Psychoanalysis Techniques and Applications 3 — Questions and Answers
Question 1: What is the difference between 'transference neurosis' and ordinary transference?
- Transference neurosis involves psychotic-level projections
- Transference neurosis is when the analyst becomes the central focus of the patient's neurotic conflicts (Correct answer)
- Transference neurosis only occurs in group therapy
- Transference neurosis refers to the analyst's unresolved issues
Correct answer: Transference neurosis is when the analyst becomes the central focus of the patient's neurotic conflicts
Transference neurosis occurs when the patient's neurosis becomes concentrated in the analytic relationship, making the analyst the primary object of conflictual feelings.
Question 2: Which of the following best describes 'countertransference' in contemporary psychoanalytic practice?
- The analyst's deliberate emotional responses to guide the patient
- All of the analyst's emotional reactions to the patient, used as clinical data (Correct answer)
- The patient transferring feelings back onto the analyst
- A technique for managing difficult patients
Correct answer: All of the analyst's emotional reactions to the patient, used as clinical data
Contemporary analysts view countertransference broadly as all the analyst's reactions to the patient, which can provide valuable information about the patient's unconscious communications.
Question 3: What is 'projective identification' as a clinical phenomenon?
- When a patient identifies with famous figures
- When a patient projects an unwanted part of the self into the analyst and then pressures the analyst to act accordingly (Correct answer)
- When the analyst projects onto the patient
- A technique for building patient identity
Correct answer: When a patient projects an unwanted part of the self into the analyst and then pressures the analyst to act accordingly
Projective identification involves projecting a part of the self into another and then exerting interpersonal pressure to make that person feel or act in accordance with the projection.
Question 4: What is the significance of 'enactment' in contemporary psychoanalytic treatment?
- Role-playing exercises assigned as homework
- When both analyst and patient unconsciously participate in a re-creation of a relational pattern (Correct answer)
- The analyst acting out their countertransference inappropriately
- Drama therapy techniques used in psychoanalysis
Correct answer: When both analyst and patient unconsciously participate in a re-creation of a relational pattern
Enactment refers to moments when both parties unconsciously participate in a relational scenario derived from the patient's past, which can be analyzed to deepen understanding.
Question 5: In object relations therapy, what does 'containment' (Bion) refer to?
- Keeping patients emotionally suppressed during sessions
- The analyst's capacity to receive, process, and return the patient's projected anxiety in a more tolerable form (Correct answer)
- Physical boundaries maintained in the therapeutic setting
- Structuring sessions with clear time limits
Correct answer: The analyst's capacity to receive, process, and return the patient's projected anxiety in a more tolerable form
Bion's concept of containment describes how the analyst functions like a mother who receives the infant's projected terror, metabolizes it, and returns it in a detoxified form.
Question 6: What is 'interpretation of defense' and why is it typically done before interpreting the underlying wish?
- It is done to shame the patient for avoiding feelings
- Defenses must be analyzed first because they protect against anxiety that would be overwhelming if the wish were interpreted directly (Correct answer)
- Defense interpretation is only done in supportive therapy, not analysis
- It establishes the analyst's authority before addressing content
Correct answer: Defenses must be analyzed first because they protect against anxiety that would be overwhelming if the wish were interpreted directly
Interpreting defenses before the underlying impulse reduces the patient's anxiety and resistance, making them more receptive to understanding what they are defending against.
Question 7: What does 'therapeutic alliance' refer to in psychoanalytic treatment?
- The formal contract signed at the beginning of treatment
- The collaborative working relationship between the rational part of the patient's ego and the analyst (Correct answer)
- The patient's idealization of the analyst
- The agreement between supervisor and supervisee
Correct answer: The collaborative working relationship between the rational part of the patient's ego and the analyst
The therapeutic alliance (Zetzel, Greenson) is the non-transferential, collaborative bond that allows the patient to work productively even while experiencing transference.
Psychoanalysis Techniques and Applications 3
What is the difference between 'transference neurosis' and ordinary transference?