PAGE 16

 This approach, is based on certain definite premises regarding the nature and dynamic function of the ego in respect to the control and neutralization of instinctual energy and unconscious fantasy. While the importance of early object relations is not neglected, the conviction that early transference interpretation is ineffective and potentially dangerous is related to the hypothesis that the instinctual energy available to the mature ego has been neutralized and is, for all effective purposes, relatively or absolutely divorced from its unconscious fantasy meaning at the beginning of analysis. In contrast, there are many analysts of differing theoretical orientation who do not view the development of the mature ego as a relative separation of ego functions from unconscious sources, but consider that unconscious fantasy continues to operate in all conscious mental activity. This analyst also tends to emphasize the crucial significance of primitive fantasy in respect to the development of the transference situation. The individual entering analysis will inevitably have unconscious fantasies concerning the analyst derived from primitive sources. This material, although deep in one sense, is, nonetheless, strongly current and accessible to interpretation. Mrs. Klein, in addition, relates the development and definitive structure of both ego and superego to unconscious fantasy determined by the easiest phases of object relationships. She emphasis the role of early introjective and projective processes in relation to primitive anxiety ascribed to the death instinct and related aggressive fantasies. The unresolved difficulties and conflict of the earliest period continue to colour object relations throughout life. Failure to achieve an essentially satisfactory object relationship in this early period, and failure to master relative loss of that object without retaining its good internal representative, will not only affect all object relations and definitive ego function, but more specifically determine the nature of anxiety-provoking fantasies on entering the analytic situation. According to this point of view, therefore, early transference interpretation, though it may relate to fantasies derived from an early period of life, should result not in an increased, but a decrease of anxiety.
 In considering next problems of transference in relation to analysis of the transference neurosis, two main points must be kept in mind. First: Those who emphasize the analysis of defence tend to make a definite differentiation between transference as therapeutic alliance and the transference neurosis as a compromise formation that serves the purposes of resistance. In contrast, those who emphasize the importance of early object relations view the transference primarily as a revival or repetition, sometimes attributed to symbolic processes of early struggles in respect to objects. Yet, no sharp differentiations are made between the early manifestations of transference and the transference neurosis. In view, moreover, of the weight given to the role of unconscious fantasy and internal objects in every phase of mental life, healthy and pathological functions, though differing in essential respects, do not differ as for their direct dependence on unconscious sources.
 In the second place, the role of regression in the transference situation is subject to wide differences of opinion. It was, of course, one of Freud’s earliest discoveries that regression to earlier points of fixation is a cardinal feature, not only in the development of neurosis and psychosis, but also in the revival of earlier conflicts in the transference situation. With the development of the psychoanalysis and its application of experience, an ever increasing range of disturbed personalities, the role of regression in the analytic situation had received increased attention. The significance of the analytic situation for fostering regression as a prerequisite for the therapeutic work has been emphasized by Ida Macalpine in a recent paper of differing opinions as to the significance, value, and technical handling of regressive manifestations from the basis of important modifications of analytic technique, in respect, however, to the transference neurosis, the view recently expressed by Phyllis Greenacre, in that regression, an indispensable feature of the transference situation, is to be resolved by traditional technique would be generally accepted. It is also a matter of general agreement that a prerequisite for successful analysis is revival and repetition in the analytic situation of the struggles of primitive stages in the developmental distributives of contributory dynamic functionalities. Those who bring out defence analysis, however, tend to view regression as a manifestation of resistance: As a primitive mechanism of defence employed by the ego in the setting of the transference neurosis. Analysis of these regressive manifestations with their dangers depends on the existing and continued functioning of adequate ego strength to maintain therapeutic alliance at an adult level, those, by contrast, who stress the significance of transference as a revival of the early mother-child relationship does not place emphasis on regression as an indication of resistance or defence. The revival of these primitive experiences in the transference situation is, in fact, regarded as an essential prerequisite for satisfactory psychological maturation and true genitality. The Kleinian schools, as already showed, stress the continued activity of primitive conflicts in determining essential features of the transference at every stage of analysis. Their increasingly overt revival in the analytic situation, therefore, signifies a deepening of the analysis, and in general, is regarded as an indication of diminution than an increase of resistance. The dangers involved according to this point of view are determined more by failure to mitigate primitive anxiety by suitable transference interpretation, than by failure to achieve, in the early phases of analysis, a sound therapeutic alliance based on the maturity of the patient’s essential ego characteristics.
 Briefly considering the terminal phases of analysis. Many unresolved problems concerning the goal of therapy and definition of a completed psychoanalysis must be kept in mind. Distinction must also be made between the technical problems of the terminal phase and evaluation of transference resolution after the analysis has been ended. There is widespread agreement as to the frequent revival in the terminal phases of primitive transference manifestations apparently resolved during the earthly phase of analysis? Balint, and those accept Ferenczi’s concept of primary passive love, suggest that some gratifications of primitive passivity need be the essentially successive in succeeding by its end. To Mrs. Klein the terminal phases of analysis also represent a repetition of important features of the early mother-child relationship. According to her point of view, this point represents, in essence, a revival of the early weaning situation. Completion depends on a mastery of early depressive struggles culminating in successful introjection of the analyst as a good object. Although, as for this, emphasis differs considerably, it should be noted that those in whom stress the importance of identification with the analyst as a basis for therapeutic alliance, also accept the inevitability of some permanent modifications of a similar nature. Those, however, who make a definite differentiation between transference and the transference neurosis stress the importance of analysis and resolution of the transference neurosis as a main prerequisite for a successful end. The identification based on therapeutic alliance must be interpreted and understood, particularly about the reality aspects of the analyst’s personality. In spite, therefore, of significant important differences, there are, as already showed about the earlier papers of Sterba and Styrachey, important points of agreement in respect to the goal of the psychoanalysis.
 Differences already considered, as far as discussions have permitted of a limited variation within the framework of a traditional technique, nonetheless, we are drawn  to consider problems related to overt modifications in due consideration as a preliminary to classical psychoanalyses, and modification based on changes in basic approach, lead to significant alterations regarding both the method and to the aim of therapy.
 It is generally agreed, that some variations of technique are shown in the treatment of certain character neurosis, borderline patients, and the psychoses. The nature and meaning of such changes are, however, viewed differently according to the relative emphasis placed on the ego and its defences, on underling unconscious conflicts, and on the significance and handling of regression in the therapeutic situation. In Analysis Terminable and Interminable, Freud suggested, that certain ego attributes may be inborn or constitutional and, therefore, probably inaccessible to psychoanalytic procedure. Hartmann has suggested that beyond these primary attributes, other ego characteristics, originally developed for defensive purposes, and the related neutralized instinctual energy at the disposal of the ego, may be relatively or absolutely divorced from unconscious fantasy. This not only explains the relative inefficacy of early transference interpretation, but also hints on the possible limitations in the potentialities of analysis attributable to secondary autonomy of the ego considered being irreversible. In certain cases, moreover, it is suggested that analysis of precarious or seriously pathological defences - particularly those concerned with the control of aggressive impulses - may not only be ineffective, but dangerous. The relative failures of ego development in such cases not only preclude the serious regressive, often predominantly hostile transference situations. In certain cases, therefore, a preliminary period of psychotherapy is recommended to explore the capacities of the patient to tolerate a traditional psychoanalysis. In others, as Robert Knight, in his paper on borderline states, and as many analysts working with psychotic patient has suggested. Psychoanalytic procedure is not considered applicable. Instead, a therapeutic approach based on analytic understanding that, in essence, uses an essentially implicit positive transference for reinforcing, than analysing the precarious defences of the individual, is advocated.
 In contrast, Herbert Rosenfeld has approached even severely disturbed psychotic patients with small modifications of psychoanalytic technique. Only changes that the severity in therapy is not emphasized since primitive fantasy is considered active under all circumstances. The most primitive period is viewed as early object relations with special stress on prosecutory anxiety related to the death instinct. Interpretations of this primitive fantasy in the transference situation, is considered to diminish rather than to increase psychotic anxiety and offer the best opportunity of strengthening the severely threatened psychotic ego. Other analysts, Dr. Winnicott, for example, an attribute psychosis mainly to severe traumatic experiences, particularly of deprivation in early infancy. According to this view, profound regression offers an opportunity to fulfil, in the transference situation, primitive needs that had not been met at the appropriate level of development. Similar suggestions have been proposed by Margolin and others, in the concept of anaclitic treatment of serious psychosomatic disease. This approach is also based on the premise that the inevitable regression shown by certain patients should be used in therapy, for gratifying, in an extremely permissive transference situation, demands that had not been met in infancy. It must, for this, be of note, that the gratifications recommended in the treatment of severely disturbed patients are determined by the conviction that these patients are incapable of developing transference as we understand it in connection with neurosis and must therefore be handled by a modified technique?
 The opinions so far considered, is, nonetheless a great deal more than they may differ in certain respects, are nonetheless all based on the fundamental premise that an essential difference between analysis and other methods of therapy depends on whether interpretation of transference is an integral feature of technical procedure. Results based on the effects of suggestion are to be avoided, as far as possible, whenever traditional technique is employed. This goal has, nonetheless, proved more difficult to achieve. Freud expected when he first discerned the significance of symptomatic recovery based on positive transference. The importance of suggestion, even in the most strict analytic methods, has been repeatedly stressed by Edward Glover and others. Widespread and increasing emphasis as to the part played by the analyst’s personality in determining the nature of the individual transference also implies recognition of unavoidable suggestive tendencies in the therapeutic process. Many analysts today believe that the classical conception of analytic objectivity and anonymity cannot be maintained. Instead, thorough analysis of reality aspects of the therapists personality and point of view are able prerequisite for the dynamic changes already discussed in relation to the end of analysis. It thus remains the ultimate of the psychoanalysis, whatever their theoretical orientation, to avoid, as far as is humanly possible, results based on the unrecognized or unanalysed action of suggestion, and to maintain, as a primary goal, the resolution of such results through consistent and careful interpretation.
 There are, however, many therapists, both within and outside the field of the psychoanalysis, who consider that the transference situation should not be handled only or mainly as a setting for interpretation even in the treatment or analysis of neurotic patients. Instead, they advocate use of the transference relationship for the manipulation of corrective emotional experience. The theoretical orientation of those using this concept of transference may be closer to, or more distant form, a Freudian point of view according to the degree to which current relationships are seen as determined by past events. At one extreme, current aspects and cultural factors are considered very important: At the other, mental development is viewed to inherent limitations of the analytic method rather than to essentially changed conceptions of the early phases of mental development. Of this group, Alexander is perhaps the best example. It is thirty years since, in his Salzburg paper, he suggested the tendency for patients to regress, even after apparently successful transference analysis of the oedipal situation to narcissistic dependent pregenital levels that prove stubborn nd refractory to transference interpretation, in his more recent work, the role of regression in the transference situation has been increasingly stressed. The emergence and persistence of dependent, pregenital demands’ in a very wide range of clinical conditions, it is arguably suggested that the encouragement of a regressive transference situation is undesirable and therapeutically ineffective. The analyst, therefore, should when threatens adopt a definite role explicitly differing from the behaviour of the parents in early childhood on order to cause therapeutic results through a corrective emotional experience in the transference situation. This, it is suggested, will prevent the tendency to regression, thus curtailing the length of treatment and improving therapeutic results. Limitation of regressive manifestations by active steps modifying traditional analytic procedure in a variety of ways is also frequently suggested, according to this point of view.
 To those who clearly maintain the conviction that interpretation of all transference manifestation remain an essential feature of the psychoanalysis, the type of modification presently described, though based on a Freudian reconstruction of the early phases of mental development, represents as major modification. It is determined by a conviction that psychoanalysis, as a therapeutic method, has limitations related to the tendency to regression, which cannot be resolved by traditional technique. Moreover, the fundamental premise on which the conception of corrective emotional experience is based minimizes the significance of insight and recall. It is, essentially, suggested that corrective emotional experience alone may cause qualitative dynamic alternations in mental structure, which can lead to a satisfactory therapeutic goal. This implies a definite modification of the analytic hypothesis those current problems are determined by the defences against instinctual impulses and internalized objects that had been set up during the decisive periods of early development. An analytic result therefore is depending on the revival, repetition and mastery of early conflicts if the current experience on the transference situation with insight an indispensable feature of an analytic goal.
 Since certain important modifications are applicable concepts latent upon the regression of the transference situation, it should be to believe that to consider this concept in relation to the repetition compulsion, that transference is essentially a revival of earlier emotional experiences, much of which can be related as a manifestation of the repetition compulsion that is generally accepted. Distinguishing it between repetition on compulsion as an attempt to master traumatic experience and repetition compulsion as an attempt to return to a real or fantasied earlier state of rest or gratification is, however, necessary. Lagache, in a recent paper, announced that the repetition compulsions to an inherent need to regress back to any problem that had previously been left unsolved, in that, from this point of view, the regressive aspects of the transference situation are to be regarded as a necessary preliminary to the mastery of unresolved conflict. From the second point of view, however, the regressive aspects of transference are mainly attributed to a wish to return to an earlier state of rest or narcissistic gratification, to the maintenance of the status quo instead of any progressive action, and finally, to Freud’s original conception of the death instinct. There is a good deal to suggest that both aspects of the repetition compulsion may be seen in the regressive aspects of every analysis. To those who feel that regressive self-destructive forces tend to be stronger than progressive libidinal impulses, the potentialities of the analytic approach will be limited. Those, by contrast, who regard the reappearance in the transference situation of earlier conflicts as an indication of tendencies to master and progress will continue to feel that the classical analytic method remains the optimal approach to psychological illness wherever it is applicable.
 In the attemptive efforts in trying to show an outline in some current problems of transference both in relation to the history of psychoanalytic thought and in relation to the theoretical premises on which they are based. In that, regarding contemporary views that advocate serious modifications of analytic technique, it cannot be to improve in the remarks made by Ernest Jones, in his Introduction to the Salzburg Symposium thirty years ago. Depreciation of the Freudian (infantile) factors at the expense of the pre-Freudian, 'pre-infantile' and 'post-infantile', is a highly characteristic manifestation of the general human resistance against the former, being usually a flight from the Oedipus conflict that is the centre of infantile factors. We also can note that in the practice to showing a psychoanalysis it really does not always insure immunity from this reaction. With regard, to the important problems that arise from genuine scientific differences within the framework of traditional technique, the focussing of issues for discussion by emphasizing as objectively as possible divergence rather than agreement. All of which, by which the primary importance of transference analysis may have accepted as significant modifications of traditional technique as either shortening analysis or accepting a modified analytic goal, as to the basic importance of understanding the significance and dangers of countertransference manifestations. Unfortunately, however, this vitally important unconscious reaction is not limited to the individual analytic situation. It may also be aroused in respect to scientific theories both within and outside our special fields of knowledge. Therefore, resolutions of the individual transference situation depend on the analyst’s understanding of his own countertransference, so too, similar insight and objectivity on a wider scale may determine of the problems outlined above.
 In a balanced way, we, once, again, point out Freud’s statement, as he writes regarding transference resistance: Thus, the solution of the puzzle is that transference to the doctor is suitable for resistance to the treatment only in as far as it is a negative transference or a positive transference of repressed erotic impulses. If we ‘remove’ the transference by making it conscious, we are detaching only those two components of the emotional set from the person of the doctor, the other component, which is admissible consciousness and unobjectionably, persists and is the vehicle of success in the psychoanalysis exactly as it is in other methods of Treatment (1912).
 The ‘negative transference’ and ‘positive transference of repressed impulses’ have generally been accepted as sources of resistance, although we have come to recognize that ‘removing’ they by making them conscious are much more difficult than it sounds. However, most of us have no doubts about the necessity of resolving them to a considerable extent, even if we are not so optimistic about being able to ‘remove’ them. How often we do all we can in this respect is open to question.
 Strictly speaking, our attentions will personify to what Freud called ‘the other component', which is admissible to consciousness and unobjectionable, persists and is the vehicle of success in analysis. . . . ‘On the face of it, assuming that there is some is reasonable enough factors that allow the patient to begin work and to continue to cooperate during analysis, and that this factor bears some relation to the positive transference, without, however, being clearly based on ‘repressed erotic impulses.’
 Inevitably, this brings us to question how we are first to cultivate this component, which is essential for the success of the analysis, what is to be done with it as the analysis ends, and how we may recognize and understand the origins, development, and meaning of this useful, even essential component. The answer to the latter question, is basically by no clear means. This positive component has hardly been neglected in the literature and in clinical work, but we may question whether it has been subjected to the same degree of analytic scrutinies as have other elements of the transference. It has been exploited most obviously by those who developed the concept of the 'alliance' between patient and analyst, for example, Greenson (1967) and Zetzel (1970). Greenson emphasized that the working alliance is indeed part of the transference, just when contrasting it with the full-blown transference neurosis, also he sees them as parallel antithetical forces in the analysis. Elsewhere, he refers to ‘transference reactions, a working alliance and [the] real relationship’.
 Greenson and Zetzel are not alone or even in a minority in considering some concept such as the working alliance integral to our understanding of the therapeutic process in analysis. There are many variants: Erikson’s (1959) ‘basic trust’, many references to ‘rapport’, and the like. One way or another they all are related to Freud’s ‘unobjectionable’ component, although we may conclude that their true sources are far more ancient.
 For appropriate reasons, the terms working alliance and therapeutic alliance have entered the common idiomatic expression of analysis and perhaps make more even the variants of analysis classed as psychotherapy. A positional claim to which it can seem as generally stated that an adequate alliance is a prerequisite for successful therapy, which on them face of it might seem unquestionable. Of course, the patient must be willing to manage to do his best to conform to the behavioural demands of the treatment, to come to the analyst’s office with some regularity, to talk as transparently honest as he can, to make a payment of his bills and generally to show that he and the analyst have some goals in common. If, on the other hand, he behaves in a way that made the analysis impossible, we could lay claim to an adequate alliance that was never established or, if it were, not maintained. Nevertheless, if all goes smoothly, we might congratulate ourselves onto the support of a good working alliance.
 A finer calibrated accompaniment with Brenner (1979) and Curtis (1979), and others a serious concern about the usefulness of the concept and the adherent direction and, even more, about its capacity to be misleading by encouraging the blurring of important transference elements and impeding our search for the nature of the ‘unobjectionable’ component, to which, Freud referred.
 In particular, when patients express, as they go on expressing their transference to feelings, predominantly positive, respectful, and sometimes affectionate, employ the very effective devices of selfly limited and only rarely deeply disturbing episodic events to experiences, often dispose of their necrotic symptoms within a few months of beginning analysis, and they go on annualizing just as eagerly as before. Resistance is expressed with silences, usually not at all, to a very prolonged, on one side of a complaint, not factually insufferable, or by acting out, not particularly disruptive. One condition, however, does not change. These attractive people may be married or single, living with a lover or alone. Nevertheless, they are not in love and doubt the capacity for passionate sexuality. There may be affectionate, but sexual intensities seem strangely distant and lacking in these otherwise sensitive and often loving individuals.
 In them, at any rate, the transference neurosis is very highly developed, taking on distinctly oedipal forms: It is powerfully defended by these patients, who show in their characteristics of brilliant, charming, and precocious children, who of a superficial level appear very mature. The main current of their sexuality becomes directed into the analysis, turning the process into a kind of exciting, yet innocent, liaison. When this transference neurosis is brought to these patients’ attention, that is, interpreted for what it is, the reaction is likely to be dramatic: Most often they become anxious and depressed, experience great difficulty in associating, stop remembering dreams, and may be inclined to engage in acting out. This may be the one area of interpretation that produces a distinct reaction of anger and some distress. The analysis is no longer such an unalloyed pleasure, and one almost regrets having introduced the subject. After all, the machine had been running so smoothly.
 The commonality is that of a highly intelligible combination of developed ego and super-ego organization, the use of sophisticated and effective defences and a history of having established a well-developed oedipal organization, and difficulty in achieving resolution of the conflicts arising out of the phase type of transference neurosis. Assiduously, to evoke complications and complexities in the reactions in the analyst, stimulating his own transference neurosis or, as it is more a comfortable situation dominated by mutual reciprocity, appreciative and intellectual competition. It is likely, therefore, that such patients will evoke of the analyst what corresponds to the ‘unobjectionable’ component of the transference. He finds himself regarding the patient as if he or she were a favourite child, going out of his way to be kindly and protectively considerate, in that of the appreciating patient’s accomplishments, and so on.
 Although such attitudes are kept strictly within the bounds of analytic propriety, these patient types are too sensitive to allow otherwise, their subtle effects may, nonetheless, be hostile to the analytic process, perpetuating infantile patterns by the analysand, and making it very difficult for both parties to cause a proper cancellation. In this respect the analysis of the ‘good’ patient offers difficulties that, while they are less upsetting than determinants responsible laded upon the status quo and it's fractional determinates. As, presented by others, more challenging as, if, by conquest, are the patients who are justly as important to a resolution by which any inexhaustible force of  attentions weave themselves into the transference resistance concealed by the overpowering attributions by making some presents on one side.
 The emphasis placed upon the role in the resistance of such as rationality, intelligence, and the capacity for cooperative efforts should not be construed as a denigration of their vital part in making analysis at all possible, components of any mature, not to say civilized, behaviour. All the same, however, reminding ourselves from time to time that even the essential may be necessary and finely construct instruments are double-edged, and these aspects of character are no exception. We are simply less likely to perceive the same as their function and not only in resolving, but in maintaining neurosis, and they may operate by seducing the analyst into the self-satisfying belief that he has accomplished far more than is in fact the case. Sadly, therefore, we must confront and analyse unsparingly those traits we are most likely to admire, least of mention, that the same principles and problems would apply if the structure of the neurosis had been more firmly rooted in pre-oedipal than in oedipal conflict. The difficulties would simply have been more severe for both analyst and patient.
 During the intervening time, as to solving the problem of analysing the transference neurosis, necessary for more than purely abstract reasons, would have a justifiable impossible. Following Freud’s (1913) principle, which of his earlier statement he had not only described this unobjectionable part of the transference, but went further: ‘while the patient’s communications and ideas run in without any obstruction, the theme of transference should be left untouched’ working alliance and, while not quoted by Kohut (1971), may have contributed to his specific advice to delay interpreting positively, idealizing statements made by the narcissistic analysand.
 If we examine Freud’s statement more closely, we are struck by many difficulties. First, what is meant by ‘admissible to consciousness’? In 1912, it implied that this transference component was part of the system PcsCs. Since during this period interpretation consisted in essence of making conscious that which had been unconscious, it would in any case have been irrelevant, if not conceptually impossible, to do more than is depicted by the patient’s attention (hyper-cathexis) to it, but there could be no question of unconscious elements playing an important role.
