Transference: Shibboleth or Albatross (Book Review)

Author:  Schachter, Joseph
Publisher:  Hillsdale, N J: Analytic Press, 2002
Reviewed By:  Michael Wm. MacGregor and Michael Sheppard, Fall 2004, pp. 54-55

What is psychoanalysis? Is there a uniformly accepted definition? Is there even agreement on the components necessary for treatment to be considered psychoanalytic? Kernberg (1999) suggests that there are three essential features to psychoanalysis and psychoanalytic treatment: Interpretation, (historical) transference analysis, and technical neutrality. Interpretation, although a hallmark of psychoanalytic treatment, is not unique to psychoanalysis alone. Joseph Schachter in Transference: Shibboleth or Albatross advocates discarding transference analysis. Does that mean that all we are left with is technical neutrality to define psychoanalysis and psychoanalytic treatment? Does discarding the traditional theory of transference and its treatment goals undermine psychoanalysis, or represent an important and necessary paradigm shift?

Schachter’s goals in writing Transference are to create a foundation for the dismantling of Freud’s theory of transference, and to replace that rejected theory it with a new theory of Habitual Relationship Patterns. In thirteen chapters Schachter presents the historical origin of Freud’s theory of transference, problems (as he sees them) with the theory, and then provides and alternative theory, Habitual Relationship Patterns, to replace transference as a cornerstone of psychoanalysis and psychoanalytic treatment.

In the first chapter of Transference, Schachter orients the reader to the role of transference in traditional psychoanalysis. He then devotes the next four chapters to attacking and dismantling the traditional conceptualization of the childhood origins of neurosis and the transference neurosis. Schachter argues that, although individually traumatic events do occur in childhood, these events do not influence the psyche to the degree that is believed by traditional psychoanalytic thinkers, and that they are not re-lived in neuroses or in transferences neuroses. To strengthen his argument Schachter discusses evolutionary theory, changes in the conceptual context of the theory of transference, and determinism. Schachter devotes an entire chapter to this latter point as he argues that “infant determinism is the keystone to the theory of transference” (p. 89) and that if infant determinism falls then the entire theory of transference falls.

In Chapter 6, Schachter brings chaos theory into his argument against the traditional theory of transference. This chapter is almost entirely theoretical. Schachter suggests that chaos theory can be used as a model for understanding psychological phenomena. For example, psychological phenomena are unstable (i.e., seemingly small perturbations can have large effects) and chance plays a role in the development of change. Schachter argues that although many psychological events are likely determined, determinism does not mean predictability. Accordingly, determinism becomes a less meaningful construct as one cannot know what impact an event will have in the future; or know which past events caused the present event to occur. As such, Schachter argues that this renders the analysis of transference irrelevant as we can not infer determinism or cause and effect, and can not make predictions. This chapter seems misplaced both in the sequence of the chapters and in the book as a whole. This use of chaos theory in his argument may leave some readers puzzled; however, it does raise interesting questions about psychoanalysis, psychotherapy, and psychology as a discipline.

In the next chapter Schachter discusses the practical difficulties associated with transference analysis. He suggests that the questionable validity of the theory of transference leads to the questionable reliability of the transference interpretation. Schachter also suggests that interpretations have the very real possibility of acting not as interpretations but as suggestions and thus undermine the therapeutic relationship. Accompanying this discussion is a second discussion of how therapy works, the placebo effect, and the analyst’s authority. Schachter suggests that the by focusing on historical transference interpretations the analyst may fail to “explore the role of suggestion and placebo” (pp. 123-124). He further suggests that power of the therapeutic alliance may be ignored while the therapist digs for “psychic fossils” from the patient’s past. This latter point is important to address whether one agrees with Schachter’s arguments or not, as it is often leveled against psychoanalysis and psychoanalytic treatment. In fact, this is an often heard argument by proponents of interpersonal therapy who argue that analytic work avoids dealing with current conflicts and feelings.

