![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 10 to 34 of 47. Go back in thread:
Posted by starloree on April 6, 2006, at 19:34:16
In reply to Re: Against Transference » pseudoname, posted by fairywings on April 5, 2006, at 22:01:41
see, the things i find attractive about my T are things i have found attractive (immensly) about other guys....accomplishment, attractiveness, motivated....but of course I can never attract those types of guys, just stand by foolishly, salivating :) that smile really is making light of my situation, because it's really actually painful knowing that, once again, i have fallen for a guy who is unnattainable.
starloree
Posted by special_k on April 7, 2006, at 9:24:45
In reply to Re: Against Transference, posted by starloree on April 6, 2006, at 19:34:16
> it's really actually painful knowing that, once again, i have fallen for a guy who is unnattainable.
hmm. is that a pattern you have noticed in your life?
;-)
Posted by special_k on April 7, 2006, at 9:38:50
In reply to real feelings » Veracity, posted by pseudoname on April 5, 2006, at 18:31:55
i think feelings of love are feelings of love...
but that doesn't rule out transference as one possible explanation of the origin / presence of those feelings...
> I guess I would say then that I can't see a basis for declaring the feeling not real
i guess i think transference feelings are every bit as real as non-transference feelings. like burns caused by the sun are every bit as real as burns caused by the stove. it is just that the origins of the burns / feelings may be different.
> what if these feelings have important triggers and effects just like the feelings you would call “real”? What if, just because they're about the therapist and seem shallow, they are therefore ruled to be transference from early childhood, and those important NON-childhood connections are never discovered?
?
triggers and effects?
i'm not quite sure what you mean...
what kinds of important NON-childhood connections might be passed over?
> I think it's worth noting that no physiological or developmental basis has ever been observed that supports making a distinction between “real” and transferential emotions.i thought the idea was the origin... but i might be wrong. maybe i have a very idiosyncratic notion of transference...
> > We cannot ever really know our therapists beyond limited general information so if we fall IN love with them, it seems like we're just falling in love with some IDEA of them we have in our heads. And that's not real to me, that's transference.i think it is real. it is just that if you tried to have a relaitonship in the real world you would appreciate soon enough that the person doesn't match the ideal and so your feelings of intense love are likely to evolve into feelings of disappoitment and maybe resentment or rage or something like that. i'd say that might be a difference between transference feelings (maybe more based around an ideal) and non-transference feelings which are more based on seeing someone in a variety of contexts over time... well... when all goes well. i grant there may be no hard and fast line...
> People sometimes FALL in love for real, as the expression suggests, very easily, on the basis of minimal information and contact, and end up married. That sure seems real.yes. is there usually a significant power imbalance in their relaitonship in the first place (ie teacher / student; therapist / client; etc etc...)
> But I would still deny that there are any grounds for EVER confidently asserting that a particular current emotional response is a transfer of stored-up emotions toward a figure from childhood.oh. is that what transference is supposed to be... i guess... maybe it is more... when you feel an intense response and you wonder 'why on earth am i having such an intense response' and then you can get to thinking what it reminds you of... and then you can come up with a story. maybe it seems to fit maybe it doesn't... but i guess it is in the effort to explain / understand why you feel as you do. sometimes we don't analyse our feelings in that way. maybe you do marry someone who reminds you of your father (or someone who seems the opposite of your father) and maybe transference is the basis for the attraction. i guess it doesn't matter so long as the relationship is mutually beneficial / satisfying. but if you find yourself longing for someone you don't really want to be longing for (rationally) or if you find yourself longing for someone who doesn't reciprocate, or who treats you badly or something... well then that might be the time to figure if there is some transference going on to explain your emotion... and if you get to thinking what it reminds you of etc etc... maybe that process of working through... means that the feelings get less. you kind of get over it... and have feelings for people who are more appropriate.. maybe that is what it is about?
(just rambelling along)
Posted by pseudoname on April 7, 2006, at 12:32:59
In reply to Re: real feelings » pseudoname, posted by special_k on April 7, 2006, at 9:38:50
> > what if these feelings have important triggers and effects just like the feelings you would call “real”?
>
> triggers and effects?
> i'm not quite sure what you mean...I should point out that I'm not thinking of transference as just love-for-the-therapist. In psychoanalysis, transference feelings can be love or anger or whatever.
If you present to a therapist who does NOT subscribe to transference theory, say, some very troublesome emotional reactions about her, she and you can look freely through a wide range of possibilities for *any* features of the situation that may be involved in triggering your responses. And the two of you would be free to consider a wide range of possible short- and long-term effects that your responses have that may be maintaining them despite their troublesome side.
A therapist disposed to expect “transference” and to think in those terms will not be free to consider such a wide range of possible causes or hidden benefits. “I remind you of your mother, hmm?” Well, maybe in part — but also maybe not despite some superficial similarities. The ways that events influence our emotional responses are enormously complex and very often simply untraceable with any degree of scientific confidence. The assumption that transference is going on cuts off inquiry as soon as enough superficial similarities to prominent childhood figures are found.
