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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 41. This is the beginning of the thread.
Posted by pegasus on October 8, 2010, at 9:47:41
I've seen my new T for 4 sessions, and I'm already in the thick of it. In my last session, I mentioned that I was still in that golden moment where I could not give a sh*t what he thinks. He thought that was really funny. I loved that he laughed, and I knew right then that the moment was gone.
We're talking a lot about my old T, who moved away on me. New T asks a lot about the transference, and clearly working explicitly with transference is the heart of his technique. I'm not opposed to that, and surely there is lots of transference from my relationship with my old T to this new T. And yet, when I think of that older relationship, what seems helpful about it is the attachment in it, not the transference of it. Does that make sense? I suppose attachment to a T is a form of transference. But that attachment is also healing and powerful, wherever it came from. My thinking is muddled on this.
What is to be gained by framing this as transference, and examining that in therapy?
- P
Posted by pegasus on October 8, 2010, at 12:38:04
In reply to Attachment vs. transference, posted by pegasus on October 8, 2010, at 9:47:41
It might help if a clarify what I'm talking about.
I like this definition for tranference: "A process during psychoanalysis, whereby a client attaches feelings towards the therapist that were previously unconsciously directed towards a significant person in their life, who may have been involved in some form of emotional conflict."
And I'm trying to understand how that relates to the idea of attachment in therapy. The idea is that the therapy relationship can involve an attachment a lot like the attachment of a young child to a caregiver, which allows social and emotional development to occur. That attachment can then allow continued emotional development as an adult. I feel like that describes perfectly what I experienced in therapy with my old T.
- P
Posted by sigismund on October 8, 2010, at 18:54:08
In reply to Some definitions, posted by pegasus on October 8, 2010, at 12:38:04
I don't know if I'm missing the point, but there is nothing invalid about transference.
I see it as describing the origins (and the style?) of the attachment.
Let's say you are in therapy, freely exploring the moment.....I guess that could be attachment without transference?
Posted by emmanuel98 on October 8, 2010, at 19:41:47
In reply to Re: Some definitions » pegasus, posted by sigismund on October 8, 2010, at 18:54:08
I think most therapists now define transference to include not just repeating past relationships but trying to rework a bad relationship. So attaching to a therapist as a child would to parents (when one had no decent parents to attach to) is considered transference, since the intensity of the emotion and neediness is really above and beyond what the actual relationship entails. Glen Gabbard writes of the "golden fantasy", where patients want their therapist to be there for them and love them always, as parents do. One point of therapy, he says, is to relinquish this fantasy and mourn the loss of that as a child.
Posted by twinleaf on October 9, 2010, at 10:11:12
In reply to Attachment vs. transference, posted by pegasus on October 8, 2010, at 9:47:41
I think you are making an important distinction. Just allowing the relationship to *be* - letting the attachment develop - seems to me to be the most helpful thing to do. Pointing out the transference aspects of the relationship runs the risk of making it a less close and important part of our experience. I think the word psychoanalysts use is "experience-near" to describe the powerful effect of just being with your therapist.
The analyst I have now makes a point of NOT interpreting or explaining anything about our relationship - he just wants it to be experienced. If I want to talk about something that happened between us, that is fine, but the experiencing is what counts for him.
Its hard to say why, but it's tremendously helpful.
Posted by Dinah on October 9, 2010, at 10:26:14
In reply to Some definitions, posted by pegasus on October 8, 2010, at 12:38:04
> And I'm trying to understand how that relates to the idea of attachment in therapy. The idea is that the therapy relationship can involve an attachment a lot like the attachment of a young child to a caregiver, which allows social and emotional development to occur. That attachment can then allow continued emotional development as an adult. I feel like that describes perfectly what I experienced in therapy with my old T.
I tend to see attachment that way too.
I think I view transference as a misunderstanding or distortion in our view of a person, the relationship, or a situation based on past experiences. So that someone sees their therapist as having authority, so infers that their therapist must also have other qualities they associate with authority, and interprets interactions in a way that reflects prior relationships rather than the current one.
