This document discusses the concepts of transference and countertransference in psychoanalysis. It notes that transference refers to how patients view their analysts based on past significant relationships, while countertransference refers to how analysts may respond to patients. The document outlines different perspectives on these concepts from Freud, Lacan, and other schools of thought. It emphasizes that transference and countertransference must be carefully handled by analysts to avoid resistance or premature termination from patients.

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CLINICAL NOTES
Bruce Fink (2007). ‘Handling Transference and Countertransference,’ Fundamentals of
Psychoanalytic Technique: A Lacanian Approach for Practitioners (New York and
London: W. W. & Company), pp. 126-188.
The terms ‘transference’ and ‘counter-transference’ are used often in the
psychoanalytic literature.
These terms are not only important for clinicians, but also for anybody who is
interested in the theory and practice of psychoanalysis since, as Sigmund Freud was
fond of saying, ultimately everything in the analytic clinic has to be fought out in the
transference.
That is because every analysis in the analytic situation takes on the form of a
‘transference neurosis.’
So whatever the diagnosis of the underlying ‘mental structure’ of a given patient
might be, the analysis proceeds by working with and through the transference
neurosis.
There is no way of relating to the unconscious in the clinic minus the transference.
The only question in terms of analytic technique - as far as the clinicians are
concerned - is whether given the overwhelming importance of the transference
neurosis, they should call attention to it.
Should the patient be acquainted with the fact and forms of the transference?
In other words, should clinicians interpret the transference?
There is also the terminological problem of transference and counter-transference.
Jacques Lacan uses only the term ‘transference’ and minimizes the use of the term
‘counter-transference’ because he has a propensity to deconstruct the use of these
terms, but it would be incorrect to say that he ignores the counter-transference.

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Lacan was only too well-acquainted with the literature on the counter-transference
since he located the main source of resistance in the analytic situation in the locus of
the analyst rather than the patient.
Bruce Fink is amongst the few Lacanians who even use this term though he does so
mainly in order to incorporate the literature on the counter-transference into
Lacanian studies.
Likewise, Lacan does not differentiate between a ‘therapeutic’ analysis and a
‘training analysis,’ but a number of analytic schools do so. There is also a literature
on training analyses as opposed to therapeutic analyses.
An important problem for Bruce Fink then is to reconcile these technical
vocabularies across the different schools of thought though he is mainly trying to
explain what Lacanians mean by ‘transference dynamics.’
So, broadly speaking, the term ‘transference’ is mainly used from the patient’s point
of view and the term ‘counter-transference’ is used from the analyst’s point of view.
Both forms of transference serve as forms of ‘imaginary distortion’ in the analytic
clinic since they tell us more about what the patient and the analyst think or feel
about significant others in their own lives rather than about what they really think of
each other.
These forms of imaginary distortion seek expression in the analytic situation when
the analysis nears the pathological nucleus that constitutes the core of the neurosis.
While transferential phenomena can take a positive or a negative form, they become
significant for the analysis when it takes the form of ‘resistance’ on the part of the
patient or the analyst.
Transferential phenomena are not specific to the analytic situation; Freud, for
instance, pointed out that there are extra-mural transferences at play as well in
educational institutions, hospitals, and in the work place.
The Lacanian formulation of these phenomena is that the transference is triggered
off wherever there is a subject ‘supposed to know’ the secret of the patient’s desire.
The prototypes of the transference then in the history of philosophy are the
relationship between Socrates and his disciples or even that of Jesus Christ and his
Apostles.
In his seminar on the Transference, for instance, Lacan calls attention to an instance
in the Socratic dialogues where a disciple of Socrates points out that the secret of his

