How To Relationship #Transference

How To Relationship

The 3 Levels

September 13, 2015

I am a Psychiatrist, which means I form relationships for a living.

Much like the Surgeon who uses a scalpel, or a Cardiologist using a stethoscope, the Psychiatrist uses their relationship to diagnose and treat.  The mind has it own layers and rhythms that can be exposed and dissected as trust develops. This unique interaction that mirrors important relationships in life can be experienced by the therapist and then communicated to the patient.  It is in this way the person in therapy learns how they affect other people.

scalpel 2steth 1

It is my hope to break down the parts of how we interact with others, in this series, so you look at your own relationships in a different way.

Let’s start with the obvious that our relationships are super important to us.  They are the reason we do stuff in the first place. And we do stuff for many reasons, mostly because of the different types of relationships that humans enjoy. That sounds circular because most of life generally is. We start from nothing and end as nothing. Our earth, solar system, atoms, and even the oxygen in our veins (resting on a circular red blood cell) are circles of one form or another. And even our relationships can be seen as a cycle of predictable interactions, based on a few factors best described using a triple-decker outhouse.

In general, there are 3 basic Relationship Styles that can be place hierarchically, like floors on an outhouse.

outhouse 2

If you don’t find that image tasteful, then let’s think of it like 3 people in a Life Boat, with a paddle.


There is the person in charge, steering and navigating, the person doing all the rowing, and the person along for the ride.  Each of these 3 particular ‘jobs’ on the Relationship Boat, require the other members to agree, to an unspoken set of rules.  Most of us agree, because our unconscious mind tells us that these 3 human occupations are the only kinds there are.  When the people in the boat do what is expected, life glides merrily down the stream.

In Psychiatry, we call these unspoken and unconscious rules ‘transference.

Transference refers to the automatic way in which we interact with others, based upon what we have learned from important relationships earlier in our life.  In essence, we learn how to have ‘authority relationships’ from our Parents, and develop an internal set of unspoken rules that we guard unconsciously.  Throughout life, we then transfer these specific social skills and guidelines, to other important relationships.

Transference can be Positive, Negative, or Mixed.

The most common example of transference is one we learn from our parents. When we grow up, most of us essentially accept that our parents are in charge. That is not to say, we do not test the limits of their power over us, at times.

teen rebel 2

But for the most part, we kiss and make up, and get back to the same basic arrangements, perhaps with a renegotiated curfew.

More often, we refer to this type as ‘paternal transference’, which represents the automatic template our brains uses in authority situations, when we are not the authorities.  Generally these are feelings of dependence representing our desire for support and resources from our parents or those in charge.

The way you were submissive, or continually challenged your parents, can replay itself later in life around other authority figures.

A clear example would be how most of us relate to doctors, celebrities, teachers, police officers, and other people in our lives who influence us or enforce the rules.

police 3

As the size and shape of families change over time, attitudes towards parents have shifted too.  Some for better, some for worse. These societal variables may lead to teenagers and young adults questioning authority in different ways.

For those individuals who experienced hardships growing up: abused, apprehended, or living in difficult foster homes, a very different view of authority figures emerges, compared to growing up in a gated suburb.

Although at the extremes, there can be similarities.

Each one of us forms our own type of paternal transference, or way of dealing with those who hold more societal ‘power’, over us.

It gets even trickier if we add in another way of dividing up transferences to authority, which I will introduce with the following RIDDLE (answer at bottom of post).


A Father and Son were driving when they were involved in a horrible accident that killed the Father and badly hurt the Son.
The Son was rushed to the hospital, buT the Surgeon refused to save his life, EXPLAINING:
“I can’t operate on my own Son!”
How is this possible?


Not all relationships with authority are paternalistic.

‘Paternal’ types, mentioned above, are related to early patterns of interaction, with ‘Dad’.

We form a different type of relationship with Mom, compared to Dad.


The type of bonding that occurs between children and mothers, is called maternal transference. The different ‘feels’ that Authority has, when we imagine or encounter it, correspond to how you view Maternal vs. Paternal Transference.  This is an unspoken and unconscious process that we are only often aware of, after a significant interaction has occurred, such as being pulled over by the cops.

cops 2


If we move away from Authority relationships for a moment, we can shift laterally, to those types of relationships where you feel like an EQUAL.  These are often called ‘sibling transferences’, a reference to how you felt towards siblings, or peers, while growing up.