 With patients to whom of many derivatives of oedipal fantasies, may be largely within awareness. Nonerotic or de-erotised admiration and affection may be conscious from the first, and their role in the analytic process may be quite clear. What is generally obscure is the role of this positive, overtly Nonerotic transference in maintaining a powerful resistance, not only to the resolution of inhibitions, but also to the analytic exploration of hidden springs of defiance and revenge. What looks accessible to consciousness may be so only in part: What seems free of suppressed erotic impulses may be not so in fact, and what seemed altogether unobjectionable may after a time constitutes the most difficult aspect of the transference neurosis. What appears on the surface to be so very positive may also be the screen for stubborn aggressive elements, in that respect a persistent obstacle to analytic resolution.
 To return to Freud’s 1912 formulation, we need to be reminded that he never regarded consciousness as a simple matter, but always conceived of it as fluid and uncertain of definition. This is evident in The Interpretation of Dreams and is elaborated in his brilliant little paper, A Note upon the Mystic Writing-Pad (1925) in which he presents a view of consciousness as not simply a passive receptor, but bring dependent on an active function: This agrees with a notion that has long since been at work the method by which the perceptual apparatus of our mind functions, which I have as yet kept to myself.
 Its theory is that cathectic innervations are sent out, withdrawn in rapid peridotic impulses from within into the completely pervious system Pcpty.-Cs. If that system is cathected in this manner, it receives perceptions (which are accompanied by consciousness) and passes the excitation onto the unconscious anemic system, but as soon. As the cathexis is withdrawn, consciousness is extinguished. The functioning. Of the system comes to a standstill. It is as though the unconscious stretches. Out feelers, through the medium of the system Pcpty.-Cs. Toward the external world and hastily withdraws them when they have sampled the excitations coming from it.
 Freud might have been describing a kind of psychic radar, an ingenious device by which the mind tests external reality. In any casse, a careful reading of his work from the Project (1895) to the New Introductory Lectures (1933) gives no comfort to those who would see a simple definition of what was meant by ‘admissible to consciousness’. How accessible, how fleeting, under what conditions, are all open questions, the answer to which are not determined in any simple way.
 By 1937, when Freud published, Analysis Terminable and Interminable, it was evident of how much of his views had developed. He no longer insisted on the existence of a relatively simple Nonerotic or de-erotised conscious positive transference that required no analysis. Now, with some regret, he emphasized the presence of conflictual elements that were inaccessible to analysis not because they were conscious and ‘unobjectionable’, but because they were latent or inactive during the treatment. They could, in fact, be very objectionable indeed. Not the least of these conflicts were those centred on the transference that, unanalyzed, could so often predispose to future difficulties.
 These latent conflicts, he decided, could not be brought into the analysis by the analyst, either by verbal intrusions or by active manipulation, manoeuvres he regarded as both ineffective and potentially damaging. Yet in the same paper he stated what is a contradiction, in his disavowal of the principle of ‘letting sleeping dogs lie’. He went further: ‘Analytic experience has taught us that the better is always the enemy of good and that in every phase of the patient’s recovery we fight against his inertia, which is ready to be content with an incomplete solution’ (Freud, 1937).
 Defining it precisely what would justify that we are to regarding a conflict as an inactive or latent and therefore inaccessible to analysis is difficult. Undoubtedly, some conflicts are so heavily defended from analysis that as good as we suspect their presence, but we are baffled to uncover them, much less to analyse them. We may become aware of them only when the patient returns to us for further help or when he enters analysis with a colleague and lets us know of his decision. Achieving some comfort by convincing ourselves that condition had not been propitious is possible, for example, that the patient was a candidate in training, was caught in a difficult marriage or in another situation that favoured stubborn resistances. No doubt this is often the case - still, was that the only reason? Could we and should we have done more?
 The analyst, by his very presence and his willingness to listen, sets up a relationship described by Bird (1972) as ‘false’ transference', to become in effect ‘the worst enemy of the transference’. To some analysts are agreeable with this assessment of the complications inherent in this necessary, early development of the analytic situation, however, the inclining inclination of being ‘false’ is regarded as controversial, it is often manifested before the first visit, sometimes even in transparent dreams, and as such it reflects the wishes and fantasies of the patient rather than that his recognition of the reality of the situation.
 Questioning ourselves would be wise, therefore, as to the nature of this response, to ask which conflicts are being expressed and concealed by it, and to what extent it is dependent on the reality of the analytic situation, the patient’s conviction that the person he consults is benign, wise, and helpful is, we hope, justified by the reality. Yet we know well enough that a patient may experience extreme distrust of an analyst who is in fact perfectly trustworthy, and conversely he may place his implicit confidence in one who deserves it not at all. The personal success of so many charlatans in the mental health field is evidence enough.
 This positive response to the analyst corresponds in part at least to Freud’s unobjectionable component, and in its more developed phases it may be called the working alliance. Yet though it is necessary and useful for initiating and maintaining the analysis, we are hardly justified in concluding that it is altogether accessible to consciousness, nor that it is by its unobjectable nature. In fact, it carried a particular heavy load of unconscious conflict, much of which has to be repressed in order for the treatment to begin, and its long-term effects often highly objectionable. Eventually, therefore, we need to understand this phenomenon as thoroughly as any other we encounter in analysis. If we accept that eventually it must be interpreted, we accept also that we must study it in detail. But, nonetheless how?
 Listening carefully to a patient’s first impressions of us is instructive. They may consist of apparently diverse observations about the furniture of the office, of personal idiosyncrasies, and the like. Just when there is a neglect of such matters as whether or not we are relaxed and confident, youthful or aged in appearance and manner, and other factors we regard as far more significant.
 This is not to say that these latter details are not perceived and stored in memory, quite the contrary. However, they are often repressed and subject to distortion, to appear later in the analysis in various forms. Often the patient will question, for example, whether I wear glasses, although he has seen me a hundred times or more, never without them, or he will be wildly wrong in estimating my age, or astonishing becoming aware of a picture that has been facing the couch for years. Such familiar phenomena may, with some effort, be understood and analysed: It is to be believed that they contain the clues that can help us solve the mystery of the unobjectionable element.
 The patient’s reaction to and impressions of the analyst are built up of many determinants. They are first and most profoundly the needs and desires he brings to the analysis, the unconscious wishes that seek to be gratified. Superimpose on these are his early impressions of the analyst, derived from a host of perceptions, for example, the mode of referral, the initial telephone call, early impressions of appearance and manner, discussions of indications and conditions for the analysis, including hours and fees. An entry in a new world, it often takes on aan overwhelming quality - far too much to be dealt within a few sessions. Inevitably its effects are manifested throughout even a very long analysis, often in forms that make their sources difficult to detect. Yet before us, is the material of much of the transference, especially of the unobjectionable component.
 This aspect is not so willingly scrutinized with the same intensity with which we approach other phenomena. The reasons are, upon examination, not so obscure. For one thing, the trusting, positive attitude of the analysand does allow the analysis to continue, and it is comfortable for the two parties - unless the analyst forces himself to put aside that comfort. Secondly, it seems free of conflict. Third, it seems to make sense, to be entirely rational, that one person should admire and trust another who is so worthy of it. Finally, we are influenced by the dictum that we analyse the transference only when it serves the resistance, advice that would be easy to follow if we could always be sure when that took place. Suspicions are that without much difficulty prescience is a very rare gift. If we resist the temptation to take the positive transference for granted, therefore, we must find some way of analysing a component that on the surface looks unanalyzable.
 In 1955 Lewin wrote Dream Psychology and the Analytic Situation, a work that has been insufficiently recognized for its theoretical and technical importance. It described the analyst as fulfilling a double role, first as one who encourages the patient to allow himself to regress, to suspend criticism, to associate freely, to put himself into his past, to allow himself to feel helpless and to restrain his impulses toward physical change of position, although not to oral communication. Lewis pointed out the analogy with hypnosis, with the analyst as inducer of quasi-sleep and dreaming states, in which the wish to analyse is substituted for the wish to sleep.
 The encouragement of regression is fundamental to the analytic process, but it is hardly the analyst only function, a fact that may be ignored in many therapeutic innovations. The analyst must also become the one who rouses the ‘dreaming patient’, who interprets, who encourages and guides the process of self-observation. By this token, he is the one who awakens, who insists on the substitution of secondary for primary process. Of higher ego functions for more archaic ones. Inevitably he becomes the transference representative of that agency most often responsibly for insomnia, the conscience.
 Perhaps, its venture that the loving, conscious, unobjectionable part of the transference is directed toward the analyst as the one who soothes, who induces sleep and allows the patient to feel less frightened, for he is ‘safe’, but not for a long time can this love be directed toward the one who accomplishers the awakening. Conducting a long treatment is possible, of course, while maintaining one’s role as the inducer of sleep and dreams, to accomplish a good deal in the way of symptom relief, and thus be rewarded by expressions of gratitude. Whether, without fulfilling one’s role as awakener, one may be rewarded by having accomplished effective analysis is another matter.
 To employ Lewin’s striking metaphor, it might be taken care of, in that we mindfully experiment in treating the patient’s demands on the analyst as if these were derivative of unconscious wishes expressed in a dream, and that we consider the various perceptions stored and used from time to time as if they were the memories and day residues employed by the dream work. By this device we may treat the patient’s overtly expressed altitudes as if they corresponded to a manifest dream. We make the assumptions that there are unconscious wishes that seek gratification, that such wishes are subject to conflict and must attain expression in disguised forms. To achieve expression, memory traces of percept, including a day residue, are used both to afford a vehicle for the wish fulfilment and to disguise, as far as necessary, their true purpose. Thus, these wishes are allowed to reach consciousness in some form in spite of disapproval by other agencies, e.g., by evading the (preconscious) censorship according to the model described in The Interpretation of Dreams (Freud, 1900), or the (larger unconscious) repressive functions of the ego and superego according to the later structure model.
 The patient’s wishes and fantasies may be worked over further, brought into more rational, logical, organized form by a process analogous to secondary revisions: In the topographic model this depends on the preconscious system, in the structural model it would be considered a manifestation of the synthetic function of the ego. The description of secondary revision, described by Freud in 1900, may be regarded as one of the earliest precursors of the structural model of the ego.
 To pursue further the analogies between this aspect of transference and secondary revision of dreams let us look upon the Freudian say-so, atop which Freud wrote, ‘because of its efforts, the dream loses its appearance of absurdity and disconnectedness and approximates to the model of an intelligible experience. The connection of secondary revision with daydreams may also be extended to transferences, how much of the patient’s attitudes is based on fantasies of what the ideal patient-analyst relationship should be? A respectful, finial attitude, an eager pupil-teacher re-enactment, an innocent liaison with no threat os consummation? These are so appropriate, so sensible, so truly helpful to the analysis that we tend to forget how much of the wild aspects of this analysis are thus ‘moulded’ into a kind of daydream.
 In what is admittedly a highly simplified fashion, we might consider the case of these patients who treat their analysts as if they were kindly, intelligent, benign, and in a good manner, trained and disciplined, rightly interested and even fond of them, but not a danger in any erotic sense. It seems of reasonable enough description of the actual situation if one does not examine its unconscious components.
 Rather than taking this at face value as an intelligent patient’s evaluation of the reality of the analytic situation, accepting gratefully a fine working alliance or an unobjectionable component, if instead we insist upon the arduous and possibly disagreeable task of analysing beliefs and attitudes, we find something very different, far more conflicted, complex, and not altogether benign. The patient has been a model analysand, working hard, associating well, bringing gifts of associations and dreams. For example, she may be charming without being erotically seductive, and faithful to the point of causing concern for both of us. It may be entirely rational, justified by the reality of the situation. It is, of course, much too good to be true, for it is not accompanied by progress in the most urgent therapeutic goals, for example, that of achieving a gratifying sexual life and an ultimately satisfying career. There are also likely to be curious distortions and self-deceptions displayed, for example, when a patient talks of herself as obnoxious and without friends, statements that are manifestly false whatever their unconscious truth. Young women’s patients particularly complain of the usual distortions of a body image so common in them, to being fat and ugly, all of which being quite aware of the contrary. They may be fishing for expressive respects, but that is not all. These analyses, smooth as they are most of the time, do not altogether result in untroubled ‘sleep’. Sometimes without understanding why, patients become frightened, agitated, and depressed, as if repressed impulses had broken through, like a bad dream.
 We might now try the experiment of treating this material as if it were a manifest dream, consisting of a childlike, innocent, and highly educational liaison under the name of analysis. The underlying wishes that have emerged contain erotic fantasies about the parents, combined usually with violent impulses to destroy them both. Behind the befittingly-behaved and rational person may be the image of a lustful, destroying angel, who would kill without mercy in a kind of oedipal rage. To allow these wishes to achieve any kind of expression, they must be made more acceptable for the patient by allowing her to assume such desires without a penalty whose weakness is such that she need not fear of destroying the beloved parents. Or they may be expressed more openly by an ironic stance, which allows them to be proclaimed, and to be disowned.
 These memory traces may again be compared to how they are dealt within the dream work. The patient may recall; being a great favourite of many older people and always having a teacher’s pet at school, always loved: These generally seem accurate. They often recall at least one and perhaps more screen memories that include some early sexual experience’s h a parent, fantasies that may have been related to horseplay with siblings and even to a greater extent to medical procedures later in childhood. Most of the childhood memories reported in the analysis are generally quite plausible and subject to relatively little obvious distortion, except the inevitable effects of the passage of time. There is little of the bizarre and strange about them, reflecting both the powerful reality sense of these patients and the highly organized structure of their intelligent and well-disciplined families.
 Whatever is observed in the analytic environment, the patient uses as a day residue, as material to carry fantasies. Yet the whole is likely to be so sensible, so rationalized, so free of manifest erotic or violent elements, that we must assume that a powerful synthesized ego function is at work, like a very effective secondary revision of an otherwise bizarre and disturbing dream, with few breakthroughs of incongruous ideation and affect.
 This process, again by analogy, ‘protects sleep.’ That is, it helps the ego to maintain a comfortable regressive state of affairs in analysis, in which the patient is apparently a sensible, conscious, and sophisticated adult and an erotically excited, vengeful child. To ‘awaken’ her, that is, to interpret, would be to lead her to recognize her unconscious wishes for what they are, to help her deal with her repressive and ironic defences that have allowed the neurosis to continue and the analysis to go on without much real impact on the most important problem. To continue in a sleep-like state, on the other hand, permits her to act both roles and to continue to play out the surprising contradictions in her personality.
 If we suppose that interpretation ‘removes’ the transference, as Freud suggested in 1912, we should be hesitant to bring it to consciousness before it has produced a resistance - assuming we are so prescient as to be able to detect the moment at which that latter event occurs. Still, we are not sure any more that transference is so easily ‘removed’ by interpretation. It seems certain that Freud no longer believed this when he wrote Analysis Terminable and Interminable.
 How and when to interpret phenomena such as these make up a really reasonable dilemma. Kohut (1971), for example, approaching his patients with a theory that emphasizes a developmental view and puts’ aside conflictual considerations, would ‘accept’, possibly for a long period, even the most highly idealized expressions of admiration for himself. He warns against ‘premature interpretation’ of such positive expressions, especially in the cases he classifies as narcissistic character disorders.
 Many years earlier, Phyllis Greenacre (1954), employing a different point of view, cautioned against early transference interpretations with narcissistic patients who are prone to acting out, since such interventions might result in at least temporary impairments of certain defensive controls and result in episodes of destructive behaviour. She made it clear that she was discussing a limited group of patients and her remarks were not confined to the ‘unobjectionable’ component. She was very much concerned with the development of a fix in a firm manner of over-idealizing attitudes toward the analyst and the problems engendered by these.
 Without question interpreting the patient’s good-nature appears rarely advisable, cooperative attitude during the early part of analysis. Being inadvisable is not merely likely: It is worse than that, because during the first few weeks or months we could not possibly understand the unconscious components of this phenomenon. Early interpretations may remarkably be possible in a quickening notation that may prove sufficiently used for a vivid notable in characterizing its mark of notoriety, out of luck or intuition, but during the phase when we hardly know the patient venturing definite statements of meaning would be foolhardier.
 We need not interpret early, therefore, and could not if we would. Nevertheless, there is a vast difference in accepting a phenomenon as reality-based, conflict-free, representing only itself, and, on the other hand, treating it more properly as a surface manifestation of a complex set of opposing forces, most of which operate outside conscious awareness, which require explanation eventually in analysis.
 The questions we encounter are like those addressed to a particularly good manner of defending its dream, in that, taken on a superficially reasonable form. A good example would be Freud’s Dream of the Botanical Monograph. Repeating is brief enough: ‘I had written a monograph ion a certain plant. The book lay before me and I was just over a folded coloured plate. Bound up in each copy there was a dried specimen of the plant, as though it had been taken from a herbarium’ (1900). Jumping to the conclusion would have been easy, by no incorrect means, that the dream expressed the wish that the yet incomplete monograph intended to make his reputation was already published and on display. How reasonable and easy to understand. Freud was, fortunately, not so easily satisfied. He discovered, in his analysis of the dream. References to matters ranging from his experiments with cocaine back to infantile sexual investigations, to which he understandably only eluded.
 Similarly, if the patient imagines that his analyst is a fine and helpful person, he is expressing a wish, which on the face of it is perfectly reasonable. He is, we hope, correct in his expectations. We are certainly not obliged to contradict him, any more than we contradict the statements of a manifest dream. However, we are obliged to ask ourselves questions, not only about the origins of this wish, which may make an impression on us both obvious and universal, but also about a complex of different wishes and defensive operations that may lie concealed beneath this understandable and benign phenomenon. To what extent is it seductive? To what degree masochistic and tricky? Is it possible that the patient harbours a deeply passive wish that says in effect, ‘You are so great, my fate lies in your hand, do, your best and I shall yet defeat you?’
 These probe need not be spoken aloud, but neither need they are entirely some secrets from the patient. The latter, when deeply engaged in the analytic process, are likely to be especially sensitive to nuances in the analyst’s state of mind, especially with respect to emotionally charged attitudes, a phenomenon commonly observed in children and present to a disconcerting degree in certain paranoid individuals. In the analysis of neurotic patients it varies with the state of regression encouraged by use of the couch and of free association.
 Complex as it is, there is nothing necessarily mysterious about it. While the patient does not during the session itself see, the analyst’s facial expression, he is generally keenly aware of his minimal responses, his tone of voice, movements, and the like. Furthermore, he has the opportunity to pick up clues from the latter’s expression at the beginning and end of the session. That he may draw some quite inaccurate conclusions is to be expected, and these misinterpretations themselves become material for the analysis. Some patient sense quite quickly and often accurately, for example, whether the analyst responds to expressions of appreciation by a warm glow of satisfaction or by a questioning attitude, the latter signifying a willingness to wait until the phenomenon can be understood in depth.
 Whether the analyst reacts by ‘acceptance’ or by questioning makes considerable difference in the future course of the treatment. What has often been taken for granted as an ‘empathic’ approach tends to reduce emphasis on the importance of questioning, treating the patient’s appreciation, for example, as if it were simply genuine, taking it at face value, justifying this by the need to establish the kind of transference situation that is believed essential for the progress of the treatment.
 Such an approach has its own appeal: It seems humane, understanding, and protective, it is often regarded as a manifestation of a loving attitude by the analyst, which is perfectly appropriate - a counterpart, it would seem, of the unobjectionable component of the patient. Nevertheless, that we must raise questions whether its usefulness may not ultimately be outweighed by its cost.
 The failure to maintain a questioning attitude, an active curiosity about the unconscious dynamics and meaning of this type of response, is likely to favour the persistence of troublesome misunderstanding as to the true nature of the transference. This may in turn lead to serious errors in attempts to place too great an emphasis on an introspective-empathic response at the expense of thoughtful questioning and evacuations of all types of detained by observation of the analytic situation. One of the risks of the former approach is that patient and analyst may find them existing in a state of mutual narcissistic regression, a kind of near-erotic mutual sleep. This can be a very gratifying experience for both: Its prototype was the sleep therapy employed by the Greeks at Epidaurus and Pergamum, which provided symptomatic relief. We need not decry it, if it is recognized.
 Analysis, however, requires regular ‘arousal’ in Bertram Lewin’s sense, accomplished by the analyst’s activity, by questioning and interpretation, which may be explicit and verbalized or silent, expressed by a less intrusive means, e.g., by gesture, look and tone. Only in this way are we likely to achieve some understanding of the function and the origins of the ‘unobjectionable’ component and the other factors in the transference with which being joined is likely.
 Establishing some hypotheses to account for the origins of this phenomenon of transference would seem important that at this point. This is not so easily accomplished, and must wait for further exploration. Up too now, our efforts have been partial at best, and for the most part has failed to take into account such factors as genetic endowment, at the one extreme, and late childhood, adolescent, and adult experiences at the other. Its genetic sources have been sought for largely in the experiences of early childhood, the neonatal and preverbial phases by choice, concentrating especially on mother-child exchanges. Denying the importance of early mothering in this regard would be rash, but being persuaded by those who would make it the one crucial determinant is difficult, as if good mothering were not only the earliest, but also the only essential genetic factor in the capacity to develop this aspect of transference.
 It is too-simple if appealing explanation, and too dependent upon treating the manifest phenomenon as the whole article, as if the patient’s trust and cooperation were a direct reflection of the trust and cooperation he learned at his mother’s breast, and on the other hand, as if it reflected the need to replace a disappointing ‘unemphatic’ mother by a new and more reliable object - or, ‘self-object,’ to employ Kohut’s (1971) term.
 Primordial explanations are understandably popular. Those historical events that are most deeply buried in the distant past are the most difficult to evaluate and thus the more apt for myth-making. Even the most meticulous hypotheses about the psychic developments of preverbial children require influences based on giant steps that become even larger when we attempt to extend them into explanations of behaviour and symptoms in adults. It is undeniable that very early experiences contribute significantly to the nature and severity of adult psychopathology, and the more we know about them the better. Still, to know them is not nearly enough. It is essential that we undertake the arduous task of tracing the effects of such experiences through later childhood, adolescence, and adult life, thus establishing the coherent chain of historical events that is indispensable for a soundly based sense of conviction. It is only by accomplishing this that we may be able to precent psychological explanations from deteriorating into a series of appealing fantasies, a kind of pseudo history based on presumed prehistoric events, which tends to operate as a defence against the discovery of something close to the genuine article.
