JAPA 42/4

LOVE IN THE ANALYTIC SETTING

OTTO F. KERNBERG, M.D.

In the context of viewing the analytic setting as a "clinical labora-

tory" to study the nature of love relations, this paper starts by outlin-
ing the relationships of transference love, "normal" love, neurotic
love, and oedipal love. After a description of the vicissitudes of
transference love when patient and analyst are of the same sex
and of opposite sex, developments of transference love regarding
homosexual and heterosexual longings in neurotic and narcissistic
pathology are considered.
Countertransference reactions in response to transference love
are explored next, with emphasis on conditions under which erotic
countertransference may become particularly intense. In describing
the technical management of erotic countertransference, the ana-
lyst's ability to explore his own feelings and fantasies without con-
straint is stressed.
The usefulness of understanding the erotic countertransference
in arriving at transference interpretations is illustrated by a clinical
case of a female patient with a neurotic personality structure and
predominantly masochistic conflicts.

clinical laboratory that has

T HE ANALYTIC SETTING IS THE
permitted us to study the nature of love in its myriad
forms. The transference, in conjunction with the countertrans-
ference, is the vehicle for our study of these forms, and there-
fore will receive most of my attention in what follows. Psychoan-
alytic investigation started with the centrality of the oedipal
situation and infantile sexuality in determining the dynamics
of love in neurotic adulthood. Subsequently it has mapped out
the participation of preoedipal object relations and the vicissi-
tudes of superego development in codetermining the nature

Associate Chairman and Medical Director, The New York Hospital-Cor-

nell Medical Center, Westchester Division; Professor of Psychiatry, Cornell
University Medical College; Training and Supervising Analyst, Columbia
University Center for Psychoanalytic Training and Research.
Presented at the panel on "Love in the Analytic Setting," the Fall Meeting
of the American Psychoanalytic Association, New York, December 19, 1992.
Accepted for publication October 7, 1993.

1137
1138 OTTO F. KERNBERG

of not only normal and pathological sexuality, but mature as

contrasted to neurotic love, and the dynamics of inhibition and
the pathology of love relationships. This developing knowl-
edge, and experiencing the vicissitudes of transference love in
different types and degrees of psychopathology, has allowed
us to see the relation between transference love, "normal" love,
neurotic love, and oedipal love more clearly.

Transference
To turn first to the relationship between the original oedipal
situation and transference love: the main difference between
the original oedipal situation and transference love is the possi-
bility, under optimal circumstances, of fully exploring in the
transference the unconscious determinants of the oedipal situa-
tion, the full exploration of oedipal conflicts in a gradual con-
scious integration of infantile sexuality into the adult ego as part
of analytic work. Working through transference love signifies
working through the renunciation and mourning that normally
resolve the oedipal situation, but also the acknowledgment of
the permanent nature of the oedipal structuring of reality as a
consistent frame for all future love relationships. The patient
has to learn, in the context of the resolution of his or her
transference love, that the search for the oedipal object is going
to be a permanent, implicit feature of all love relationships
(Bergmann, 1987). This does not imply reducing all future love
relationships to the oedipal situation; it does imply the influence
of the oedipal structure in framing the new experiences in an
individual's and a couple's love life.
Under optimal circumstances, the regressive experience of
transference love and its working-through is facilitated by the
"as-if' nature of transference regression-and the underlying
ego strength implied in such a limited regression-and by the
patient's growing capacity for gratification of oedipal longings
by sublimation in an actual reciprocal love relationship. The
lack of such reciprocity sharply differentiates transference love
 LOVE IN THE ANALYTIC SETTING 1139

