Further thoughts on transference

• Accelerated Learning and Positive Templates by Francine Shapiro, 8/4/97
  
  

The treatment of the client I described in "Object relations" lasted about six months until his managed care company cut him off. During that time, I don't recall devoting significant time to processing his transference with me. With other clients with whom I have used a similar strategy of using outside relationships as the source of transference material and processing it with EMDR, there has also been relatively little processing of therapist-client transference. The traditional psychodynamic work I have done, however, has focused often on transference material in the therapist-client relationship. I speculate that the reason for this difference is that in the EMDR work the exploration of historical material, although intense at times, is narrowly focused whereas in typical psychodynamic work, the client is immersed in the historical material and can live it, often for weeks or months at a time. Once painful material has been accessed with EMDR and brought into consciousness, the client is required to hold it for less time than traditional therapies because it is processed more rapidly and the session is typically longer allowing more time for a painful memory to be fully reprocessed. There is therefore less fear of the therapist, less of a perception of the therapist as the source of dysphoria between sessions, less of a sense of dependency on the therapist, less of a need to test the therapist, and less transference acting out. A certain amount of negative transference is of course inevitable and it is helpful for the client to work it through and see that negative feelings need not poison a relationship; transference acting out, on the other hand, when it persists represents a distortion in the relationship between therapist and client that interferes with developing a productive therapeutic alliance.

Bessel van der Kolk pointed out in his address at the 1997 plenary session of the EMDRIA conference that when a client with PTSD recalls a traumatic memory the left brain becomes inactive; these clients can not use language to organize traumatic memories and sooth themselves. Consequently, these clients are likely to be retraumatized by recalling their traumatic memories in a "talk therapy," without necessarily receiving substantial benefit. For clients with personality disorders who were severely traumatized as children, one can assume that coming in contact with these memories in a traditional therapeutic setting leads to a negative transference with the therapist representing the hurtful, neglectful, or abusive person who caused the trauma. Accurately interpreting and processing this transference helps the client to understand herself and gives her a positive experience of working difficulties through in a relationship. With personality disorders, however, these distortions in the therapeutic relationship can be very difficult to process and can take over the central focus of the treatment. I have found that this type of transference is less common, and is easier to process if it does occur.

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