7 ..9
During this process, many primitive and powerful emotions are experienced by the patient towards the analyst: feelings of love, hate, rage, loathing, revenge, sorrow, guilt, regret and many others. The consequences of these feelings are usually experienced by both patient and analyst. Powerful sexual feelings also arise. Everyone is familiar with the stereotype of the patient who falls in love with their analyst. This may indeed happen and, when it does, it can sometimes be a very painful experience for the patient and, occasionally, for the analyst also. It is certainly not a situation that can simply be ignored, glossed over or, even worse, dismissed as an episode of incomprehensible madness. It is a situation that must unfailingly be handled with considerable tact, empathy and understanding.
Under these circumstances, at different times and to varying degrees, patients experience their analyst in much the same way as, during their childhood, they experienced their principal caregivers. At times they may experience the positive aspects of those early relationships but, at other times, they will inevitably experience their analyst as reflecting the, entirely subjectively perceived, negative and unpleasant aspects of those early relationships; no matter how the analyst might behave towards the patient in reality or, for that matter, regardless of how the relevant figure from the past might, in reality, have hehaved towards the child in their care. There is very little concerning the transference that is necessarily about any actual, objectively observed history of early relationships: almost all of it is about early subjectively perceived experiences of such relationships and a considerable discrepancy between these two points of reference is often a distinct possibity, though not necessarily one with which analyst and patient need specifically to concern themselves.
It is precisely within the context I have outlined above that the dangers will lie, in relation to possible complaints against practitioners under the fitness to practise rubric. It is, of course, vital that no analyst should gratify their patient, in terms of any reality, in relation to such trasference feelings. To do so would almost always be harmful to the patient. Thus, in many analyses, the patient will be confronted by powerful, apparently inexplicable feelings about their analyst who will also, very possibly, be experienced at times as unrewarding and often as cold, uncaring and remote, no matter how empathetic the analyst might be in reality. Under these circumstances, the possibility of almost limitless opportunities to make official complaints about the analyst are likely, sooner or later, to be seen as pursuits that are difficult to resist. Under the current conditions that prevail within the profession, the difficult situations that arise in relation to the transference can usually be contained and worked through between analyst and patient together, within the privacy of the analysis itself. However, under the proposed HPC regime, the opportunity to act out the dynamics of the transference, beyond the analysis and within the alternative forum provided by the complaints procedures, would be very likely to prove too much of a temptation for many patients. As soon as a complaint is made, the analysis would have to come, almost always irreversably, to an abrupt and often damaging end and the issues would then be acted out in that other forum, where there would be no prospect of working through them with any degree of understanding and containment.