Many times our ability to play well with others in social sandboxes, such as at school or work, relates to how we played with our brothers and sisters.

sib rivalry 1

Some families have very competitive siblings, hence the term ‘sibling rivalry’.  This attitude towards peers, can transfer itself into future relationships in University classes, athletic endeavors, or coworkers.  One example of this type of Sibling Rivalry can occur between Neighbors, who may argue over property lines, eerily like sibs in the back seat of the car, complaining the other is ‘on my side!’.

And these types of neighbor battles can drag on for years, as my wife would attest to as the former By-Law Prosecutor in our city.

familt feud 1

And lastly, there are the relationships where we are in charge, and the other person is dependent upon us in some way.  We get our earliest practice at these relationships, if we have younger siblings, especially separated by a few years.

Often Parents will start to create a slight power differential between their kids, based upon ages, and developmental abilities.  There are times, when we get our first tastes of Authority, when we are put in charge of our little Brother or Sister, for short periods of time.

phinneas 1

We often mirror our Parent’s approach, as it is the only way we have really seen it done.

We get more practice in school situations through patrols, tutoring, mentorship, committees, and student politics.   Our first chores and jobs create more experiences with responsibility, and others being dependent upon us builds upon the self confidence, of our earlier accomplishments.

Years later, when we are parents ourselves, it is how our Parents parented us, as well as the accumulation of responsibility, independence, and nurturing relationships, that determines how well we adjust to our offspring being dependent upon us for life.


These concepts make it much easier to begin to predict which types of relationships we seek, due to this unconscious familiarity, even though we may end up getting hurt in the end.

abuse 1

Transference explains how Abuse can repeat itself, in some families, over multiple generations.

The Abused Child learns, whether they want to or not, that important Authority relationships that may include Love, also include Pain, in some form.

When they are next in line to be the Authority, there is a risk of replaying this style of ‘parenting’, termed ‘repetition compulsion’.

Looking at it from the point of view of victim, many people seek the ‘Bad Boy/Girl’ at certain times in their life. This may represent an attempt to control something that seems uncontrollable, perhaps just like earlier relationship experiences.

This can cause a pattern of seeking out types of people that could potentially hurt them in some way, just like Cowboys choose Bucking Bulls, over Calm Cows.

bull 3

In the formative years, of Life’s Rodeo, Parental Love included being saddled by some form of punishment or pain.


Who we are in life, is who we are in our relationships.

It is the way we define ourselves, and each level occupies a particular strata, in the human hive.

I am defined as a Father, Widower, Son, Brother, Soon To Be Uncle (no pressure Matt), Cousin, as well as a host of twice removed titles.

I am also an Employee, Teacher, Student, Doctor, Patient, and you get the idea.

Each one of these types of relationships falls into one of 3 levels.

When I was younger, I was the passenger in my Parent’s Boat: at times was along for the ride, and at others, I could help with the paddling.

As my parents get older, their position in my power hierarchy will shift, as they become the Dependents.

pyramid 2

As people enter and leave my boat, each taking up their unique positions, in the Motley Crew of my life, I feel the shifts of responsibility, competition, and dependence.

And as difficult as relationships are, at times, floating down the river of time, without them I would not ever know myself.


For that reason, whether the water is calm or rough, I wouldn’t have it any other way.

Tune in for Part 2: Me, We, Them.

Simon Trepel, MD

Simon Trepel, MD FRCPC, is a practicing Child and Adolescent Psychiatrist, in Winnipeg, Canada.  He is an Assistant Professor, at the University Of Manitoba, in the Faculty of Medicine, and the Co-founder of the GDAAY Clinic.  He is, more importantly, the proud Father of 2 beautiful Daughters.  He writes in his spare time about things he knows something about, and occasionally about things he doesn’t; like Yoga, and Italian flavored coffees.  The Surgeon was the Son’s Mother. Or the Surgeon was the Son’s other Father. Take your pick.

Check out his Blog, called Simon Says Psych Stuff, at



One thought on “How To Relationship #Transference

  1. Peter Russell says:

    As the soon to be dependent, I liked this article very much. I suspect all of us know this stuff in one form or other but lose the fine points in the daily shuffle. Probably something we could go back to every month. I look forward to the next one.
    And, everybody, no fighting over the only paddle!

    Liked by 1 person

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s