from a love relationship outside the analytic setting, just as

the full conscious exploration of oedipal conflicts differentiates
transference love from the original oedipal situation. One
might say that transference love resembles neurotic love in that
transference regression fosters the full-fledged development of
unrequited love. But the analytic resolution of the transference,
in turn, sharply differentiates transference love from the act-
ing-out quality of neurotic love, where unrequited love in-
creases the attachment rather than resolving it through a
mournmg process.
The psychoanalytic exploration of transference love pro-
vides evidence of all the components that are part of the usual
process of falling in love: the projection onto another (the ana-
lyst) of mature aspects of the ego ideal; the ambivalent relation
to the oedipal object; the defenses against as well as the deploy-
ment of polymorphous perverse infantile as well as genital oedi-
pal strivings. All these combine to bring about the experience
of romantic love and sexual passion in the transference, even if
relatively briefly and transitorily. These feelings are ordinarily
diluted by displacements onto the available objects in the pa-
tient's life. Indeed, there is probably no other area of psychoan-
alytic treatment in which the potential for acting out and for
growth experiences are so intimately condensed and difficult
to differentiate from each other.
Transference love may betray its neurotic components by
its intensity, rigidity, and stubborn persistence, particularly
when masochism is acted out in the transference. At the oppo-
site extreme, the absence of evidence of transference love may
reflect either strong sadomasochistic resistances against a posi-
tive oedipal relationship, or a narcissistic transference within
which positive oedipal developments are significantly curtailed.
Transference developments also depend on the differing char-
acteristics of the oedipal relationship of male and female pa-
tients who are in analysis with an analyst of the opposite sex,
including significant differences regarding the manifestations
of narcissistic pathology in the transference. As has been widely
1140 OTTO F. KERNBERG

observed (Bergmann, 1971, 1980, 1982; Blum, 1973; Chasseg-

uet-Smirgel, 1984a; Goldberger and Evans, 1985; Karme,
1979; Lester, 1984; Person, 1985; Silverman, 1988) and as I
have also explored elsewhere (unpublished), transference love
varies with the sex of the participants.
In summary, neurotic female patients in analysis with male
analysts tend to develop typical positive oedipal transfer-
ences-witness the cases described in Freud's (1915) classic pa-
per on transference love. In contrast, women with narcissistic
personality in analysis with male analysts tend not to develop
such transference love or to develop it only at very late stages
of the treatment, usually in rather subdued forms. Narcissistic
resistances against dependency in the transference, part of the
defense against unconscious envy of the analyst, preclude the
development of transference love; the patient experiences any
sexualized longings for the analyst as humiliating, as making
her feel inferior.
Neurotic male patients in analysis with female analysts usu-
ally show some degree of inhibition of direct manifestations of
transference love, a tendency to displace it onto other o~ects,
and develop instead intense anxieties over sexual inferiority
or insufficiency as part of the reactivation of normal infantile
narcissistic features in regard to the oedipal mother. As Chas-
seguet-Smirgel (1970, 1984b) has pointed out, the little boy's
unconscious fear that his small penis will not be able to satisfy
his big mother is a significant dynamic here. In contrast, narcis-
sistic male patients in analysis with female analysts often display
what appears to be intense transference love, but is in fact
an aggressive, sexualized seductiveness reflecting transference
resistance against feeling dependent on an idealized analyst,
and an effort to reproduce a conventional cultural situation in
which the power(ul, seductive male relates to the passive and
idealizing female. This is the counterpart to the conventional
cultural facilitation of a dependent sexualized relationship of
the neurotic female patient with the male analyst, as well as the
 LOVE IN THE ANALYTIC SETTING 1141

reproduction, in that latter case, of the little girl's oedipal desire

for the idealized father.
Obviously, these are generalizations and only represent
overall patterns. Even when one might expect the development
of strong positive oedipal longings in the transference, the de-
fenses against such longings reflecting deep-seated guilt feel-
ings may result in stubborn resistances, requiring consistent
interpretation for their resolution.
Patients who have been sexually traumatized, particularly
incest victims and patients with a history of sexual involvements
with psychotherapists may, owing to the trauma-induced
heightened pressure for repetition compulsion, try to seduce
the analyst, their demands perhaps dominating the transfer-
ence over an extended period of time. Unconscious identifica-
tion with the aggressor plays an important role in these cases,
and the careful analysis of the patient's enraged resentment at
the analyst's not responding to his or her sexual demands may
require a great deal of attention before the patient experiences
relief and appreciation for the maintenance of the psychoana-
lytic frame.
Narcissistic women with strong antisocial features may at-
tempt to sexually seduce the analyst in what may be erroneously
understood as oedipal transference love. But the aggressive
implications of their efforts to corrupt the treatment are often
quite clear in the transference. Such women should be distin-
guished from masochistic women who may or may not have a
history of sexual abuse, and have a predisposition to being
sexually abused and exploited. The intensity of erotized trans-
ferences in patients with hysterical personality structure repre-
sents an instance of classic transference love: a defensive, sexu-
alized idealization of the analyst often hides significant
unconscious aggression derived from oedipal disappointment
and unconscious oedipal guilt.
The neurotic features of transference love are evident not
only in the intensification of the erotic longings in connection
1142 OTTO F. KERNBERG

