Sunday, February 17, 2013

This article in The American Journal of Psychiatry by James W. Lomax and Glen O. Gabbard discusses the nature of transference love with reference to a particular case of a patient Dr. A. The central theme is the analogy of transference love with an artificial rose, derived from a dream that the patient had. The patient dreamt that the therapist gave her an artificial rose, which disappointed her. She would have preferred a real rose, but also acknowledged that real roses 'don't do well in Houston' and don't last long. This is taken by the patient and the therapist as a representation of the artificial nature of transference love in comparison to the real love of other relationships.

Below are some excerpts from the article:

Dr. Gabbard: '... transference love almost always carries with it an undercurrent of aggression and hate. Inherent in the analytic frame is the notion that there is an asymmetrical expression of feelings. The patient attempts to say whatever is on his or her mind, including all of the feelings toward the analyst. In most cases, however, the analyst expresses his or her own feelings judiciously, but only when it seems therapeutically helpful to do so. This asymmetry often creates a chronic sense of rage in the patient about the inequality of the setup. Moreover, the patient must pay the analyst, who, as the patient noted, is just "doing a job." Winnicott stressed that both love and hate are inherent in the analytic frame for these reasons. While love is typified by the empathic holding environment that the analyst creates and the effort to understand the patient’s life in a nonjudgmental context, hate is reflected in the fact that time with the analyst is always limited by the professional hour and that a fee is paid for the service.'

Dr. Lomax: 'For Dr. A, being involved in a loving relationship within analysis carried with it the risk of being lured into a conflictual, critical, and frustrating relationship. While sorting through these urges and the reluctances and prohibitions associated with them, she dreamt of my giving roses to each of my patients. Naturally, she wished for a real rose and a real relationship—one without the imbalance and artificiality of psychoanalysis. The artificial rose she received instead was, of course, disappointing. However, she also recognized that the artificiality of the therapeutic relationship allows it to last longer and to serve the function it was designed to accomplish. In her metaphor, in Houston (our relationship), the living roses (the natural expression of love) would not do well....
Dr. A was right. Love in psychoanalysis is an artificial rose. The psychoanalytic relationship does copy or include elements of more natural relationships. In that sense, it was a real relationship. Yet, if it was to serve as a means to an end, it must also have remained "artificially" within a therapeutic structure, providing the limits required to achieve therapeutic results.'

Dr. Gabbard: '... at the risk of splitting hairs, I don’t think I agree with either the patient or Dr. Lomax that love in psychoanalysis is an artificial rose. I think the love experienced in one’s analysis is basically similar to the love experienced outside of analysis. The feelings are just as real, but the actions are different.... [F]rom the patient’s perspective, the feelings are definitely real. In fact, the only difference between love inside and outside the transference is that the former is analyzed. All of our significant relationships are a mixture of real elements in the present situation and the recreation of past relationships.'


If I were to describe it, I would call transference love 'synthetic' rather than 'artificial'. The analogy I have in mind is the goal of creating life out of scratch in a laboratory. [J. Craig Venter has already created the first complete synthetic bacterial genome in a lab.] Such life, if it is ever created, would be as real as life gets, but it would be synthetic, and because it would be synthetic, it could be genetically programmed to have properties that natural life does not possess. Similarly, transference love is perhaps in some sense like creating love in a psychoanalytic lab, and it is as real as love gets, but because this love is synthetic, it can be programmed to have properties and serve functions that natural love does not.

Just as creating life in a lab raises questions about the value and meaning of life in general, I think that transference love also raises questions about the value and meaning of love in general.

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