Introductory Lectures on Neuropsychoanalysis: Lecture Five, Part 4 " How to Treat the Mind" Transference/Extratransference

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Transference and extra transference interpretations are common in psychoanalysis/psychotherapy, so I will not go over them here in detail. What I do want to point out is why they must be done not only in the past but in the present. Neuropsychoanalytic theory teaches that the repressed, unconscious, and unworkable prediction from childhood is repeated in the patient's present, here and now, relationships. And this is happening in their present lives with their significant others including you as the therapist. Neuropsychoanalytic theory further teaches that because the prediction is unconscious (meaning non declarative) it cannot be remembered in the traditional sense of that term. Because it is non declarative it no longer remains in the mind as an episodic memory. The patient cannot recall it. It cannot be brought back to the their mind in the form of rememberable scenes from childhood. The memory is now only a procedural memory or an emotional response. This means it only remains as an action plan or a strong feeling. So although the patient cannot remember the prediction, they do unconsciously and compellingly repeat it in their present relationships. And they can see this repeating if the therapist points it out to them. So the main emphasis in your extrtransference and transference interpretations will be in the present. In the patient's present repeated patterns with significant others today, and in their present repeated patterns with you in the transference. Now this does not mean that you never attempt to help reconstruct the patient's past life that they can no longer remember. You do try to reconstruct their repressed prediction patterns from the past, and even how those patterns may have developed in their childhood experiences, thoughts, and feelings. But you only do this to help the patient understand that these are the same patterns being repeated in the present. It is only the present that your patient is capable of bringing to consciousness. The repressed past is not capable of coming to consciousness.

So, the Middle Phase of neuropsychoanalytic treatment is about discovering the repressed, unconscious prediction in the patient's history and their significant relationships in the present. The next step is to take these extratransference and transference interpretations and work them through. I will talk about working through in a forthcoming section. But before doing so I want to share in the next section about defenses and their interpretation in neuropsychoanalysis/psychotherapy.