At the beginning Freud disliked transferential reactions, considering them interferences, without a specific meaning ( like " suggestion" ). In order to distinguish the real therapeutic problems from " transfert " resistance and " suggestion" improvement, he recommended the analist "opaqueness" to his disciples. Then he discovered the specificity of the"transfert" still recommending the analist "opaqueness". Today we want to distinguish the "placebo" effect from the pharmacodynamic effect in a therapeutic drug. But it's the first homogenous and non specific in the general population ?
Surely there are some people more prone to placebo - nocebo effect than other.
Placebo effect is different from transference. With the former one does not know that they are taking a sugar pill but strongly believe in their mind that the doctor has given an actual pill and thus starts feeling the effect as though the real pill is working. With transference it is the emptying or off loading of emotions from the patient on to the psychoanalyst that provides much relief to the patient, some people call this humorously as transference cure. The patient feels much better after the transference and thus is ready to listen to the therapist and make positive changes in their lives.
I dont want at all medicalise psychotherapy. My question is a real question, aiming to ask and discuss the hypotesis about an individually specific psychological factor in placebo effect, with some similarity to history of the discover of the transfert. For example, the "negative reaction" of Dora to the treatment of S Freud was probably a specific, transferential reaction. Indeed there are a lot of differences between the two phoenomena and I admit that the question is at the moment quite blurred, but I think the psychonalitical tradition is not to skip blurred questions.
I think that you are onto something there in that, if you apply Betty Joseph's Total Situation transference idea to others, you will find patterns of relating in placebo experiments that will have unconscious phantasy behind them.
Both in the case of suggestion, involved in the placebo effect, as well as in the transference, it focused on the aspect of the therapeutic relationship. In Freud, this topic is very important in the course of an analysis, to the point where a good part of his work is to unveil it. In some way Freud achieves a journey in which hypnotic suggestion is abandoned as a therapeutic instrument to give rise to free association and the interpretation of transference.
If there is one aspect in which the suggestion of the placebo effect and the transference can be linked conceptually, that is the one that describes the influence that the psychological relationship between patient and therapist exerts on the process with which it intends to treat a disorder. In that concern it is worth remembering that Freud came to propose "Very often the transference is enough to suppress the most common symptoms, but temporarily and while it lasts, In such a case, the treatment cannot be a psychoanalysis and it is only of suggestion: The name of psychoanalysis applies exclusively to the procedures in which the intensity of the transfer is used against the resistances ". From the foregoing, it can be deduced that Freud recognized the "temporary curative effect" of suggestion, which suggests that, to a certain extent, it resembles transference, even though it is outside the boundaries of psychoanalysis.
It is also necessary to focus on the multiple existing differences. Keep in mind that, within the conflict between Jung, Adler and Freud, the concept of suggestion serves the first two people to oppose the notion of transference. On the conceptual level, suggestion designates a psychological means used to convince the individual of the falsity of his beliefs. It is a vector that goes from the therapist to the patient. Something very different happens in the case of the transference. If you want to represent also through a vector, it would go in the opposite direction, from the analysand to the analyst. Furthermore, the transferred is not a conscious intention (that uses the placebo) but the unconscious desires concerning the external objects.
@Milton Cardona Parra thanks for your extensive and complex answer. Could you give me the reference of your citation of Freud? It s very interesting nowadays: it s true psychoanalysis only if we use the transference against resistances .
About your observation, indeed in the transference there is a vector from the patient to the analyst. In placebo the patient receive the drug. But the patient give his expectation to be treated well. Maybe it s useful to remark that actually we dont want a placebo reaction in a pharmaceutical test. Actually in the double blind test nor the patient nor the doctor knows if they are in the group of the active drug or in the group of placebo drug.
You´re welcome. The text of the quote was extracted from the Dictionary of Psychoanalysis by Elisabeth Roudinesco and Michel Plon - in Spanish, within the section dedicated to defining the concept of suggestion.
Roudinesco, E., & Plon, M. (2008). Diccionario de psicoanálisis. Buenos Aires: Paidós.
However, the content of it could be traced back to the original source. I do not know if it is correct in this space to quote some internet pages, but I leave here an electronic address where it also appears:
http://www.elortiba.org/old/dicpsi/s.html
In Spanish, the quote says: "Muy a menudo -dice Freud- basta la transferencia para suprimir los síntomas mórbidos, pero sólo temporariamente y mientras dura. En tal caso, el tratamiento no puede considerarse un psicoanálisis, y sólo se trata de sugestión. La denominación de psicoanálisis se aplica exclusivamente a los procedimientos en los que la intensidad de la transferencia es utilizada contra las resistencias"
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