Transference is the unconscious redirection of feelings and expectations from an earlier experience, usually one from childhood, onto someone or some thing in the present. A patient becomes certain that the therapist is losing patience, the way a father once did. Nobody chooses to do this. The old expectation simply arrives first, and the new person is met through it.

The American Psychological Association defines transference in psychoanalysis as "a patient’s displacement or projection onto the analyst of those unconscious feelings and wishes originally directed toward important individuals, such as parents, in the patient’s childhood." Its broader meaning, the same entry adds, "is acknowledged as applying to all human interactions." (APA Dictionary of Psychology)

Psychoanalysis puts transference at the center of treatment. When an old relationship turns up in the room, aimed at the therapist, it can be examined while it is happening, which is a good deal more useful than hearing about it afterwards.

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Freud, Breuer and the first transference

The idea began with someone else’s patient. Between 1880 and 1882 Josef Breuer treated a young woman known as Anna O. (International Dictionary of Psychoanalysis) Writing in 1914, Freud said that Breuer had made use of "a very intense suggestible rapport on the part of the patient, which may serve us as a prototype of what we call ‘transference’ to-day." (Freud, "On the History of the Psycho-Analytic Movement," 1914)

Freud suspected that Breuer then discovered the sexual motive in that rapport, missed how universal it was, and "broke off all further investigation." (Freud, 1914) Breuer stopped there. Freud kept going.

In 1895 Freud described a patient of his own who had once wished that a man she was talking with would seize her and kiss her. During treatment the wish came back, now attached to Freud, and she spent a sleepless night. He called it a "false connection" and added: "It is remarkable how the patient falls a victim to deception on every new occasion." (Freud, "The Psychotherapy of Hysteria," 1895)

By 1905 he had a definition. Writing about the young woman he called Dora, he described transferences as "new editions or facsimiles of the tendencies and phantasies which are aroused and made conscious during the progress of the analysis," with one peculiarity: "they replace some earlier person by the person of the physician." (Freud, "Fragment of an Analysis of a Case of Hysteria," 1905)

Dora also taught him how easily it is missed. She broke off the treatment, and Freud admitted, "I did not succeed in mastering the transference in good time." He concluded that she had left him as she believed herself "deceived and deserted" by a man the case calls Herr K. (Freud, 1905) The founder of the idea learned it by being left.

Transference examples from everyday life

Transference happens wherever people matter to each other. A 2025 systematic review in Clinical Psychology & Psychotherapy states that "transference phenomena occur in all close relationships, including therapeutic settings." (Marazzi and colleagues, 2025) Therapy did not invent it. Therapy simply sits still long enough for it to be seen.

Some ordinary examples, invented for illustration:

  • A man whose mother met every silence with a reproach reads a two-line email from his manager as fury, and spends the evening drafting a defense nobody requested.
  • The reliable eldest of five finds herself doing a colleague’s share of the work, resenting it, and volunteering again the following week.
  • Someone who learned early not to bother busy adults leaves the doctor’s office without mentioning the symptom that brought him there.
  • A new partner is late twice, and a betrayal by someone else entirely, years ago, takes over the evening.

What marks each of them is a reaction a size too large for the present and oddly familiar from somewhere else. The feeling is real enough. It has been sent to the wrong address.

Couples do this to each other all the time. Each partner arrives with expectations laid down long before they met, about what happens when you need someone and what it costs to be angry, and each experiences the result as the other person’s doing. In couples therapy the pattern tends to show itself in the session, where both people can watch it happen.

What transference looks like in a session

In therapy the same process meets a listener trained to notice it. Freud described it in 1914: the patient "reproduces it not in his memory but in his behaviour; he repeats it, without of course knowing that he is repeating it." His example was a patient who never mentions how defiant he had been toward his parents and simply "behaves in that way towards the physician." (Freud, "Recollection, Repetition and Working Through," 1914)

The same tendency, followed across a whole life, is what psychoanalysis calls repetition compulsion. In the Dora case Freud called the handling of transference "by far the hardest part of the whole task," partly because it "has to be detected almost without assistance and with only the slightest clues to go upon." (Freud, 1905)

Those clues look ordinary. A patient apologizes for taking up time in an hour that is entirely hers. Every week someone arrives with good news, as though the therapist needed cheering up, and leaves out whatever went badly. A neutral question is heard as an accusation, and the rest of the hour goes into answering it.