I guess I'd also include ingrained responses to certain situations. Lots of people are attracted to their therapists even if their therapists aren't ordinarily people they'd be attracted to. The situation of getting undivided attention, sharing personal information, making eye contact etc. mimics the relationship that are biologically associated with early parent child interactions or romantic relationships. So to the extent that attachment occurs because of the framework of therapy, perhaps the attachment *results* from a type of transference? In that it is a product of the situation?
But the attachment itself is attachment and is used in the way you describe.
Not that I totally understand all the terminology so I could be completely wrong.
Posted by Dinah on October 9, 2010, at 10:30:13
In reply to Re: Some definitions, posted by Dinah on October 9, 2010, at 10:26:14
As to what can be gained, I'm not really sure. If the attachment is causing problems, for example, if someone is becoming attached in a way that hinders rather than helps therapy, it might be useful to examine the transference.
But in the situation you describe, you (and I) see the attachment as a helpful way to achieve growth. So in that case, why not use the attachment without overmuch exploring its roots?
Posted by pegasus on October 11, 2010, at 9:37:22
In reply to Re: Some definitions » pegasus, posted by sigismund on October 8, 2010, at 18:54:08
I think you're right. I've been doing some reading this weekend, about a more recent view of transference that takes into account the client *and* therapist's influence on what is happening in therapy. So, transference then becomes the client's tendency toward interpreting relational events in a particular way, when multiple possible interpretations might be possible. I think I was getting hung up on a more old fashioned view of transference, as something that is entirely coming from the client's past, with no significant basis in the reality of what happens in the therapy relationship.
Clearly I have more reading to do about modern views of transference.
- P
Posted by pegasus on October 11, 2010, at 10:28:55
In reply to Re: Some definitions, posted by emmanuel98 on October 8, 2010, at 19:41:47
See, now, I disagree that relinquishing the "golden fantasy" and mourning the lack of good parenting was what was helpful in my past therapy. On the contrary, I think experiencing that intimate, attached relationship, and believing wholeheartedly in it, was what allowed me to make the positive changes that I made in my previous therapy. Maybe that's why I see framing it as transference (in this way) as unhelpful.
Maybe you're right that it is transference because the intensity of the emotion and neediness is beyond what the actual therapy relationship entails. But I'm not sure. I mean, I think my old T would disagree about the therapy relationship not encompassing all of that. He seemed fine with it, and even encouraging of it.
I've been reading this book called "Attachment in Psychotherapy", that talks about a new "intersubjective" approach to therapy, that welcomes and uses the attachment that naturally forms in therapy. I'm only part way through, but it's helping me start to make sense of my past experience, and how it seems different than some discussions of transference that I've heard.
- P
Posted by pegasus on October 11, 2010, at 10:34:06
In reply to Re: Attachment vs. transference » pegasus, posted by twinleaf on October 9, 2010, at 10:11:12
Oh, that sounds lovely, and very validating, and healing. And more like me older therapy.
On the other hand, I'm not necessarily minding that my new T wants to talk explicitly about the transference, either. It *is* interesting when he points out when I seem to be thinking or worrying about a reaction he has, and then tells me what his real reaction is. And then we talk about maybe why I went where I went with it. Maybe that's why I'm confused. I kind of want to do it both ways.
Maybe it's what you say, that I want permission to let the attachment develop and be real, without being interpreted into nothing. But I also want to see more clearly where I have my own internal tendencies.
Thanks for helping me clarify that for myself.
- P
Posted by pegasus on October 11, 2010, at 10:40:06
In reply to Re: Some definitions, posted by Dinah on October 9, 2010, at 10:30:13
Yes. That's my quandary exactly. Or . . . maybe one can do both, with different types of benefits. I think that's what my new T might say. But I'll ask him more about it when I get a chance.