 Gill (1979) has described some of the difficulties in the tendency to interpret transference by a too-ready resorted to early genetic factors rather than by recognizing the immediate context of the analytic situation. We need to go all the way with him in his emphasis on the ‘here-and-now’ in the analysis of the transference, to recognize the relevance of its argument.
 Here-and-now work with transference materials is an emotionally potent experience for both patient and therapist. Anxieties and misunderstandings in both patient and therapist may lead them to resist this focus. Transference can be a powerful therapeutic tool: being aware of impediments to effective intervention is important, Freud (1905) once commented that ‘transference, which seemed ordained to be the greatest obstacle to the psychoanalysis, becomes its most powerful ally, if its presence can be detected each time and explained to the patient’. Leading to conclude that ‘In psychoanalysis therapy, the phenomenon of projection of feelings, thoughts, and wishes onto the analyst, who has come to represent an object from the patient’s past’ also, that ‘the patient sees in the analyst the return - the reincarnation - of some important figure out of his childhood or past, and consequently transfers onto him feelings and reactions that undoubtedly applied to this model’. Analysis of transference in the here-and-now opens the way to new object relations through a step-by-step removal of implements to such relations as represented by the transference. As the patient can understand and work through distortions resulting from transference attitudes, he begins to see others starting with the therapist, in a new way. The goal of here-and-now is to establish more realistic object relations. First with the therapist, then with others: The therapist strives to help the patient develop more successful interaction within the therapy relationship than was experienced in the past. A focus on transference is intended to remove obstacles that interfere with the patient’s ability to deal with the therapist in a relatively mature, rational, and a non-conflictual manner. If transference is a preexisting perceptual and emotional bias, resolution of the transference helps the patient add flexibility and decrease constriction to the manner in which the therapeutic situation is viewed. Both the therapist and patient attempt to work out a relationship that is a realistic reflection of the present and without excess baggage from the past: The message to be conveyed is that relationships are not conflict-free, and that the therapist is willing to continue, with openness and purpose, toward resolution of conflict with others.
 Yet, the analysis of the transference is generally acknowledged to be the central feature of analytic technique. Freud regarded transference and resistance as facts of observation, not as conceptual inventions. He wrote: ‘ . . . the theory of psychoanalysis is an attempt to account for two striking and unexpected facts of observation that emerge whenever an attempt is made to trace the symptoms of neurotic backs their sources in the past life, the facts of transference and of resistance . . . anyone who takes up other sides of the problem while avoiding these hypotheses will hardly escape a charge of misappropriation of property by attempted impersonation, if he persists in calling himself a psychotherapist.’ Rapaport (1967) argued, in his posthumously published paper on the methodology of psychoanalysis, that transference and resistance inevitably follow from the fact that the analytic situation is interpersonal.
 Despite this general agreement on the centrality of transference and resistance in technique, its impressions drawn from ones experience as to observe of the transference that is not to pursue as systematically and comprehensively compensable state of one how would imaginatively think of what really should be. The relative primacy in which psychoanalysts work makes it possible for one or one’s state to view as anything more than its own impression. On the assumptions that even if we were wrong, reviewing issues in the analysis of the transference will be useful and to state many reasons to posit of itself as an important aspect of the e analysis of the transference, namely, resistence to the awareness of the transference, is especially often slightly in analytic practice that one or one’s reasons to acknowledge these issues and of what really should be.
 Seemingly, the first gaiting steps of which did not originate with a big-bang but forwarded forthright through a whimpering between two types of interpretations of the transference. The one is an interpretation of resistance to the awareness of transference. The other is an interpretation of resistances to the resolution of transference. The distinction, however, had been best explained in the literature by Greenson (1967) and Stone (1967). The first kind of resistance may be called defence transference. Although that terminology is mainly employed to refer to a phase of analysis characterized by a general resistance to the transference of wishes. The second whimpering overture of resistance is usually called transference resistance. With some oversimplification, one might say that in resistance to the awareness of transference, the transference is what is resisted, whereas in resistance to the resolution of transference, the transference is but the withstanding resistance.
 Yet, another descriptive way of stating this distinction between resistance and the awareness of transference and resistance to the resolution of transference is between implicit and indirect reference to the transference and explicit or direct references to the transference, the interpretation of resistance to awareness of the transference in intended to make the implicit transference explicit, while the interpretation of resistance to the resolution of transference is intended to make the patient realize that the already explicit transference does include a determinant from the past.
 It is also important to distinction between the general concept of an interpretation of resistance to the resolution of transference and a particular variety of such an interpretation, namely, a genetic transference interpretation - that is, in the interpretation of how an attitude in the present is an inappropriate carry-over from the past. While there is a tendency among analysts to deal with explicit references to the transference primarily by a generic transference interpretation, there are other ways of working toward a revolution of the transference. It will be argued that not only is it not enough of an emphasis being given to interpretation of the transference in the here-and-now, that is, to the interpretation of implicit manifestations of the transference, but also that interpretations intended to resolve the transference as manifested in explicit references to the transference should be primarily in the here-and-now, rather than genetics transference interpretation.
 A patient’s statement that he feels the analyst is harsh, for example, is, at least to begin with, likely best dealt with not by interpreting that this is a displacement from the patient’s feeling that his father was harsh but by an elucidation of another aspect of his here-and-now attitude, such as what has gone on in the analytic situation that is the patient to justify his feedings or what as the anxiety that made it so difficult for him to express his feelings. How the patient experiences the actual situation is an example of the role of the actual situation in a manifestation of transference, which will be one point contributive to both the transference in the here-and-now and genetic transference interpretations valid and constitute a sequence. We presume that a resistance that transference ultimately rests on the displacement onto the analyst of altitudes from the past.
 Transference interpretations in the here-and-now and genetic transference interpretations are of course, exemplified in Freud’s writings and are in the repertoire of every analyst, but they are not distinguished sharply enough.
 Because Freud’s case histories focus much more on the yield of analysis than on the details of the process, they are readily but perhaps incorrectly construed as emphasizing work outside the transference much more than work with the transference, and, even within the transference, emphasizing genetic transference interpretations much more than work with the transference in the here-and-now (Muslin and Gill 1978). The example of Freud’s case reports may have played a role in what is to be considered as a common maldistribution of emphasis in these two respects - not enough on the transference and, within the transference, not enough on the here-and-now, least of mention, is a primary reason for a failure to deal adequately with the transference. It is that work with the transference is that aspect of analysis that involves both analyst and patient in the apprised affect-laden and potentially disturbing interactions that by participants in the analytic situation are motivated to avoid these interactions. Flight away from the transference and to the past can be a relief to both patient and analyst.
 The importance of transference interpretations will surely be agreeing to by all analysts, the greater effectiveness of transference interpretations than interpretations outside the transference will be agreeing to by many, and that of the relative roles of interpretation of the transference and interpretation outside the transference?
 Freud can be read either as saying that the analyst of the transference is auxiliary to the analysis of the neurosis or that the analyst of the transference is equivalent to the analysis of the neurosis. The first position is stated in his saying (1913) that the disturbance of the transference has to be overcome by the analysis of transference resistance to get on with the work of analysing the necrosis. It is also implied in his reiteration that the ultimate task of analyses is to remember the past, to fill the gaps in memory. The second position is stated in his saying that the victory must be won on the field of the transference (1912) and that the mastery of the transference neurosis ‘coincides with getting rid of the illness that was originally brought to the treatment’(1917). In this second view, he says that after the resistances are overcome, memories appear without difficulty (1914).
 These two different positions also find expression in the two very different ways in which Freud speaks of the transference. In Dynamics of Transference, he refers to the transference, on the one hand, as ‘the most powerful resistances to the treatment’ (1912) but, on the other hand, as doing us ‘the inestimable service of masking the patient’s . . . impulses immediate and manifest. For when all is said and done, destroying anyone in an absentia or in effigies’ is impossible (1912).
 One or one’s mindful purposes of incitation can draw from its demonstration that his principal emphasis falls on the second position. He wrote once, in summary: ‘Thus our therapeutic work falls into two phases. In the first, all libidos are forced from the symptoms into the transference and concentrated there, in the second, the struggle is waged around this new object and the libido is liberated from it’ (1917).
 Yet, the detailed demonstration that he advocated that the transference should be encouraged to expand as much as possible within the analytic situation lies in clarifying that resistance is primarily expressed by repetition, that repetition takes place both within and outside the analytic situation, but that the analyst seeks to deal with it primarily within the analytic situation, that repetition cannot be only in the motor sphere (acting) but also in the physical sphere, and that the physical sphere is not confined to remembering but includes the present, too.
 Freud’s emphasis that the purpose of resistance is to precent remembering can obscure his point that resistance shows itself primarily by repetition, whether inside or outside the analytic situation: ‘The greater the resistance, the more extensive will acting out (repetition) replaces remembering’ (1914). Similarly, in The Dynamics of Transference, Freud said, that the main reason that the transference is so well suited to serve the resistance is that the unconscious impulses ‘do not want to be remembered . . . but, endeavour to reproduce themselves . . .’ (1912). The transference is a resistance primarily insofar as it is a repetition.
 The point can be restated as to the relations between transference and resistances. The resistance expresses itself in repetition, that is, in transference both inside and outside the analytic situation. To deal with the transference, therefore, is equivalent to dealing with the resistances. Freud emphasized transference within the analytic situation so strongly that it has come to mean only repetition within the analytic situation, even though, conceptually speaking, a repetition outsider the analytic situation is transference too, and Freud once used the term that way: ‘We soon perceive that the transference is itself only a piece of repetition, and that the repetition is a transference of the forgotten past not only on the doctor but also on all other aspects of the current situation. We . . . find . . . the compulsion to repeat, which now replaces the impulsion to remember, not only in his personal attitude to his doctor but also in every other activity and relationships that may occupy his life at the time . . . ‘ (1914).
 Realizing that the expansion of the repetition inside the analytic situation is important, whether or not in a reciprocal relationship to repetition outside the analytic situation, is the avenue to control the repetition: ‘The main instrument . . . for curbing the patient’s compulsion to repeat and for turning it into a motive for remembering lies in the handling of the transference. We render the compulsion harmless, and really useful, by giving it the right to assert itself in a definite field’ (1914).
 Kanzer has discussed this issue well in his paper on The Motor Sphere of the Transference, (1966). He writes on a ‘double-pronged stick-and-carrot’ technique by which the transference is fostered within the analytic situation and discouraged outside the analytic situation. The ‘stick’ is the principle of abstinence as exemplified in the admonition against masking important decisions during treatment, and the ‘carrot’ is the opportunity afforded the transference to expand within the treatment ‘in almost complete freedom’ as in a ‘playground’ (Freud, 1914). Freud writes: ‘Provided only that the patient shows compliance enough to respect the necessary conditions of the analysis, we regularly succeed in giving all the symptoms of the illness a new transference meaning and in replacing his ordinary neurosis by a ‘transference neurosis’ of which he can be cured by the therapeutic work’ (1914).
 The reason that being expressed within the treatment is desirable for the transference is that there, it ‘is at every point accessible to our intervention’ (1914). In a later statement he made the same point this way: ‘We have followed this new edition [the transference-neurosis] of the old disorder from its start, we have observed its origin and growth, and we are especially well able to find our way about in it since, as its object, we are situated at it’s very centre’ (1917). It is not that the transference is forced onto the treatment, but that it is spontaneously but implicitly present and is encouraged to expand there and become explicit.
 Freud emphasized ‘acting’ in the transference so strongly that one can overlook the repetition in the transference providing it does not necessarily mean it is enacted. Repetition need not go as far as motor behaviours. It can also be expressed in attitudes, feelings, and intentions, and, the repetition often takes such form rather than motor action. Such repetition is in the physical rather than the motor sphere. The importance of making this clear is that Freud can be mistakenly read to mean that repetition in the physical sphere can only mean remembering the past, as when he writes that the analyst ‘is prepared for a perpetual struggle with his patient to keep in the physical sphere all the impulses that the patient would like to direct into the motor sphere, and he celebrates it as a triumph for the treatment if he can bring it about that something the patient wishes to discharge in action are disposed of through the work of remembering’ (1914),
 Still, it is true that the analyst’s efforts are to convert acting in the motor sphere into an intuitive awareness upon the certainty of which the physical sphere of transference, however, transference may be in the physical sphere to begin with, even if disguised. The physical sphere includes those of an awakened spheres of awareness through which the transference is just as well as to remembering.
 An objection one hears, from both analyst and patient, to a heavy emphasis on interpretation of associations about the patient’s real life primarily about the transference is that it means the analyst is disregarding the importance of what goes on in the patient’s real life. The criticism is not justified. To emphasize the transference meaning is not to deny or belittle other meanings, but to focus on the one of several meanings of the contentual representations set forth, that is most important for the analytic process.
 Another way in which interpretations of resistance to the transference can be, or at least appear to the patient as to be belittling of the importance of the patient’s outside life is to make the interpretation as though the outside behaviour is primarily an acting out of the transference. The patient may undertake some actions in the outside world as an expression of and resistance to the transference, that is, acting out. Til now, the interpretation of associations about actions in the outside world as having implications for the transference needs mean only that the choice of outside action to figure in the associations in co-determined needs to express of the transference indirectly. It is because of the resistance to awareness of the transference that the transference has to be disguised. When the disguise is unmasked by interpretations, despite the inevitable differences between the outside situations and the transference situation, the content is clearly the same for the analytic work. Therefore, the analysis of the transference and the analysis of the neurosis coincide. Particularly because some critics of earlier versions of our agreement that in its advocating the analysis of the transference for its own sake rather than in overcoming the neurosis. Freud wrote, ‘that the mastering of the transference neurosis ‘coincides with getting rid of the illness that was originally brought to the treatment’ (1917).
 The transference is encouraged to develop within the analytic situation, toward fostering this development of attitudes with primary determinants in the past, i.e., transferences. The analyst’s reserve gives the patient few and equivocal cues. The purpose of the analytic situation fosters the development of strong emotional responses, and the very fact that the patient has a neurosis means, as Freud said, that
‘ . . . It is a perfectly normal and intelligible thing that the libidinal cathexis [we would now add negative feelings] of someone who is partly unsatisfied, a cathexis held readily in anticipation, should be directed as well to the figure of the doctor’ (1912).
 There is important resistance for both patient and analyst to awareness of the transference. On the patient’s part, this is because of the difficulty in recognizing erotic and hostile impulses toward the very person to whom they have to be revealed. On the analyst’s part, this is because the patient is likely to attribute the very attitudes to himself, in that causing him discomfort is most likely. The attitudes the patient believes that the analyst has toward him are often the ones the patient is least likely to voice, in a general sense because of a feeling that it is impertinent for him to concern himself with the analyst’s feelings. In a more specific sense because the attitudes that the patient ascribes of the analyst are often attitudes the patient feels the analyst will not like and be uncomfortable about having ascribed to him. It is so that the analyst must be especially alert to the attitudes the patient believes he has, not only to the attitudes the patient does have toward him. If the analyst can see himself as a participant in an interaction, as he will become much more attuned to this important area of transference, which might otherwise escape him.
 The investigation of the attitudes ascribed with the analyst makes easier the subsequent investigation of the intrinsic factors in the patient that played a role in such ascriptions. For example, the exposure of the fact that the patient ascribes sexually, an interest in him to the analyst, and genetically to the patient, easily makes the subsequent exploration of the patient’s sexual wish toward the analyst, and genetically the parent.
 The resistance to the awareness of these attitudes is responsible for their appearing in various disguises in the patient’s manifest associations and for the analyst’s reluctance to unmask the disguise. The most commonly recognized disguise is by displacement, but identification is an equally important one. On displacement, the patient’s attitudes are narrated for being a third party. In identification, the patient attributes to himself attitudes he believes the analyst has toward him.
 To encourage the expansion of the transference within the analytic situation, the disguises in which the transference appears have to be interpreted. In displacement the interpretation will be of allusions to the transference in association not manifestly about the transference. This is a kind of interpretation every analyst often makes. With identification, the analyst interprets the attitude the patient ascribes himself as an identification with which attitudes he attributes toward the analyst. Lipton (1977) has recently described this form of disguised allusion to the transference with illuminating illustrations.
 Many analysts believe that transference manifestations are infrequent and sporadic at the beginning of an analysis and the patient’s associations are not dominated by the transference unless a transference neurosis has developed. Other analysts believe that the patient’s associations have transference meanings from the beginning and throughout. That is to say, if one is to think of those who believe otherwise are failing to recognize the persuasiveness of indirect allusions to the transference - that is, what is called the resistance to the awareness of the transference.
 In his autobiography, Freud wrote: ‘The patient remains under the influence of the analytic situation abounding in even if he is not directly his mental activity onto a particular subject. We will be justified in assuming that nothing will occur to him that has not some reference to that situation’ (1925). Since associations are obviously often not directly about the analytic situation, the interpretation of Freud’s remark rests on what he meant by the 'analytic situation'.
 Trusting of what, Freud’s meaning can be clarified by reference to a statement he made in The Interpretation of Dreams. He said that when the patient is told to say whatever comes into his mind, his associations become directed by the ‘purposive ideas inherent in the treatment’ and that there are two such inherent purposive themes, one relating to the illness and the other - concerning which, Freud said, the patient had ‘no suspicion’ - relating to the analyst (1900). If the patient has ‘no suspicion’ of the theme relating to the analyst, the clear implication is that the theme appears only in disguise in the patient’s association. Its following interpretation is that Freud’s remark not only specifies the themes inherent in the patient’s associations, but also means that the associations are simultaneously directed by these two purposive ideas, not sometimes by one and sometimes by the other.
 One important reason that the early and continuing presence of the transference is not always recognized is that it is considering being absent in the patient who is talking freely and apparently without resistance. As Muslin and others have pointed out on the early interpretation of transference (Gill and Muslin, 1976), resistance to the transference is probably present from the onset, even if the patient is talking apparently freely. The patient might be talking about issues not manifestly about the transference that are nevertheless also allusions to the transference. Nevertheless, the analyst has to be alert to  the percussiveness of such allusions to discern them.
 The analyst should continue the working assumption, to assert that the patient’s associations have transference implications pervasively. This assumption is of course, not to be confused with denial or neglect of the current aspects of the analytic situation. Giving precedence to a transference interpretation is theoretically always possible if one can only discern it through its disguise by resistance. This is not to dispute the desirability of learning as much as one can about the patient, if only to be a position to make correct interpretations of the transference. It therefore does not interfere with an apparently free flow of associations, especially early, unless the transference threatens the analytic situation to the point where its interpretation is mandatory rather than optional.
 With the recognitions that even the apparently freely associating patient may also be showing reluctance to awareness of the transference, in that, the formularisation of one should not interfere if useful information is being gathered should replace Freud’s dictum that the transference should not be interpreted until it becomes a resistance (1913).
 It may be argued of all transference manifestations with something in the actual analytic situation has some connection to some aspect of the current analytic situation, in that, all the determinants of the transference are current in the sense that past can exert an influence only because it exists in the present. What, however, the distinguishing is, of its current reality of the analytic situation, that is, what goes on between patient and analyst in the present, from how the patient is currently formed as of his past.
 All analysts would doubtless agree that there are both current and transferential determinants of the analytic situation, and probably no analyst would argue that a transference idea can be expressed without contamination, as it was, that is, without any connection to anything current in the patient-analyst relationship. Nevertheless, the applicable implication of this fact for techniques is often neglected in practice and is believed that it will be dealt among them as past-present point references.
 After-all, several authors (e.g., Kohut 1959, Loewald 1060) have pointed out that Freud’s early use of the term transference in The Interpretation of Dreams, in a connection not immediately recognized as related to the present-day user of the term, reveals the fallacy of considering that transference can be expressed free of any connection to the present. That early use was to refer to the fact that an unconscious ideas cannot be expressed as such, but only as it becomes connected to a preconscious or conscious representation of content. Thus holding to contentual representations in the phenomenon with which Freud was then concerned, the dram, transference took place from an unconscious wish to a day residue. In the Interpretation of Dreams Freud used the term transference both for the general rule that an unconscious content is expressible only as it becomes transferred to a preconscious or conscious content and for the specific application of this rule to a transference to the analyst. Just as the day residue is the point of attachment of the dream wish, so must there be an analytic-situation residue, though Freud did not use that term, as the point of attachment of the transference.
 Analysts have always limited their behaviour, both in variety and intensity, to increase the extent to which the patient’s behaviour is determined by his idiosyncratic interpretation of the analyst’s behaviour. In fact, analysts unfortunately sometimes limit their behaviour so much, as compared with Freud’s practice, that they even conceptualize the entire relationship with the patient a matter of technique, with no nontechnical personal relation, as Lipton (1977) has pointed out.
 Nonetheless, no matter how far the analyst attempts to carry this limitation of his behaviour, the very existence of the analytic situation gives the patient innumerable cues that inevitably become his rationale for his transference response. In other words, the current situation cannot be made to appear - that is, the analytic situation is real. It is say to forget this truism in one’s zeal to diminish the role of the current situation in determining the patient’s responses. One can try to keep past and present determinants as a step-by-step perceptible form of one and another, but one cannot obtain either in ‘pure culture’. Freud wrote: ‘Insist on this procedure [the couch], however, for its purpose and result are to prevent the transference from mingling with the patient’s associations imperceptibly, to isolate the transference and to allow it to come forwards in due courses sharply defined as a resistance.’ Even ‘isolate’ is too strong a word in the light of the inevitable intertwining of the transference with the current situation.
 If the analyst remains under the illusion that the current cues he provides to the patient can be reduced to the vanishing point, he may be led into a silent withdrawal, which is not too distant from the caricature of an analyst as someone who does indeed refuse to have any personal relationship with the patient. What happens then is that silence has become a technique rather than merely an indication that the analyst is listening. The patient’s responses under such conditions can be mistaken for uncontaminated transference when they are in fact transference adaption to the actuality of the silence.
 The recognition that all transferences must have some relation to the actual analytic situation, from which it takes its point of departure, as it was, has a crucial implication for the technique of interpreting resistance to the awareness of transference, to which the analyst becomes persuaded of the certainty of transference and the importance of encouraging the transference to expand within the analytic situation, he has to find the presenting and plausible interpretations of resistance to the awareness of transference he should make. At this point, his most reliable asset is the cues offered by what will go on in the analytic situation: On the one hand, the events of the situation, such as change in time of session, or an interpretation made by the analyst, and, on the other, however, the patient is experiencing the situation as reflected in explicit remarks about it, however fleeting these may be. This is the primary yield for technique of the recognition that any transference must have a link to the actuality of the analytic situation. The cue points to the nature of the transference, just as the day residue for a dream may be a quick pointer to the latent dream thoughts. Attention to the current stimulus for a transference elaboration will keep the analyst from making mechanical transference interpretation, in which he interprets that there are allusions to the transference in associations not manifestly about the transference, but without offering any plausible basis for the interpretation. Attention to the current stimulus also offers some degree of protection against the analyst’s inevitable tendency to project his own views onto the patient, either because of countertransference or because of a preconceived theoretical bias about the content and hierarchical relationship in psychodynamics.
