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The Territory of the Transference and the Value of Phantasy Interpretation: a Kleinian Expansion

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The Territory of the Transference and the Value of Phantasy Interpretation: a Kleinian Expansion Chapter 2 The Territory of the Transference and the Value of Phantasy Interpretation: A Kleinian Expansion With some patients in psychoanalytic treatment, the most effective interpre- tive route is primarily genetically rooted, linking their internal and external struggles from the past with current psychological issues and with the trans- ference. However, with many other patients, the interpretive approach is much more effective when based in both the transference and the externalization or projection of internal phantasy. Here, the analyst helps the patient move from more conscious external self and object anxiety to deeper, unconscious internal conflicts. Whatever material the patient is bringing to us, their core phantasy con- flict is embedded within it and we can interpret it as how it relates to us in the clinical setting or at other times simply interpret the deeper psychologi- cal struggle we hear between the lines. In other words, our task is to help the patient understand, face, and resolve particular anxieties regarding self and other within their internal world and work with how projective identification brings those phantasies alive in the external world. Our interpretive tools must include exploration of the immediate transference when possible but also the rest of the patient’s object relational experiences. This is the entire territory of the transference. Hanna Segal (1989) discussed how interpreting in the transference does not mean only verbalizing here-and-now issues between analyst and patient. She believes it is more a combination, over time, of interpretively working on the patient’s past, the interplay of phantasy and reality, the transference to the an- alyst, defensive structures, the conflicts between the instincts of life and death, and the basic urges of love, hate, and knowledge. Betty Joseph (1985) has de- scribed the “total transference” situation. I believe she is talking about the same thing Segal has described what I would like to term the territory of the transference. This new term connotes our attempt to help the patient to even- tually experience one internal world, instead of split off, fragmented chucks of life with the past not linked to the present and the future unreachable. Arundale (2015) has noted how Melanie Klein was well aware of the value of extra-transference interpretations and the relationship between current ex- ternal reality and the unconscious past. The territory of the transference is a concept that expands and extents this idea. © Koninklijke Brill NV, Leiden, 2018 | doi 10.1163/9789004357198_004 The Territory of the Transference 27 Case Material By the second year of his analytic treatment, Perry had worked through many of the specific problems he came into therapy for, especially the more severe interpersonal issues between Perry and his wife as well as various workplace situations. We worked on Perry’s depressive (Klein 1935;1940) fear of conflict with his wife and how Perry felt pressured to make her happy but always felt he was a disappointment. These issues routinely came alive in the transference and when they did we worked directly on them. Through exploring his marital issues and his conflicts within the transference, we came to a deeper under- standing of his internal world and the intense depressive conflicts he suffered from. So, we would explore how Perry assumes I am “sick of him and his pet- ty problems” and how he wants to be assertive but is too anxious or plays it down to me for fear of “looking pushy or impatient”. And, we would notice the same conflicts and transference issues with his wife. Gradually, we worked through those object relational anxieties. As a result, he became much more familiar with and more able to solve the constant and intense anxiety that took such a central place in his internal phantasy world, the wider territory of the transference. Even with this emotional growth and stronger sense of individuality, Perry still struggles with crippling depressive position uncertainty. Guilt, dread of interpersonal conflict, and not feeling he can ever feel safe or relaxed still cre- ate ongoing tension, obsessive compulsive symptoms, and a feeling of being “powerless, exposed, and vulnerable”. We have explored Perry’s traumatic childhood over the last year and it has certainly provided a background for understanding his internal object rela- tional conflicts. However, this historical working through of grief and resent- ment has not been a major part of the interpretive process. It has made up probably 25-30% of the work, while the transference focus takes up another third and the externalization of internal phantasy takes up the rest. Working with this last part is often termed the extra-transference interpretation but I prefer to think of it as the territory of the transference because it still involves the patient’s internal attachment or detachment to the analyst. With the distortion created by pathological projective identification mechanisms overused to fend off, seduce, attack, devour, or otherwise engage/ disengage the depressive or paranoid-schizoid object, the patient is in a transference mode at all times, to everyone and everything. Thus, we must interpret the entire territory of the transference, wherever it may show itself in the moment, be it the transference to the analyst or the transference to .
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