, M. (1958).  One the development of mental functioning. International Journal of Psychoanalysis, 39, 84-90.

Levin, D. (1960). What happened in Salem? New York: Harcourt, Brace and Company. 

Menzies-Lyth, I. (1960). A case in the functioning of social systems as a defence against anxiety: A report on a study of nursing service of a general hospital.  Human Relations, 13, 95-121.

Menzies-Lyth, I. (1988). Containing anxiety in institutions: Selected essays. London: Free Association Books.

Miller, A. (1990). For your own good: Hidden cruelty in childrearing and the roots of violence. (Hildegard and Hunter, Trans.). New York: Noonday Press.

New English Bible. (n.d.). London: Oxford University Press and Cambridge University Press.

Roach, M. (2004). The Salem witch trials:  A day-by-day chronicle of a community under siege. Lanham, MD:  Taylor Trade Publishing.

Segal, H. (1973). Introduction to the work of Melanie Klein. New York: Basic Books.

Segal, J. (1992). Melanie Klein. London: Sage.

Summers, F. (1994). Object relations theories and psychopathology:  A comprehensive text. Hillsdale, NJ: The Analytic Press.

Volkan, V. (1985). The need to have enemies and allies: a developmental approach. Political Psychology, 6, 219-247.



Anna Freud, references
The Ego and the Mechanisms of Defence (1946),

 Jung on Transference

The Psychology of the Transference,"CW16, par. 420.]

Some Crucial Points in Psychoanalysis,"CW4, par. 601.]

Some Crucial Points in Psychoanalysis,"CW4, par. 661.]

"The Psychology of the Transference,"CW16, par. 445


Bibliography om  Transference
1. Freud S. Estudos sobre a histeria. In: Edição standard brasileira das obras psicológicas completas de Sigmund Freud. Rio de Janeiro: Imago; 1969. v. 2, p. 63-90.
2. Freud S. Fragmentos da análise de um caso de histeria. In: Edição standard brasileira das obras psicológicas completas de Sigmund Freud. Rio de Janeiro: Imago; 1969. v. 7, p. 5-107. 
3. Freud S. Pós-escrito do caso Dora. In: Edição standard brasileira das obras psicológicas completas de Sigmund Freud. Rio de Janeiro: Imago; 1969. v. 7, p. 109-19
4. Freud S. Notas sobre um caso de neurose obsessiva. In: Edição standard brasileira das obras psicológicas completas de Sigmund Freud. Rio de Janeiro: Imago; 1969. v. 10, p. 159-250.        [ Links ]
5. Freud S. Recordar, repetir e elaborar. In: Edição standard brasileira das obras psicológicas completas de Sigmund Freud. Rio de Janeiro: Imago; 1969. v. 12, p. 193-203.
6. Freud S. Além do princípio do prazer. In: Edição standard brasileira das obras psicológicas completas de Sigmund Freud. Rio de Janeiro: Imago; 1969. v. 13, p. 17-85.
7. Klein M. Los orígenes de la transferencia. In: Obras completas. Buenos Aires: Paidós-Hormé; 1974. p. 47-77.
8. Dewald P. Transferência. In: Psicoterapia: uma abordagem dinâmica. Porto Alegre: Artes Médicas; 1989. p. 213-39.
9. Greenson R. A transferência. In: A técnica e a prática da psicanálise. Rio de Janeiro: Imago; 1981. p. 167-247.
10. Freud S. Observações sobre o amor transferencial. In: Edição standard brasileira das obras psicológicas completas de Sigmund Freud. Rio de Janeiro: Imago; 1969. v. 12, p. 208-21]
11. Sandler J. Formas especiais de transferência. In: O paciente e o analista: fundamentos do processo psicanalítico. 2ª ed. Rio de Janeiro: Imago; 1986. p. 45-55.
12. Bolognini S. Transference: erotized, erotic, loving, affectionate. Int J Psychoanal. 1994;75:73-86
13. Blum HP. The concept of erotized transference. J Am Psychoanal Assoc. 1973;21:61-76.
14. Rappaport EA. The management of an erotized transference. Psychoanal Q. 1956;25:515-29
15. Teixeira da Silva TN. Transferências e contratransferências eróticas. O manejo das mesmas. Rev Bras Psicanal. 1996;30:1205-22.
16. Saul LJ. The erotic transference. Psychoanal Q. 1962;31:54-61.
17. Zimerman D. Transferências. In: Fundamentos psicanalíticos: teoria, técnica e clínica. Porto Alegre: Artmed; 1999. p. 331-45
18. Kumin I. Erotic horror: desire and resistance in the psychoanalytic situation. Int J Psychoanal Psychotherapy. 1985-86;11:3-25.
19. Kernberg OF. O amor no setting analítico. In: Psicopatologia das relações amorosas. Porto Alegre: Artes Médicas; 1995. p. 109-21.
20. Freud S. As perspectivas futuras da therapeutic psicanalítica. In: Edição standard brasileira das obras psicológicas completas de Sigmund Freud. Rio de Janeiro: Imago; 1969. v. 11, p. 125-36.
21. Freud S. Recomendações aos médicos que exercem psicanálise. In: Edição standard brasileira das obras psicológicas completas de Sigmund Freud. Rio de Janeiro: Imago; 1969. v. 12, p. 149-59.
22. Racker H. Os significados e usos da contratransferência. In: Estudos sobre técnica psicanalítica. Porto Alegre: Artes Médicas; 1982. p. 120-57.
23. Heimann P. Sobre a contratransferência. Rev Psic Soc Psicanal Porto Alegre. 1995;2:171-6.
24. Araujo MS, Bassols AM, Escobar J, Dal Zot J. Sexualidade e prática psicanalítica: identidade de gênero e sua influência no processo psicanalítico. Rev Bras Psicanal. 1996;30:1071-9
25. Lester EP. The female analyst and the erotized transference. Int J Psychoanal. 1985;66:283-93
26. Gornick LK. Developing a new narrative: the woman therapist and the male patient. Psychoanal Psychol. 1986;3:299-32
27. Person ES. The erotic transference in women and in men: differences and consequences. J Am Acad Psychoanal. 1985;13;159-80.
28. Meurer JL. Manejo da transferência e da contratransferência eróticas na formação psicanalítica. Rev Bras Psicanal. 1996;30:1307-12.
29.  Wallerstein RS. On transference love: revisiting Freud. In: Person ES, Hagelin A, Fonagy P. On Freud's - Observations on transference-lovLinkse. New Haven & London: Yale University Press; 1993. p. 57-74