 The analyst may be very surprised at what in his behaviour the patient finds important or unimportant, for the patient’s responses will be idiosyncratically determined by the transference. The patient’s response may be something the patient and the analyst considers trivially, because, as in displacement to a trivial aspect of the day residue of a dream, displacement can better serve resistance when it is to something trivial. Because it is connected to conflict-laden material, the stimulus to the transference may be difficult to find. It may be quickly disavowed, so that its presence in awareness s only transitory. With the discovery of the disavowed, the patient may also gain insight into how it repeats a disavowal earlier in his life. In his search for the present stimulus that the patient is responding to transferentially, the analyst must therefore remain alert to both fleeting and apparently trivial manifest calls himself well as the events of the analytic situation.
 It is sometimes argued that the analyst’s attention to his own behaviour as a precipitant for the transference will increase the patient’s resistance to recognizing the transference. On the contrary, is that because of the inevitable interrelationship of the current and transferential determinants, it is only through interpretation that they can be disentangled - in that it is also argued that one must wait until the transference has reached optimal intensity before it can be advantageously interpreted. It is true that too hasty the interpretation of the transference can serve a defensive function for the analysts and deny him the information he needs to make a more appropriate transference interpretation. However, it is also true that delay in interpreting runs the risk of allowing an unmanageable transference to develop. It is also true that deliberate delay can be a manipulation in the service of an abreaction rather than analysis and, like silence, can lead to a response to the actual situation mistaken for uncontaminated transference. Obviously important issues of timing are involved as an important clue to when a transference interpretation is given that one to make lies in whether the interpretation can be made plausible concerning the determinant stresses, namely, something in the current analytic situation. Of course, with other aspects of the transference attitude in saying that when the analyst approaches the transference in the spirit of seeing how it appears plausibly realistic to the patient, it paves the way toward its further elucidation and expression.
 Freud’s emphasis on remembering as the goal of the analytic work implied that remembering is the principal avenue to the resolution of the transference. Yet his delineation of the successive steps in the development of analytic technique makes clear that he saw this development as a change from an effort to reach memories directly to the use of the transference as the necessary intermediary to reaching the memories.
 By contrast alone, a remembering as the way the transference is resolved, Freud also described resistance for being primarily overcomes in the transference, with remembering following easily thereafter: ‘From the repetitive reactions exhibited in the transference we are led along the familiar paths to the awakening of the memories, which appear without difficulty, as it was, after the resistance has been overcome’ (1914). ‘This revision of the process of repression can be accomplished only in part concerning the memory traces of the process that led to repression. The decisive part of the work is achieved by creating in the patient’s relations to the doctor - in the 'transference' - new editions of the old conflicts . . . Thus, the transference becomes the battlefield on which all the mutually struggling forces should meet one-another’ (1917). This is the primary insight Strachey (1934) clarified in his seminal paper on the therapeutic action of the psychoanalysis.
 Accedingly, there are two main ways in which resolution of the transference can take place through work with the transference in the here-and-now. The first lies in the clarification of what are the cues in the current situation that are the patient’s point of departure for a transference elaboration. The exposure of the current point of departure at once raises the question of whether it is adequate to the conclusion drawn from it. The relating of the transference to a current stimulus is, after all, parts of the patient’s effort to make the transference attitude plausibly determined by the present. The reserve and ambiguity of the analyst’s behaviour are what increases the ranges of apparently plausible conclusions the patient may draw. If an examination of the basis for the conclusion makes clear that the actual situation to which the patient responds is subject to other meanings than the one the patient had reached, he will more readily consider his pre-existing bias - that is, his transference.
 A decisive summation would include that, in speaking of the current relationship and the relation between the patient’s conclusions and the information on which they seem plausibly based, may as to imply of some absolute conception of what is real in the analytic situation, of which the analyst is the final arbiter. That is not the case. Seemingly, what the patient must come to see is that the information he has is subject to other possible interpretations implies the very contrary to an absolute conception of reality. In fact, analyst and patient engage in a dialogue in a spirit of attempting to arrive at a consensus about reality, not about some staged out-and-out reality.
 The second way in which resolution of the transference can take place within the work with the transference in the here-and-now is that in the very interpretation of the transference the patient had a new experience. He is being treated differently from how he expected to be. Analysts seem reluctant to emphasis this new experience, ads though it endangers the role of insight and argues for interpersonal influence as the significant factor in change. Strachey’s emphasis on the new experience in the mutative transference interpretation has unfortunately been overshadowed by his views on introjection, which have been mistaken to advocate manipulating the transference. Strachey meant introjection of the more benign superego of the analyst only as a temporary step on the road toward insight. Not only is the new experience nit to be confused with the interpersonal influence of a transference gratification, but the new experience occurs with insight into both the patient's-based expectation and the new experience. As Strachey points out, what is unique about the transference interpretation is that insight and the new experience take place in relation to the very person who was expected to behave differently, and it is this that gives the work in the transference its immediacy and effectiveness. While Freud did stress the affective immediacy of the transference, he did not make the new experience explicit.
 Recognizing that transference interpretation is not a matter of experience is important, in contrast to insight, but a joining of the two together. Both are needed to cause and maintain the desired changes in the patient. It is also important to recognize that no new techniques of intervention are required to provide the new experience. It is an inevitable accomplishment of interpretation of the transference in the here-and-now. It is often overlooked that, although Strachey said that only transference interpretations were mutative, he also said with approval that most interpretations were outside the transference.
 In a further explication of Strachey’s paper and entirely consistent with Strachey’s position, Rosenfeld (1972) has pointed out that clarification of material outside the transference is often necessary to know what is the appropriate transference interpretation, and that both genetic transference interpretation and extratransference interpretations play an important role in working through. Strachey said relatively little about working through, but surely nothing against the need for it, yet made so explicitly to a recognized role for recovery of the past in the resolution of the transference.
 The holding position is to emphasis the role of the analysis of the transference in the here-and-now, both in interpreting resistance to the awareness of transference and in working toward its resolution by relating it to the actuality of the situation. Believing that the interpretation of resistance to awareness of the transference should figure in most of sessions, and that if this is done by relating the transference to the actual analytic situation, the very same interpretation is a beginning of work to the resolution of the transference. To justify this view more persuasively would require detailed case material.
 One might be taken in some specified state as siding with the Kleinians whom, many analysts feel, are in error in giving the analysis of the transference too great if not even an exclusive role in the analytic process. It is true that Kleinians emphasize the analysis of the transference more, in their writings at least, than do the overall run of analysts. Anna Freud’s (1968) complaint that the concept of transference has become overexpanded is directed against the Kleinians. One reason the Kleinians consider themselves the true followers of Freud in technique is precisely because of the emphasis they put on the analysis of the transference. Hanna Segal (1967), for example writes as follows: ‘To say that all communications are seen as communications about the patient’s phantasy plus current external life is equivalent to saying that all communications contain something used for the transference situation. In Kleinian technique, the interpretation of the transference is often more central than in the classical technique.’
 Yet, it is nonetheless, the insistence on exclusive attention to any particular aspect of the analytic process. Like the analysis of the transference in the here-and-now, can become a fetish. In that other kinds of interpretation should not be made, but the emphasis on transference interpretation within the analytic situation needs to be increased or at the least reaffirmed, and that we need more clarification and specification of just when other kinds of interpretations are in order.
 Of course making a transference interpretation is sometimes tactless. Surely two reasons that would be included in a specification of the reasons for not making a particular transference interpretation, even if one seems apparent to the analyst, would be preoccupation with an important extratransference event and an inadequate degree of rapport, to use Freud’s term, to sustain the sense of criticism, humiliation, or other painful feelings the particular interpretation might engender, though the analyst had no intention of evoking such a response. The issue might be, however, not of whether or not an interpretation of resistance to the transference should be made, but whether the therapist can find that transference interpretation that in the light of the total situation, both transferential and current, the patient can hear and benefit from primarily as the analyst intends it.
 Transference interpretations, like extratransference interpretations, indeed like any behaviour on the analyst’s part, can affect the transference, which in turn needs to be examined if the result of an analysis is to depend as little as possible on the unanalyzed transference. The result of any analysis depends on the analysis of the transference, persisting effects of unanalyzed transference, and the new experience that particularly have in emphasizing as the unique merit of a transference interpretation in the here-and-now. Remembering this less one’s zeal to ferret out the transference itself becomes is especially important an unrecognized and objectionable actual behaviour on the analyst’s part, with its own repercussions on the transference.
 The emphasis that is of placing on the analysis of resistance to the transference could easily be misunderstood as implying that recognizing the transference is always easy as disguised by resistance or that analysis would go without a hitch if only such interpretations were made. If not only to imply of neither, but rather than the analytic process will have the best chance of success if correct interpretation of resistance to the transference and work with the transference in the here-and-now are the core of analytic work.
 However it remains, that the significance of the transference phenomenon impressed Freud so profoundly that he continued through the years to develop his ideas about it. His classical observations on the patient Dora formed the basis for his first formulation of this concept. He says, ‘What is the transference? They are the new edition or facsimiles of the tendencies and phantasies aroused and made consciously during the progress of the analysis.  However, they have this peculiarity, which is characteristic for their species, that they replace some earlier person by the person of the physician. To put it another way: A whole series of psychological experiences is revived, not as belonging to the past, but as applying to the person of the physician currently.’
 According to Freud’s view, the process of a psychoanalytic cure depends mainly upon the patient’s ability to remember that which is forgotten and repressed, and thus to gain conviction that the analytical conclusions arrived at being correct. However, ‘the unconscious feelings derive to avoid the recognition that the cure demands,’ they seek instead, emotional discharge, despite the reality of the situation.
 Freud believed that these unconscious feelings that the patient strives to hide are made up of that part of the libidinal impulse that has turned away from consciousness and reality, due to the frustration of a desired gratification. Because the attraction of reality has wakened, the libidinal energy is still maintained in a state of regression attached to the original infantile sexual object, although the reasons for the recoil from reality have disappeared.
 Freud states that in the analytic treatment, the analyst pursues this part of the libido to its hiding place, ‘aiming always at unearthing it, making it accessible to consciousness at last serviceable to reality.’ The patient tries to achieve an emotional discharge of this libidinal energy under the pressure of the compulsion to repeat experiences repeatedly again rather than to become conscious of their origin, but he uses the method of transferring to the person of the physician past psychological experiences and reacting to this, at times, with all the power of hallucination. The patient vehemently insists that his impression of the analyst be true for the immediate present, in this way avoiding the recognition of his own unconscious impulses.
 Thus, Freud regarded the transference-manifestations as a major problem of the resistance. However, Freud says, ‘It must not be forgotten that they (the transference-manifestations) and they only, render the invaluable service of making the patient’s buried and forgotten love-emotions and manifestations.’
 Freud regards the transference-manifestations as having two general aspects
- positive and negative. The negative, was at first regarded as having no value in psychoanalytic cures and only something to be 'raised' into consciousness to avoid interference with the progress of the analysis. He later accorded it a place of importance in the therapeutic experience. The positive transference he concluded to be ultimately sexual in origin, since Freud says, ‘To begin with, we knew none but sexual objects.’ However, he divides the positive transference into two components - one, the repressed erotic component, which is used in the service of resistance, the other, the friendly and affectionate component, which, although originally sexual, is the 'unobjectionable' aspect of the positive transference, and is involved with that ‘causation of a successful result on the psychoanalysis, as in all other remedial methods.’ Freud refers here to the element of suggestion in psychoanalytic therapy.
 Although not agreeing with the view of Freud that human behaviour depends ultimately on the biological sexual drives, and that it would be a mistake to deny the importance of his formulations regarding transference phenomena, I differ on certain points with Freud. However, I do not differ with the formulation that early impressions acquired during childhood is revived in the analytical situation, and are felt as immediate and real - that they form paternally the greatest obstacles to analysis, if unnoticed and, as Freud puts it, the greatest ally of the analysis when understood. Agreeing that the main work of the analysis consists in analysing the transference phenomena, although differing about how this results in a cure -that the transference is a strictly interpersonal experience. Freud gives the impression that under the stress of the repetition-compulsion the patient is bound to repeat the identical pattern, despite the other person. Thus and so, I believe that the personality of the analyst tends to decide the character of the transference illusion, and especially to figure out whether the attempt at analysis will result in a cure. Horney has shown that there is no valid reason for assuming that the tendency to repeat experiences repeatedly has an instinctual basis. The particular character of the person requires that he integrate with any given situation according to the necessities of his character structure - and the implications of in the psychoanalytic therapy.
 Transference, and its use in therapy, has now become necessary to begin at the beginning, and to point out in a very schematic way how a person finds his particular orientation to himself and the world - which one might call his character structure.
 The infant is born without a frame of reference, as far as interpersonal experience goes. He is already acquainted with the feelings of bodily movement - with sucking and swallowing - but, among other things, he has had no knowledge of the existence of another person in relationship of himself. Although I do not wish to draw any particular conclusions from this analogy, however, to mention a simple phenomenon, described by Sherif, connected with the problem of the frame of reference. If you have a completely dark room, with no possibility of any light being seen, and you then turn on a small-pin-point of light, which is kept stationary, this light will be moving about. It is certainty with which many of you have noticed that this phenomenon when gazing at a single star. The light seems to move, and it does so, apparently, because there is no reference point in relation to which one can establish it at a fixed place in space and time. It just wanders around. If, however, one can at the same time see some light as a fixed object in the room, the light immediately becomes stationary - its reference point becomes the centre of a fixed frame reference from which its orientation from a pin-of-light, soon becomes the reference point in which has been established, and there is no longer any uncertainty of wandering of the spot of light. It is fixed. The pinned-point of light wandering in the dark room is symbolic of the original attitude of the person to himself, undetermined, unstructured, with no reference points.
 The new-born infant probably perceives everything in a vague and uncertain way, including himself. Gradually, reference points are established that a connection begins to occur between hunger and breast, between a relief of bladder tension and a wet diaper, between plating with his genitals and a smack on the hand. The physical boundaries and potentialities of the self are explored. One can observe the baby investigating the extent, shape and potentialities of his body. He finds that the realm of him and his other will come, or will not come, in that he will in spite hold his breath. Everything will get excited that he can smile and speak lovingly? People will be enchanted, or just the opposite? The nature of the emotional reference points that the determiner depends upon the environment. By that still unknown quality called ‘empathy,’ he discovers the reference points that help to figure out his emotional attitude toward himself. If his mother did not want him, is disgusted with him, treats him with utter disregard, he comes to look upon himself as a thing-to-be-disregarded. With the profound human drive to make this rationally, he gradually builds up a system of ‘reasons why.’ Underneath all these ‘reasons’ is a basic sense of worthlessness, undetermined and undefined, related directly to the origin reference frame. Another child discovers that the state of being regarded is dependent upon specific factors - all is well if one does not act spontaneously, since one is not a separate person, since one is good, as the state of being good is continuously defined by the parents. Under these conditions, and these only, this child can feel a sense of self-regard.
 Other people are encountered with the original reference frame in mind. The child tends to carry over into later situations the patterns he first learned to know. The rigidity with which these original patterns are retained depends upon the nature of the child’s experience. If this had been a traumatic character so that spontaneity has been blocked and further emotional development has been inhibited, the original orientation will tend to persist. Discrepancies may be rationalized or repressed. Thus, the original impression of the hostile mother may be retained, while the contact with the new person is rationalized to fit the original reference frame. The new person encountered acts differently, but probably that is just a pose. She is just being pleasant because she does not know me. If she really knew me, she would act differently. Or, the original impressions are so out of line with the present actuality, that they remain unconscious, but make themselves apparently inappropriate in behaviour or attitudes, which remain outside the awakening awareness of the person concerned.
 The incongruity of the behaviour, or of the attitude, may be a souse of astonishment to the other person involved. Sullivan provides insight into the process by the elucidation of what he calls the ‘parataxic distortions.’ He points out that in the development of the personality, certain integrative patterns are organized in response to the important persons in the child’s past. There is a ‘self-in-relation-to-A’ pattern, or ‘self-in-relation-to -B’ pattern. These patterns of response become familiar and useful. The person learns to get along as a ‘self-in-relation-to A’ or B, C, D and E, depending on the number of important people to whom he had to adjust during his early development. For example, a young woman, who had a severely dominating mother and a weak, kindly father, learned a pattern of adjustment to her mother that could be briefly described as submissive, mildly rebellious in a secret way, but mostly lacking in spontaneity. Toward the father she developed loving, but contemptuous attitude. When she encountered other people, whatever sex, she oriented herself to them partly as the real people they were, and partly as she had learned to respond to her mother and father in the past. She thus was feeling toward the real person involved as if she were dealing with two people at once. However, since it is very necessary for people to behave as rational persons, she suppressed the knowledge that some of her reactions were inappropriate to the immediate situation, and wove an intricate mesh of rationalizations, which permitted her to believe that the person with whom she was dealing really was someone either to be feared and submitted to, as her mother, or to be contemptuous of, as her father. To a greater extent, the real person fitted the original picture of the mother and father, the easier it was for her to maintain that the original ‘self-in-reflation-to-A-or-B’ was the real and valid expression of herself.
 It happened, however, that this woman had, had a kindly nurse who was not a weak person, although occupying an inferior position in the household. During the many hours when she was with this nurse, she can experience a great deal of undeserved warmth, and of freedom for self-realization, no demands for emotional conformity were made on her or his relationship. Her own capacities for love and spontaneous activity could flourish. Unfortunately, the contact with this nurse was all too brief. Still, they’re remained, despite the necessity for the rigid development of the patterns toward the mother and father, a deeply repressed, but still vital experience of self, which most closely approximated the fullest realization of her potentialities. This, which one might call her ‘real self,’ although ‘snowed under’ and impeded by all the distortions incurred by her relationship to the parents, was finally able to emerge and become again active in analysis. In this treatment, she learned how much her reactions to people were ‘transference’ reactions, or as Sullivan would say, ‘parataxic distortions.’
 Of course, a deliberate schematization was made to illustrate the earliest frames of reference and then, least of mention, the parents are not overlooked as to other possible reference frames. Also, one has to realize that one pattern connects with another - the whole making a tangled mass that only years of analysis may buoyantly unscramble. Also, an attemptive glimpse into what has not taken of its time to outline the compensative drives that the neurotic person has to develop to handle his life situation. Each compensatory manoeuver causes some change in his frame of reference, since the development of a defensive trait in his personality sets off a new set of relationships to those around him. The little child who grows ever more negativistic, because of injuries and frustrations, evokes more hostility in his environment. However, and this is important, the basic reactions of hostility by the parents, which originally induced his negativism, are still there. Thus, the pattern does not change much in character, and it just gets worse in the same direction. Those persons whose later life experiences perpetuate the original; frames of reference are more severely injured. A young child, who has a hostile mother, may then have a hostile teacher. If, by good luck, she got a kind teacher and if his own attitude was not already badly warped, so that he did not induce hostility in this kind teacher, he would be introduced into a startlingly new and pleasant frame of reference. His personality might not suffer too greatly, especially if a kindly aunt or uncle happened to be around. Surely, that if the details of the life histories of healthy people were studied, it would be found that they had some very satisfactory experiences early enough to establish in them a feeling of validity as persons. The profoundly sick people have been so early injured, in such a rigid and limited frame of reference, that they are not able to use kindliness, decency or regard when it does come their ways. They meet the world as if it were potentially menacing. They have already developed defensive traits entirely appropriate to their original experience, and then carry them out in completely inappropriate situations, rationalizing the discrepancies, but never daring to believe that people are different to the ones they early learned to distrust and hate. Because of bitter early experience, they learn to let their guards down, never to permit intimacy, lest at that moment the death blow would be dealt to their already partly destroyed sense of self-regard. Despairing of real joy in living, they develop secondary neurotic goals that a pseudo-satisfaction. The secondary gains at first glance might be what the person was really striving for - revenge, powerfulness and exclusive possession. Actually, these are but the expressions of the deep injuries sustained by the person. They cannot be fundamentally cured until those interpersonal relationships that caused the original injury are brought back to consciousness in the analytic situation. In stages, each phase of the long period of emotional development is exposed, by no means chronologically, the interconnectivity in overlapping reference frames is made conscious, those points at which a distortion of reality, or a repression of part of the self had to occur, are uncovered. The reality gradually becomes 'undistorted', the self, refound, in the personal relationship between the analyst ant the patient. This personal relationship with the analyst is the situation in which the transference distortions can be analysed.
 In Freud’s view, the transference was either positive or negative, and was related in an isolated way to a particular person in the past. Perhaps, the transference is the experiencing in the analytic situation the entire pattern of the original reference frames, which include at every moment the relationship of the patient to himself, to the important persons, and to others, as he experienced them at the time, in the light of his interrelationships with the important people.
 The therapeutic aim in this process is not to uncover childhood memories that will then lend themselves to analytic interpretation - the important difference to Freud’s view. Fromm has pointed this out in a recent lecture. Psychoanalytic cure is not the amassing of data, either from childhood, or from the study of the present situation. Nor does cure resolve itself from a repetition of the original injuries’ experience in the analytic relationship. What is curative in the process is that in tending to reconstruct with the analyst the atmosphere that obtained in childhood, the patient achieves something new. He discovers that part of himself that had to be repressed at the time of the original experience. He can only do this is an interpersonal relationship with the analyst, which is suitable to such a rediscovery. To illustrate this point, If a patient had a hostile parent toward whom he was required to show deference, he would have to repress certain of his own spontaneous feelings. In the analytical situation, he tends to carry over his original frame of reference and again tends to feel himself to be in a similar situation. If the analyst’s personality in addition contains elements of a need for deference that need will be the unconscious implication as imparted to the patient, who will, therefore ease the repressive magnitude of his spontaneity as previously he was the same benevolence. True enough, he may act or try to act as if analysed, since by definition, that is what the analyst is attempting to accomplish. Nevertheless, he will never have found his repressed self, because the analytical relationship contains for him elements actually identical with his original situation. Only if the analyst provides a genuinely new frame of reference - that is, if he is truly non-hostile, and truly not in need of deference - can this patient discover, and it is a real discovery, the repressed elements of his own personality. Thus, the transference phenomenon is used so that the patient will completely re-experience the original frames of reference, and himself within those frames, in a truly different relationship with the analyst, to the end that can discover the invalidity of his conclusions about himself and others.