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eloquence is the ‘presence’ of Socrates, but that he is not able to perform when
Socrates is not present.
These phenomena relate to the ‘presence of the analyst’ in the analytic literature.
This is a topic that Lacan analyses in Seminar XI.
Suffice it to note in these clinical notes that transferential phenomena must be
handled with great delicacy because they are implicated in problems like acting-out,
repetition, and the abrupt termination of the treatment as any number of case studies
in the history of psychoanalysis demonstrate.
Bruce Fink’s starts his analysis of these phenomena by pointing out that the analyst
must first of all ‘recognize’ the existence of the transference in the patient.
There is also a term in the literature that is known as the ‘pre-transference.’
It basically means that even before the analysis has started, the patient is confronted
with the choice-of-the-analyst problem.
The patient is revealing the transference by choosing to work with a particular
analyst that he might have heard about or even read in part before starting an
analysis with that analyst.
It would not be a stretch to say that in the context of the pre-transference, the first
diagnosis is made by the patient himself when he realizes that his illness is not
because of an organic ailment, but requires a full-fledged analysis.
That is also why – as Fink points out - patients in analysis do not reveal their organic
illnesses early on in the treatment.
They are afraid that the analyst will come to a pre-emptive conclusion about their
condition and not be willing to explore the fantasies induced by their illness.
Fink emphasizes at the beginning that the transference might be triggered off by
resemblances between the analyst and early figures (significant others) in the life of
the patient.
Though these are forms of ‘imaginary distortion,’ they could serve as a spur to the
analysis.
If the transference is positive, it is best to leave it alone.
If the transference is negative, it is best to be careful with the patient. The ‘negative
therapeutic reaction’ is also related to the negative transference.

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Analysts also use terms like ‘flight into illness’ to describe these phenomena in the
patient’s life. In such a situation, the patient prefers to fall ill rather than work-
through a conflict that is of consequence to his sense of identity.
Alternatively, the patient may also seek recourse to a ‘flight into health’ in order to
avoid the analysis. All these transferential phenomena are forms of psychic
resistance to the treatment and must be dealt with as such.
It would not be an exaggeration to say that both positive and negative therapeutic
reactions are really forms of resistance to analysis.
The ‘scope’ of the transference is also important.
Some analysts define everything that happens in their clinic as transference whereas
others differentiate between the inside and the outside of the transference though
this cannot be done with technical precision.
Ego psychologists, for instance, try to differentiate between the healthy and the
unhealthy parts of the ego and try to get the healthy part to go along with the
analysis: this is known as a ‘therapeutic alliance.’
Likewise they also differentiate between that part of the ego which ‘experiences’
conflict and that part which merely ‘observes’ the conflict and try to get the part that
can ‘objectively’ observe what is going on to their side.
Lacan’s critique of ego-psychology is based on the argument that transferential
distortions can be so severe that both the analyst and the patient will be subject to
imaginary distortions if they attempt to do this.
There is no absolutely neutral space in which the analyst can strike a deal with the
healthy part of the patient’s ego in order to further the treatment.
This approach to the treatment presupposes that the patient will behave on the
couch in a way that is no different from how he spoke to the analyst during the
‘preliminary interviews’ before he was put on the couch.
It is therefore important to differentiate between falling prey to the lure of the
imaginary and seeking a symbolic correction for the temptation of doing so (albeit in
the best interest of the patient).
The huge literature on the counter-transference is based on the assumption that as an
analyst increases his clinical experience, he will have a much better idea of his own
counter-transferential impulses and learn to control them in order to keep the
analysis on course.

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The analyst should not be deflected by any form of imaginary distortions or by the
any number of projective identifications that will inevitably emerge in the course of
the analysis.
That is why Fink reviews the literature on projective identification in the analysis of
the transference and the countertransference.
The better analysed the analyst himself is, the less likely it is that he will make
mistakes in the treatment, since as Lacan pointed out, ‘he who is not in love with his
own unconscious goes astray.’
In order to do this, both the analyst and the patient must learn to harness love within
the transference. As Jacques Lacan puts it, ‘If psychoanalysis is a means, it situates
itself in the place of love.’
SHIVA KUMAR SRINIVASAN