Melanie Klein Bibliography
1921 Klein, M. 'The development of a child'. Suggestion that the child protectively splits off an unwanted part of the mother.
1926 Klein, M. 'The psychological principles of early analysis'. This paper and the one above describe the child's oral and anal sadistic attacks on the mother as resulting in a persecutory superego (internal mother imago).
1929 Klein, M. 'Personification in the play of children.'
1930 Klein, M. 'The importance of symbol formation in the development of the ego'. This paper and the one above explore the child's use of splitting into good and bad and the use of projection as a defence and as a means of working through internal conflicts and anxieties.
1932 Klein, M. The Psychoanalysis of Children. Klein adopts Freud's concepts of the life and death instincts, the deflection of the death instinct and introduces the idea of splitting the id.
1933 Klein, M. 'The early development of conscience in the child'. The splitting of the id is elaborated (later to become splitting of the ego).

1935 Klein, M. 'A contribution to the psychogenesis of manic-depressive states'. The framework of 'positions' is introduced, the depressive position is contrasted with the earlier paranoid phase and a differentiation made between part- and whole-object relating.
1940 Klein, M. 'Mourning and its relation to manic-depressive states.' Manic defences of idealisation and denial are elaborated.

1946 Klein, M. 'Notes on some schizoid mechanisms'. The definitive paper in which the 'paranoid-schizoid' position is introduced and its anxieties and the defences against them are set out.
1952 Klein, M. 'Some theoretical conclusions regarding the emotional life of the infant'. Good summary of both paranoid-schizoid and depressive positions. Increasing emphasis on importance of securely established good object.
1955 Klein, M. 'On identification'. Continued emphasis placed on the importance of a securely established good object. Projective identification is illustrated.
1957 Klein, M. 'Envy and gratitude'. An expanded description of both the depressive and the paranoid-schizoid positions; envy is introduced as the expression of the death instinct.
1963 Bion, W. Elements of Psychoanalysis. Heinemann. Ch. 8. Fluctuation between paranoid-schizoid and depressive positions, symbolised as Ps<–>D.
1987 Steiner, J. 'The interplay between pathological organisations and the paranoid-schizoid and depressive positions'International Journal of Psychoanalysis. 68: 69-80; republished in E. Spillius (ed.) _Melanie Klein Today, Vol. 1. Routledge (1988). Movement between the two positions explored.
1998 Britton, R. 'Before and after the depressive position; Ps(n)–>D(n)–>Ps(n+1)'. Belief and Imagination: Explorations in Psychoanalysis. Routledge. Importance of capacity to fluctuate between the two positions is emphasised.