 That is not to mean that this is to deny the correctness of Freud’s view of the transference, yet acting as a resistance is a matter of fact, in that the tendency of the patient to reestablish the original reference frame is precisely because he is afraid to experience the other person in a direct and unreserved way. He has organized his whole system of getting along in the world. Bad as that system might be, based on the original distortions of his personality and his subsequent vicissitudes. His capacity for spontaneous feeling and a ting has gone into hiding. Now it has to be sought. If some such phrases as the 'capacity for self-realizations' are substituted in place of Freud’s concept of the repressed libidinal impulse, much the same conclusions can be reached about the way in which the transference-manifestations appear in the analysis as resistance. It is just in the safest situation, where the spontaneous feeling might come out of hiding, that the patient develops intense feelings, sometimes of a hallucination character, that relate to the most dreaded experiences of the past. It is at this point that the nature and the use by the patient of the transference distortions have to be understood and correctly interpreted by the analyst. It is also here that the personality of the analyst modifies the transference reaction. A patient cannot feel close to a detached or hostile analyst and will therefore never display the full intensity of his transference illusions. The complexity of this process, by which the transference can be used as the therapeutic instrument and, while, as a resistance may be illustrated by an example through which a patient having had developed intense feelings of attachment to a father surrogate in his everyday life. The transference feelings toward this man were of great value in explaining his original problem with his real father. As the patient became more aware of his personal validity, he found his masochistic attachment to be weakening. This occasional acute feeling of anxiety, since his sense of independence was not yet fully established. At that point, he developed very disturbing feelings regarding the analyst, believing that she was untrustworthy and hostile, although before this, he has successes in establishing a realistically positive relationship to her. The feelings of untrustworthiness precisely reproduced an ancient pattern with his mother. He experienced them at this point in the analysis to retain and to justify his attachment to the father figure, the weakening of which attachment had threatened him so profoundly. The entire pattern was explained when it was seen that he was re-experiencing an ancient triangle, in which he was continuously driven to a submissive attachment to a dominating father, due to the utter untrustworthiness of his weak mother. If the transference character of his sudden feeling of untrustworthiness of the analyst had not been clarified, he would have turned again submissively to his father surrogate, which would have further postponed his development of independence? Nonetheless, the development of his transference to the analyst brought to light a new insight.
 To the fundamental direction upon which Freud’s view of the so-called narcissistic neurosis, was that Freud felt that personality disorders called schizophrenia or paranoia cannot ne analysed because the patient is unable to develop a transference to the analyst. Yet nonetheless, it is viewed as that of a real difficulty in treating such disorders that the relationship is essentially nothing but transference illusions of reality. Nowhere in the realm of psychoanalysis can one find complete proof of the effect of early mention experience on the person that in attempting to treat these patients. Frieda Fromm-Reichmann has shown in her work with schizophrenics the necessity to realize the intensity of the transference reaction, which have become almost completely real to the patient. Yet, if one knows the correct interpretations, by actually feeling the patient’s needs, one can over years of time do the identical thing accomplished more quickly than is less dramatical with patients suffering some less severe disturbances within their own interpersonal relationships.
 Psychoanalysis, since the earliest days of the, Studies on Hysteria (Breuer and Freud, 1993-1905), have always given special attention to the  transference and to the interpretation of transference, believing it to be central in our theory and technique. While there, has never been a lack of interest in transference interpreting. It is not clear why this is so, and the reasons may vary in different parts of the international psychoanalytic community. In America, at least, Gill’s (1982) recent, and somewhat radical presentation of transference interpretation has surely helped to the grasping upon our developing attentions, nevertheless, of another reasons for our intensified interests in transference interpretation is the opportunity it provided for rhetorically dialectic awareness, in that discussions, have lead us to the diverse analytic theories and techniques that today complete of the global diversities in our lives’. Our attentions and allegiance. In this respect, transference interpretation seems to have replaced self-psychology as the encompassing topic that allows analysts of varied persuasions among many structural and fundamental elements that forge out the shape for taking upon the imparting of instinctual information, as to know, and knowing that you know, however, its depthful concerning contemplations are distinguished by the evolving characterizations that are of knowing that you know is really nothing whatsoever.
 Despite the diversity of the transference and its interpreting in analytic process and cure, differing only in whether transference is everything or almost everything to give a clear-cut definition of what transference is.
 Laplanche and Pontalis (1973) had written that, ‘The reason it is so difficult to produce a definition of transference is that for many authors the notion has taken on a very broad extension, even coming to connote all the phenomena which constitute the patient’s relationship with the psychoanalyst, as a result the concept is burdened down more than any other with each analyst’s particular view on the treatment - on its objective, dynamics, tactics, scope, and so forth. The question of the transference is thus beset by a whole series of difficulties which have been the subject of debate in classical psychoanalysis.’
 Sandler (1983) has discussed how the terms transference and transference resistance, as well as other terms have undergone profound changes in meaning as new discoveries and new trends of psycho-analytic technique assume ascendency. He said, . . . major changes in technical emphasis brought about the extension of the transference concept, which now has dimensions of meaning which differ from the official definition of the term. I am not sure there has ever been a simplified definition of the term. While a certain flexibility of definition makes conversation possible in a field of diverse views, which we may never be clear on what any two people mean when they use the term is a significant disability to our discourse.
 However: with this in mind we might review one of Freud’s last comments on transference. In ‘An Outline of Psycho-Analysis’ (1940), published posthumously, he wrote on the analytic situation:
 The most remarkable thing is this. The patient is not satisfied with regarding the analyst in the light of reality as a helper and advisor who, moreover, is remunerated for the trouble he takes and who would himself be content with some role that of a guide on a different mountain to climb, on the contrary, the patient sees in him, the return, and the reincarnation, of some important figure out of his childhood or past, and consequently transfer onto him, feelings and reactions which undoubtedly apply this prototype. This fact of transference soon proves to be a factor of an undreamt-of importance, on the other hand bud an instrument of irreplaceable value and on the other, that he set out on a different undertaking without any suspicion to the extraordinary power that would be at his command. . . .
 Another advantage of transference, too, in that in it the patient produces before us with plastic clarity an important part of his life-story, of which he would, otherwise have probably given us only an insufficient account. He acts it before us, as it were, instead of reporting it to us.
Freud saw the transference interpretation as a method of strengthening the ego against past unconscious wishes and conflicts.
 It is the analyst’s task constantly to tear the patient out of his menacing illusions and to show him again and again, of what it takes to be or begin of a new life, are the reflections of the past. And least, he should fall into a state in which he is inaccessible to all evidences, the analyst takes that neither the love nor the hostility reaching an extreme height. This is effected, by preparing him in good time for these possibilities and by not overlooking the first signs of them. Careful handling of the transference on these lines is as a role richly rewarded. If we succeed, as we usually can, in enlightenment the patient on the true nature of the phenomena of the transference, we thus have struck a powerful weapon out of the hand of his resistance and will have converted dangers into gains. For a patient never forgets again what  he has experienced in the form of transference, it carries a greater force of conviction than anything he can acquire in other ways.
We have used the term ‘transference’ several times, and in the last, we attributed the therapeutic results to the transference without further definition of the word. As our concerning considerations are more closely intertwined by its emotional relationship, which the word or, perhaps, a combination of words, by which something can be called and by means of which it can be distinguished or identified. During a psychoanalytic treatment, the patient  allows the analyst to play a predominating role in his emotional life. This is of great importance in the analytic process. After the treatment for and situation is changed. The patient builds up feelings of affection for the resistance to his analyst which, in their ebb ans flow, so exceed the normal degree of feeling that the phenomenon has long since actuated the theoretical interests of the analyst. Freud studied this phenomenon thoroughly, explained it, and gave it the name ‘transference’
 I cannot reproduce for you, all of Freud’s research about the transference, bu t must limit myself to essentials, such as the statement of ‘counter-transference’, is the emotional attitude of the analyst toward the patient, the analyst toward his charge, the therapist toward the patient. The feeling which the child develops for the mentor is conditioned by a much earlier relationship to someone else. We must take cognizance of this fact in order to understand these relationships. The tender relationship which go to make up the child’s love life are no longer strange to us. Many of these have already been touched upon in the foregoing contentual frames. We have learned how the small boy takes the father and mother as love objects. We gave in following the strivings which arose in this relationship, the oedipus situation, in that we have seen how this runs its course and terminates in an identification with the parent. We have also had opportunity to consider the relationship between brothers and sisters, how their original rivalry is transformed into affection through the pressure of their feeling for the parent. We know that the boy at puberty must give up his first love objects within the family and transfer his libido to individuals exteriority or outside of the family. not allows the analyst to play a predominating role in his emotional life. This is of great importance in the analytic process, after all the treatment for and situation is changed, as the patient builds up feelings of affection for the resistance to his analyst which, in their ebb and flow, exceed the normal degree of feeling that the phenomenon has long since actuated the theoretical interests of the analyst. Freud studied this phenomenon thoroughly, explained it, and gave it the name ‘transference’
 Freud’s research about the transference, such as the statement of ‘counter-transference’, is the emotional attitude of the analyst toward the patient, the analyst toward his charge, the therapist toward the patient. The feeling which the child develops for the mentor is conditioned by a much earlier relationship to someone else. We must take cognizance of this fact in order to understand these relationships. The tender relationship which go to make up the child’s love life are no longer strange to us. Many of these have already been touched upon in the foregoing contentual frames. We have learned how the small boy takes the father and mother as love objects. We gave in following the strivings which arise in this relationship, the oedipus situation, we have seen how this runs its course and terminates in an identification with the parent. We have also had opportunity to consider the relationship between brothers and sisters, how their original rivalry is transformed into affection through the pressure of their feeling for the parent. We know that the boy at puberty must give up his first love objects within the family and transfer his libido to the individuals exteriority or outside of the family.
 The key to understanding the essential pathology as well as the therapeutical impasse was in the failure of the patient to develop a reliable working relation with the analyst. In each case the patient was unable to either establish or maintain a durable working alliance with the analyst and the analyst neglected this fact, pursuing instead the analyst of other transference phenomena, as this error in technique was observable in psychoanalysts with a wide range of clinical experience and to recognize the same shortcomings when resuming the transference interpretations.
 In this connection, and, if transference is to be regarded as a significant  ego function, a number of inferences are rather obvious. One is that analysis does not ‘cause’ transference. Yet, although not caused by analysis, transference as it occurs in analysis does seem unique. What is unique, however, may not be transference itself, but rather the effect upon transference of the unique conditions of the analytic situation. These conditions may affect most strongly such things as the choice of content of transference reaction, the intensity of these reactions, their exclusiveness, and their sharp focus on the person of the analyst. Although, as a result of these conditions, transference developments in analysis may differ from those occurring elsewhere, this does not mean that in analysis transference as a function is any different.
 Another rather obvious inference, following from the first, is that transference can never be resolved. The content may be, but not the function. Through analysis, the symptomatic, neurotic and historical plexuity have been brought into the transference may be resolved, but not the function itself. The function of transference, like other functions of the ego, may be affected by analysis in many ways, but it never goes away.
 Still, another inference is a general one concerning transference and the analyst. If transference is to be regarded as an ever active ego function, then the analyst’s transference goes on all the time too, just like the patient’s, and despite what he might wish to think. His transference has not been resolved in his own analysis. Admittedly, the impact of the analytic situation upon the analyst is vastly different from what it is upon the patient, but many aspects of that situation do favour development in the analyst of transference relations involving his patient. This does not mean, however, that it would be correct too believe the analyst should attempt to inhibit his transference function, much less disavow it. Yet, what the analyst should do about this transference  is a question that has never been significantly pondered over. Aside from any belief that the analyst’s transference is remarkably useful in the process of analyzing and may be essential for certain aspects of analysis, what can be said?
 Would it be wrong, to propose that this ego function be dealt within the same way the analyst deals with his other ego function? Just as the analyst must consciously regulate his responses to the functions in order to create and sustain the analytic situation, should he not also regulate his responses to his transference activity?
 This does not mean nor should mean his responses and sustain the analytic situation he not also regulate his responses to his transference activity?  This does not mean, not to be thought that the analyst must decide either whether or when a transference reaction to his patient exists. Such an attempt is the point on which has in itself, at least two counts. For one thing, significant transference reactions are usually not conscious, and, fo r another, transference activity in some form is always going on.
 In view of these considerations, the simplest position for the analyst to take, and the one most likely to be helped, may be to assume that all feelings and reactions of the analyst concerning the patient are ‘prima-facie’ evidence  of the analyst’s transference. Under this arrangement every feeling of warmth, pity, sadness, anger, hope, excitement, even interest, every feeling of coldness, indifference, disinterest, boredom, impatience, discouragement, and every absence of feeling, should be assumed to contain significant elements of the analyst’s transference as focussed on the patient. This would mean, essentially, that everything arising in the analyst about his patient assumed to be part of the substance of analysis, that nothing presents merely the analyst’s ‘real’ reaction to his patient, and that especially when something seems most real it can be counted on to contain important aspects of the analyst’s transference.
 Were the analyst to take this rather imperative view of his own transference potential, he might be much more likely to remain abreast of the personal, neurotic meaning of the myriad but often subtle reactions and attitudes he develops toward his patient. This in turn might make it possible  for him, at least to keep his transference out of the patient’s way and hopefully to use it to further the analysis.
 Th e final inference from all this is perhaps the most promising. This is that transference, if it belongs to the family of ego functions, can be counted on to posses many of this family ‘s characteristics. Thus, presently existing knowledge about the ego should provide many ready-made leads as to the nature of transference. The ego’s way of reality testing, for instance, its responses to internal and external stimuli, its uses of defence mechanisms, may all reveal much about the basic phenomonenology of transference. Similarly, much may be surmised about transference’s functional vicissitudes by assuming that transference suffers the same general developmental and neurotic deficiencies, distortions, limitations, and fixations to which various other functions of the ego are susceptible. A particularly important study would seem to be the special strengths of transference functioning, especially its way  of joining with other agencies to serve and facilitate the individual’s idiosyncratic interests and developments. Such a study, for instance, might centre on the ego’s object relations to the reference to the question of whether transference is the ego function mainly responsibly for their development.
 Viewing transference in this way as an ego function means, of course, relinquishing certain elements of our existing viewpoint. One prominent feature of these existing viewpoints, no matter what form they take, is how hard they are to define or even to elicit. Another is how unquestioning we seem to be about the viewpoints we grew up with, how easily we assume transference to be, but a therapeutically helpful given, an isolated  psychological event having little to do with other psychological event s, and, except in the analytic situation, to be lacking useful purpose. Assigned, without even wondering why, to neither ego nor id, it is usually dropped somewhere in-between. Labelled but rarely described, it is most commonly called a ‘projection’ or a ‘repetition’ of the past, neither of them labels of great distinction.
 Nevertheless, no matter how inadequate the form in which transference presently exists, it is a form that is deeply entrenched and that does not beg for change. Accordingly, wresting transference from its syntonic limbo is not likely to be easy and may be impossible, but doing so, bringing it out into open view where it can be contemplated as a major member of the ego family, is an utterly fascinating prospect, one that permits one to see transference not only as the best tool clinical analysis has, but possibly the best tool the ego has. It well may be, as Freud suggested, the basis of all human relationship and, as suggested, many may be involved in all the ego’s differentiations, integrative and creative capacities. It is these aspects of transference that offer the most exciting questions, and it is with these questions that we will continue.
 Without minor exceptions or flaws we are founded against the realm of fact that holds with the distinctive quality of being actual, but, nonetheless, it was from very early times that Freud had called attention to the fact that transference manifested itself in two ways - negatively as well as positively  - a good deal less said or known about the negative transference than about the positive. This, of course, corresponds to the circumstance that interest in the destructive and aggressive impulses in general, is only a comparatively recent development. Transference was regarded predominantly as a libidinal phenomena. It was suggested that in everyone there existed a certain number of unsatisfied libidinal impulses, and that whenever some new person came upon the scene these impulses were readily attach themselves to him. This was the account of transferences a universal phenomenon. In neurotics, owing to the abnormally large quantities of unattached libido present in the tendency to transference would be correspondingly greater, and the peculiar circumstances of the analytic situation would further increase it. It was evidently the existence of these feelings of love, thrown by the patient upon the analyst, that provided the necessary y extra force to induce his ego to give up its resistance, undo the repressions and adopt a fresh solution of its ancient problems. This instrument, without which no therapeutic result could be obtained, was at once seen to be no stranger; it was in fact the familiar power of suggestion, which had ostensibly been abandoned long before. Now, however, it was being employed in the very different way, in fact in a contrary direction. In pre-analytic days it had aimed at bringing about an increase in the degree of repression, now it was used to overcome the resistance of the ego, that is to say, to allow the repression to be removed.
 But the situation became more and more complicated as more facts about transference came to light. In the first place, the feelings transferred turned out to be of various sorts, besides the loving ones there were the hostile ones, which were naturally far from assisting the analyst’s efforts. But, even apart from the hostile transference. The libidinal feelings themselves fell into two groups; friendly and affectionate feeling which were capable of being conscious, and purely erotic ones which has usually too remain unconscious. And these latter feelings, when they became too powerful, stirred up the repressive forces of the ego and thus increased its resistance instead of diminishing them, and in fact produced a state of things that was not easily distinguishable, from a negative transference. And beyond all this there arose the whole question of the lack of permanence of all suggestive treatments. Did not the existence of the transference threaten to leave the analytic patient in the same unending dependence upon the analyst?
 All of these difficulties were got over by the discovery that the transference itself could be analyzed. Its analysis was soon found to be the most important part of the whole treatment. It was possible to make consciously its roots in the repressed unconscious just as it was possible to make conscious any other repressed material - that is, by inducing the ego to abandon its resistance - and there was nothing self-contradictory in the fact that the forces used for resolving the transference was the transference itself. And once it had been made conscious, its unmanageable, infantile, permanent  characteristics disappeared, what was left was like any other ‘real’ human relationship. But the necessity for constantly analyzing the transference became still more apparent from another discovery. It was found that, as work proceeded the transference tended, as, it were, to eat up the entire analysis. More and more of the patient’s libido became concentrated upon their relation to the analyst, the patient ‘s original symptoms were drained of their cathexis, yet and there appeared instead an artificial neurosis to which Freud gave the name of the ‘transference neurosis’. This original conflict, which have to the onset of neurosis, began to be re-enacted in the relation to the analyst, now this unexpected event is far from being the misfortune than at first. Sight it might seem to be. In fact, it gives us our great opportunity. Instead, of having to deal as best we may with conflicts of the remote past, Which are concerned with dead circumstances and mummified personalities, and whose outcome is already determined, we find ourselves involved in an actual and immediate situation, in which we and the patient are the principal characters and the development of which is to some re-extent, at least under control. But if we bring it about, that in this revivified transference conflict  the patient chooses a new solution instead of the old one, a solution in which the primitive and unadaptable methods of repression is replaced by behaviour more in contact with reality, then, even after his detachment from the analysis, he will never be able to fall back into his former necrosis, the solution of the transference conflict implies as the simultaneous solution of the infantile conflict of which it is a new edition. The ‘blame’, says Freud in his, ‘Introductory Lectures‘ has been made possible by alterations in the ego’s occurring as a consequent of the analyst’s suggestion. At the expense of the unconscious, the ego becomes wider by the words of interpretation. In which brings the unconscious material into consciousness; through education it becomes reconciled to the individual and is made willing to grant it a certain degree of satisfaction, and its horror of the claim of its libido is lessoned by the new capacity it acquires to expend a certain amount of the libido in sublimation, the more nearly the course of the treatment corresponds with this ideal description the greater will be the success of the psycho-analytic therapy.
 Freud made it clear that the ultimate factor in the therapeutic action of psychoanalysis was suggestion on the part of the analyst acting upon the patient’s ego in such a way as to make it more tolerant of the libidinal trends. However, Freud had produced extremely little that bears on the subject, and that little goes to show that he had not altered his views on the main principles involved. In additional lectures which were published last year, he explicitly states that he has nothing to add to the theoretical discussions upon therapy given in the original lectures fifteen years earlier. At the same time, there has in the interval been a considerable further development of his theoretical opinions. And especially in the region of ego-psychology. He had, in particular, formulated the concept of the super-ego. The restatement in super-ego terms of analysis may not involve many changes. But it is reasonable of resistance information about the super-ego will be of special interest from our point of view, and in two ways. In th e first place, it would at first glance seem highly probable that the super-ego should play an important part, direct or indirect, in the setting up and maintaining of the repressions and resistance the demolition of which has been the chief aim of analysis, and is confirmed by an examination of the classification of the various kinds of resistance made by Freud in, ‘Hemmung Symptom and Amgst’ (1926). Of the five sorts of resistance there mentioned it is true that only one is attributed to the direct intervention of the super-ego, but two of the ego-resistance - the repression resistance and the transference resistance - although actually originally from the ego, as a rule set up by out of fear of the super-ego. It seems likely enough therefore that when Freud wrote the words which, in effect, are the favourable change in the patient. ‘Is made possible by alterations in the ego’, he was thinking, in part at all events, of that portion of the ego which he subsequently separated off into the super-ego? Quite apart from this, moreover, in another of Freud’s more recent works, ‘The Group Psychology’ (1921), there are passages which suggest a different point - namely, that it may be largely through the patient’s super-ego that the analyst on the nature of hypnosis and suggestion. He definitely rejects Bernheim’s view that all hypnotic phenomena are traceable to the factor of suggestion, and adopts an alterative theory that suggestion is a partial manifestation of the state of hypnosis. The state of hypnosis, again, is found in certain respects, to resemble the state of being in love. There is, ‘the same humble subjection, the same compliance, the same absence of criticism toward the hypnotist as towardly the loved object, has stepped into the place of the subject’s ego-ideal’. Now since suggestion is a partial form of hypnosis and since the analyst brings about his changes in the patient’s attitude by means of suggestion. It seems to follow that the analyst owes into effectiveness, at all events in some respects, to his having stepped into the place of th e patient’s super-ego. Thus, there are two convergent lines of argument which point to the patient’s super-ego as occupying a key position in analytic therapy. It is a part of the patient’s mind in which a favourable alteration would be likely to lead to general improvement, and it is a part of the patient’s mind which is especially subject to the analyst’s influence.
