Transference interpretations and long-term change after dynamic psychotherapy of brief to moderate length

In our study of 43 neurotic outpatients treated with brief dynamic psychotherapy, a significant inverse relationship was found between frequency of transference interpretations and long-term outcome for the subsample of 21 patients with a history of high quality of interpersonal relationships. At four-year follow-up, only one of four such patients achieved successful dynamic change when the interpretive focus had been on the transference relationship, whereas three of four patients achieved successful dynamic change when the interpretive focus had been on extratransference relationships. Contrary to what we expected, the subsample of 22 patients with a history of low quality of interpersonal relationships were more able to tolerate high numbers of transference interpretations from early on in treatment. Interpretive work on the transference is ancillary to work outside the transference. This, indeed, was Freud's theoretical position.