At this point in the book Schachter suggests that while the historical assumptions of transference have been defeated there is still something that can be salvaged for psychoanalysis. He argues that the focus needs to be on patient’s current feeling both inside (i.e., towards their analyst) and outside the therapeutic environment. In the next three chapters Schachter introduces the concept of Nachträglichkeit and then presents his theory of Habitual Relationship Patterns and his techniques to replace analysis of the (historical) transference. Schachter uses Nachträglichkeit as the foundation for his Habitual Relationship Pattern theory and suggests that the focus of analysis should be on current relationships, especially the relationship between the patient and the analyst. Schachter states that “the dynamics of the irrational aspects of a Habitual Relationship Pattern can be formulated in whatever theoretical terms and concepts the analyst is comfortable” (p. 150), and that, although other ways are possible, he favors structuring them in terms of defenses.

Although many will agree that the analysis of Habitual Relationship Patterns is useful and may be as valid as the analysis of transference, some readers may be disappointed with these latter chapters. Schachter himself states, “it was humbling to learn that my current ideas about analytic theory, which I had thought of as innovative, had been described almost word for word more than 60 years ago by Karen Horney” (pp. 145-146). It is possible that some readers will simply see Habitual Relationship Patterns as an interpersonal view of understanding transference. If this is the case, then the reader is left wondering how Habitual Relationship Patterns are new and different from what is already discussed in the literature. In fact, Schachter makes this same point himself by stating that there are numerous other theorists whose ideas are “essentially consonant with [my] own” (p. 146), from schools within and outside of psychoanalysis and that in terms of Habitual Relationship Patterns, “the concept is functionally the same as Fosshage’s organization model of ‘transference,’ without the distracting terminological link to an older, outmoded conception” (pp. 149). In chapter 10 Schachter also promotes doing away with most therapeutic rules in the service of self-reflective responsiveness. This is somewhat reminiscent of Yalom’s claim that therapists must create a new therapy for each patient (1998, 1999, 2001).

In Chapter 11 Schachter provides the case of “Pat” to illustrate psychoanalysis with Habitual Relationship Pattern analysis as opposed to transference analysis. Once again, I think that some readers will be left wondering how the treatment is psychoanalytic and not simply interpersonal or interpersonal-dynamic. Schachter seems to anticipate this and closes the chapter with a defense of the “psychoanalytic-ness” of his therapy of Pat. I imagine a number of readers will be unconvinced by his explanation that the investigation of unconscious forces is sufficient for a therapeutic technique to be called psychoanalytic.

Schachter concludes Transference with a discussion of post-termination relationships. Given that in Habitual Relationship Pattern analysis the therapist and the patient engage in mutual self-disclosure and foster a certain degree of intimacy, it is likely that at some point the two will want to continue their relationship as a friendship. Schachter acknowledges this and the ethically thin ice of therapeutic relationships turning into personal relationships. He suggests, however, that under some conditions it may not be unethical for therapists to develop friendships with ex-patients. I felt uneasy reading this argument and believe that the topic deserves more attention than one chapter. I think this is especially important given the potential harm that could befall either party in a post-termination relationship, particularly those in long term intensive therapy.

Shibboleth was a word used by the Gileadites to distinguish themselves from the Ephraimites who could not pronounce the initial “sh” and refers to a password that enables a person to identify himself with a particular group. Schachter argues that transference and transference interpretation has been psychoanalysis’s shibboleth. At the same time he argues that transference and transference interpretation is currently psychoanalysis’s albatross, and burdens if not completely impedes the progress of psychoanalysis. Schachter wonders whether abandoning the theory of transference constitutes a paradigm shift within psychoanalysis. He notes that reviewers have commented that the definition of psychoanalysis is becoming vague. In light of this book, which can be argued to promote interpersonal psychodynamic psychotherapy as opposed psychoanalysis, this concern seems to be valid. To return back to the question I posed at the beginning of this review I once again ask, “What is psychoanalysis?”

References

Kernberg, O. F. (1999). Psychoanalysis, psychoanalytic psychotherapy, and supportive psychotherapy: Contemporary controversies. International Journal of Psychoanalysis, 80, 1075-1157.
Yalom, I. (1999). Momma and the Meaning of Life: Tales of Psychotherapy. New York: Basic Books.
Yalom, I. (2001). The Gift of Therapy. New York: Harper Collins.
Yalom, I. & Yalom, B. (1998). The Yalom Reader. New York: Basic Books.

Reviewer Note

Michael Wm. MacGregor is an Associate Professor in the Department of Psychology, University of Saskatchewan. Michael Sheppard is a candidate in the Department of Psychology, University of Saskatchewan. Dr. McGregor’s email: michael.macgregor@usask.ca.

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