 Such plausible notions as these were followed up almost immediately after the super-ego made its first début.  It has been developed by Ernest Jones, for instance, in his paper on, ‘The Nature of Auto-Suggestion’. Soon thereafter, Alexander launches his theory that the principal aim of all psycho-analytic therapy must be the complete demolition of the super-ego and the assumption of its functions by the ego. According to his account, the super-ego are handed over to the analyst, and in the second phase they are passed back again to th e patient, but this time to his ego. The super-ego, according to this view of Alexander’s (though he explicitly limits his use of the word to the unconscious parts of the ego-ideal), is a portion of the fundamental apparatuses which is essentially primitive, out of data and out of touch with reality, which is incapable of adapting itself, and which operates automatically, with the monotonous uniformity of a reflex. Any useful functions that it performs can be carried out by the ego. And there is therefore, nothing to be done with it but to discard it. This wholesome attack upon the super-ego seems to be of questionable validity. It seems probable that its abolition, even if that were practical politics, would involve the abolition of a large number off highly desirable mental activities. But the idea that the analyst temporarily takes over the functions of the patient’s super-ego during the treatment and by so doing on some way alters it agrees with the tentative literatures.
 So, too, do some passages in a paper by Radô upon ‘The Economic Principle in Psycho-Analytic Technique’. The second, as such was to have dealt with psych-analysis, that in which has unfortunately never been published, but the first one, on hypnotism and catharsis, contains much that is of interest. It includes a theory that the hypnotic subject introjects the hypnotist in the form of what Radô calls a ‘parasitic super-ego’, which draw off the energy and takes over the functions of the subject’s original super-ego. One feature of the situation brought out by Radô is the unstable and temporary nature of this whole arrangement. If, for instance, the hypnotist gives a command, which is too much in opposition to the subject’s original super-ego. The parasite is promptly excluded. And, in any case, when the state of hypnosis comes to an end, the sway of the parasite super-ego also terminates and the original super-ego resumes its functions.
 However debatable may be the details of Radô description, it not only emphasizes once again, the notion of the super-ego as the function of psych-therapy, but it draws attention to the important distinction between the effects of hypnosis and analysis in the matter of permanence. Hypnosis acts essentially in a temporary way, and Radô theory of the parasitic super-ego, which does not really replace the original one but merely throws it out of action, gives a very good picture of its apparent workings. Analysis, on the  other hand, in so far as it seeks to effect the patient’s super-ego, aims at something much more far-reaching and permanent - namely, at an integral change in the nature of the patient’s super-ego itself. Some even more recent developments in psych-analytic theory give a hint, so it seems as though it seems as the kind of thing, that along which a cleaver understanding of the question may perhaps be reached.
 This latest growth of theory has been very much occupied with the destructive impulses and has brought them for the first time into the centre of interests, and attention has at the same time been concentrated on the correlated problems of guilt and anxiety. That is to say, that in the mind, especially are the ideas upon the formation of the super-ego, recently developed by Melanie Klein and the importance which she attributes to the processes of ‘introjection’ and ‘projection’ in the development of the personality. In a schematic outline, the individual, she holds, is perpetually introjecting and projecting the objects of its id-impulses, and the character of the introjected objects depends on the character of the id-impulses, directed toward the external objects. Thus, for instance, during the stage of a child’s libidinal development in which it is dominated by feelings of oral aggression,  its feelings toward its external object will be orally aggressive; It will then introject the object, and the introjected object will now act (in the manner of a super-ego) in an orally aggressive way toward the child’s ego. (The next even will be the projection of this orally aggressive introjected object back onto the external object, which will now in its turn appear to be orally aggressive). The fact of the external object being thus felt as dangerous and destructive once more causes the id-impulses to adopt an even more aggressive and destructive attitude toward the object in self-defences. A vicious circle is thus launched in the celebrations that this process seeks to account for the extreme severity of the super-ego, in that of small children, as well as for their unreasonable fear of outside objects. In the course of the development of the normal individual, his libido eventually reaches the genital stage, at which the positive impulses predominant, and his attitude toward his external objects will thus become more friendly. That according to his introjected object, or super-ego will become less severe and his ego’s contact with reality will be less distorted. In the case of the neurotic, however, for various reasons - whether an account of frustration of the destructive components - development to the genital stage does not occur, but the individual remains fixated at a pre-genital level. His ego is thus left exposed to the pressure of a savage id on the one hand and a correspondingly savage super-ego on the other, and the vicious circle is perpetuated.
 The human brain is the most highly organized form of matter known, and in plexuity in bains of the other higher animals are not greatly inferior. For certain purposes regarding the brain for being analogous to a machine is expedient. Even if it is so regarded, however, it is a machine of a totally different kind from those made by man. In trying to understand the workings of his own brain man meets his highest challenge. Nothing is given; There are no operating diagrams, no maker's instructions.
 The first step in trying to understand the brain is to examine its structure to discover the components from which it is built and how they are related to each another. After that one can attempt to understand the mode of operation of the simplest components. These two modes of investigation - the morphological and the physiological - have now become complementary. In studying the nervous system with today's sensitive electrical device, however, finding physiological events that cannot be correlated with any known anatomical structure is all too easy. Conversely, the electron microscope reveals many structural details whose physiological significance is obscure or unknown.
 At the close of the past century the Spanish anatomist Santiago Ramón Cajal showed how all parts of the nervous system are built up of individual nerve cells of many different shapes and sizes. Like other cells, each nerve cell has a nucleus and the surrounding cytoplasm. Its outer surface consists of many fine branches - the dendrites - that receive nerve impulses from other nerve cells, and one relatively long branch - the axon - that transmits nerve impulses. Near its end the axon divides into branches that end at the dendrites or bodies of other nerve cells. The axon can be as short as a fraction of a millimeter or if a meter, depending on its place and function. It has many properties of an electric cable and is uniquely specialized to conduct the brief electrical waves called nerve impulses. In very thin axons these impulses travel at less than one meter per second; In others, for example in the large axons of the nerve cells that activate muscles, they travel as fast as 100 meters per second.
 The electrical impulse that travels along the axon ceases abruptly when it comes to the point where the axon's terminal fibers contact another nerve cell. These junction points were given the name ‘synapses’ by Sir Charles Sherrington, who laid the foundations of what is sometimes called synaptology. If the nerve impulse is to continue beyond the synapse, it must be regenerated afresh on the other side. As recently as 15 years ago some physiologists held that transmission at the synapse was predominantly, if not exclusively, an electrical phenomenon. Now, however, there is abundant evidence that transmission is made by the release of specific chemical substances that trigger a regeneration of the impulse. In fact, the first strong evidence showing that some transmitter substance act across the synapse was provided more than 40 years ago by Sir Henry Dale and Otto Loewi.
 It has been estimated that the human central nervous system, which of course includes the spinal cord and the brain itself, consists of about 10 billion nerve cells. With rare exceptions each nerve cell receives information directly as impulses from many other nerve cells - often hundreds - and transmits information to a like number. Depending on its threshold of response, a given nerve cell may fire an impulse when stimulated by only a few incoming fibers or it may not fire until stimulated by many incoming fibers. It has long been known that this threshold can be raised or lowered by various factors. Moreover, it was supposed some 60 years ago that some incoming fibers must inhibit the firing of the receiving cell rather than excite it. The conjecture was subsequently confirmed, and the mechanism of the inhibitory effect has now been clarified. This mechanism and its equally fundamental counterpart - nerve-cell excitation - are of its topic.
 In the levels of anatomy there are some clues to show how the fine axon terminals impinging on a nerve cell can make the cell regenerate a nerve impulse of its own nerve cell and its dendrites are covered by fine branches of nerve fibers that end in knob-like structures. These structures are the synapses.
 The electron microscope has revealed structural details of synapses that fit in nicely with the view that a chemical transmitter is involved in nerve transmission, as there are enclosed in the synaptic knob are many vesicles, or tiny sacs, which appear to contain the transmitter substances that induce synaptic transmission. Between the synaptic knob and the synaptic membrane of the adjoining nerve cell is a remarkably uniform space of about 20 millimicrons that is termed the synaptic cleft. Many of the synaptic vesicles are concentrated adjacent to this cleft; It seems plausible that the transmitter substance is discharged from the nearest vesicles into the cleft, where it can act on the adjacent cell membrane. This hypothesis is supported by the discovery that the transmitter is released in packets of a few thousand molecules.
 The study of synaptic transmission was revolutionized in 1951 by the introduction of delicate techniques for recording electrically from the interior of single nerve cells. This is done by inserting into the nerve cell an extremely fine glass pipette with a diameter of .5 microns - about a fifty-thousandth of an inch. The pipette is filled with an electrically conducting salt solution such as concentrated potassium chloride. If the pipette is carefully inserted and held rigidly in place, the cell membrane appears to seal quickly around the glass, thus preventing the flow of a short-circuiting current through the puncture in the cell membrane. Impaled in this fashion, nerve cells can function normally for hours. Although there is no way of observing the cells during the insertion of the pipette, the insertion can be guided by using as clues the electric signals that the pipette picks up when close to active nerve cells.
 At the John Curtin School of Medical Research in Canberra first employed this technique, choosing to study the large nerve cells called motoneurons, which lie in the spinal cord whose function is to activate muscles. This was a fortunate choice: Intracellular investigations with motoneurons are easier and more rewarding than those with any other kind of mammalian nerve cell.
 Finding that when the nerve cell responds to the chemical synaptic transmitter, the response depends in part on characteristic features of ionic composition that are also concerned with the transmission of impulses in the cell and along its axon. When the nerve cell is at rest, its physiological makeup resembles that of most other cells in that the water solution inside the cell is quite different in composition from the solution in which the cell is bathed. The nerve cell can exploit this difference between external and internal composition and use it in quite different ways for generating an electrical impulse and for synaptic transmission.
 The composition of the external solution is well established because the solution is essentially the same as blood from which cells and proteins have been removed. The composition of the internal solution is known only approximately. Indirect evidence suggests that the concentrations of sodium and chloride ions outside the cell are respectively some 10 and 14 times higher than the concentrations inside the cell. In contrast, the concentration of potassium ions inside the cell is about 30 times higher than the concentration outside.
 How can one account for this remarkable state of affairs? Part of the explanation is that inside the cell is negatively charged with the respect of the cell about 70 millivolts. Since like charges repel each other, this internal negative charge tends to drive chloride ions (Cl-) outward through the cell membrane and, at the same time, to impede their inward movement. In fact, a potential difference of 70 millivolts is just sufficient to maintain the observed disparity in the concentration of chloride ions inside the cell and outside it; Chloride ions diffuse inward and outward at equal rates. A drop of 70 millivolts across the membrane therefore defines the ‘equilibrium potential’ for chloride ions.
 To obtain a concentration of potassium ions (K) that is 30 times higher inside the cell than outside would require that the interior of the cell membrane be about 90 millivolts negative with respect to the exterior. Since the actual interior is only 70 millivolts negative, it falls short of the equilibrium potential for potassium ions by 20 millivolts. Evidently the thirtyfold concentration can be achieved and maintained only if there is some auxiliary mechanism for ‘pumping’ potassium ions into the cell at a rate equal to their spontaneous net outward diffusion.
 The pumping mechanisms have fewer, but more difficult tasks of pumping sodium ions (Na) out of the cell against a potential gradient of 130 millivolts. This figure is obtained by adding the 70 millivolts of internal negative charge to the equilibrium potential for sodium ions, which is 60 millivolts of internal positive charge. If it were not for this postulated pump, the concentration of sodium ions inside and outside the cell would be almost the reverse of what is observed.
 In their classic studies of nerve-impulse transmission in the giant axon of the squid, A.L. Hodgkin, A.F. Huxley and Bernhard Katz of Britain proved that the propagation of the impulse coincides with abrupt changes in the permeability of the axon membrane. When a nerve impulse has been triggered in some way, what can be described as a gate opens and lets sodium ions pour into the axon during the advance of the impulse, making the interior of the axon locally positive. The process is self-reinforcing in that the flow of some sodium ions through the membrane opens the gate further and makes it easier for others to follow. The sharp reversal of the internal polarity of the membrane makes up the nerve impulse, which moves like a wave until it has traveled the length of the axon. In the wake of the impulse the sodium gate closes and a potassium gate opens, by that restoring the normal polarity of the membrane within a millisecond or less.
 With this understanding of the nerve impulse in hand, one is ready to follow the electrical events at the excitatory synapse. One might guess that if the nerve impulse results from an abrupt inflow of sodium ions and a rapid change in the electrical polarity of the axon's interior, something similar must happen at the body and dendrites of the nerve cell in order to generate the impulse in the first place. Indeed, the function of the excitatory synaptic terminals on the cell body and its dendrites is to depolarize the interior of the cell membrane essentially by permitting an inflow of sodium ions. When the depolarization reaches a threshold value, a nerve impulse is triggered.
 As a simple instance of this phenomenon we have recorded the depolarization that occurs in a single motoneuron activated directly by the large nerve fibers that enter the spinal cord from special stretch-receptors known as annulospiral endings. These receptors in turn are found in the same muscle that is activated by the motoneuron under study. Thus the whole system forms a typical reflex arc, such as the arc responsible for the patellar reflex, or ‘knee jerk.’
 To conduct the experiment we anesthetize an animal (most often a cat) and free by dissection a muscle nerves that contains these large nerve fibers. By applying a mild electric shock to the exposed nerve one can produce a single impulse in each of the fibers; Since the impulses travel to the spinal cord almost synchronously, they are referred to collectively as a volley. The number of impulses contained in the volley can be reduced by reducing the stimulation applied to the nerve. The volley strength is measured at a point just outside the spinal cord and is displayed on an oscilloscope. About half a millisecond after detection of a volley there is a wavelike change in the voltage inside the motoneuron that has received the volley. The change is detected by a microelectrode inserted in the motoneuron and is displayed on another oscilloscope.
 What we find is that the negative voltage inside the cell becomes progressively fewer negative as more of the fibers impinging on the cell are stimulated to fire. This observed depolarization is in fact a simple summation of the depolarization produced by each individual synapse. When the depolarization of the interior of the motoneuron reaches a critical point, a ‘spike’ suddenly appears on the second oscilloscope, showing that a nerve impulse has been generated. During the spike the voltage inside the cell changes from about 70 millivolts negative to as much as 30 millivolts positive. The spike regularly appears when the depolarization, or reduction of membrane potential, reaches a critical level, which is usually between 10 and 18 millivolts. The only effect of a further strengthening of the synaptic stimulus is to shorten the time needed for the motoneuron to reach the firing threshold. The depolarizing potentials produced in the cell membrane by excitatory synapses are called excitatory postsynaptic potentials, or EPSP's.
 Through one barrel of a double-barreled microelectrode one can apply a background current to change the resting potential of the interior of the cell membrane, either increasing it or decreasing it. When the potential is made more negative, the EPSP rises more steeply to an earlier peak. When the potential is made less negative, the EPSP rises more slowly to a lower peak. Finally, when the charge inside the cell is reversed so as to be positive with respect to the exterior, the excitatory synapses give rise to an EPSP that is actually the reverse of the normal one.
 These observations support the hypothesis that excitatory synapses produce what amounts virtually to a short circuit in the synaptic membrane potential. When this occurs, the membrane no longer acts as a barrier to the passage of ions but lets them flow through in response to the differing electric potential on the two sides of the membrane. In other words, the ions are momentarily allowed to travel freely down their electrochemical gradients, which means that the sodium ions flow into the cell and, to a lesser degree, potassium ions flow out. It is this net flow of positive ions that creates the excitatory postsynaptic potential. The flow of negative ions, such as the chloride ion, is apparently not involved. By artificially altering the potential inside the cell one can establish that there is no flow of ions, and therefore no EPSP, when the voltage drop across the membrane is zero.
 How is the synaptic membrane converted from a strong ionic barrier into an ion-permeable state? It is currently accepted that the agency of conversion is the chemical transmitter substance contained in the vesicles inside the synaptic knob. When a nerve impulse reaches the synaptic knob, some of the vesicles are caused to eject the transmitter substance into the synaptic cleft. The molecules of the substance would take only a few microseconds to diffuse across the cleft and become attached to specific receptor sites on the surface membrane of the adjacent nerve cell.
 Presumably the receptor sites are associated with fine channels in the membrane that are opened in some way by the attachment of the transmitter-substance molecules to the receptor sites. With the channels thus opened, sodium and potassium ions flow through the membrane thousands of times more readily than they normally do, by that producing the intense ionic flux that depolarizes the cell membrane and produces the EPSP. In many synapses the current flows strongly for only about a millisecond before the transmitter substance is eliminated from the synaptic cleft, either by diffusion into the surrounding regions or as a result of being destroyed by enzymes. The latter process is known to occur when the transmitter substance is acetylcholine, which is destroyed by the enzyme acetylcholinesterase.
 The substantiation of this general picture of synaptic transmission requires the solution of many fundamental problems. Since we do not know the specific transmitter substance for the vast majority of synapses in the nervous system, we do not know whether there are many different substances or only a few. The only one identified with reasonable certainty in the mammalian central nervous system is acetylcholine. We know practically nothing about the mechanism by which a presynaptic nerve impulse causes the transmitter substance to be injected into the synaptic cleft. Nor do we know how the synaptic vesicles not immediately next to the synaptic cleft follow to moved up to the firing line to replace the emptied vesicles. It is supposed that the vesicles contain the enzyme systems needed to recharge themselves. The entire process must be swift and efficient: The total amount of transmitter substance in synaptic terminals is enough for only a few minutes of synaptic activity at normal operating rates. There are also knotty problems to be solved on the other side of the synaptic cleft. What, for example, is the nature of the receptor sites? How are the ionic channels in the membrane opened?
 The second type of synapse that has been identified in the nervous system. These are the synapses that can inhibit the firing of a nerve cell even though it may be receiving a volley of excitatory impulses. When inhibitory synapses are examined in the electron microscope, they look very much like excitatory synapses. (There are probably some subtle differences, but they need not concern us here.) Microelectrode recordings of the activity of single motoneurons and other nerve cells have now shown that the inhibitory postsynaptic potential (IPSP) is virtually a mirror image of the EPSP. Moreover, individual inhibitory synapses, like excitatory synapses, have a cumulative effect. The chief difference is simply that the IPSP makes the cell's internal voltage more negative than it is normally, which is in a direction opposite to that needed for generating a spike discharge.
 By driving the internal voltage of a nerve cell in the negative direction inhibitory synapses oppose the action of excitatory synapses, which of course drive it in the positive direction. So if the potential inside a resting cell is 70 millivolts negative, a strong volley of inhibitory impulses can drive the potential to 75 or 80 millivolts depreciating count. One can easily see that if the potential is made more negative in this way the excitatory synapses find it more difficult to raise the internal voltage to the threshold point for the generation of a spike. Thus, the nerve cell responds to the algebraic sum of the internal voltage changes produced by excitatory and inhibitory synapses.
 The internal membrane potential is altered by the flow of an electric current through one barrel of a double-barreled microelectrode, one can observe the effect of such changes on the inhibitory postsynaptic potential. When the internal potential is made less negative, the inhibitory postsynaptic potential is deepened. Conversely, when the potential is made more negative, the IPSP diminishes; it finally reverses when the internal potential is driven below minus 80 millivolts.
 One can therefore, claim that excitatory synapses the ability to change the ionic permeability of the synaptic membrane. The difference is that inhibitory synapses enable ions to flow freely down an electrochemical gradient that has an equilibrium point at minus 80 millivolts rather than at zero, as is the case for excitatory synapses. This effect could be achieved by the outward flow of positively charged ions such as potassium or the inward flow of negatively charged ions such as chloride, or by a combination of negative and positive ionic flows such that the interior reaches equilibrium at minus 80 millivolts.
 If the concentration of chloride ions within the cell is increased as much as three times, the inhibitory postsynaptic potential reverses and acts as a depolarizing current; that is, it resembles an excitatory potential. On the other hand, if the cell is heavily injected with sulfate ions, which are also negatively charged, there is no such reversal. This simple test shows that under the influence of the inhibitory transmitter substance, which is still unidentified, the subsynaptic membrane becomes permeable momentarily to chloride ions but not to sulfate ions. During the generation of the IPSP the outflow of chloride ions is so rapid that it more than outweighs the flow of other ions that generate the normal inhibitory potential.
 The effect of injecting motoneurons with more than 30 kinds of negatively charmed ions. With one exception the hydrated ions (ions bound to water) to which the cell membrane is permeable under the influence of the inhibitory transmitter substance are smaller than the hydrated ions to which the membrane is impermeable. The exception is the formate ion (HCO2-), which may have an ellipsoidal shape and so be able to pass through membrane pores that block smaller spherical ions.
 Apart from the formate ion all the ions to which the membrane is permeable have a diameter not greater than 1.14 times the diameter of the potassium ion; That is, they are less than 2.9 angstrom units in diameter. Comparable investigations in other laboratories have found the same permeability effects, including the exceptional behavior of the formate ion, in fishes, toads and snails. It might be that the ionic mechanism responsible for synaptic inhibition is the same throughout the animal kingdom.
 The significance of these and other studies is that they strongly suggest that the inhibitory transmitter substance open the membrane to the flow of potassium ions but not to sodium ions. It is known that the sodium ion is somewhat larger than any of the negatively charged ions, including the formate ion, that are able to pass through the membrane during synaptic inhibition. Testing the effectiveness of potassium ions by injecting excess amounts into the cell is not possible, however, because the excess is immediately diluted by an osmotic flow of water into the cell.
 The concentration of potassium ions inside the nerve cell is about 30 times greater than the concentration outside, and to maintain this large difference in concentration without the help of some metabolic pumps inside of the membrane would have to be charged 90 millivolts negative with respect to the exterior. This implies that if the membrane were suddenly made porous to potassium ions, the resulting outflow of ions would make the inside potential of the membrane even more negative than it is in the resting state, and that is just what happens during synaptic inhibition. The membrane must not simultaneously become porous to sodium ions, because they exist in much higher concentration outside the cell than inside and their rapid inflow would more than compensate for the potassium outflow. In fact, the fundamental difference between synaptic excitation and synaptic inhibition is that the membrane freely passes sodium ions in response to the former and largely excludes the passage of sodium ions in response to the latter.
 This fine discrimination between ions that are not very different in size must be explained by any hypothesis of synaptic action. It is most unlikely that the channels through the membrane are created afresh and accurately maintained for a thousandth of a second every time a burst of transmitter substance is released into the synaptic cleft. It is more likely that channels of at least two different sizes are built directly into the membrane structure. In some way the excitatory transmitter substance would selectively unplug the larger channels and permit the free inflow of sodium ions. Potassium ions would simultaneously flow out and thus would tend to counteract the large potential change that would be produced by the massive sodium inflow. The inhibitory transmitter substance would selectively unplug the smaller channels that are large enough to pass potassium and chloride ions but not sodium ions.