I have a feeling he'll have a lot to say about it. As we've discussed, he likes to talk about himself, including his opinions and ideas, quite a lot. This bit of that tendency, though, is one thing I like about him. He is very thoughtful and articulate about his own therapeutic approach. I don't get the sense that he's flying by the seat of his pants with this stuff. It's comforting.
- P
Posted by emmanuel98 on October 11, 2010, at 21:44:46
In reply to Re: Some definitions » emmanuel98, posted by pegasus on October 11, 2010, at 10:28:55
I guess my p-doc didn't encourage the attachment. He understood it and interpreted it, but he told me constantly that he was not as wonderful as I thought he was, that he cared for me as a patient but not as he would a loved one, that I was experiencing with him what I did not experience as a child. He saw this as transference and I guess that's how I came to think of transference.
Posted by Dinah on October 12, 2010, at 1:06:09
In reply to Re: Some definitions » sigismund, posted by pegasus on October 11, 2010, at 9:37:22
> I've been doing some reading this weekend, about a more recent view of transference that takes into account the client *and* therapist's influence on what is happening in therapy. So, transference then becomes the client's tendency toward interpreting relational events in a particular way, when multiple possible interpretations might be possible.
I like that definition.
Posted by pegasus on October 12, 2010, at 9:51:01
In reply to Re: Some definitions, posted by emmanuel98 on October 11, 2010, at 21:44:46
> I guess my p-doc didn't encourage the attachment. He understood it and interpreted it, but he told me constantly that he was not as wonderful as I thought he was, that he cared for me as a patient but not as he would a loved one, that I was experiencing with him what I did not experience as a child. He saw this as transference and I guess that's how I came to think of transference.
I feel so sad when I read this. I imagine that it would have been very painful to hear this. Is that what you found? Or maybe I'm projecting my stuff onto you.
- Peg
Posted by lucielu2 on October 12, 2010, at 18:57:45
In reply to Attachment vs. transference, posted by pegasus on October 8, 2010, at 9:47:41
This is such an important topic! In many therapies, the relationship *is* the therapy and mine has been like that. My transference initially was so intense, I had difficulty tolerating the attachment. (That's a really good book, by the way, and I like the way he writes.) Nonetheless, through his consistency and steadfast supportiveness, the attachment was able to form. At some point, I could both feel the attachment and begin to differentiate him from past figures. I used to tell him that when I was able to see him completely clearly, for himself, then I would be done with my therapy. I think I would amend this now, that if I can see him as he is and feel secure and nurtured by the attachment as it is, then I will have taken a big step forward.
Posted by emmanuel98 on October 12, 2010, at 19:48:12
In reply to Re: Some definitions » emmanuel98, posted by pegasus on October 12, 2010, at 9:51:01
The whole experience was so intense and painful that I still cry whenever I think about it. My p-doc is just very straight-forward and is meticulous about boundaries. He was never cruel though. I loved him so intensely, almost from the beginning (which is why I think of it as transference -- I barely knew him, was just blown away by someone being kind and compassionate to me) that I would profess my love all the time, always in tears. He would say, why does this make you sad? BEcause I don't love you in the same way?
Posted by emmanuel98 on October 12, 2010, at 19:52:55
In reply to Re: Attachment vs. transference » pegasus, posted by lucielu2 on October 12, 2010, at 18:57:45
That's interesting. I used to say that too -- when I could accept my p-doc as just a therapist, I would be done. I came to accept that, but not entirely. I still get sad thinking that I can't be his friend or lover or daughter. I still find him unaccountably beautiful (he is 71 and his face is heavily lined). I am too attached and too intense and always have been. I tried quitting therapy last winter, as I didn't really have any more work to do with him (we had been seeing one another weekly for five years). We set an end date, made a med appointment for three months away. I was okay for a while, but by June I was begging to see him again.
Posted by Dinah on October 12, 2010, at 20:06:56
In reply to Re: Attachment vs. transference » lucielu2, posted by emmanuel98 on October 12, 2010, at 19:52:55
How often are you seeing him now?
