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develop during treatment involve the patient’s identification with an aspect of his infantile self, while projecting the corresponding object representation onto the analyst. Reversals of this enactment, where the patient identifies with the object representation while projecting the corresponding self representation onto the analyst, are less frequent. In contrast, in the case of severe psychopathology, such reversals are frequent, and the consistent alternating reversals of self and object representations becomes the rule, which gives an apparently chaotic character to the transference developments (Kernberg, Yeomans, Clarkin et al., 2008). In addition, other complications emerge in these cases: the reciprocal activation of the patient’s grandiose self and his depreciated self representation as dominant object relations pathology in the transference manifestations of narcissistic pathology; and the regression to symbiotic relations in which the patient cannot tolerate any differences of views and relatedness in the therapist, experiencing all triangulations as intolerable traumatic situations. The interpretation and working through of these primitive transference regressions may represent the dominant therapeutic feature of these cases (Kernberg, 2019). (See aso separate entries OBJECT RELATIONS THEORIES, EGO PSYCHOLOGY, DRIVES, SELF) VI. F. Relational Perspectives The relational/interpersonal view of transference is firmly rooted in a two-person psychology and thus views the transference as inextricable from the countertransference. That is, for relationalists, transference cannot be simply the “transfer” of internalized templates in the patient onto the analyst but rather it is a part of a clinical situation which in Racker’s view (1988), is an interaction between two personalities… “each personality has its internal and external dependencies, anxieties, and pathological defenses; each is also a child with his internal parents, and each of these whole personalities – that of the analysand and that of the analyst – responds to every event in the analytic situation” (p. 132). Steven Mitchell (2000) states that psychoanalytic knowledge is generated in the intersubjective mix between patient and analyst through the study of transactional patterns and with an internal structure derived from an interactive, interpersonal field. As the pattern is the object of analytic study, transference does not exist without participation from its object (countertransference). For relational analysts, transference is grounded in a social constructivist model. Irwin Z. Hoffman (1983) points out that the transference is not a distortion of reality but a selective attention to certain aspects of the analyst’s participation, both conscious and unconscious. One major implication of this view is that the analyst inevitably influences the nature of the patient’s transference. As Thomas Ogden (1994) observes, a given patient will have a different analysis depending on the particularities of his analyst, both conscious and unconscious, as they co- create an ‘analytic third’. Rooted in Harry Stack Sullivan’ s “Interpersonal Theory of Psychiatry” (1953), which states that a person can only be known in the context of a social interaction that constitutes an ever-shifting ‘interpersonal field’. As Sullivan sees the ‘self system’ as designed to reduce anxiety which comes with having to interact with a significant ‘other’, a patient’s transference to his analyst may likely be a form of adaptation designed to
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