> > What if […] those important NON-childhood connections are never discovered?
>
> what kinds of important NON-childhood connections might be passed over?Any fears, hopes, attitudes, habits, assumptions, incorrect information, tastes, conditioning, etc, that were not apparently acquired in childhood and have no obvious corollaries to childhood events or relationships have to be excluded because they don't fit the theory.
If I was really angry with my analyst, his operating principle dictated that I was responding with anger because the current situation somehow reminded me of my childhood relationship with my father. Or mother. Or brother. (Whatever intuitively thrilled him the most at the time.)
But what if I was angry with my analyst because of things I'd more recently learned about scientific validation and the ethical obligations of service providers? What if recent changes in my political thinking led me to demand greater accountability from people like him? What if his attitude was contrary to the spirit of honest inquiry I was getting steeped in by my friends at school?
He would only consider those questions if they could somehow be framed to be congruent to troubles I had (or at least reported myself to have had) in my childhood with specific important figures.
> but i guess it is in the effort to explain / understand why you feel as you do.
I think you have nailed the attractiveness of the theory of transference. As I said yesterday, the fact that feelings come out of nowhere without any control or identifiable reason is itself scary.
But when we rely on a comforting fictitious explanation to the extent that it cuts off inquiries and interventions that really could improve our lives, it has to go.
Posted by special_k on April 7, 2006, at 20:09:03
In reply to Re: real feelings » special_k, posted by pseudoname on April 7, 2006, at 12:32:59
> I should point out that I'm not thinking of transference as just love-for-the-therapist. In psychoanalysis, transference feelings can be love or anger or whatever.
sure.
> If you present to a therapist who does NOT subscribe to transference theory, say, some very troublesome emotional reactions about her, she and you can look freely through a wide range of possibilities for *any* features of the situation that may be involved in triggering your responses.including the fact that she might have actually done something which anyone in their right mind would be rather pissed off about!
yes. i hear what you are saying. sometimes 'transference' is used to write off the clients experience / perception. i agree: the feelings are real. so then what is transference? if it is about the origins of the feelings then maybe it is about whether the feelings are responses to the present or the past situations (might be a matter of degree) but to consider a feeling to be 'transference' might incline the therapist to emphasise past causes over looking at their present actions.
> The assumption that transference is going on cuts off inquiry as soon as enough superficial similarities to prominent childhood figures are found.
ok. i don't think it has to... but sometimes concepts are abused...
> But what if I was angry with my analyst because of things I'd more recently learned about scientific validation and the ethical obligations of service providers? What if recent changes in my political thinking led me to demand greater accountability from people like him? What if his attitude was contrary to the spirit of honest inquiry I was getting steeped in by my friends at school?ROFL!!!! yeah. you are too funny :-)
though... a therapist who didn't take those concerns seriously... well thats not so good. but then by the same token if you are getting really very wound up about this kind of stuff...
when you are supposed to be in therapy to help you figure out how the past impacts and affects the present (i mean that is what this brand of therapy is about - right? so you have agreed to participate in that process and your therapist is supposed to help you out with doing that...
> > but i guess it is in the effort to explain / understand why you feel as you do.
> I think you have nailed the attractiveness of the theory of transference. As I said yesterday, the fact that feelings come out of nowhere without any control or identifiable reason is itself scary.yeah. and people are 'active information processors' we actively engage in creating meaning, sense, narration, we like to tell ourselves stories to answer the why why why's.
> But when we rely on a comforting fictitious explanation to the extent that it cuts off inquiries and interventions that really could improve our lives, it has to go.ah. yeah.
where should you spend your time?
in the past to learn about how you got to here.
in the here to figure where to go from here.
balance IMO.
and sometimes one can get lost in the past
(at the expense of presnt functioning for example)
and sometimes one can get lost in the present / future
(at the expence of coming to grasp patterns and cycles that have impact you don't recognise)balance.
sigh.
Posted by pseudoname on April 8, 2006, at 14:47:18
In reply to Re: real feelings » pseudoname, posted by special_k on April 7, 2006, at 20:09:03
You've raised a really interesting question. (I've used the word “interesting” a lot lately. And I'm not even on Metadate today, LOL.)
If transference issues are considered in psychoanalysis, isn't that what the client is paying for? Just as a palm-reader provides the service requested? I guess I would like people to reconsider whether they want either of those services.
> when you are supposed to be in therapy to help you figure out how the past impacts and affects the present (i mean that is what this brand of therapy is about - right? so you have agreed to participate in that process and your therapist is supposed to help you out with doing that...