with unrequited love. They are also manifest in the usual infan-
tile narcissistic wish to be loved rather than the adult active
love for the analyst, the wish for sexual intimacy as a symbolic
expression of symbiotic longings or preoedipal dependency,
and the general accentuation of sexualized idealization as a
defense against aggressive strivings from many sources. Pa-
tients with borderline personality organization may manifest
particularly intense wishes to be loved, erotic demands with
strong efforts to control the therapist, and even suicidal threats
as an effort to extract love from the therapist by force.
Developments in homosexual transference love are similar
with both sexes, but important differences may emerge in the
countertransference of male and female analysts, differences I
shall explore shortly. Patients with neurotic psychopathology
may develop intense homosexual longings for their analyst of
the same sex, in which the negative oedipal complex and preoe-
dipal, oral-dependent and anal strivings converge; the elements
of sexual passion may be explored after the systematic analysis
of resistances against the transference regression.
In narcissistic pathology, homosexual transferences usually
acquire the same demanding, aggressive, and controlling char-
acteristics as heterosexual narcissistic transferences of male nar-
cissistic patients with female analysts, and female borderline
and antisocial narcissistic patients with male analysts.
As a general rule, the analyst's comfortable tolerance of
the positive, sexualized transference love of the neurotic pa-
tient, and the protection of the analytic frame with the pseudo-
positive transference love of narcissistic pathology are key pre-
conditions for full analytic exploration and resolution of all
these developments. I see the vicissitudes and the countertrans-
ference as of central importance in this process.

Countertransference
Although the analysis of the countertransference as a factor
in the formulation of transference interpretations is receiving
 LOVE IN THE ANALYTIC SETTING 1143

growing attention in the literature on psychoanalytic technique,

we find far more has been written about aggressive counter-
transference than about erotic countertransference. The tradi-
tionally phobic attitude toward the countertransference that
has changed only in recent decades still operates with regard
to the analyst's erotic response to the erotic transference.
In general, when the patient's erotic feelings and fantasies
in the transference are repressed, they usually evoke little erotic
response in the countertransference. But when the patient's
erotic fantasies and wishes become conscious, the analyst's
countertransference response may include erotic elements that
alert him to the possibility of the patient's conscious suppression
of erotic fantasies and wishes. When the resistances against the
full expression of the transference have decreased significantly
and the patient experiences strong sexual wishes toward the
analyst, erotic countertransference responses may become in-
tense, fluctuating with the intensity of the erotic transference.
My emphasis here is on fluctuations of the transference.
Ordinarily, even intense erotic transferences wax and wane as
the patient displaces transference feelings and wishes onto
available opportunities for enactment, acting out, and/or extra-
analytic gratification of sexual feelings. When the patient's
erotic wishes center exclusively on the analyst, the resistance
aspect becomes quite evident and the aggressive component of
sexual demands more accentuated. This development tends to
decrease the intensity of erotic countertransference feelings.
When projective identification predominates over projec-
tion, that is, when the patient attributes to the analyst sexual
feelings the patient recognizes in himself or herself, rejecting
these feelings as dangerous while attempting to control the
analyst in order to avoid a feared sexual attack from him or
her-in contrast to a simple projection of unconscious im-
pulses-erotic countertransference is usually absent. In fact, a
strange discrepancy between intense projected sexual fantasies
of a patient with an erotomanic transference and a counter-
transference response reflecting only the sense of intimidation
1144 OTTO F. KERNBERG

