Übertragungsneurose

This chapter is an integration of several presentations I have given over the past several years on Davanloo’s conceptualization of Transference Neurosis, from a metapsychological, clinical and technical point of view. The history of the development of the concept of Transference Neurosis is reviewed. Initially described by Freud as a “new edition of the old disease,” it was the hallmark of psychoanalytic therapy. It had been a tenet of psychoanalysis that by working through the Transference Neurosis, via interpretation, neurosis could be cured. 
Transference Neurosis is defined. Davanloo’s most recent work is summarized. It is his view that Transference Neurosis is a morbid process that adds a new, destructive defensive system on top of the Original Neurosis. Davanloo states that when DISTDP is practiced in an optimum fashion there is no development of Transference Neurosis. However, not every treatment is optimum. Unconscious factors, including Transference Neurosis/Neuroses in the unconscious of the therapist, can complicate therapy. 
Davanloo’s broader sense of Transference Neurosis is explicated. Clinical indications of the presence of a Transference Neurosis are reviewed and specific clinical types are described. The negative effect of Transference Neurosis on access to the Original Neurosis in the Unconscious is reviewed. Lastly, Davanloo’s method of removal of the Transference Neurosis is described, which relies heavily on his method of Multidimensional Unconscious Structural Change. Davanloo has pointed out the insidious nature of Transference Neurosis in the clinical situation and has shown that it is reversible. 
The theoretical concepts presented in this chapter including the terminology such as Mobilization of the Unconscious, Transference Component of the Resistance, Complex Transference Feeling, Unconscious Therapeutic Alliance, Central Dynamic Sequence, Perpetrator of the Unconscious, Fusion of Primitive Murderous Rage with Guilt and Sexuality, Intergenerational Destructive Competitive Transference Neurosis, Uplifting the Transference Neurosis, Unlocking the Unconscious, and others, are not mine. They were developed by Dr. Davanloo over more than fifty years of his systematic clinical research. My aim has been to integrate these concepts for my colleagues and to solidify my own understanding of them in the process. I wish to acknowledge the contribution that Dr. Davanloo has made to me personally and professionally, and to our field.

This chapter addresses the development of the work of Habib Davanloo, M.D. from the early 1960’s to the present. His focus has been both on shortening the length of psychoanalytic therapies and expanding the base of patients treatable with his techniques. He, like others at the time, initially worked with highly motivated patients with a single therapeutic focus. Over the decades his clinical and clinical research base expanded to include patients with the highest complexity in their unconscious structure and the highest unconscious resistance. This includes the full spectrum of neurotic and characterologic disturbances, fragile character structure and complex cases of persistent, unresolved Transference Neurosis. His current clinical work, clinical research and education of therapists have major implications for the future of dynamic psychotherapy. His metapsychology is presented with attention to the issues of unconscious feelings, manifestations of unconscious anxiety and his unique perspective on the unconscious defensive structure. His methods of Intensive Short-term Dynamic Psychotherapy (DISTDP) with “unlocking the unconscious,” Mobilization of the Unconscious, and Total Removal of Resistance are described. The evidence base for short-term dynamic and DISTDP is briefly reviewed. Lastly, the focus of Davanloo’s current work is introduced, namely his concentration on Transference Neurosis. This topic is discussed further in the next chapter.