Gentle Handling of Transference in a Patient Who is Difficult to Reach

Abstract

Transference is the redirection of past emotional experiences of the patient relived in the relation with the psychotherapist. In patient who is difficult to reach, transference manifestations are usually intense and unpredictable. This study aims to analyze the transference experience of a 29-year-old woman during the course of a psychoanalytic oriented psychotherapy in an educational psychology service. A case study was used as the methodological strategy, and the psychoanalytic approach was applied to analyze the data. In therapy, the link was constantly attacked by paranoid defenses and manifestations of distress that interrupted the flow of associations, sometimes redeemed by the therapist’s emotional continence. From the standpoint of transference, the permanence of analytic contact, destabilizing the thought patterns and defensive behaviors of the patient, possibly produced the feeling that part of his inner world was in disarray because in many instances, the patient seemed to bother with the interpretations. The results indicate that considering the potential disorganization of the patient’s internal world, the possibilities of using transference interpretations should be handled carefully and with moderation by the psychotherapist so that it does not intensify the primitive states of ego-fragmentation.

Transference; Psychotherapy; Psychoanalytical interpretation