and constraint in the analyst should alert the analyst to the

existence of severe narcissistic psychopathology in the patient
or deep regression in the transference.
In my experience, the most intense erotic countertransfer-
ence probably obtains in any of the following three situations:
(a) in male analysts treating female patients with strong masoch-
istic, but not borderline, features who develop an intense, "im-
possible" sexualized love for an unavailable oedipal object; (b)
in analysts of either sex with strong, unresolved narcissistic
characteristics, and (c) in some female analysts with strong mas-
ochistic tendencies, treating highly seductive narcissistic male
patients. Some female masochistic patients are able to generate
marked rescue fantasies in their male analyst, "seducing" him
to attempt to help them only to prove how misguided or useless
that help really is. These seductions of the analyst to become
helpful may become sexualized, and manifest themselves in the
countertransference as rescue fantasies that have a strong erotic
component. Typically, for example, the male analyst may ask
himself, how is it that this extremely attractive woman patient is
unable to keep any man and ends up being repeatedly rejected?
From there to the countertransference fantasy, "I would make
a very gratifying sexual partner to this patient," is only one
step.
I have found it helpful to be attentive with masochistic
patients having a long history of unhappy love affairs to mo-
·ments in which such rescue fantasies or an erotic countertrans-
ference develop. More often than not, such transference-coun-
tertransference seductions culminate in the patient's sudden
frustration, disappointment, or angry misunderstanding of the
analyst's comments, or a shift into sudden, inordinate demands
on the analyst that in an instant destroy that erotized rescue
countertransference development.
It may be helpful for the analyst to tolerate his sexual
fantasies about the patient internally, even let them develop
into a narrative of an imaginary sexual relationship. Soon
 LOVE IN THE ANALYTIC SETTING 1145

enough the analyst's own fantasy will cause the idea to evapo-
rate because of his preconscious awareness of the help-re-
jecting, "antilibidinal," self-defeating aspects of the patient's
personality; this approach will facilitate an interpretation of the
transference even before its sudden shift into negative affects.
Inconsistencies in the treatment arrangements, requests for
changing hours, alleged insensitivities of the analyst to special
circumstances, financial irresponsibility, and late payments of
the treatment fees are some of the obvious ways in which such
a patient unconsciously attempts to prevent or destroy the pos-
sibility of a stable positive relationship with the analyst; alertness
to the countertransference narratives may detect these tenden-
cies before their enactment in the treatment.
Intense erotic transference manifestations require differ-
entiation from the patient's desire to be loved by the analyst.
Beneath conscious or unconscious seductive efforts in the trans-
ference may lie the wish to become the object of the analyst's
desire, at a deep level, to become the analyst's phallus, with
implicit fantasies of physical inferiority and, basically, fantasies
of castration. I therefore like to analyze not only a patient's
defenses against full expression of the erotic transference, but
to analyze in detail the nature of transference fantasies them-
selves. Under what may look like the wish for a sexual relation-
ship with the analyst are multiple transferences and meanings.
For example, intense erotization can be a frequent defense
against aggressive transferences from many sources, an effort
to escape painful conflicts around oral dependency, the en-
acting of perverse transferences (the wish to seduce the analyst
in order to destroy him).
The analyst who feels free to explore in detail, in his own
mind, his sexual feelings toward the patient will be able to
assess the nature of transference developments and thus avoid
a defensive denial of his own erotic response to the patient; he
must at the same time be able to explore transference love
without acting out his countertransference in a seductive ap-
proach to the exploration of the transference. The patient's
1146 OTTO F. KERNBERG

erotic transference may be expressed in nonverbal behavior, in

an erotization of the patient's relationship to the analyst, to
which the analyst should respond by exploring the defensive
nature of nonverbalized seduction without either contributing
to an erotization of the treament situation or defensively re-
jecting the patient.
The analyst's unresolved narcissistic pathology is probably
the major cause for countertransference acting out in the form
of a contribution to the erotization of the psychoanalytic situa-
tion and even a rupture of the boundaries of the psychoanalytic
setting. Sexual relations with patients are, I believe, more often
than not a symptom of the analyst's narcissistic character pa-
thology and its attendant significant superego pathology. There
are, however, also purely oedipal dynamics involved in some
cases, the crossing of the boundaries of the analytic relationship
symbolically representing the crossing of the oedipal barrier.
Sometimes the analyst's crossing of sexual boundaries reflects
an acting out of masochistic pathology, an unconscious wish to
be punished for an oedipal transgression.
The exploration of sexual feelings in the transference, of
the complex and intimate aspects of the patient's erotic fantasies
and desire for a sexual love relation with the analyst, provides
a unique opportunity for the analyst to penetrate the sexual
life of the opposite sex. Homosexual as well as heterosexual
dynamics enter here, the positive as well as the negative Oedi-
pus complex. Insofar as the analyst identifies with the emotional
experiences of the opposite-sex patient, the concordant identi-
fication in the countertransference with the patient's erotic ex-
periences with other heterosexual objects activates the analyst's
capacity for and resistances against the identification with the
sexual yearnings of the opposite sex. The male analyst, in order
to be able to establish a concordant identification in the counter-
transference with his female patient's interest for another man,
has to be free to reach his own feminine identification. When
this same female patient experiences sexual feelings toward the
analyst, he may acquire a much better understanding of the
 LOVE IN THE ANALYTIC SETTING 1147