No way. People typically have no idea what the brand of therapy is that they're about to receive. Studies show people don't even know whether they're seeing a psychiatrist or a masters-degree counselor. I, for example, was referred to a psychotherapist in downtown Chicago. It was only after a few sessions that he mentioned he was “a neo-Freudian”, whatever that means. As I gradually discovered what he was about, my resistance to his ideas was diagnosed as Resistance®, and I couldn't leave until THAT was worked through, too. I certainly never gave sufficiently-informed consent for getting into that sort of quicksand.
If an idea is at best unhelpful and more likely pernicious, those who understand that should be clearly spelling it out for others in the hope that fewer people will “agree” to such a process for themselves.
Transference has a fairly clear technical psychoanalytic definition, but it is also used in very vague senses both by analysts and by many “eclectic” therapists with no real psychoanalytic background. In both cases I think it is counterproductive. It also comes up on this board a lot when people who are not necessarily in psychoanalysis are using the idea of transference in trying to understand and improve their emotional problems.
I'm trying to suggest to them, and to anyone else who cares, that the theory of transference is baseless and distracting. My hope is that people will NOT agree to therapy in which it is seriously considered.
Whew.
(Gets up; staggers around a little...)
Um, what were we talking about?
;-) LOL
Posted by special_k on April 9, 2006, at 4:46:23
In reply to that brand of therapy ;-) » special_k, posted by pseudoname on April 8, 2006, at 14:47:18
> If transference issues are considered in psychoanalysis, isn't that what the client is paying for?
Kind of...
> I guess I would like people to reconsider whether they want either of those services.
Okay.
> People typically have no idea what the brand of therapy is that they're about to receive.
Yep. And that isn't very good, I agree.
> Studies show people don't even know whether they're seeing a psychiatrist or a masters-degree counselor.
Yeah.
> I certainly never gave sufficiently-informed consent for getting into that sort of quicksand.
Okay. I think there should be more information on different varieties of therapy and what they may be best suited to. I think there is some info on that available online, for example. It would be nice if there was stuff to give to people in person too so people can pick the orientation that may be most suited to them.
> If an idea is at best unhelpful and more likely pernicious, those who understand that should be clearly spelling it out for others in the hope that fewer people will “agree” to such a process for themselves.Hrm. You know CBT only JUST outperformed brief psychotherapy (on depression, anxiety, and OCD I believe) - right? Re: psychoanalysis... That was developed for a different set of problems... And may be best suited to those...
> Transference has a fairly clear technical psychoanalytic definition, but it is also used in very vague senses both by analysts and by many “eclectic” therapists with no real psychoanalytic background. In both cases I think it is counterproductive.I agree it is most often used in a counter-productive way, but I disagree that it is ALWAYS used in a counter-productive way...
> I'm trying to suggest to them, and to anyone else who cares, that the theory of transference is baseless and distracting. My hope is that people will NOT agree to therapy in which it is seriously considered.
Oh.
You don't find that doing the same things over and over happens in your life?
I think I have many unhelpful patterns...
Sometimes I find awareness of how present behaviour fits into past pattern... Helps with the present behaviour. Can help an intense feeling be less as I gain some perspective on it (for example).
Nice to talk about this though.Maybe we could start another thread on it?
I have been struggling a little with different theorietical orientations myself. Sometimes I think I'd like to do analysis... Othertimes I think the whole thing is a crock. I'll admit I have less sympathy for the notions of 'id, ego, and superego' than I have for the defence mechanisms 'repression, transference, etc'.
Apparantly the latter were independently discovered (that may be wrong) and it would be interesting what could be done with them in the absence of the theorietical baggage that tends to freeride...
Posted by gardenergirl on April 9, 2006, at 12:10:11
In reply to that brand of therapy ;-) » special_k, posted by pseudoname on April 8, 2006, at 14:47:18
> > I'm trying to suggest to them, and to anyone else who cares, that the theory of transference is baseless and distracting. My hope is that people will NOT agree to therapy in which it is seriously considered.
I'm not sure I can adequately communicate how valuable my therapy, which is psychoanalytically informed, has been. And I have no doubt that analyzing the transferences that have come up, in many cases not towards my T but towards others in my life with whom I was having the same types of issues over and over again, has helped me recognize this pattern. I feel so much freedom and lightness now that I am empowered to start to let go of the thoughts and feelings I project into the relationship that do not need to be there for current purposes. These interactions are so much simpler and much less muddled up with all the false assumptions, expectations, fears, feelings, worries, etc. that I would otherwise get paralyzed or confused by.
In short, I absolutely believe transference exists, and can be present in all types of therapy and in all kinds of relationships in real life. I agree that analyzing transference does not necessarily need to be a part of therapy. And I agree that transference includes real feelings, although I would argue that these feelings originate from something other than the present circumstances. And I agree that not all feelings ARE transference. It's quite a complicated construct and not one to be tossed around lightly.