Posted by pegasus on October 13, 2010, at 12:21:29
In reply to Re: Attachment vs. transference » lucielu2, posted by emmanuel98 on October 12, 2010, at 19:52:55
> That's interesting. I used to say that too -- when I could accept my p-doc as just a therapist, I would be done.
I think I know this feeling, but I'm not sure this is the same thing as what I experienced in my very attached previous therapy. I did come to see my T more clearly as an independent person throughout the therapy (and after). Which I think was a sign of progress of some sort for me. But the attachment didn't fade at all. Still hasn't 7 years later.
I think of it kind of like my relationship with my mother. I was/am attached to her (for better or worse). I figure I will always be attached, but as time goes on I can see her more and more clearly, as an independent person. I can appreciate her struggles and strengths more, and I also see more clearly, with less pain, exactly where she could have done better by me.
So, the latter stuff is happening outside of my attachment to her. But when I'm with her, I can still feel that intense sense of home that is the (healthy part of the) attachment. And that is helpful to me, and - yes - sometimes painful when I want comforting and she's not available in one way or another. That comfort is something I internalized more and more as I grew up, which is good. And yet, internalizing it doesn't make the attachment to her go away, I find. Moreover, it's not a part of my relationship with her that I want/expect to grow out of.
Is it reasonable to see a T relationship in a similar way? I mean, eventually I'll end therapy (or he'll end it for me like before), and it won't be like my mom where I can call her, or go visit, or even talk to other people who know and love her. And yet my experience of my old T is that I will *never* see him as just a therapist, however long my life goes on without any contact with him.
It's still such a tangle in my mind.
- P
Posted by emmanuel98 on October 13, 2010, at 19:27:33
In reply to Re: Attachment vs. transference » emmanuel98, posted by Dinah on October 12, 2010, at 20:06:56
> How often are you seeing him now?
>
> I started out at once a week because I had been hospitalized. But now I am down to once a month. I feel that part of the reason I became so depressed at the beginning of summer is that I hadn't really grieved this properly. I just said, I'm done, set a date to end, ended and then tried to push it aside. But seeing him every two months for meds was so painful because I would be reminded of what I had lost. I think I'm better now. I think I've gotten past the grief.
Posted by emmanuel98 on October 13, 2010, at 19:35:37
In reply to Re: Attachment vs. transference, posted by pegasus on October 13, 2010, at 12:21:29
I don't think the attachment ever really ends when it's been so powerful and intense. My p-doc changed my life. I went through this profound process with him and he was steadfast and loving and supportive. I had no relationship with my parents and left home at 14, so this was really powerful to me and always will be. I can still get myself into a state thinking that he will retire and could get sick or die and I will never even know about it or be able to help care for him. I am not part of his real life, no matter how important he is to me. He used to say, when we were seeing one another every week that he probably spent more time with me than he did with close friends, that I mattered a lot to him, that seeing me grow and change was a gift, that he cared a lot for me and there was a way in which he loved me too. But still, in his non-professional life, I don't have any place at all. And that can make me so sad, especially when I think how old he is getting.
Posted by Dinah on October 14, 2010, at 6:11:55
In reply to Re: Attachment vs. transference » pegasus, posted by emmanuel98 on October 13, 2010, at 19:35:37
> I can still get myself into a state thinking that he will retire and could get sick or die and I will never even know about it or be able to help care for him. I am not part of his real life, no matter how important he is to me. He used to say, when we were seeing one another every week that he probably spent more time with me than he did with close friends, that I mattered a lot to him, that seeing me grow and change was a gift, that he cared a lot for me and there was a way in which he loved me too. But still, in his non-professional life, I don't have any place at all. And that can make me so sad, especially when I think how old he is getting.
I hate that part of the therapy arrangement. It seems so unnatural.