sexual desire of a member of the opposite sex, by integrating

his concordant identification with his patient's sexual desire
with his complementary identification as the object of her de-
sire. This understanding on the part of the analyst includes an
emotional resonance with his own bisexuality as well as the
crossing of a boundary of intimacy and communication that is
only reached in culminating moments of intimacy of a sexual
couple.
This is an experience unique to the psychoanalytic situa-
tion, an activation of an intensity and complexity of counter-
transference that probably can be tolerated and used for work
only because of the protection offered by the boundaries of
the psychoanalytic relationship. In ironic confirmation of the
uniqueness of this countertransference experience may be the
observation that, although psychoanalysts have a unique oppor-
tunity to study the psychology of the love life of the opposite
sex, this knowledge and experience tend to evaporate when it
comes to understanding their own experiences with the oppo-
site sex outside the psychoanalytic situation. This, of course,
may also be stated briefly in saying that, outside the psychoana-
lytic situation, the analyst's love life becomes simply human.
When patient and analyst are not of the same sex, the
concordant identification in the countertransference relies on
the analyst's tolerance of his homosexual components; in con-
trast, in the case of complementary identification in the coun-
tertransference, heterosexual components prevail. This distinc-
tion becomes blurred when patients of the same sex as the
analyst experience intense transference love. Here homosexual
transferences and the analyst's erotic response to such transfer-
ences tend to activate preoedipal as well as oedipal libidinal
strivings and conflicts, particularly with patients whose homo-
sexual conflicts and longings are expressed in the context of a
neurotic personality organization. If the analyst can tolerate his
own homosexual components, the countertransference explo-
ration of his identification with the preoedipal parents should
help to analyze the negative oedipal implications of the patient's
1148 OTTO F. KERNBERG

homosexual feelings. This rarely seems to become a major

problem, except with analysts who are struggling with a confiic-
tual repression of their own homosexual longings or a sup-
pressed homosexual orientation.
The transference developments in homosexual patients
with narcissistic personality structure in analysis with analysts
of the same sex acquire an intensely demanding, aggressive
quality that reduces or eliminates strong homosexual counter-
transferences and their corresponding difficulties. Naturally,
the lack of sexual resonance in the countertransference of a
same-sex analysis with a homosexual patient who suffers from
severe narcissistic pathology also requires exploration in terms
of a possibly specific phobic reaction of the analyst to his or
her homosexual impulses. The stronger cultural bias against
male homosexuality in contrast to female homosexuality unfor-
tunately may represent a stronger countertransference burden
for the male psychoanalyst.
From the preceding observations, it would seem that the
most important technical issues in the analysis of transference
love are, first of all, the analyst's tolerance of the development
of sexual feelings toward the patient, both homosexual and
heterosexual, which demands the analyst's internal freedom to
utilize his or her psychological bisexuality; second, the impor-
tance of analyzing systematically the patient's defenses against
the full expression of transference love, steering a middle
course between phobic reluctance to explore the resistances
against the full expression of the sexual transference and to
risk being seductively invasive; third, to fully analyze both the
expression of the patient's transference love and the reactions
to the frustration of the transference love that will follow un-
avoidably. Thus, in my view, the analyst's tasks include (a) re-
fraining from communicating his countertransference to the
patient as a precondition for assuring his internal freedom to
explore fully his feelings and fantasies, and (b) integrating the
understanding he gained of his countertransference into the
 LOVE IN THE ANALYTIC SETTING 1149