But please don't discourage anyone from seeking the therapy process that best fits them. If I had not entered into the process I'm engaged in, it's unlikely I'd be in an emotional and cognitive place to stop participating in the same maladaptive dynamics I've repeated throughout my life.
gg
Posted by pseudoname on April 9, 2006, at 13:04:33
In reply to I disagree » pseudoname, posted by gardenergirl on April 9, 2006, at 12:10:11
Hey, gg. I'm glad you said so.
> But please don't discourage anyone from seeking the therapy process that best fits them.
I think this is the point in my post where I may have gone over the line from “sharing” to “discouraging”:
> I'm trying to suggest to them, and to anyone else who cares, that the theory of transference is baseless and distracting. My hope is that people will NOT agree to therapy in which it is seriously considered.
It seems *technically* civil to me, since it's a summary of my previous points and a statement of personal “hope”. But I could've put it less confrontationally: “I hope people will consider such criticisms before agreeing to therapy that's based on transference theory.”
That does sound better.
I'm pretty sure you don't mean that people should not make comments here that are critical – even strongly critical – of transference theory. I think people can seriously evaluate their therapeutic “best fit” better – especially when they haven't tried the therapy yet – by being aware of critical views.
But I appreciate your very gentle advice about my tone. :-) (Five years w/o a PBC!! LOL)
Posted by gardenergirl on April 9, 2006, at 13:40:45
In reply to Re: I disagree » gardenergirl, posted by pseudoname on April 9, 2006, at 13:04:33
Thanks for your reply. Absolutely, I think critically thinking about these concepts is fine as long as it respects that others' views may vary.
Actually, I was responding personally, not as a deputy. :) I just would hate it if I had missed out on what has been such a powerful and important aspect of my life from only learning one view of the issue. I guess I wouldn't want anyone else who might benefit miss out, either.
But heck, CBT would not be as huge as it is if it didn't work. And transference is not a component of that work.
>I think people can seriously evaluate their therapeutic “best fit” better – especially when they haven't tried the therapy yet – by being aware of critical views.
Yep!
And a five year virgin? Wow! You must not f*rt much. ;)
Take care,
gg
Posted by special_k on April 9, 2006, at 21:12:15
In reply to Re: I disagree » gardenergirl, posted by pseudoname on April 9, 2006, at 13:04:33
i thought it was a good discussion...
you okay pseudoname?
i thought it was a good discussion...
that was why i suggested starting another thread.
i'm interested in this stuff.
if you are sceptical about varieties of therapy
(aside from straight CBT lol)
then i think people do jump a bit on this board
but that's okay.
good to get 'em jumping, eh?
and what you have to say...
is supportive to the person who started the thread.
(are you still around? where are you at right now?)
Posted by gardenergirl on April 9, 2006, at 22:45:29
In reply to Re: I disagree » pseudoname, posted by special_k on April 9, 2006, at 21:12:15
I think it's a good discussion, too and certainly didn't intend to cause it to come to a crashing halt.
Perhaps this is an example of the dual role issue with deputies who also post personally?
gg
Posted by special_k on April 9, 2006, at 23:08:56
In reply to Re: I disagree » special_k, posted by gardenergirl on April 9, 2006, at 22:45:29
nah i think you are right.
i think pseudoname sometimes takes things personally (as we all do)
and just wanted to check that he was doing alright.i really appreciate these discussions...
so i hope he comes back and continues...
Posted by pseudoname on April 10, 2006, at 10:32:54
In reply to Re: I disagree » gardenergirl, posted by special_k on April 9, 2006, at 23:08:56
> you okay pseudoname?
So sweet to ask. Yeah, I'm okay. I had to go away visiting on Sunday, so I didn't get enough time to post in this thread, which requires more thought for me than most of my posts.
> i think pseudoname sometimes takes things personally
Man, you got that right! LOL!! But it wasn't the case in this situation.
Actually, though, there was something about *my own* posts that was mildly frustrating to me and I couldn't figure it out what it was. But I now see, thanks to gg's observation, that I was sorta posting my conclusions without filling in what led me to think that way. Those posts were then less satisfying to write. (As well as less Babble-friendly.)
So I'll post more today here, in between errands. I really enjoy discussion about psychoanalytic subjects and therapy generally.
Posted by pseudoname on April 10, 2006, at 12:56:19
In reply to still here :-), posted by pseudoname on April 10, 2006, at 10:32:54
(Possibly book-length. <chuckle>)
A couple times K has suggested that transference theory can be over-applied or isn't appropriate in interpreting all emotional problems. That sounds reasonable, but as far as I know, there isn't any scale or test for telling what is an appropriate situation to consider transference and what isn't. Gardernergirl also points out that not all emotions are transference, but there again, as far as I know, there is no test for telling what response is or isn't transferential.
Two candidates come up, but neither seems very good to me: intuition and therapeutic outcome.
