Transference and relationship: Technical Implications in the psychoanalytic process with a borderline patient

Abstract

This paper reviews how the bond between the therapeutic relationship and transference is created, illustrates its technical management, and provides a basic methodology for the exploration of both transference and the therapeutic relationship. For this purpose, the current therapeutic relationship, the concept of affective dominance, the object relation triggered by transference, the past and present unconscious, and the relationship pattern (CCRT) applied to dreams will all be considered. The approach in this paper is based on an object relation conceptualization. Highlights of the theory underlying the technique will be illustrated in a succinct discussion of the clinical treatment of a borderline patient in psychoanalysis.

Keywords:

• Affective dominance
• core conflictual relationship theme
• CCRT
• object relations
• past unconscious
• present unconscious

Acknowledgments

My gratitude to Dr César Garza-Guerrero for his helpful comments on a previous draft of this manuscript.

Notes

They had both undergone marriage counseling with a psychoanalyst, who concluded, after witnessing a fierce quarrel between them, that there was nothing left of their marriage.

In respect to reality, Thomä & Kächele (6:339) assert that, “If the reality principle is subject to rational scrutiny, the technical consequences are that the patient's perceptions should be taken seriously, because it is at that time that an act of will find its object and, thereby, constitutes reality … individual conception of reality is determined in a socio-cultural context, no single side should be taken as an absolute. Thus the reality of the analytic situation is constituted in the exchange, appropriation, or rejection of opinions.”

A few complications that should be prioritized for intervention are: 1) self-destructiveness or aggressions to others; 2) danger of interrupting treatment; 3) dishonesty; 4) severe behavior in and out of the therapy sessions; and 5) devaluating the treatment (Kernberg, 1995, workshop conducted at the Asociación Psicoanalitica Mexicana (APM)).