Regressive transferences--a manifestation of primitive personality organization

Regressive transferences are but one manifestation of dynamic infantile and frequently unconscious fantasies seen in patients with a primitive personality organization. Such transference relationships may vary from an apparent profound unrelatedness to intense symbiotic dependencies. These transferences are primarily preoedipal and may include grandiose, persecuting, somatizing and dehumanized object experiences as well as narcissistic idealizing and denigrating selfobject formations. Three types of regressive transferences in patients with primitive personalities are described: primitive libidinal, transference automatism, and somatization. All three demonstrate symbolically meaningful but primarily unconscious primitive transference reenactments. Regressive transferences not only represent impulses seeking gratification but are also restitutive attempts for earlier losses and lack of self-cohesion. Patients with a primitive personality organization often have suffered early deprivations that bring about the formation of unstable internal representations. This makes acceptance of ambivalence and mourning difficult due to fear of ego dissolution caused by the aggression toward the self and others. Identification and exploration of shared intersubjective phenomena may facilitate conscious reconstruction and eventual interpretation of these regressive transferences.