Intuition about transference simply can't be evaluated. It isn't a naturalistic sort of “intuitive” inference like those we make when deciding whether someone's angry or lying. Those “intuitive” judgments can be tested in the laboratory and turn out sometimes to be reliable (like with sussing others' emotions) and sometimes not (detecting liars).
I personally found my analyst's appeals to his “gut” authority to be maddening. Intuition is often wrong, especially when there's no absolute standard to train it against. Intuition can be extremely valuable to humans in detecting subtle environmental cues, but when it does work in those situations it can also be backed up (later) by breaking down and referring to the environmental details that really *are* involved. In this way we can scientifically point to mouth/eyebrow correlations to show what makes a smile intuitively convincing.
That sort of scientific back-up is something the intuitive assessment of “transference” (etc) doesn't have, as far as I know.
I feel that therapeutic intuition is highly unreliable, meaning that different therapists have different intuitions. Studies running therapists head-to-head against each other diagnosing films of patient interviews showed very poor agreement in their intuitive judgments of things like transference. I personally think that the same therapist will have different intuitions about the same patient's transference on different days of the week because there's never anything that she can check her intuitions against in order to learn to make them better.
That leaves therapeutic outcome. I haven't looked for a study that isolates transference as a factor in therapy, but studies looking at psychoanalysis (in which transference theory is typically a big part) famously show dramatically poorer outcomes even than doing nothing. That doesn't blame transference theory itself, of course, but it doesn't look good.
Still, transference theory could be therapeutically *valid* (i.e., “work”) if the person improves due to its use, even if we can never say that transference of stored-up childhood emotions is really what's going on. Even if the idea of transference helps calm someone emotionally, that does not say that it's an accurate description of what's going on. Let me illustrate.
Consider Kleinian transference, which prominently involves The Breast. The hungry child sees himself as filled with badness and his mother's breast as filled with goodness. In suckling, the goodness in The Breast goes into the child and things are great for a while, until he's hungry again and then both resents and demands the goodness in The Breast. The child both hates and loves, rejects and needs The Breast, setting up a conflict played out in transference all the rest of his life.
Nice story, eh? Powerfully explanatory.
Consider a financially strapped guy who needs to ask his boss for raise. The guy feels he is highly deserving and should've gotten the raise from his rich, lazy boss long ago without asking. In a Kleinian interpretation, he sees himself as filled with weakness and passivity and insecurity and dependence — in short, with badness, just like when he was a hungry baby. He both hates and needs his boss, who can give him the goodness (money, promotion, etc) he both resents and loves.
He's emotionally all tied up in knots over this situation. He's too upset and afraid to approach his boss, yet he must in order to live. His Kleinian therapist explains the transference issues involving The Breast and voilà! The guy can approach his boss with a reasonable assertive request for a raise. Why? Because he no longer sees the boss as a threatening, all-powerful figure. He knows that the boss is really The Breast, and, heck, he's managed that type of situation since he was a baby.
Transferential awareness, the working-through, and cure.
Is Kleinian transference really going on? I really, really doubt it, despite the apparent therapeutic success. The pattern of behavior alleged here seems too specific to me, when we know that learning and mental connections are enormously complex and cross-referenced. This transference doesn't “look like” the behavioral changes we see in developmental biology, where early-stage responses drop off quite cleanly and naturally as mature adaptations appear.
But anyway I doubt that this sort of transference story-inspired courage will last the employed guy very long. The next insecurity problem he faces may not be so easily mapped onto the story of his infantile conflicts with The Breast.
To the extent that such transference stories *do* help, I think there is something else going on. And I think that the “something else” is what therapy and research should focus on. I think the therapeutic key here is that the guy acknowledges his fears and bad feelings and stops fighting them. His (I think mythical) explanation of transference allows him to relegate those feelings to a sort of sideline where he tolerates feeling them because he thinks they're not really related to any current *real* threats. They're left over from childhood. He can't do anything about them, so he feels them but ignores them and goes and asks his boss for a raise. I think THAT'S the therapy and that's what we should deal with more deliberately & directly.
Posted by zazenduck on April 10, 2006, at 14:36:53
In reply to Testing transference, posted by pseudoname on April 10, 2006, at 12:56:19
Thanks. That was really well thought out.
Posted by pseudoname on April 10, 2006, at 19:34:57
In reply to Re: Testing transference » pseudoname, posted by zazenduck on April 10, 2006, at 14:36:53
Posted by Dinah on April 10, 2006, at 20:19:05
In reply to that brand of therapy ;-) » special_k, posted by pseudoname on April 8, 2006, at 14:47:18
I rather think that transference isn't a useless or baseless theory.
If you look at Babble, you can see it in action every day. Dr. Bob is the same person, yet different people see him so wildly differently. He's a rather distant figure, so we don't have a lot of information to do reality checks on, and we tend to shove him into whatever template we have for people who exhibit the bits of information we know about him. And for many of us, those same templates might contain a lot of other people we meet in our life. And we might have other templates we shove other people into. And we might react to them with all the stored up perceptions we have to anyone stuffed in the same template. Perceptions that probably aren't all that accurate. If we can see past our own transference templates and into the real world, wouldn't that be helpful?
