A foundational principle of depth therapy is that until mourned, the past is never truly past. It lives on in the present in our relationships shaping how we see others, how we see ourselves and in how others see us. In the consulting room, this process plays out much the same way as it does in our regular lives but here it can be thought about and worked with. We call it transference.
Transference defined?
Transference is the unconscious repetition of early relationships in the present. The patient unwittingly re-enacts old relational patterns with the therapist which gives the skilled therapist an insight and understanding of how the patient learnt to navigate their relationships as an infant and from there onwards. Put simply, these relational patterns were once necessary in order for the infant to get their needs met (to varying degrees) but over time they have harden into fixed ways of relating that restrict emotional freedom.
Freud saw this phenomenon as both the greatest obstacle to therapy and its most powerful tool describing transference as “the prototype of all love.” Transference shows how the mind repeats what is familiar, even when it causes suffering. The therapeutic relationship becomes the arena in which these repetitions can be recognised, thought about, and over time different relational patterns experimented with whereby the patient comes to see the therapist as someone who is different to those in their past.
Why do we repeat relational patterns?
The repetition of the past in the present is not accidental. We repeat what we cannot yet remember or think about with the unconsciously hope that we may eventually get a different outcome. The patient unconsciously assigns to the therapist the role of the critical parent, the unavailable caregiver, or the idealised rescuer, depending on where their relational trauma lies. And these roles cannot be mentalized until they are lived through in the therapeutic dyad.
In this way, the therapeutic relationship becomes both a mirror from the past and an opportunity for change. It reflects the patient’s inner world while providing a new relational context in which that world can evolve.
Working with the transference
A common misunderstanding is that the therapist’s role is to correct the patient’s distortions of reality, however this is unlikely to lead to any relational change as simple insight rarely does. Relational depth psychotherapy instead takes the view of observing what unfolds in the relationship, as a vital indictor of what has unfolded in the patient’s early primary relationship. But, instead of reacting to how they, the psychotherapist, feel in response to the transference, they instead use what is known as their counter-transference to work but the patient’s projections and to name the pain and grief locked within those relational patterns.
Freud called this process working through. It involves returning to these patterns again and again in the therapeutic relationship until their meaning becomes clear to the patient.
The aim is not insight for its own sake, but the gradual loosening of the grip that the past exerts on the present through mourning.
The therapist as separate to the patient
Over time, the work is such that the patient begins to experience the therapist not as a figure from their past, but as a real person with a separate mind. This marks a crucial developmental step which didn’t happen when the patient was growing up and has kept them relationally stuck. It is the developmental step of recognising that others exist independently of one’s own needs and projections.
Analytical psychotherapists call this capacity the two-person world. In this world, the therapist is neither idealised nor devalued but experienced as a whole separate person. The patient’s growing ability to recognise separateness opens the possibility of genuine relatedness in all their relationships.
The emotional demands of change
Transference is not an intellectual concept but an emotional event that is worked with leads to developmental change and psychological maturity. The feelings it stirs can be intense, confusing, and often painful and throughout he therapist’s task is to stay present, holding onto their thinking mind and to use these emotional currents to help the patient understand what happened to them.
For the patient, the process invariably involves mourning. Old hopes of finally being loved or rescued must give way to the reality that the past cannot be undone as its only by grieving what was not possible that a person becomes free to live differently in the present – the past can be let go of.
Why transference matters
Transference provides a living picture of the patient’s inner world and defines how they do relationships. It brings into the open what might otherwise has remained hidden in repetition throughout the patient’s life. Without transference, depth therapy is imply not possible and the therapeutic encounter remains insightful at best.
The goal therefore is not to eliminate transference but to firstly understand it and then help the patient work through it. This is not easy work for the therapist as they must not only be asking themselves ‘who do I represent in the transference?’ But must also survive the patient’s idealisation and hate. Resolution means recognising these patterns for what they are: echoes of earlier life and not the reality of the therapeutic relationship.
Relational freedom
When the transference has been worked through, the patient no longer needs the therapist to embody old roles and this becomes a felt experience in the encounter. The patient can tolerate the therapist as separate to them and neither perfect nor dreadful. The therapist can be disappointing to them in an ordinary way. This is what psychoanalysis calls relational freedom. The patient becomes able to love, to hate, to desire, and to depend, all while knowing that both self and other remain distinct.
Psychotherapy is not an intellectual exercise. It is a living relationship that requires both participants to learn to feel and to think together. The transference provides the raw material for transformation IF the therapist is skilled enough to hold it and work with it.
Mark Vahrmeyer is a UKCP-registered psychotherapist working in private practice in Hove and Lewes, East Sussex. He is trained in relational psychotherapy and uses an integrative approach of psychodynamic, attachment and body psychotherapy to facilitate change with clients.
Further reading by Mark Vahrmeyer –
AI psychosis: why depth therapy cannot be automated
All depth psychotherapy is trauma therapy – and the rest is marketing
Why there is no such thing as a patient
How AI tools between sessions are undermining the therapeutic relationship
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