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Shirah Vollmer, MD
Shirah Vollmer MD


Does the past influence the present?

My 24-year-old male patient, who has entered my most recent posts, looks to me to struggle with his issues, but he does not look to me for comfort. I characterize our relationship as one that involves a lot of mutual fondness. He sees me as an intelligent participant in his life who helps him think and reflect on his life, but he also experiences me as emotionally distant.

Transference, first described by Sigmund Freud, is a phenomenon in psychotherapy in which there is an unconscious redirection of feelings from one person to another. In his later writings, Freud learned that understanding the transference was an important piece of the psychotherapeutic work.

In the case of this patient, he has a distant mom and a warm dad who he does not see very often. When his parents divorced, he and his mom developed an intense, but in his terms, a "weird" relationship. By "weird," he means that she took care of him, but she did not want to spend a lot of time with him. He came to understand that he was not "worthy" of her time. Although it would be too simple to say that he has made me into his mother, it does appear that he assumes that I cannot comfort him based on his childhood experience of his mother.

I know that my critics are going to argue that perhaps I am a cold person and so this is not transference, but rather a repetition of his past. The question becomes how much is my patient responding to his past relationships and how much is he responding to the present connection. As with most things, the past and the present are now woven together and it becomes nearly impossible to sort out. Having said that, the idea that his childhood relationship with his mom has shaped his expectations of our therapeutic relationship may be worth exploring.

According to The Source, published in 2001, "During transference, people turn into a 'biological time machine."' A nerve is struck when someone says or does something that reminds you of your past. This creates an "emotional time warp" that transfers your emotional past and your psychological needs into the present.

My client wants to grow and he wants to feel comfort. At the moment, he is able to access the growth and reflection aspect of psychotherapy. I am hopeful that by talking about the nature of our relationship, he will begin to feel the comfort that is embedded in the deep affection that we have for one another. We will start by looking at the transference.

About the Author
Shirah Vollmer, MD

Shirah Vollmer, MD, is an Associate Clinical Professor of Family Medicine and Psychiatry at the David Geffen School of Medicine at UCLA.

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