Announced months ahead, a holiday break can produce a surprising amount of feeling, or a surprising absence of it. A remark the therapist made in passing turns out to have been carried around for three weeks. The patient knows perfectly well who the therapist is. An old expectation has simply found a new place to stand.

What triggers transference?

Transference is triggered by anything in the present that resembles an earlier relationship closely enough to wake it: a tone of voice, a pause, a fee, the therapist’s age, a session that ends on time while the patient is in the middle of a sentence. The resemblance can be slight and the response out of all proportion to it.

Freud’s 1912 account explains why. Every person, he argued, develops early a particular way of loving, shaped by temperament and by childhood, and this "forms a cliché or stereotype in him, so to speak (or even several), which perpetually repeats and reproduces itself as life goes on." (Freud, "The Dynamics of the Transference," 1912)

The trigger is often perfectly real. In 1905 Freud noted that a transference may attach itself to "some real peculiarity in the physician’s person or circumstances." (Freud, 1905) Perhaps the therapist did glance at the clock. What gets transferred is the meaning of the glance, which is how a particular parent’s glances used to read.

Types of transference, positive and negative

The three types of transference usually described are positive, negative and sexualized, meaning romantic or sexual feelings for the therapist. (Psychology Today) All three go back to Freud.

Freud drew the main distinction in 1912: "One is forced to distinguish ‘positive’ transference from ‘negative’ transference, the transference of affectionate feeling from that of hostile feeling." (Freud, "The Dynamics of the Transference," 1912)

Positive transference covers trust, warmth and admiration, sometimes the conviction that this therapist understands as nobody else has. A moderate amount is what brings a person back on the weeks when coming back is hard. In larger amounts it becomes idealization. An idealized therapist is difficult to disagree with, and that can make the most important things the hardest to say.

Negative transference covers suspicion and resentment, or the steady expectation of being judged and let down. It is unpleasant for both people. It can also be the more informative of the two, since the expectation of being failed is now in the room, where it can be looked at.

Transference is often mixed, and Freud found negative transference "alongside the affectionate transference, often both directed on to the same person at the same time, a condition for which Bleuler has coined the useful term ambivalence." (Freud, 1912) A patient can be grateful to the therapist and furious with them within one hour, which is, not by coincidence, how a great many people feel about their parents.

Transference can also be sorted by the figure it revives: maternal, paternal, sibling. Freud noticed this in 1912: the physician is often placed in line with the "father-imago," but the transference "is not bound to this prototype; it can also proceed from the mother- or brother-imago and so on." (Freud, 1912) These labels say whose place the therapist has been given. The process underneath is the same whichever figure it revives.

Transference vs countertransference in therapy

Countertransference is the therapist’s emotional reaction to the patient, including the reaction to the patient’s transference. The APA Dictionary defines it as "the therapist’s unconscious (and often conscious) reactions to the patient and to the patient’s transference." (APA Dictionary of Psychology) Transference runs from patient to therapist, and countertransference runs back.

Countertransference therapy is not a separate kind of treatment. The phrase usually means countertransference in therapy: the feelings a patient stirs in the therapist, and what the therapist does with them. The APA’s magazine for psychologists calls countertransference "a phenomenon that can arise in virtually any form of psychotherapy." (APA Monitor on Psychology, 2025) In psychoanalytic work it is noticed, examined and put to use.

Freud named it in 1910 and treated it as a hazard. Analysts, he wrote, had "nearly come to the point of requiring the physician to recognize and overcome this counter-transference in himself," because "every analyst’s achievement is limited by what his own complexes and resistances permit." His remedy was that the analyst "should begin his practice with a self-analysis and should extend and deepen this constantly." (Freud, "The Future Prospects of Psycho-Analytic Therapy," 1910)

Later analysts found a use for it. The APA entry records the change: in classical psychoanalysis countertransference "was viewed as a hindrance," while "to modern analysts and therapists, it may serve as a source of insight into the patient’s effect on other people."

Two invented examples show how that insight is used. One therapist feels an unusual urge to rescue a particular patient, to run over time and offer advice nobody asked for. Another grows drowsy ten minutes into every session with one man, and wonders whether the people in his life drift away for the same reason.