I don't think a therapist could do that by concentrating only on transference in the therapeutic relationship, but if they bring up distortions of reality in our views of various people, or if we learn to start considering that ourselves...
I'm not entirely convinced that therapy love is transference though. I tend to think it's the unintended consequence of the setup of therapy. The artificial intimacy of the therapy room, the undivided attention, all are things that our minds confuse with the situations that we're evolutionarily wired to associate with those conditions. Parent child (particularly mother child) and courtship and mating. It doesn't seem fair to mimic those situations then call the resulting feelings transference.
Posted by Dinah on April 10, 2006, at 20:23:38
In reply to Re: that brand of therapy ;-) » pseudoname, posted by Dinah on April 10, 2006, at 20:19:05
Posted by annierose on April 10, 2006, at 21:48:40
In reply to Re: that brand of therapy ;-) » pseudoname, posted by Dinah on April 10, 2006, at 20:19:05
You made loads of sense, and I thank you for that. It was well said and I feel that way too.
Posted by special_k on April 10, 2006, at 23:23:48
In reply to Re: that brand of therapy ;-) » Dinah, posted by annierose on April 10, 2006, at 21:48:40
interesting... i guess i have my own theory of transference (not sure how that sits with the standard lit lol).
imo...
- transference feelings can be qualitatively indistinguishable from non-transference feelings (which is just to say that they *can* be phenomenologically identical to non-transference feelings from the subjects point of view).
- transference feelings are differentiated from non-transference feelings by their aetiology. an analogy... someone presents with a burn. the burn is very real. you can see it. you can't tell whether it is a sunburn or not until you know more about what caused the burn. it is part of the identity condition for something being a sunburn that it was caused by the sun. analogously it is part of the identity condition for transference feelings that they are caused by the past rather than the present.
- an indicator of whether feelings are due to transference (as opposed to not being due to transference) is their intensity. if feelings are experienced as being particularly intense then that probably indicates that the feelings are a response to more than the present situation. or that the present situation has become a symbol for some greater situation.
i guess i was thinking of transference feelings as feelings originating in the past... but perhaps not... the 'greater context' line is probably important too. thinking here along the lines of what dinah was saying...
hrm.
i personally think a criterion of adequacy on a theory is that it should be consistent with the findings of evolutionary cognitive neuro psychology. because IMHO those fields are the fields in which our understanding is being advanced at a rapid rate of knotts. but that is just to say... if you want to be scientific (ie if it is truth rather than pragmatic value that interests you) then IMHO that is the way to go.
regarding pragmatism... i think the truth as traditionally conceived (ie of a relation to reality) is likely to pragmatically outperform theorists fictions in the long run. and theorists fictions tend to put an end to inquirey rather than advancing it...
i had significant issues with being told about 'rational mind' 'emotional mind' 'wise mind' in skills group because i thought those were fairly comperable examples of theorists fictions that prevent real understanding. i guess it might be a useful fiction for some. but i'm rather attached to the truth myself... my t was pretty good at differentating between fiction / metaphor and the rest so that was good for me. i remember one of my lecturers saying that he had trouble with meditation because they asked him to imagine that when he inhaled the air was reaching into his toes and he became disturbed at the view of anatomy that was presupposed... i guess there must be a middle way...
;-)
Posted by special_k on April 11, 2006, at 0:41:18
In reply to Re: that brand of therapy ;-), posted by special_k on April 10, 2006, at 23:23:48
> - transference feelings are differentiated from non-transference feelings by their aetiology. an analogy... someone presents with a burn. the burn is very real. you can see it. you can't tell whether it is a sunburn or not until you know more about what caused the burn. it is part of the identity condition for something being a sunburn that it was caused by the sun. analogously it is part of the identity condition for transference feelings that they are caused by the past rather than the present.
though of course that is a matter of degree (and so there wouldn't be a hard and fast line). i think it is about categorisation... and we are always classifying instances in the present according to categories we have had past experience with. and we are going around doing the symbol thing too with respect to interpreting the significance of things. so once again... a matter of degree.