 Kristeva, J. Powers Of Horror: An Essay On Abjection. Columbia University Press, 1982

Jung on the dream Bibliography

Edinger, Edward (1995), The Mysterium Lectures. Toronto: Inner City Books.
Hannah, Barbara (1976), Jung: His Life and Work, A Biographical Memoir. New York: G.P. Putnam.
Jung, C.G. (1960), “The Structure and Dynamics of the Psyche,” CW 8. Princeton: Princeton University Press.
________ (1959), “The Archetypes and the Collective Unconscious,” CW 9i. Princeton: Princeton University Press.
________ (1959), “Aion,” CW 9ii. Princeton: Princeton University Press.
________ (1970), “Civilization in Transition,” CW 10. Princeton: Princeton University Press.
________ (1969), “Psychology and Religion: East and West,” CW 11. Princeton: Princeton University Press.
________ (1953), “Psychology and Alchemy,” CW 12. Princeton: Princeton University Press.
________ (1976), “The Symbolic Life,” CW 18. Princeton: Princeton University Press.
Meier, C.A. ed. (2001), Atom and Archetype: The Pauli/Jung Letters 1932-1958. Princeton: Princeton University Press.
Pauli, Wolfgang (1955), “The Influence of Archetypal Ideas on the Scientific Theories of Kepler,” The Interpretation of Nature and the Psyche. New York: Pantheon Books.
Rudhyar, Dane (1973), An Astrological Mandala. New York: Vintage Books.
Sparks, Gary (2010), Valley of Diamonds: Adventures in Number and Time with Marie-Louise von Franz. Toronto: Inner City Books.
von Franz, Marie-Louise (1980), On Divination and Synchronicity. Toronto: Inner City Books.
Zabriskie, Beverley (2001), “Jung and Pauli: A Meeting of Rare Minds,” in Meier, Atom and Archetype. Princeton: Princeton University Press.

Jung references on the dream
[1]Collected Works 8, ¶356, note 24. Hereafter Collected Works will be abbreviated CW.
[2] Ibid., ¶870.
[3] CW 18, ¶461.
[4] Sparks (2010), 15.
[5] Hannah (1976), 41.
[6] Sparks (2010), 13-14.
[7] Ibid., 14.
[8] World Book Encyclopedia Dictionary II, 1328.
[9] CW 8, ¶356.
[10] Ibid., ¶871.
[11] Ibid., ¶965.
[12] Ibid., ¶870.
[13] CW 18, ¶461.
[14] CW 8, ¶870.
[15] Jung described himself as an empiricist; for more on this, see the blog essay “The Psyche is Real: Materialism, Scientism and Jung’s Empiricism,” archived on this blog site.
[16] Sparks (2010), 61.
[17] Ibid., 61-62.
[18] CW 9i, ¶679.
[19] Ibid. By “incorporeal intelligences,” Jung might have been referring to the vix mediatrix naturae, the healing force of nature that lies within each of us that knows how to heal us.
[20] CW 11, ¶180.
[21] CW 9i, ¶679.
[22] Ibid.
[23] CW 10, ¶692.
[24] CW 12, ¶313.
[25] CW 8, ¶870.
[26] Ibid., ¶871.
[27] Ibid.
[28] Ibid., ¶356, note 24.
[29] Ibid., ¶871.
[30] Ibid., ¶870.
[31] I.e. in symbolic, non-rational or mysterious ways that the logical ego mind cannot always grasp. Ibid.
[32] Ibid., ¶870.
[33] Symbols, in Jung’s definition, can never be fully grasped or defined; for more on Jung and symbols, see the essay “A Way into Mystery,” archived on this blog site.
[34] CW 8, ¶965.
[35] CW 10, ¶778.
[36] CW 8, ¶356.
[37] Sparks (2010), 15.
[38] E.g. von Franz (1980) and Edinger (1995).
[39] Sparks (2010), 15.
[40] Rudhyar (1973). My students tell me this is now out of print.
[41] CW 8, ¶870.
[42] Ibid.
[43] Ibid.
[44] CW 10, ¶778.
[45] Sparks (2010), 15.
[46] CW 8, ¶870.
[47] Quoted by Jung, CW 8, ¶943.
[48] CW 10, ¶778.

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