Neither therapist acts on the reaction. Each examines it, first for what belongs to their own history and then for what it shows about the patient’s effect on others. Left unexamined, countertransference can lead a therapist to act out old patterns of their own, "such as meeting anger with defensiveness or detachment." (APA Monitor on Psychology, 2025)

The research points the same way. In meta-analyses by Hayes and colleagues, countertransference reactions were modestly related to poorer therapy outcomes, and managing them successfully was related to better ones, though the studies varied considerably. (Hayes and colleagues, Psychotherapy, 2018)

Why psychoanalysis works through transference

A conflict cannot be settled at a distance. Freud’s version, from 1912, is more vivid: "in the last resort no one can be slain in absentia or in effigie." (Freud, 1912) A pattern described as history stays history. When it turns up in the room, aimed at the therapist, it can be examined while the feeling is still present.

Seven years earlier, in the Dora case, he had concluded that transference, "which seems ordained to be the greatest obstacle to psycho-analysis, becomes its most powerful ally, if its presence can be detected each time and explained to the patient." (Freud, 1905)

Explaining it to the patient is called interpretation. In practice it is a quiet thing. At a moment the patient can use it, the therapist points out that the certainty in the room has a history, and that it has turned up before with a father, a teacher and two husbands.

The approach has also been tested. Researchers at the University of Oslo randomly assigned outpatients to a year of weekly dynamic psychotherapy with or without transference interpretations, and both groups improved. Patients with "a lifelong pattern of poor object relations" did better with the interpretations, and the advantage held through the four-year study period. (Høglend and colleagues, American Journal of Psychiatry, 2008)

Frequency matters as well. Meeting several times a week can make it easier to notice how feelings enter the treatment relationship, which is one of the differences between psychoanalysis and psychoanalytic psychotherapy. Both work with transference, and analysis, meeting more often, gives it more room.

Transference in online psychoanalysis

Psychoanalysis and psychoanalytic psychotherapy are both available online, and at this practice every session is held by secure video. Transference comes too. Freud called it "an inevitable necessity" with "no means of avoiding it," and a screen offers no exemption. (Freud, 1905)

What changes are the occasions. A frozen frame can look exactly like a cold stare. A connection that drops at a painful moment can feel like being hung up on. The bookshelf behind the therapist becomes evidence about who the therapist is. Each of these is a real event, and each can be met with an old expectation, which then becomes something to talk about.

On video therapy in general, the evidence is specific. A 2021 meta-analysis concluded that "therapy is no less efficacious when delivered via videoconferencing than in-person, with efficacy being most pronounced in CBT for affective disorders." (Fernandez and colleagues, Clinical Psychology & Psychotherapy, 2021) Its strongest results came from CBT, so it says more about video therapy in general than about psychoanalysis in particular.

For transference, the frame counts for a great deal: the same time, the same person, reliably. Regularity is what allows a theme to be picked up where it was left.

Questions people ask

Is transference the same as projection?

Projection, in the APA’s definition, attributes "one’s own individual positive or negative characteristics, affects, and impulses to another person." (APA Dictionary of Psychology) Transference moves feelings that belonged to a relationship with someone else onto a person in the present. The two often arrive together, which is why they are easily confused.

What is a transference neurosis?

It is Freud’s name for what happens when a patient’s symptoms take on "a new transference-colouring" and the old conflict comes to be lived out with the analyst. In 1914 he called the transference "a kind of intermediary realm between illness and real life." (Freud, 1914)

Is transference a defense mechanism?

Transference is usually described as a form of repetition, and it can also serve as resistance. Freud wrote in 1914 that "the greater the resistance the more extensively will expressing in action (repetition) be substituted for recollecting." (Freud, 1914)

How long does transference last?

Transference has no fixed schedule, and in treatment it tends to lose force as it is understood. Understanding something once is not the same as being free of it, though. That is why analysis includes a phase of working through, and why its ending is decided together.

Begin with a conversation

Understanding a pattern while it is happening can be different from explaining it later, when it has become a familiar story. This practice offers psychoanalysis and psychoanalytic psychotherapy, with online sessions only, for residents of Washington, DC, Florida and Michigan, and (through PsyPact) participating PSYPACT jurisdictions including Maryland and Virginia. The first 15-minute consultation is free, and carries no obligation. To arrange one, contact the practice.

About Dr. John J. Hartman

John J. Hartman, Ph.D. is a board-certified psychoanalyst (FABP) with over 50 years of clinical experience. He holds a B.A. from Harvard College and a Ph.D. in clinical psychology from the University of Michigan, with psychoanalytic training at the Michigan Psychoanalytic Institute. A former tenured Associate Professor of Psychiatry at the University of Michigan, he is a training and supervising analyst and has published six books and numerous peer-reviewed papers. He practices online and is licensed in DC, Florida and Michigan, with PsyPACT authorization across more than 40 states.

References and further reading