 To explain certain types of inhibition other features must be added to this hypothesis of synaptic transmission. In the simple hypothesis chloride and potassium ions can flow freely through pores of all inhibitory synapses. It has been shown, however, that the inhibition of the contraction of heart muscle by the vagus nerve is due almost exclusively to potassium-ion flow. On the other hand, in the muscles of crustaceans and in nerve cells in the snail's brain synaptic inhibition is due largely to the flow of chloride ions. This selective permeability could be explained if there were fixed charges along the walls of the channels. If such charges were negative, they would repel negatively charged ions and prevent their passage; if they were positive, they would similarly prevent the passage of positively charged ions. One can now suggest that the channels opened by the excitatory transmitter are negatively charged and so do not permit the passage of the negatively charged chloride ion, even though it is small enough to move through the channel freely.
 One might wonder if a given nerve cell can have excitatory synaptic action at some of its axon terminals and inhibitory action at others. The answer is no. Two different kinds of nerve cells are needed, one for each type of transmission and synaptic transmitter substance. This can readily be shown by the effect of strychnine and tetanus toxins in the spinal cord; They specifically prevent inhibitory synaptic action and leave excitatory action unaltered. As a result the synaptic excitation of nerve cells is uncontrolled and convulsions result. The special types of cells responsible for inhibitory synaptic action are now being recognized in many parts of the central nervous system.
 This account of communication between nerve cells is necessarily oversimplified, yet it shows that some significant advances are being made at the level of individual components of the nervous system. By selecting the most favorable situations we have been able to throw light on some details of nerve-cell behavior. We can be encouraged by these limited successes. Nevertheless, the task of understanding in a comprehensive way how the human brain operates staggers its own imagination.
 Our brain begins with its portion of the central nervous system contained within the skull. The brain is the control center for movement, sleep, hunger, thirst, and virtually every other vital activity necessary to survival. All human emotions - including love, hate, fear, anger, elation, and sadness - are controlled by the brain. It also receives and interprets the countless signals that are sent to it from other parts of the body and from the external environment. The brain makes us conscious, emotional, and intelligent
 The human brain has three major structural components: the large dome-shaped cerebrum, the smaller somewhat spherical cerebellum, and the brainstem. Prominent in the brainstem are the medulla oblongata and the thalamus - between the medulla and the cerebrum. The cerebrum is responsible for intelligence and reasoning. The cerebellum helps to maintain balance and posture. The medulla is involved in maintaining involuntary functions such as respiration, and the thalamus act as a relay center for electrical impulses traveling to and from the cerebral cortex.
 The adult human brain is a 1.3-kg. (3-lb.) Mass of pinkish-gray jellylike tissue made up of approximately 100 billion nerve cells or neurons: The Neuroglia (supporting-tissue) cells, and vascular (blood-carrying) and other tissues.
 Between the brain and the cranium - the part of the skull that directly covers the brain - are three protective membranes, or meninges. The outermost membrane, the dura mater, is the toughest and thickest. Below the dura mater is a middle membrane, called the arachnoid layer. The innermost membrane, the pia mater, consists mainly of small blood vessels and follows the contours of the surface of the brain.
 A clear liquid, the cerebrospinal fluid, bathes the entire brain and fills a series of four cavities, called ventricles, near the center of the brain. The cerebrospinal fluid protects the internal portion of the brain from varying pressures and transports chemical substances within the nervous system.
 From the outside, the brain as for being visible in that, given to the appearance among them is a settling of three associatively distinct but connected parts, the cerebrum (the Latin word for brain) - two large, almost symmetrical hemispheres; the cerebellum ('little brain') - two smaller hemispheres located at the back of the cerebrum; and the brain stem - a central core that gradually becomes the spinal cord, exiting the skull through an opening at its base called the foramen magnum. Two other major parts of the brain, the thalamus and the hypothalamus, lie in the midline above the brain stem underneath the cerebellum.
 The brain and the spinal cord together make up the central nervous system, which communicates with the rest of the body through the peripheral nervous system. The peripheral nervous system consists of 12 pairs of cranial nerves extending from the cerebrum and brain stem; a system of other nerves branching throughout the body from the spinal cord, and the autonomic nervous system, which regulates vital functions is not very consciously of its own control, such as the activity of the heart muscle, smooth muscle (involuntary muscle found in the skin, blood vessels, and internal organs), and glands.
 Many motor and sensory functions have been ‘mapped’ to specific areas of the cerebral cortex, some of which are indicated here. In general, these areas exist in both hemispheres of the cerebrum, each serving the opposite side of the body. Fewer defined are the areas of association, located mainly in the frontal cortex, operatives in functions of thought and emotion and responsible for linking input from different senses. The areas of language are an exception: Both Wernicke’s area, concerned with the comprehension of spoken language, and Broca’s area, governing the production of speech, have been pinpointed on the cortex. 
 Most high-level brain functions take place in the cerebrum. Its two large hemispheres make up approximately 85 percent of the brain's weight. The exterior surface of the cerebrum, the cerebral cortex, is a convoluted, or folded, grayish layer of cell bodies known as the gray matter. The gray matter covers an underlying mass of fibers called the white matter. The convolutions are made up of ridgelike bulges, known as gyri, separated by small grooves called sulci and larger grooves called fissures. Approximately two-thirds of the cortical surface is hidden in the folds of the sulci. The extensive convolutions enable a very large surface area of brain cortices - roughly, 1.5 m2  (16 ft2) in an adult - to fit within the cranium. The pattern of these convolutions is similar, although not identical, in all humans.
 The two cerebral hemispheres are partially separated from each other by a deep fold known as the longitudinal fissure. Communication between the two hemispheres is through several concentrated bundles of axons, called commissures, the largest of which is the corpus callosum.
 Several major sulci divides the cortex into distinguishable regions. The central sulcus, or Rolandic fissure, runs from the middle of the top of each hemisphere downward, forwards, and toward another major sulcus, the lateral (side), or Sylvian, sulcus. These and other sulci and gyri divide the cerebrum into five lobes: The frontal, parietal, temporal, and occipital lobes and the insula.
 Although the cerebrum is symmetrical in structure, with two lobes emerging from the brain stem and matching motor and sensory areas in each, certain intellectual functions are restricted to one hemisphere. A person’s dominant hemisphere is usually occupied with language and logical operations, while the other hemisphere controls emotion and artistic and spatial skills. In nearly all right-handed and many left-handed people, the left hemisphere is dominant.
 The frontal lobe is the largest of the five and consists of all the cortices in front of the central sulcus. Broca's area, a part of the cortex related to speech, is located in the frontal lobe. The parietal lobe consists of the cortex behind the central sulcus to some sulcus near the back of the cerebrum known as the parieto-occipital sulcus. The parieto-occipital sulcus, in turn,  formulate of an outward appearance of something as distinguished from the substance of which it is made in configurations within the front border of the occipital lobe, which are the rearmost part of the cerebrum. The temporal lobe is to the side of and below the lateral sulcus. Wernicke's area, a part of the cortex related to the understanding of language, is located in the temporal lobe. The insula lies deep within the folds of the lateral sulcus.
 The cerebrum receives information from all the sense organs and sends motor commands (signals that results in activity in the muscles or glands) to other parts of the brain and the rest of the body. Motor commands are transmitted by the motor cortex, a strip of cerebral cortex extending from side to side across the top of the cerebrum just in front of the central sulcus. The sensory cortex, parallel strips of cerebral cortex just in back of the central sulcus, receives input from the sense organs.
 Many other areas of the cerebral cortex have also been mapped according to their specific functions, such as vision, hearing, speech, emotions, language, and other aspects of perceiving, thinking, and remembering. Cortical regions known as associative cortices are responsible for integrating multiple inputs, processing the information, and carrying out complex responses.
 The cerebellum coordinates body movements. Located at the lower back of the brain beneath the occipital lobes, the cerebellum is divided into two lateral (side-by-side) lobes connected by a fingerlike bundle of white fibers called the vermis. The outer layer, or cortex, of the cerebellum consists of fine folds called folia. As in the cerebrum, the outer layer of cortical gray matter surrounds a deeper layer of white matter and nuclei (groups of nerve cells). Three fiber bundles called cerebellar peduncles connect the cerebellum to the three parts of the brain stem - the midbrain, the pons, and the medulla oblongata.
 The cerebellum coordinates voluntary movements by fine-tuning commands from the motor cortex in the cerebrum. The cerebellum also maintains posture and balance by controlling muscle tone and sensing the position of the limbs. All motor activity, from hitting a baseball to fingering a violin, depends on the cerebellum.
 The limbic system is a group of brain structures that play a role in emotion, memory, and motivation. For example, electrical stimulation of the amygdala in laboratory animals can provoke fear, anger, and aggression. The hypothalamus regulates hunger, thirst, sleep, body temperature, sexual drive, and other functions.
 The thalamus and the hypothalamus lie underneath the cerebrum and connect it to the brain stem. The thalamus consist of two rounded masses of gray tissue lying within the middle of the brain, between the two cerebral hemispheres. The thalamus are the main relay station for incoming sensory signals to the cerebral cortex and for outgoing motor signals from it. All sensory input to the brain, except that of the sense of smell, connects to individual nuclei of the thalamus.
 The hypothalamus lies beneath the thalamus on the midline at the base of the brain. It regulates or is involved directly in the control of many of the body's vital drives and activities, such as eating, drinking, temperature regulation, sleep, emotional behavior, and sexual activity. It also controls the function of internal body organs by means of the autonomic nervous system, interacts closely with the pituitary gland, and helps coordinate activities of the brain stem.
 The brain stem, is the lowest part of the brain. It serves as the path for messages traveling between the upper brain and spinal cord but is also the seat of basic and vital functions such as breathing, blood pressure, and heart rates, as well as reflexes like eye movement and vomiting. The brain stem has three main parts: the medulla, pons, and midbrain. A canal runs longitudinally through these structures carrying cerebrospinal fluid. Also distributed along its length is a network of cells, referred to as the reticular formation, that governs the state of alertness.
 The brain stem is revolutionarily the most primitive part of the brain and is responsible for sustaining the basic functions of life, such as breathing and blood pressure. It includes three main structures lying between and below the two cerebral hemispheres - the midbrain, pons, and medulla oblongata.
  The topmost structure of the brain stem is the midbrain. It contains major relay stations for neurons transmitting signals to the cerebral cortex, as well as many reflex centers - pathways carrying sensory (input) information and motor (output) command. Relays and reflex centers for visual and auditory (hearing) functions are located in the top portion of the midbrain. A pair of nuclei called the superior colliculus control reflex actions of the eye, such as blinking, opening and closing the pupil, and focusing the lens. A second pair of nuclei, called the inferior colliculus, controls auditory reflexes, such as adjusting the ear to the volume of sound. At the bottom of the midbrain are reflex and relay centers relating to pain, temperature, and touch, as well as several regions associated with the control of movement, such as the red nucleus and the substantia nigra.
 Continuously with and below the midbrain and directly in front of the cerebellum is a prominent bulge in the brain stem called the pons. The pons consists of large bundles of nerve fibers that connect the two halves of the cerebellum and also connect each side of the cerebellum with the opposite-side cerebral hemisphere. The pons serves mainly as a relay station linking the cerebral cortex and the medulla oblongata.
 The long, stalklike lowermost portion of the brain stem is called the medulla oblongata. At the top, it is continuous with the pons and the midbrain; at the bottom, it makes a gradual transition into the spinal cord at the foramen magnum. Sensory and motor nerve fibers connecting the brain and the rest of the body cross over to the opposite side as they pass through the medulla. Thus, the left half of the brain communicates with the right half of the body, and the right half of the brain with the left half of the body.
 Running up the brain stem from the medulla oblongata through the pons and the midbrain is a netlike formation of nuclei known as the reticular formation. The reticular formation controls respiration, cardiovascular function, digestion, levels of alertness, and patterns of sleep. It also determines which parts of the constant flow of sensory information into the body are received by the cerebrum.
 There are two main types of brain cells, neurons and neuroglia. Neurons are responsible for the transmission and analysis of all electrochemical communication within the brain and other parts of the nervous system. Each neuron is composed of a cell body called a soma, and a major fiber called an axon, and a system of branches called dendrites. Axons, also called nerve fibers, convey electrical signals away from the soma and can be up to 1 m. (3.3 ft.) in length. Most axons are covered with a protective sheath of myelin, a substance made of fats and protein, which insulates the axon. Myelinated axons conduct neuronal signals faster than do unmyelinated axons. Dendrites convey electrical signals toward the soma, are shorter than axons, and are usually multiple and branching.
 Neuroglial cells are twice as numerous as neurons and account for half of the brain's weight. Neuroglia (from glia, Greek for 'glue') provides structural support to the neurons. Neuroglial cells also form myelin, guide developing neurons, take up chemicals involved in cell-to-cell communication, and contribute to the maintenance of the environment around neurons.
 Twelve pairs of cranial nerves arise symmetrically from the base of the brain and are numbered, from front to back, in the order in which they arise. They connect mainly with structures of the head and neck, such as the eyes, ears, nose, mouth, tongue, and throat. Some are motor nerves, controlling muscle movement; some are sensory nerves, conveying information from the sense organs; and others contain fibers for both sensory and motor impulses. The first and second pairs of cranial nerves - the olfactory (smell) nerves and the optic (vision) nerve - carry sensory information from the nose and eyes, respectively, to the undersurface of the cerebral hemispheres. The other ten pairs of cranial nerves originate in or end in the brain stem.
 The brain functions by complex neuronal, or nerve cell, circuits. Communication between neurons is both electrical and chemical and always travels from the dendrites of a neuron, through its soma, and out its axon to the dendrites of another neuron.
 Dendrites of one neuron receive signals from the axons of other neurons through chemicals known as neurotransmitters. The neurotransmitters set off electrical charges in the dendrites, which then carry the signals electrochemically to the soma. The soma integrates the information, which is then transmitted electrochemically down the axon to its tip.
 At the tip of the axon, small, bubble-like structures called vesicles’ release neurotransmitters that carries the signal across the synapse, or gap, between two neurons. There are many types of neurotransmitters, including norepinephrine, dopamine, and serotonin. Neurotransmitters can be excitatory (that is, they excite an electrochemical response in the dendrite receptors) or inhibitory (they block the response of the dendrite receptors).
 One neuron may communicate with thousands of other neurons, and many thousands of neurons are involved with even the simplest behavior. It is believed that these connections and their efficiency can be modified, or altered, by experience.
 Scientists have used two primary approaches to studying how the brain works. One approach is to study brain function after parts of the brain have been damaged. Functions that disappear or that is no longer normal after injury to specific regions of the brain can often be associated with the damaged areas. The second approach is to study the response of the brain to direct stimulation or to stimulation of various sense organs.
 Neurons are grouped by function into collections of cells called nuclei. These nuclei are connected to form sensory, motor, and other systems. Scientists can study the function of somatosensory (pain and touch), motor, olfactory, visual, auditory, language, and other systems by measuring the physiological (physical and chemical) change that occur in the brain when these senses are activated. For example, electroencephalography (EEG) measures the electrical activity of specific groups of neurons through electrodes attached to the surface of the skull. Electrodes incorporate directly into the brain can give readings of individual neurons. Changes in blood flow, glucose (sugar), or oxygen consumption in groups of active cells can also be mapped.
 Although the brain appears symmetrical, how it functions is not. Each hemisphere is specializing and dominates the other in certain functions. Research has shown that hemispheric dominance is related to whether a person is predominantly right-handed or left-handed. In most right-handed people, the left hemisphere processes arithmetic, language, and speech. The right hemisphere interprets music, complex imagery, and spatial relationships and recognizes and expresses emotion. In left-handed people, the pattern of brain organization is more variable.
 Hemispheric specialization has traditionally been studied in people who have sustained damage to the connections between the two hemispheres, as may occur with a stroke, an interruption of blood flow to an area of the brain that causes the death of nerve cells in that area. The division of functions between the two hemispheres has also been studied in people who have had to have the connection between the two hemispheres surgically cut in order to control severe epilepsy, a neurological disease characterized by convulsions and loss of consciousness.
 The visual system of humans is one of the most advanced sensory systems in the body. More information is conveyed visually than by any other means. In addition to the structures of the eye itself, several cortical regions - collectively called a primary visual and visual associative cortex - as well as the midbrain are involved in the visual system. Conscious processing of visual input occurs in the primary visual cortex, but reflexive - that is, immediate and unconscious - responses occur at the superior colliculus in the midbrain. Associative cortical regions - specialized regions that can associate, or integrate, multiple inputs - in the parietal and frontal lobes along with parts of the temporal lobe are also involved in the processing of visual information and the establishment of visual memories.
 Language involves specialized cortical regions in a complex interaction that allows the brain to comprehend and communicate abstract ideas. The motor cortex initiates impulses that travel through the brain stem to produce audible sounds. Neighboring regions of motor cortices, called the supplemental motor cortex, are involved in sequencing and coordinating sounds. Broca's area of the frontal lobe is responsible for the sequencing of language elements for output. The comprehension of language is dependent upon Wernicke's area of the temporal lobe. Other cortical circuits connect these areas.
 Memory is usually considered a diffusely stored associative process - that is, it puts together information from many different sources. Although research has failed to identify specific sites in the brain as locations of individual memories, certain brain areas are critical for memory to function. Immediate recall - the ability to repeat short series of words or numbers immediately after hearing them - is thought to be located in the auditory associative cortex. Short-term memory - the ability to retain a limited amount of information for up to an hour - is located in the deep temporal lobe. Long-term memory probably involves exchanges between the medial temporal lobe, various cortical regions, and the midbrain.
 The autonomic nervous system regulates the life support systems of the body reflexively - that is, without conscious direction. It automatically controls the muscles of the heart, digestive system, and lungs; Certain glands, and homeostasis - that is, the equilibrium of the internal environment of the body. The autonomic nervous system itself is controlled by nerve centers in the spinal cord and brain stem and is fine-tuned by regions higher in the brain, such as the midbrain and cortex. Reactions such as blushing indicate that cognitive, or thinking, centers of the brain are also involved in autonomic responses.
 The brain is guarded by several highly developed protective mechanisms. The bony cranium, the surrounding meninges, and the cerebrospinal fluid all contribute to the mechanical protection of the brain. In addition, a filtration system called the blood-brain barrier protects the brain from exposure to potentially harmful substances carried in the bloodstream.
 Brain disorders have a wide range of causes, including head injury, stroke, bacterial diseases, complex chemical imbalances, and changes associated with aging.
 Head injury can initiate a cascade of damaging events. After a blow to the head, a person may be stunned or may become unconscious for a moment. This injury, called - concussion, - usually leaves no permanent damage. If the blow is more severe and hemorrhage (excessive bleeding) and swelling occurs, however, severe headache, dizziness, paralysis, a convulsion, or temporary blindness may result, depending on the area of the brain affected. Damage to the cerebrum can also result in profound personality changes.
 Damage to Broca's area in the frontal lobe causes difficulty in speaking and writing, a problem known as Broca's aphasia. Injury to Wernicke's area in the left temporal lobe results in an inability to comprehend spoken language, called Wernicke's aphasia.
 An injury or disturbance to a part of the hypothalamus may cause a variety of different symptoms, such as loss of appetite with an extreme drop in body weight, increase in appetite leading to obesity; Extraordinary thirst with excessive urination (diabetes insipidus), failure in body-temperature control, resulting in either low temperature (hypothermia) or high temperature (fever), excessive emotionality, and uncontrolled anger or aggression. If the relationship between the hypothalamus and the pituitary gland is damaged, other vital bodily functions may be disturbed, such as sexual function, metabolism, and cardiovascular activity.
 Injury to the brain stem is even more serious because it houses the nerve centers that control breathing and heart action. Damage to the medulla oblongata usually results in immediate death.
 A stroke is damage to the brain due to an interruption in blood flow. The interruption may be caused by a blood clot, constriction of a blood vessel, or rupture of a vessel accompanied by bleeding. A pouchlike expansion of the wall of a blood vessel, called an aneurysm, may weaken and burst, for example, because of high blood pressure.
 Sufficient quantities of glucose and oxygen, transported through the bloodstream, are needed to keep nerve cells alive. When the blood supply to a small part of the brain is interrupted, the cells in that area die and the function of the area is lost. A massive stroke can cause a one-sided paralysis (hemiplegia) and sensory loss on the side of the body opposite the hemisphere damaged by the stroke.
 Some brain diseases, such as multiple sclerosis and Parkinson disease, are progressive, becoming worse over time. Multiple sclerosis damages the myelin sheath around axons in the brain and spinal cord. As a result, the affected axons cannot transmit nerve impulses properly. Parkinson disease destroys the cells of the substantia nigra in the midbrain, resulting in a deficiency in the neurotransmitter dopamine that affects motor functions.
 Cerebral palsy is a broad term for brain damage sustained close to birth that permanently affects motor function. The damage may take place either in the developing fetus, during birth, or just after birth and is the result of the faulty development or breaking down of motor pathways. Cerebral palsy is nonprogressive - that is, it does not worsen with time.
 A bacterial infection in the cerebrum or in the coverings of the brain, swelling of the brain, or an abnormal growth of healthy brain tissue can all cause an increase in intracranial pressure and result in serious damage to the brain.
 Scientists are finding that certain brain chemical imbalances are associated with mental disorders such as schizophrenia and depression. Such findings have changed scientific understanding of mental health and have resulted in new treatments that chemically correct these imbalances.
 During childhood development, the brain is particularly susceptible to damage because of the rapid growth and reorganization of nerve connections. Problems that originate in the immature brain can appear as epilepsy or other brain-function problems in adulthood.
 Several neurological problems are common in aging. Alzheimer's disease damages many areas of the brain, including the frontal, temporal, and parietal lobes. The brain tissue of people with Alzheimer's disease shows characteristic patterns of damaged neurons, known as plaques and tangles. Alzheimer's disease produces progressive dementia, characterized by symptoms such as failing attention and memory, loss of mathematical ability, irritability, and poor orientation in space and time.
 A magnetic resonance imaging (MRI) scan of the human brain reveals the contours of one of the brain’s hemispheres. The scans produced in the gyri, or ridges, appear in red, while the sulci, or valleys, are shown in blue. Each person has slightly different patterns of gyri and sulci, which reflect individual differences in brain development.
 Several commonly used diagnostic methods give images of the brain without invading the skull. Some portray anatomy - that is, the structure of the brain - whereas others measure brain function. Two or more methods may be used to complement each other, together providing a more complete picture than would be possible by one method alone.