> - an indicator of whether feelings are due to transference (as opposed to not being due to transference) is their intensity.though you can be mighty pissed for good reason either way.
i'm not so sure anymore...
i think that either 'transference' will be cashed out properly...
or the term will be replaced (eliminated) as the sciences progress.
i've often wondered whether psychoanalysis was entitled to invoke terms such as 'transference' etc because the explanadum was different (unique) from the rest of the sciences... but i'm not so sure... i'm not so sure... i was looking at whether i might be able to do analytic philosophy with psychoanalysis. and... i couldn't for the life of me see how that would go. it would involve translation... translating the psychoanalytic concepts into phenomena that have been observed / studied / or at least pheonomena that are observable / recordable within the cognitive neuro psychological framework... although... probably some relevant stuff in social psych too (though i don't know anything about that really)...one option (IMO by far the best option) is to consider that psychoanalysis doesn't aim to be a science... rather it is an art. the continental philosophers seem to be happy enough with it (and with doing continental philosophy on freud etc). but i can't see how do do it within my philosophical tradition where IMO philosophy is on a continuum with the natural sciences and ideally philosophy is just about the 'theory' level of developing theories that unite observed phenomena and predict what would seem to be suprising new phenomena (surprising phenomena in the sense that you wouldn't expect it without the theory).
but i dunno...
Posted by special_k on April 11, 2006, at 5:09:33
In reply to Re: that brand of therapy ;-), posted by special_k on April 11, 2006, at 0:41:18
i guess that the trouble is that CBT theorists often make a big deal of how they come up better than alternative theories for treating the main problems that people present with (anxiety, depression, and OCD i believe). they say that they are thus the *most scientific* variety of therapy available (the implication being that it is not ethically justifyable to offer less than the *most scientific* variety of therapy).
But... I have significant issues with CBT.
I have significant issues with their measures of 'improvement'. I have significant issues with the *brief* psychotherapy line that they advocate. I have significant issues with their eclecticism which means they practice from a theory that isn't even coherant (IMHO).
Sigh.
I have significant issues with the point that the CBT therapists are the ones who are running the experiments (they have managed to get the experimental psychologists on board) and so OF COURSE they are looking to justify their theory (in confirmation bias) rather than looking to do themselves out of a job!
(Okay so that is an ad homenim attack but sometimes they are justified. I think it is justified in this case as it is justified in the case of being sceptical of the findings that the drug companies report re the success of their newly developed medication)
Science is the best we have got...
But then when you consider the actual practice of science...
When you consider the ways in which statistics can be manipulated...
When you consider how *statistically significant* thresholds are arbitrary...
One is wise to remain sceptical.But I have significant issues with CBT... And so where does that leave me?
Maybe it is about... Training. And re: psychoanalysis... If you consider the majority have PhD's / are trained psychiatrists BEFORE undergoing how many years of training in psychoanalysis AND a course of analysis themselves...
Well that makes them the best trained.
Of course it might be a bit like a cult...
(And from a lot of accounts that is exactly what it is like)
But still... That is a significant amount of time to devote to studying something... And so you would expect that the average analyst... Would be *more interesting* to interact with at the very least.lol.
Posted by Dinah on April 11, 2006, at 7:44:17
In reply to Re: that brand of therapy ;-), posted by special_k on April 11, 2006, at 5:09:33
I think the problem with CBT is (well, ok it's not a problem really) is that some or all of it can be useful for almost everyone. So it comes out looking good in studies.
But apparently practitioners aren't always well trained on the exceptions.
Which probably could be said for all schools of therapy.
Besides, didn't they do studies (I remember seeing this on Dr. Bob's old grand rounds presentations) that showed that CBT was more effective for some personality structures than others?
For example, it's very effective for OCPD, which you might expect.
And although I don't recall this specifically, I'm guessing that it could be less helpful for people with borderline traits, which is why they invented DBT. The problem with DBT being that if you don't get someone of Marsha Linehan's skills, it can sometimes not come across as it was intended.
(Although to tell you the truth, I remember watching her videos, and being both charmed and realizing that I'd walk out on her early.)
Having a few borderline traits myself, I think it tends to make me worse. I tend to rebel and get angry and argue the CBT therapist into getting mad at me. (Yes, this has happened.) While my husband would think it was the therapy of therapies.
Posted by special_k on April 11, 2006, at 8:37:00
In reply to Re: that brand of therapy ;-) » special_k, posted by Dinah on April 11, 2006, at 7:44:17
> I think the problem with CBT is (well, ok it's not a problem really) is that some or all of it can be useful for almost everyone. So it comes out looking good in studies.
comes out good when compared to other *brief* forms of psychotherapy. i think they are talking 6-12 sessions... gg probably knows this stuff more than me... or someone else probably does... pseudoname? it only *just* outperforms brief psychodynamic. but it is considered to be statistically significant (which is an arbitrary threshold though to be fair i think it was arbitrarily decided on independent grounds)
;-)
i often wonder what science would look like had we set our arbitrary thresholds a bit differently... i wonder how different the 'facts' would look...
> But apparently practitioners aren't always well trained on the exceptions.think it comes out best (just) for depression, anxiety, and OCD (which are the most prevalent problems in psychotherapy). but sometimes the theory is silent on how to treat other disorders (they didn't know what to do with DID for instance. or dissociation more generally one can only suppose. i remember racer had problems trying to find someone to treat her dx. and so it goes on...)
