The Aims Of Working In The Transference

Before we can approach how to make a transference interpretation we need to consider its most fundamental aspect, namely its function. If we subscribe to the view that we represent our interactions with others as procedures for how to be with others (see Chapter 2) and further, if as research indicates that these early procedures will be for the most part inaccessible as conscious memories, then all we can really work with in therapy is the patient's behaviour in the present relationship with us in the consulting room. Through what transpires between us and our patient, we can track shifting identifications, changing expectations of self and other and the accompanying affective states that may call into play particular defensive manoeuvres. Working in the transference helps us to bring to awareness the possible meanings of patterns of current relationships so that the patient can learn to modify patterns that have become automatic through the creation of a second-order representation of his inner experience.

The transference position of the patient at each moment in therapy is predominately coloured by a particular object relationship. The interpretation tracks these shifting configurations of self-and-other-in-interaction and, in so doing, has several, overlapping aims:

• To help the patient recognise and own denied/spit-off aspects of the self. This allows for a more integrated experience of the self, characterised by greater autonomy and flexibility.

• To help the patient become aware of the discrepancy between how he perceives the therapist/other people and how they actually are. This involves helping the patient understand how perception is coloured by internal states of mind and how this, in turn, gives rise to particular affective experiences and thus shapes behaviour. Insight into these distorting influences helps the patient separate old relationships from the new ones and is the starting point for the development of new models of relationships.

• To help modify the force of the "bad" internal object. This requires an exploration of the patient's bad or persecutory internal objects and the associated matrix of anxieties and defences, with the aim of helping the patient internalise a more benign experience of the other. • The overall aim is to establish a link between internal and external figures by helping the patient appreciate the dialectical nature of internal and external reality.

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Anxiety and Depression 101

Anxiety and Depression 101

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