formulation of transference interpretations in terms of the pa-

tient's unconscious conflicts.
Here, the patient's experience of the analyst's "rejection"
as a confirmation of the prohibitions against oedipal longings,
a confirmation of narcissistic humiliation, a confirmation of the
patient's sexual inferiority and castration should be explored
and interpretively resolved. When these conditions are met,
periods of free and open expression of transference love, in-
cluding a broad spectrum of polymorphous perverse infantile
features as well as positive and negative oedipal strivings may
be deployed in the transference, and, typically, expressed in
fluctuating intensities as the emotional growth in the patient's
sexual life facilitates his or her efforts to obtain more gratifying
relations in external reality.
The analyst has to come to terms not only with bisexual
tendencies as they become activated in the erotic countertrans-
ference, but also with other polymorphous perverse infantile
strivings, such as the sadistic and voyeuristic implications of
the interpretive explorations of the patient's sexual life. It is
probably also true that, the more satisfactory the sexual life
of the analyst in terms of his or her sexual freedom and the
integration of erotic, object-relational, and ego-ideal features
in his capacity for passionate love, the more will the analyst be
able to help the patient resolve inhibitions and limitations in
this essential area of human experience. Regardless of the prob-
lematic aspects of transference love, I believe that the unique
experience psychoanalytic work provides in analyzing sexual
passion while being a temporary target of it may contribute to
the emotional as well as professional growth of the analyst.

Clinical Illustration
Miss A. was a thirty-two year-old single woman referred to
me by her internist because of chronic depression, alcohol and
polysubstance abuse, and a chaotic life style, with instability at
work and in her relationships with men. Miss A. impressed me
1150 OTTO F. KERNBERG

as intelligent, warm, and attractive enough, but somewhat plain,

neglectful of her appearance and attire. She had successfully
completed studies in architecture and had been employed in
several architectural firms, frequently changing her job, as I
gradually found out, mostly because of unhappy love affairs
with men in those firms. She had a tendency to mix work and
personal relations in ways that were self-defeating.
Miss A.'s father, a prominent businessman, had interna-
tional connections that required frequent travel overseas. Since
the death of his first wife, the patient's mother, when Miss A.
was five years old, he would travel alone, leaving the child and
her two older brothers in the care of his second wife, with
whom Miss A. did not get along. Miss A. described her mother
in idealized but somewhat ethereal .and unrealistic ways. She
had experienced intense mourning after her mother's death,
which shifted into lasting hostility toward her stepmother,
whom her father married about a year after mother's death.
The relation with father, which had until then been excellent,
also deteriorated, as he sided with his new wife against what
he experienced as the unwarranted hostility of his daughter
against her stepmother.
During Miss A.'s adolescence, her stepmother seemed to
be pleased with being able to stay at home and continue her
social engagements, while Miss A. accompanied her father on
his trips overseas. It was during her high-school years that Miss
A. discovered father's affairs with other women, and it became
clear to her that on his trips abroad those affairs were a major
focus of his activities. Miss A. became her father's confidant,
and consciously felt thrilled and happy that he trusted her,
and, somewhat less consciously, triumph over her stepmother.
Meanwhile, a pattern in her own behavior began to take
shape during her college years, continuing to her entering
treatment. Miss A. would fall in love, become intensely depen-
dent on the men, submissive and clinging, and, invariably, be
dropped by them. She then reacted with deep disappointment,
depression, and a developing tendency to resort to alcohol and
 LOVE IN THE ANALYTIC SETTING 1151

minor tranquilizers to overcome the depression. Miss A. experi-

enced a gradual deterioration of her social standing in the ex-
clusive social group to which she belonged, as she developed
the reputation of being a "pushover." When an unhappy love
affair became complicated by an unwanted pregnancy and an
induced abortion, her father became increasingly concerned
for and critical of her: it was his concern that prompted Miss
A.'s internist to refer her to me.
My diagnostic impression was that of a masochistic person-
ality, characterological depression, and symptomatic alcohol
and substance abuse. Miss A. had maintained good relations
with a few girlfriends over many years, was able to work effec-
tively as long as she did not become involved in intimate rela-
tions with men at work, and she impressed me as basically hon-
est, concerned about herself, and capable of establishing object
relations in depth. I recommended psychoanalysis, and the fol-
lowing developments took place during the third and fourth
years of her treatment.
Miss A. was involved, over an extended period of time,
with a married man, B., who had made it very clear that he was
not willing to leave his wife for her. He had offered, however, to
have a child with Miss A., and to assume financial responsibility
for this child. Miss A. was toying with the idea of becoming
pregnant as a way of cementing their relationship and hoping
that this would eventually consolidate their union. In her rela-
tionship with me, she repeatedly described her experiences with
B. in ways that portrayed him as sadistic, deceitful, and unrelia-
ble; she complained bitterly about him. When I raised the ques-
tion, however, how she understood maintaining herself in a
relationship that she was describing in those terms, she immedi-
ately accused me of attempting to destroy what was, after all,
the most meaningful relationship in her life, and of being impa-
tient, domineering, and moralizing.
It gradually became clear that she was experiencing me as
an unhelpful, critical, unsympathetic father figure, a replica of
how she experienced father's concern for her. At the same
1152 OTTO F. KERNBERG

