Insight through Transference Therapy
Insight through Transference Therapy
by Brady C. Malone, MA, TLLP
Transference-focused psychotherapy (TFP) is a type of “talk therapy” aimed at helping individuals process conflict both within one’s mind and in relationships. TFP is a structured, evidenced-based approach that fosters the development of insight. It is unique in that it leverages the relationship with the therapist to effect therapeutic change.
TFP was first developed as a treatment for borderline personality disorder; it has been expanded to treat several forms of personality disorder. Generally, TFP involves twice-weekly appointments during which the patient is expected to speak freely about whatever comes to mind while the therapist attempts to make sense of the patient’s experiences. The therapist makes every effort to avoid giving advice or disclosing any information about their own personal life. This position of neutrality is thought to advance the development of transference.
As the name suggests, transference is an essential part of TFP. Transference is an automatic process whereby an individual experiences their therapist in similar ways as they did important others in their personal history. People tend to become anxious when they don’t know what to expect from a new situation (e.g., a neutral therapist). To ease this anxiety, patients naturally “transfer” feelings from people in their past onto their therapist. This happens outside of therapy too, in all relationships. Romantic partners in couples counseling, for example, often complain about behavior they attribute to their partner that echo their experiences of previous partners, their parents, and other significant people in their life. Simply put, we often confuse what is here and now for what was there and then.
It’s the therapist’s job to monitor transference developments in treatment, identify and describe them, interpret their meaning, and then intervene if they conclude that the transference is causing some problems in life or psychological symptoms.
In TFP, the therapist has three primary intervention techniques, often called insight-oriented interventions.
- Clarification: The therapist asks questions to gain more information about and provide increased clarity to the internal experiences of the patient. Clarification can also be a summary statement of the patient’s long-form communication.
- Confrontation: The therapist empathetically brings the patient’s attention to contradictory elements of the patient’s verbal communication and or nonverbal behavior to reduce internal conflict as well as improve the consistency, coherence, and integration of the patient’s sense of self and others.
- Interpretation: The therapist provides a working hypothesis for the patient’s presenting problem or symptom. Interpretations take many forms but generally include developmental factors (how it started), maintaining factors (why it persists), and the adaptive function (how it was adaptive then, why it is dysfunctional now).
The general process goes like this. The therapist observes a transferential development (e.g., “you sound just like my dad”) and articulates hypotheses about their origin based on information from the patient’s history and behavior in session. Then the therapist tests these hypotheses by presenting their interpretation and receiving feedback from the patient. Feedback results in increasingly accurate interpretations. The result of this process is expanded self-knowledge and more opportunities for healthier choices about what goals to pursue, what kind of people to interact with, what personal boundaries to protect, what to expect from themselves and others if they become overwhelmed, and how best to contend with unavoidable episodes of unhappiness, disappointment, and loss.
TFP is an effective treatment for those with borderline, narcissistic, and other severe personality disorders. It focuses on developing insight into one’s sense of self and others through honest and reparative interactions with the therapist.
Brady C. Malone, MA, TLLP, provides psychotherapy for adults and couples at Apex Therapy Services. He uses an integrative therapeutic approach for those interested in uncovering the roots of their problems. While experienced with a range of mental health problems, he has specialized training and expertise in narcissism, low self-esteem, long-term depression, exiting long-term relationships/divorce, and self-sabotaging behavior.
