Transference, Transference Interpretations, and Transference-Focused Psychotherapies

Kenneth N. Levy and J. Wesley Scala Pennsylvania State University

The concept of transference and the use of transference interpretations in psychotherapy have been highly controversial topics garnering frequent attention both within psychoanalysis and across multiple orientations of psychotherapy. In this article, we review the empirical evidence as it bears on this controversy and discuss the implications of the evidence for psychoanalysis, psychodynamic psychotherapy, and therapy in general. We provide a brief historical and contextual overview, followed by a discussion of the development of the concept of transference. We then discuss the evidence for the concept of transference from basic psychological research and contend that these findings are not only consistent with a social–cognitive and information processing model, but that they may also indicate conflict and defensive processes suggestive of a dynamic transference process model. We continue with a discussion of the evidence for the concept of transference from psychotherapy research and examine process findings relating to the use of transference interpretations and transference-focused psychotherapies. Finally, we present the implications of this emerging evidence for clinical practice.

Keywords: psychodynamic, transference, psychotherapy outcome and process research

Although the concept of transference has been central within dersen & Berk, 1998), all of which have implications for under- psychoanalysis and psychodynamic psychotherapy since Freud’s standing basic transference processes and for clinical practice. earliest writings, and it has been used broadly across multiple Within the realm of psychotherapy research, we examine evidence psychotherapy orientations (Gelso, this issue, pp. 384–390; Gil- from process and experimental psychotherapy research (random- bert & Leahy, 2007), the concept of transference and the use of ized controlled trials [RCTs]) related to the use of transference transference interpretation in psychotherapy have been highly con- interpretations, and transference-focused psychotherapies as they troversial topics (Frances & Perry, 1983; Gabbard et al., 1994; relate to therapeutic outcome. Finally, we present the implications Gunderson, Najavitz, Leonhard, Sullivan & Sabo, 1997). In this of this emerging evidence for clinical practice. manuscript, we will review recent empirical evidence as it bears on this controversy and the implications of these findings for psycho- Brief Historical and Contextual Overview analysis, psychodynamic psychotherapy, and therapy in general. We begin with a brief historical and contextual overview, outlining Transference first appeared in Freud’s neurological writings in some of Freud’s early ideas and developments contributing to the 1888 (Freud, 1888). However, the concept of transference was not evolution of the concept of transference, as well as those contri- a simple solitary discovery, but evolved over years of creative butions from some of Freud’s followers. We then examine the synthesis that was rooted in the discourses of his time. In this early evidence for the concept of transference from both basic psycho- writing, Freud used the concept of “displaceable energies” to logical research and psychotherapy research. A substantial amount indicate the transfer of strong feelings developed within a partic- of evidence has emerged from basic social psychological research, ular relationship to another person who was independent of the suggesting that transference is not a uniquely clinical phenomenon origi