time, she was repeating her masochistic relationship pattern in

the transference. What struck me as peculiar was that, while
she described in great detail all her arguments and difficulties
with her lover, she never described the intimate aspects of their
sexual relation, except to say from time to time that they had
a marvelous time in bed together. For some reason, I failed to
explore the reasons for this discrepancy between her general
openness and this particular guardedness. Only slowly did I
realize that I was hesitating to explore her sexual life because
of my fantasy that she would immediately interpret this as se-
ductive invasiveness on my part. I sensed a particular counter-
transference reaction in myself that I did not yet fully under-
stand.
As I explored the functions of her endless repetition of
the same sadomasochistic interactions with B., I discovered that
she was afraid I would be jealous of the intensity of her relation
with him. She heard my interpretations-that she was replicat-
ing a frustrating and self-defeating relationship with me as she
was experiencing it with B.-as an invitation for erotic submis-
sion to me. I then was able to understand my previous reluc-
tance to explore her sexual life as an intuitive awareness on my
part of her suspiciousness of my seductive intentions toward
her. I interpreted her fear to share with me the details of her
sexual life as related to her fantasy that I wanted to exploit her
sexually, and seduce her into developing sexual feelings toward
me.
I should add that these developments evolved in a remark-
ably nonerotic atmosphere; to the contrary, throughout this
time moments of quiet self-reflection seemed to occur in the
middle of angry outbursts against her lover or at me because
of my alleged intolerance of her relationship with him. She
then began to explore the sexual aspects of the relationship
with B., in the sessions. I learned that, although from the begin-
ning of the relationship she had been a willing participant in
whatever sexual play or activity B. proposed, and her submis-
siveness provided him with particular pleasure, she was not
 LOVE IN THE ANALYTIC SETTING 1153

able to achieve orgasm in intercourse and experienced the same

sexual inhibition she had experienced with many previous lov-
ers. It was only when one of her men, enraged with her, hit
her, that she was able to achieve full sexual excitement and
orgasm.
This information clarified one aspect of her ongoing, cling-
ing yet provocative behavior with B., her unconscious efforts
to provoke him to hit her, so she would be able to achieve full
sexual gratification. Her abuse of alcohol and minor tranquiliz-
ers emerged as a way of presenting herself as an impulsive,
uncontrolled, demanding, and complaining woman-in con-
trast to her usual sweet and submissive self-thus both pro-
voking men to violence-with a possibility for sexual gratifica-
tion-and making herself unattractive to them. Retrospectively,
her alcohol abuse seemed one way to account for why men
eventually rejected her. Unconscious guilt over the oedipal im-
plications of these relationships gradually emerged as a major
dynamic involved here.
The analysis of this material accelerated the end of the
relationship with B.: Miss A. became less regressively de-
manding, and more realistically confronted B. with the incon-
sistencies of his behavior toward her. Faced with her alterna-
tives regarding the future of their relationship, he decided to
terminate it. In the period of mourning that followed, conscious
erotic feelings toward me evolved for the first time in the trans-
ference. Miss A., who had previously suspected me of trying
to seduce her sexually and had seen me as a replica of the
contradictory, hypocritical, moralistic, and promiscuous father,
now perceived me as opposite to her father. Her image of me
became that of an idealized, loving, protective, yet also sexually
responsive man, and she expressed rather freely erotic feelings
about me that integrated tender and sexual fantasies and
wishes. I, in turn, having experienced her previously as a some-
what plain and sexually not particularly attractive woman, now
developed erotic countertransference fantasies during the
hours, together with the thought that it was really remarkable
1154 OTTO F. KERNBERG

