While I greatly enjoy The Last Psychiatrist, I’ve come to see his work as a good foil for my own perspective. Here’s a criticism of a vignette he posted some time ago about transference.
TLP relates the story of a man going through some relationship troubles and notes who at one point flattered him with the following:
4.a. I had noticed narcissistic behavior in me before several times and I’ve been trying to change. For instance, somehow I thought I’d look ridiculous giving someone a gift so I didn’t usually did that, no matter the circumstance. I originally thought giving a gift was about me, a reflection on me, not about the person receiving the gift. When I came back from Denver I brought a Broncos jersey for my little brother, but I was worried about what my father would think of me and about my choice of a gift, and stuff like that, but I focused on how my brother would feel receiving the gift. It may sound silly but for me that was a big deal. It pisses me off that I forgot to pay attention to her feelings in this situation.
This is obviously self critical. Perhaps TLP would identify the superego effects in play with all this negative self talk? Perhaps he could point out that giving gifts is always partially self interested (See The Gift, Mauss, or Derrida, Given Time or The Gift of Death). Furthermore, he could point out that it’s natural to worry about how other people will react to a gift, and similarly to feel like you shouldn’t be so worried about it.
Instead of offering any of these TLP offers a developmental explanation which I will summarize “You want my approval, just like your fathers, and are tricking me into giving it to you with this story, and in general, by the way you are acting it out in your life.”
This is a developmental explanation tinged with the assumptions of Id analysis and commonsense moralizing. Patients are seen as crafty adversaries, childishly trying to get one over on their analysts. Or, at best, to be stuck at a developmental stage.
TLP rightly did not give his full scooby-doo explanation (why you’re really doing what you’re doing) because it would be taken as a confrontation. The analysand would be left with either:
- Denying that he is looking for approval.
- Feeling shame about looking for approval.
To see the super-ego effects you should look for what both TLP and the analysand don’t bother to question: It’s bad/wrong/evil/childish/immature to want approval, and worse to try and get it indirectly from others.
Given that we can assume they both agree on this point, it is doubtless that the client was already dealing with repressed shame about wanting approval – and thus acting it out in the transference and his life. The key to this distinction is that TLP felt disapproving. That is how I look at this. It is not in the words. The words are the content. It is in the relationship someone has to the content that you will find transference feelings, which are a clue to how the client relates to the content. Something is standing between TLP and his ability to be empathic with his client. What that is, in this case, is his client.
Not only do I think approval from important others is an ordinary adult need, I think it is normal to feel bad about wanting it. What might help this client experience some relief would be to become able to experience and talk about how he feels ashamed about wanting approval from TLP.
The traditional path to this kind of insight is to withhold response – in the old days they would call this intensifying the transfer neurosis. This is, unfortunately, a long a troublesome process. It eventually infuriates narcissists and makes borderlines feel abandoned.
Objectivity from the standpoint of the analyst/analysand dyad is not possible, as TLP correctly notes. However, an interpretation that is neutral from the standpoint of the client is possible to the extent it is ego analytical (identifies and relieves superego tension). It is never easy to arrive at this kind of thinking, but it might eventually look something like:
- “It seems like you’ve noticed some changes but are still disappointed by what seem like setbacks. You’d like to feel like you are making improvement but are undone by doubts that are subtle and difficult to dispel. It would be natural for anyone dealing with this to want some reassurance, and they would probably find it hard to imagine they could enjoy asking for it.
Even this may still just enrage or shame the client, who couldn’t help but feel accused of being childish. Then again, perhaps the client would feel this way naturally because it is exactly what TLP actually believes. TLP prevents TLP from being neutral from the standpoint of the client because of his explanatory framework and the transference effect of the clients unspoken shame about his dependency needs.