Posted by pegasus on October 14, 2010, at 10:05:23
In reply to Re: Attachment vs. transference » pegasus, posted by emmanuel98 on October 13, 2010, at 19:35:37
Yes. Exactly. That is exactly how I feel about my old T as well. I google him now and then, and I usually find some evidence that he is probably still alive and working. I still email him a brief message maybe once a year. He usually doesn't answer, unless I specifically ask him to. But it is reassuring when it doesn't bounce, at least.
I agree with Dinah that this part feels very unnatural. I wish I knew of a change to suggest that seems workable.
Posted by Daisym on October 15, 2010, at 0:19:55
In reply to Re: Attachment vs. transference, posted by pegasus on October 14, 2010, at 10:05:23
Having just finished my PhD in this very subject (Psychology, specializing in attachment theory), can I make a suggestion? Consider thinking about transference and attachment as verbs instead of nouns.
I think there is general agreement that transference describes the way human beings approach situations - not just relationships. We take our previous experiences and make judgements based on those about the current situation. It would take too long otherwise, to figure out who or what was dangerous or not. And for sure there is positive as well as negative transference. Generally speaking, the idea is to not mess with positive transferences and perhaps unpack the negative ones to find the patterns that interfere with your life. To do it overtly in therapy is actually a great way to look at how you approach situations and people. Most people don't typically do something different in therapy (with regards to approach or reactions) than they do in "real" life. Calling your patterns "transference" doesn't make what is happening any less real or important.
Attachment is a whole different ball game, IMO. You have an attachment system that can get activated in therapy - but isn't always. Lots of CBT practitioners take care not to get the attachment going. They don't work with the relationship piece so it isn't central to the therapy. But all the factors that make up therapy often can really activate a person's attachment system. As the awareness of the feelings grow, the struggle of having needs and feelings for your therapist can either feel great, feel threatening or alternate somewhat. Folks who had at least one consistent caregiver typically have the ability to develop a secure attachment without a lot of trouble. It isn't terrifying - even if it might be sort of embarrassing. These people don't worry that the relationship will hurt them or the therapist.In fact, they know that being close can provide the security and support they need to change. The therapist is the ultimate "safe base" from which to explore.
People who lacked close early relationships consistently may avoid becoming attached and will fight themselves when they feel those "needy" feelings. They don't want the relationship and sometimes quit therapy if one begins to form. But they get by fine most of the time by relying on themselves They do not need a safe base. But if you've had inconsistent care-giving, your attachment system maybe chaotic and disorganized and the relationships you have, have to be earned. And they are earned through lots of painful pushing and pulling. You want to be cared for, you want to care but it feels as threatening as death. And once in the relationship, you sort of wait all the time for it to end or go bad. So a safe base is slow to form and then it is returned to again and again.
So I think the attachment piece is important because it tells us whether the relationship with the therapist is the vehicle of change or if it needs to be the main focus of the therapy. One of the hard things the research tells us is that a person can have different types of attachment in relationships. So a child (or client) can have a secure attachment with mom and an insecure attachment with dad. And can transfer either of these experiences into the new relationship.
I'm glad you like your new therapist and hope you do develop a strong relationship with him. You've demonstrated that you can form secure attachments - which is a gift.
I hope this long-winded post helps in some way.
Daisy
Posted by twinleaf on October 15, 2010, at 9:12:23
In reply to Re: Attachment vs. transference » pegasus, posted by Daisym on October 15, 2010, at 0:19:55
Hi Daisy! It's wonderful about your doctorate, and also wonderful to see you posting here. Will you change what you are doing - to therapy and/or research, or will you keep on doing what you were doing previously?
And thanks for the contribution on transference and attachment - it was very helpful to those of us who struggle with attachment. I just think I've gotten an earned secure attachment, and then some unknown influence wrecks it, and I have to try all over again. These times do happen less often, though, and I also "carry him with me" much more easily during vacations. Do you think it's realistic to hope to get securely attached more permanently?
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