that such an attractive woman should not have been able to

maintain any permanent relationship with a man.
Miss A., in the midst of an apparent freedom to express
her fantasies of a love relation with me-in the context of which
she imagined predominantly sadomasochistic sexual interac-
tions-also became highly sensitive to any minor frustration in
the sessions. If she had to wait a few minutes, or if an appoint-
ment had to be changed, if for some reason I could not accom-
modate a change she requested, she felt hurt-at first "de-
pressed," and eventually, very angry. She felt humiliated by my
lack of response to her sexual wishes, and now considered me
cold, callous, and sadistically seductive. Images of her father's
carefree relations with various women during their trips, when
he used her to protect himself against suspicions from his sec-
ond wife, emerged as a significant theme: I was as seductive and
unreliable as her father, and was betraying her in my "carefree"
relations with my other patients and the female professionals
with whom I worked.
The intense affect of these recriminations, her accusatory,
self-depreciatory, and resentful attitude, a replica of Miss A.'s
difficulties with men and the opening of an aspect of her rela-
tionship with father that had previously been repressed, also
led to a shift in my countertransference. Paradoxically, I felt
freer to explore my countertransference fantasies, which
ranged from sexual interactions replaying her sadomasochistic
fantasies to what it would be like to live with a woman like Miss
A. My fantasies about sadomasochistic sexual interactions with
Miss A. also replicated men's aggressive behavior toward her
that she had unconsciously tended to induce in them in the
past. My fantasies culminated in the clear recognition that she
would relentlessly provoke situations of frustration of her de-
pendency needs, angry recriminations, escalating to violent in-
teractions, and public display of depression and rage. She
would present herself as my victim, which would unfailingly
destroy our relationship.
 LOVE IN THE ANALYTIC SETTING 1155

As I utilized this countertransference material in my inter-

pretation of the developments in the transference, Miss A.'s
profound feelings of guilt over the sexualized aspects of the
relationship with me became apparent. In contrast to earlier
complaints about feeling rejected and humiliated because of
my lack of a loving response to her, she now felt anxious, guilty,
and upset over her wishes to seduce me, and evoked an ideal-
ized image of my wife (about whom she had no information
or awareness). I realized in retrospect that my resistance to
exploring countertransference fantasies earlier had prevented
me from following them in a direction that would have made
the masochistic self-destructiveness of the patient's erotic wishes
toward me much dearer. In retrospect, I would say that my
unconscious counteridentification with her seductive father in-
terfered with my full freedom to explore my erotic counter-
transference and thereby perceive more clearly the masochistic
pattern in the transference as well. I also think that my resis-
tance against unconscious sadomasochistic impulses of my own
role responsiveness to Miss A. was involved here. The sexual
fantasies about father, Miss A.'s past experiences of him as
teasingly provocative and yet sexually rejecting, then became a
dominant content in the analysis.
In the context of our exploration of the profound guilt
feelings that now connected the idealized image of my wife
with the idealized image of her own mother who had died when
Miss A. was five, Miss A. realized that she had defended herself
against these guilt feelings by splitting the image of mother
into the idealized dead one and the feared and depreciated
stepmother represented by her rivals, the other women in the
life of the men she could never have for herself alone. This
awareness also helped to clarify her unconscious selection of
"impossible" men, and the unconscious prohibition against full
sexual gratification under conditions other than physical or
mental suffering.
Miss A. finally established a relationship with a man who
in many ways was more satisfactory than her previous lovers,
1156 OTTO F. KERNBERG

both in terms of his not being involved with another woman at

that time and his belonging to her own social environment
(from which, because of her turbulent lifestyle, she had felt
ostracized in the past). A lengthy period of analysis followed,
in the course of which we could explore in great detail the
fantasies and fears in her developing relationship with C. Now
she was able to talk in great detail about their sexual relation-
ship, and we could explore her feelings both of guilt toward
me-having abandoned me as her love object-and of triumph
over me in a sexual relationship that, in her fantasy, was more
satisfactory than any I might have at this time. In other words,
a highly satisfactory love relation in external reality also served
the transference function of working thro~gh a mourning pro-
cess with me that repeated the mourning and a new reconcilia-
tion regarding the ambivalent relationship with her father.
This vignette, I believe, illustrates a typical development
of transference love in a patient with a neurotic personality
structure and predominantly masochistic conflicts, and the cor-
responding vicissitudes of countertransference developments
and their integration into transference interpretations. I have
attempted to show the usefulness of exploring as fully as possi-
ble both the countertransference and the specific sexual behav-
ior and fantasies of the patient.
In conclusion, in my view, the analyst's freedom to explore
fully his feelings and fantasies evoked by the patient's transfer-
ence is basic to his understanding of his countertransference,
enabling him to formulate transference interpretations in terms
of the patient's unconscious conflicts.

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