title: An aspect of transference: the struggle to become an analysand.
abstract: The patient's efforts to enter into a collaborative relationship with the analyst, to become an analysand, are burdened with difficulties, of which a major one is the not infrequent intrinsic structuring of certain aspects of transference--its functional, secondary autonomy, or independence of its historical roots. The effect is to confuse and misrepresent, through a struggle by the patient that dissembles the major purposes of the work. The struggle is a function that has become independent of its historical origins, and is now less an anxiety-driven defense than an automatized, concrete seeking of a vaguely plausible, rationalized satisfaction and security. It represents the patient's effort to work his or her way to closeness with the surrogate, but with distancing by means of control and domination. It lacks the symbolism and metaphor of unconscious derivatives. A mutual responsiveness by the analyst is a potentially undesirable outcome. Recognizing an interactional process, there is the necessity of clarifying a future-oriented process by a patient, who is working over the establishing of a dominant self-image of integrity and security without intimacy. Illustrative vignettes and a comparison with role responsiveness are included.
authors.affiliation: Georgetown University School of Medicine, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Olinick
mesh_terms: D003674:Defense Mechanisms; D006801:Humans; D007207:Individuation; D007389:Internal-External Control; D010553:Personality Development; D010817:Physician-Patient Relations; D011573:Psychoanalytic Interpretation; D011575:Psychoanalytic Therapy; D012649:Self Concept; D014167:Transference, Psychology