> Which probably could be said for all schools of therapy.maybe... maybe they have slightly different target groups... maybe...
> Besides, didn't they do studies (I remember seeing this on Dr. Bob's old grand rounds presentations) that showed that CBT was more effective for some personality structures than others?really?
> For example, it's very effective for OCPD, which you might expect.oh. yeah, i guess. maybe because if you think of depression as a mood where people are likely to experience sadness (and therapy is about improving the feelings of sadness etc) then if you think of OCPD as a mood where people are likely to experience symptoms of OCD... i dunno. maybe i'm looking at them all wrong... but i guess... they are looking (typically) at behaviour change as the measure of improvement too... in the 'i sawed the legs off my bed and now i no longer lay awake fearing the monsters under the bed' kind of fashion... but then if your problem really is that not sleeping is majorly interfearing... well... isn't that a cure in a way?
> And although I don't recall this specifically, I'm guessing that it could be less helpful for people with borderline traits, which is why they invented DBT.heh heh. CBT theorists typically want to claim DBT as a 'varient' on CBT. but it is true it needed to be extended from 'brief' therapy (6-12 sessions or whatever) into an intensive program involving group therapy and individual therapy (so therapy 2X per week) + phone calls (or between session support) and so on... and phase one (the stage that has some empirical support for reducing inpatient days and objective measures of improvement such as ability to attend work etc) lasts one year. not so brief. and that is only supposed to be stage one - the stabilisation stage. after that there is supposed to be trauma work etc. apparantly Linehan envisaged it as fairly ongoing... I think after trauma work there is supposed to be a stage of constructing a life worth living etc etc... but in the country I was from only the first phase had empirical support so after the first year they diverted the resources into a new intake (unless peoples therapists got really very attached to them i think...).
:-(
> The problem with DBT being that if you don't get someone of Marsha Linehan's skills, it can sometimes not come across as it was intended.
yeah. or if a therapist doesn't quite get some of Linehan's skills...
;-)
> (Although to tell you the truth, I remember watching her videos, and being both charmed and realizing that I'd walk out on her early.)Lol. Haven't seen the video but I've read the book. I imagine her to be fairly stern... I think I'd resist that... But I think she also has a fairly good dynamic thing going on (though this is from the book so I don't know how she goes in real time) but a dynamic of off balancing and supporting etc. But yeah I imagine she might tend to do the off balancing thing... and have to backpeddle a fair bit. especially with clients who are getting used to her... she strikes me as fairly irreverant. heh heh. i'm not sure how i would go... okay i think though i'd probably go through a 'gee i'd really like to punch you in the face' kind of phase... and i'd probably walk out a couple times too (hmm... does her style maybe elicit borderline behaviours too????) i dunno... just how she struck me from the book.
i remember finding my t had a pretty good dynamic going on... i enjoyed it though sometimes i was fairly outraged at stuff she would say to me. but she could smile and backtrack and she could be really very soothing and softly spoken too (when she wanted to be) and so that helped things along considerably. i remember when i started dbt i had developed this unfortunate habit of curling up into a little ball (on my chair) and hiding my head in my knees when i really didn't want to talk about something. i think i used to dissociate if they continued... it was becoming a problem prior to dbt. sometimes they would just leave me there for a couple hours or something... anyways... i started to do that in maybe our second session and she said 'you know it makes it really hard to do therapy with you when you do that'. and i thought hmm. i suppose it does rather. and so i snapped out of it and we talked about something sort of related... but... a simple response... non judgemental... non confrontational... just simple... and there it was. lol. i felt that a lot 'of course how simple now that i see it that way...'.
ah memories ;-)
but ill timed irreverance... can be rather hard to take...
> Having a few borderline traits myself, I think it tends to make me worse. I tend to rebel and get angry and argue the CBT therapist into getting mad at me. (Yes, this has happened.) While my husband would think it was the therapy of therapies.
yes. i don't like hearing about my faulty logic or my cognitive distortions or about how if i would only change my thinking i could think myself into feeling different. i don't like the emphasis on thoughts -> feelings and i don't like them telling me i endorse these faulty thoughts either consciously or *unconsciously* if i deny it. i don't like how they say that those unconscious thoughts affect my behaviour when IMHO my degree of credance with which i endorse the cog distortions varies as a function of my mood rather than the other way around... i don't like it. i don't like it i say ;-) but apparantly it is because it isn't very validating of emotional responses
wah!!!!! validate me!!!!
:-)
something i did have trouble with in therapy... this isn't really related... but i remember the thing that caused us the most grief... was my lack of ability to think concretely.really.
we would talk about something abstractly and that would be okay. as soon as it came to fitting me into that picture... my mind would black out. really. just be vacant. empty. i couldn't comprehend or speak. felt so very stupid.
i do wonder how i'd do on cog. tests sometimes...
and i do wonder whether it is the ect or whether i've always been like this...
i dunno :-(
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