 Magnetic resonance imaging (MRI), introduced in the early 1980s, beams high-frequency radio waves into the brain in a highly magnetized field that causes the protons that form the nuclei of hydrogen atoms in the brain to reemit the radio waves. The reemitted radio waves are analyzed by computer to create thin cross-sectional images of the brain. MRI provides the most detailed images of the brain and is safer than imaging methods that use X-rays. However, MRI is a lengthy process and also cannot be used with people who have pacemakers or metal implants, both of which are adversely affected by the magnetic field.
 Computed tomography (CT), also known as CT scans, developed in the early 1970s. This imaging method X-rays the brain from many different angles, feeding the information into a computer that generate a succession of cross-sectional sequential images. CT is particularly useful for diagnosing blood clots and brain tumors. It is a much quicker process than magnetic resonance imaging and is therefore advantageous in certain situations - for example, with people who are extremely ill.
 This positron emission tomography (PET) scans of the brain shows the activity of brain cells in the resting state and during three types of auditory stimulation. PET uses radioactive substances introduced within the brain to measure such brain functions as cerebral metabolism, blood flow and volume, oxygen use, and the formation of neurotransmitters. This imaging method collects data from many different angles, feeding the information into a computer that produces a series of cross-sectional images.
 Changes in brain function due to brain disorders can be visualized in several ways. Magnetic resonance spectroscopy measures the concentration of specific chemical compounds in the brain that may change during specific behaviors. Functional magnetic resonance imaging (fMRI) maps changes in oxygen concentration that correspond to nerve cell activity.
 Positron emission tomography (PET), developed in the mid-1970s, uses computed tomography to visualize radioactive tracers, radioactive substances are introduced into the brain intravenously or by inhalation. PET can measure such brain functions as cerebral metabolism, blood flow and volume, oxygen use, and the formation of neurotransmitters. Single photon emission computed tomography (SPECT), developed in the 1950s and 1960s, used radioactive tracers to visualize the circulation and volume of blood in the brain.
 Brain-imaging studies have provided new insights into sensory, motor, language, and memory processes, as well as brain disorders such as epilepsy, cerebrovascular disease; Alzheimer's, Parkinson, and Huntington's diseases, and various mental disorders, such as schizophrenia.
 Although all vertebrate brains share the same basic three-part structure, the development of their constituent parts varies across the evolutionary scale. In fish, the cerebrum is dwarfed by the rest of the brain and serves mostly to process input from the senses. In reptiles and amphibians, the cerebrum is proportionally larger and begins to connect and form conclusions about this input. Birds have well-developed optic lobes, making the cerebrum even larger. Among mammals, the cerebrum dominates the brain. It is most developed among primates, in whom cognitive ability is the highest.
 In lower vertebrates, such as fish and reptiles, the brain is often tubular and bears a striking resemblance to the early embryonic stages of the brains of more highly evolved animals. In all vertebrates, the brain is divided into three regions: the forebrain (prosencephalon), the midbrain (mesencephalon), and the hindbrain (rhombencephalon). These three regions further sub-divide into different structures, systems, nuclei, and layers.
 The more highly evolved the animal, the more complex is the brain structure. Human beings have the most complex brains of all animals. Evolutionary forces have also resulted in a progressive increase in the size of the brain. In vertebrates lower than mammals, the brain is small. In meat-eating animals, particularly primates, the brain increases dramatically in size.
 The cerebrum and cerebellum of higher mammals are highly convoluted in order to fit the most gray matter surface within the confines of the cranium. Such highly convoluted brains are called gyrencephalic. Many lower mammals have a smooth, or lissencephalic (smooth head), cortical surfaces.
 There is also evidence of evolutionary adaption of the brain. For example, many birds depend on an advanced visual system to identify food at great distances while in flight. Consequently, their optic lobes and cerebellum are well developed, giving them keen sight and outstanding motor coordination in flight. Rodents, on the other hand, as nocturnal animals, do not have a well-developed visual system. Instead, they rely more heavily on other sensory systems, such as a highly-developed sense of smell and facial whiskers.
 Recent research in brain function suggests that there may be sexual differences in both brain anatomy and brain function. One study indicated that men and women may use their brains differently while thinking. Researchers used functional magnetic resonance imaging to observe which parts of the brain were activated as groups of men and women tried to determine whether sets of nonsense words rhymed. Men used only Broca's area in this task, whereas women used Broca's area plus an area on the right side of the brain.
 The Cell, in [biology] is the most basic unit of life. Cells are the smallest structures capable of basic life processes, such as taking in nutrients, expelling waste, and reproducing. All living things are composed of cells. Some microscopic organisms, such as bacteria and protozoa, are unicellular, meaning they consist of a single cell. Plants, animals, and fungi are multicellular; that is, they are composed of a great many cells working in concert. But whether it makes up an entire bacterium or is just one of the trillions in a human being, the cell is a marvel of design and efficiency. Cells carry out thousands of biochemical reactions each minute and reproduce new cells that perpetuate life.
 The word cell refers to several types of organisms. Cells such as paramecia, dinoflagellates, diatoms, and spirochetes are self-maintaining organisms; cells such as lymphocytes, erythrocytes, muscle cells, nerve cells, cardiac muscle, and chromoplasts are more specializing cells that are a part of higher multicellular organisms. Nonetheless, of its size or whether the cell is a complete organism or just part of an organism, all cells have certain structural make-over by their components that most generally are shared in or participated in by their commonalty. All cells have some type of outer cell boundary that permits some materials to leave and enter the cell and a cell interior composed of a water-rich, fluid material called cytoplasm that contains hereditary material in the form of deoxyribonucleic acid (DNA).
 Cells vary considerably in size. The smallest cell, a type of bacterium known as a mycoplasma, measures 0.0001 mm. (0.000004 in.) in diameter; 10,000 mycoplasmas in a row are only as wide as the diameter of a human hair. Among the largest cells are the nerve cells that run down a giraffe’s neck; these cells can exceed 3 m. (9.7 ft.) in length. Great cells also display a variety of sizes, from small red blood cells that measure 0.00076 mm. (0.00003 in.) To liver cells that may by their quantity amount, in the increasing order by, at least, ten times to they’re greater. About 10,000 average-sized human cells can fit on the head of a pin.
 Along with their differences in size, cells present an array of shapes. Some, such as the bacterium Escherichia coli, resemble rods. The paramecium, a type of protozoan, is a slipper shaped.  The amoeba, another protozoan, has an irregular form that changes shape as it moves around. Plant cells typically resemble boxes or cubes. In humans, the outermost layers of skin cells are flat, while muscle cells are long and thin. Some nerve cells, with their elongated, tentacle-like extensions, suggest an octopus.
 In multicellular organisms, shape is typically tailored to the cell’s job. For example, flat skin cells pack tightly into a layer that protects the underlying tissues from invasions by bacteria. Long, thin muscle cells’ contract readily to move bones. The numerous extensions from a nerve cell enable it to connect to several other nerve cells in order to send and receive messages rapidly and efficiently.
 By itself, each cell is a model of independence and self-containment. Like some miniature, walled city in perpetual rush hour, the cell constantly bustles with traffic, shuttling essential molecules from place to place to carry out the business of living. Despite their individuality, however, cells also display a remarkable ability to join, communicate, and coordinate with other cells. The human body, for example, consists of an estimated 20 to 30 trillion cells. Dozens of different kinds of cells are organized into specialized groups called tissues. Tendons and bones, for example, are composed of connective tissue, whereas skin and mucous membranes are built from epithelial tissue. Different tissue types are assembled into organs, which are structures specialized to perform particular functions. Examples of organs include the heart, stomach, and brain. Organs, in turn, are organized into systems such as the circulatory, digestive, or nervous systems. All together, these assembled organ systems form the human body.
 The components of cells are molecules, nonliving structures formed by the union of atoms. Small molecules serve as building blocks for larger molecules. Proteins, nucleic acids, carbohydrates, and lipids, which include fats and oils, are the four major molecules that underlie cell structure and also participate in cell functions. For example, a tightly organized arrangement of lipids, proteins, and protein-sugar compounds forms the plasma membrane, or outer boundary, of certain cells. The organelles, membrane-bound compartments in cells, are built largely from proteins. Biochemical reactions in cells are guided by enzymes, specialized proteins that speed up chemical reactions. The nucleic acid deoxyribonucleic acid (DNA) contains the hereditary information for cells, and another nucleic acid, ribonucleic acid (RNA), works with DNA to build the thousands of proteins the cell needs.
 Cells fall into one of two categories: Prokaryotic or eukaryotic, in a prokaryotic cell, found only in bacteria and archaebacteria, all the components, including the DNA, mingle freely in the cell’s interior, a single compartment. Eukaryotic cells, which make up plants, animals, fungi, and all other life forms, contain numerous compartments, or organelles, within each cell. The DNA in eukaryotic cells is enclosed in a special organelle called the nucleus, which serves as the cell’s command center and information library. The term prokaryote comes from Greek words that mean ‘before the nucleus’ or ‘prenucleus,’ while eukaryote means ‘a true nucleus.’
 Bacteria’s cells typically are surrounded by a rigid, protective cell wall. The cell membrane, also called the plasma membrane, regulates passage of materials into and out of the cytoplasm, the semi-fluid that fill the cell. The DNA, located in the nucleoid region, contains the genetic information for the cell. Ribosomes carry out protein synthesis. Many bacteria contain some pilus (plural pili), a structure that extends out of the cell to transfer DNA to another bacterium. The flagellum, found in numerous species, is used for the locomotion. Some bacteria contain a plasmid, a small chromosomes with extra genes. Others have a capsule, a sticky substance external to the cell wall that protects bacteria from attack by white blood cells. Mesosomes were formerly thought to be structures with unknown functions, but now are known to be artifacts created when cells are prepared for viewing with electron microscopes.
 Prokaryotic cells are among the tiniest of all cells, ranging in size from 0.0001 to 0.003 mm. (0.000004 to 0.0001 in.) in diameter. About a hundred typical prokaryotic cells lined up in a row would match the thickness of a book page. These cells, which can be rod-like, spherical, or spiral in shape, are surrounded by a protective cell wall. Like most cells, prokaryotic cells live in a watery environment, whether it is soil moisture, a pond, or the fluid surrounding cells in the human body. Tiny pores in the cell wall enable water and the substances dissolved in it, such as oxygen, to flow into the cell; these pores also allow wastes to flow out.
 Pushed up against the inner surface of the prokaryotic cell wall is a thin membrane called the plasma membrane. The plasma membrane, composed of two layers of flexible lipid molecules and interspersed with durable proteins, is both supple and strong. Unlike the cell wall, whose open pores allow the unregulated traffic of materials in and out of the cell, the plasma membrane is selectively permeable, meaning it allows only certain substances to pass through. Thus, the plasma membrane actively separates the cell’s contents from its surrounding fluids.
 While small molecules such as water, oxygen, and carbon dioxide diffuse freely across the plasma membrane, the passage of many larger molecules, including amino acids (the building blocks’ of proteins) and sugars, is carefully regulated. Specialized transport proteins accomplish this task. The transport proteins span the plasma membrane, forming an intricate system of pumps and channels through which traffic is conducted. Some substances swirling in the fluid around the cell can enter it only if they bind to and are escorted in by specific transport proteins. In this way, the cell fine-tunes its internal environment.
 The plasma membrane encloses the cytoplasm, the semifluid that fill the cell. Composed of about 65 percent water, the cytoplasm is packed with up to a billion molecules per cell, a rich storehouse that includes enzymes and dissolved nutrients, such as sugars and amino acids. The water provides a favorable environment for the thousands of biochemical reactions that take place in the cell.
 Within the cytoplasm of all prokaryote is deoxyribonucleic acid (DNA), a complex molecule in the form of a double helix, a shape similar to a spiral staircase. The DNA is about 1,000 times the length of the cell, and to fit inside, it repeatedly twists and folds to form a compact structure called a chromosome. The chromosome in prokaryote is circular, and is located in a region of the cell called the nucleoid. Often, smaller chromosomes called plasmids are located in the cytoplasm. The DNA is divided into units called genes, just like a long train is divided into separate cars. Depending on the species, the DNA contains several hundred or even thousands of genes. Typically, one gene contains coded instructions for building all or part of a single protein. Enzymes, which are specialized proteins, determine virtually all the biochemical reactions that support and sustain the cell.
 Also, immersed in the cytoplasm are the only organelles in prokaryotic cells.  Tiny bead-like structures called ribosomes. These are the cell’s protein factories. Following the instructions encoded in the DNA, ribosomes churn out proteins by the hundreds every minute, providing needed enzymes, the replacements for worn-out transport proteins, or other proteins required by the cell.
 While relatively simple in construction, prokaryotic cells display extremely complex activity. They have a greater range of biochemical reactions than those found in their larger relatives, the eukaryotic cells. The extraordinary biochemical diversity of prokaryotic cells is manifested in the wide-ranging lifestyles of the archaebacteria and the bacteria, whose habitats include polar ice, deserts, and hydrothermal vents - deep regions of the ocean under great pressure where hot water geysers erupt from cracks in the ocean floor.
 An animal cell typically contains several types of membrane-bound organs, or organelles. The nucleus directs activities of the cell and carries genetic information from generation to generation. The mitochondria generates energy for the cell. Proteins are manufactured by ribosomes, which are bound to the rough endoplasmic reticulum or float free in the cytoplasm. The Golgi apparatus modifies, packages, and distributes proteins while lysosomes store enzymes for digesting food. The entire cell is wrapped in a lipid membrane that selectively permits materials to pass in and out of the cytoplasm.
  Eukaryotic cells are typically about ten times larger than prokaryotic cells. In animal cells, the plasma membrane, rather than a cell wall, forms the cell’s outer boundary. With a design similar to the plasma membrane of prokaryotic cells, it separates the cell from its surroundings and regulates the traffic across the membrane.
 The eukaryotic cell cytoplasm is similar to that of the prokaryote cell except for one major difference: Eukaryotic cells house a nucleus and numerous other membrane-enclosed organelles. Like separate rooms of a house, these organelles enable specialized functions to be carried out efficiently. The building of proteins and lipids, for example, takes place in separate organelles where specialized enzymes geared for each job are located.
 The plasma membrane that surrounds eukaryotic cells is a dynamic structure composed of two layers of phospholipid molecules interspersed with cholesterol and proteins. Phospholipids are composed of a hydrophilic, or water-loving, head and two tails, which are hydrophobic, or water-hating. The two phospholipid layers face each other in the membrane, with the heads directed outward and the tails pointing inward. The water-attracting heads anchor the membrane to the cytoplasm, the watery fluid inside the cell, and also to the water surrounding the cell. The water-hating tails block large water-soluble molecules from passing through the membrane while permitting fat-soluble molecules, including medications such as tranquilizers and sleeping pills, to freely cross the membrane. Proteins embedded in the plasma membrane carry out a variety of functions, including transport of large water soluble molecules such as sugars and certain amino acids. Glycoproteins, proteins bonded to carbohydrates, serve in part to identify the cell as belonging to a unique organism, enabling the immune system to detect foreign cells, such as invading bacteria, which carry different glycoproteins. Cholesterol molecules in the plasma membrane act as stabilizers that limit the movement of the two slippery phospholipids layer, which slide back and forth in the membrane. Tiny gaps in the membrane enable small molecules such as oxygen to diffuse readily into and out of the cell. Since cells constantly use up oxygen, decreasing its concentration within the cell, the higher concentration of oxygen outside the cell causes a net flow of oxygen into the cell. The steady stream of oxygen into the cell enables it to carry out aerobic respiration continually, a process that provides the cell with the energy needed to carry out its functions.
 The nucleus is the largest organelle in an animal cell. It contains numerous strands of DNA, the length of each strand being many times the diameter of the cell. Unlike the circular prokaryotic DNA, long sectors of eukaryotic DNA pack into the nucleus by wrapping around proteins. As a cell begins to divide, each DNA strand folds over onto itself several times, forming a rod-shaped chromosome.
 The nucleus is surrounded by a double-layered membrane that protects the DNA from potentially damaging chemical reactions that occur in the cytoplasm. Messages pass between the cytoplasm and the nucleus through nuclear pores, which are holes in the membrane of the nucleus. In each nuclear pore, molecular signals flash back and forth as often as ten times per second. For example, a signal to activate a specific gene comes into the nucleus and instructions for production of the necessary protein go out to the cytoplasm.
 The nucleus, present in eukaryotic cells, is a discrete structure containing chromosomes, which hold the genetic information for the cell. Separated from the cytoplasm of the cell by a double-layered membrane called the nuclear envelope, and the nucleus contains a cellular material called nucleoplasm. Nuclear pores, present around the circumference of the nuclear membrane, allow the exchange of cellular materials between the nucleoplasm and the cytoplasm.
 Attached to the nuclear membrane is an elongated membranous sac called the endoplasmic reticulum. This organelle tunnels through the cytoplasm, folding back and forth on itself to form a series of membranous stacks. Endoplasmic reticulums take two forms: Rough and smooth. A rough endoplasmic reticulum (RER) is so called because it appears bumpy under a microscope. The bumps are actually thousands of ribosomes attached to the membrane’s surface. The ribosomes in eukaryotic cells have the same function as those in prokaryotic cells - protein synthesis - but they differ slightly in structure. Eukaryote ribosomes bound to the endoplasmic reticulum help assemble proteins that typically are exported from the cell. The ribosomes work with other molecules to link amino acids to partially completed proteins. These incomplete proteins then travel to the inner chamber of the endoplasmic reticulum, where chemical modifications, such as the addition of a sugar, are carried out. Chemical modifications of lipids are also carried out in the endoplasmic reticulum.
 The endoplasmic reticulum and its bound ribosomes are particularly dense in cells that produce many proteins for export, such as the white blood cells of the immune system, which produce and secrete antibodies. Some ribosomes that manufacture proteins are not attached to the endoplasmic reticulum. These so-called free ribosomes are dispersed in the cytoplasm and typically make proteins - many of them enzymes - that remain in the cell.
 The second form of an endoplasmic reticulum, the smooth endoplasmic reticulum (SER), lacks ribosomes and levels of an even surface. Within the winding channels of the smooth endoplasmic reticulum are the enzymes needed for the construction of molecules such as carbohydrates and lipids. The smooth endoplasmic reticulum is prominent in liver cells, where it also serves to detoxify substances such as alcohol, drugs, and other poisons.
 Proteins are transported from free and bound ribosomes to the Golgi apparatus, an organelle that resembles a stack of deflated balloons. It is packed with enzymes that complete the processing of proteins. These enzymes add sulfur or phosphorus atoms to certain regions of the protein, for example, or chop off tiny pieces from the ends of the proteins. The completed protein then leaves the Golgi apparatus for its final destination inside or outside the cell. During its assembly on the ribosome, each protein has acquired a group of from 4 to 100 amino acids called a signal. The signal works as a molecular shipping label to direct the protein to its proper location.
 Lysosomes are small, often spherical organelles that function as the cell’s recycling center and garbage disposal. Powerful digestive enzymes concentrated in the lysosome break down worn-out organelles and ship their building blocks to the cytoplasm where they are used to construct new organelles. Lysosomes also dismantle and recycle proteins, lipids, and other molecules.
 The mitochondria is the powerhouse of the cell. Within these long, slender organelles, which can appear oval or bean shaped under the electron microscope, enzymes convert the sugar glucose and other nutrients into adenosine triphosphate (ATP). This molecule, in turn, serves as an energy battery for countless cellular processes, including the shuttling of substances across the plasma membrane, the building and transport of proteins and lipids, the recycling of molecules and organelles, and the dividing of cells. Muscle and liver cells are particularly active and require dozens and sometimes up to hundreds mitochondria per cell to meet their energy needs. Mitochondria is unusual in that they contain their own DNA in the form of a prokaryote-like circular chromosome; Have their own ribosomes, which resemble prokaryotic ribosomes, and divide independently of the cell.
 Unlike the tiny prokaryotic cell, the relatively large eukaryotic cell requires structural support. The cytoskeleton, a dynamic network of protein tubes, filaments, and fibers, crisscrosses the cytoplasm, anchoring the organelles in place and providing shape and structure to the cell. Many components of the cytoskeleton are assembled and disassembled by the cell as needed. During cell division, for example, a special structure called a spindle is built to move chromosomes around. After cell division, the spindle, no longer needed, is dismantled. Some components of the cytoskeleton serve as microscopic tracks along which proteins and other molecules travel like miniature trains. Recent research suggests that the cytoskeleton also may be a mechanical communication structure that converses with the nucleus to help organize events in the cell.
 Plant cells have all the components of animal cells and boast several added features, including chloroplasts, a central vacuole, and a cell wall. Chloroplasts convert light energy - typically from the Sun - into the sugar glucose, a form of chemical energy, in a process known as photosynthesis. Chloroplasts, like mitochondria, possess a circular chromosome and prokaryote-like ribosomes, which manufacture the proteins that the chloroplasts typically need.
 The central vacuole of a mature plant cell typically takes up most of the room in the cell. The vacuole, a membranous bag, crowds the cytoplasm and organelles to a line or relatively narrow space that marks the outermost bound of the cell. The central vacuole stores water, salts, sugars, proteins, and other nutrients. In addition, it stores the blue, red, and purple pigments that give certain flowers their colors. The central vacuole also contains plant wastes that taste bitter to certain insects, thus discouraging the insects from feasting on the plant.
 In plant cells, a sturdy cell wall surrounds and shelters by its protection for the plasma membrane. Its pores enable materials to pass freely into and out of the cell. The strength of the wall also enables a cell to absorb water into the central vacuole and swell without bursting. The resulting pressure in the cells provides plants with rigidity and support for stems, leaves, and flowers. Without sufficient water pressure, the cells collapse and the plant wilts.
 To stay alive, cells must be able to carry out a variety of functions. Some cells must be able to move, and most cells must be able to divide. All cells must maintain the right concentration of chemicals in their cytoplasm, ingest food and use it for energy, recycle molecules, expel wastes, and construct proteins. Cells must also be able to respond to changes in their environment.
 Although many forms of bacteria are not capable of independent movement, species such as the Salmonella bacterium pictured here can move by means of fine threadlike projections called flagella. The arrangement of flagella across the surface of the bacterium differs from species to species; they can be present at the ends of the bacterium or all across the body surface. Forward movement is accomplished either by a tumbling motion or in a forward manner without tumbling.
 Many unicellular organisms swim, glide, thrash, or crawl to search for food and escape enemies. Swimming organisms often move by means of a flagellum, a long tail-like structure made of protein. Many bacteria, for example, have one, two, or many flagella that rotate like propellers to drive the organism along. Some single-celled eukaryotic organisms, such as the euglena, also have a flagellum, but it is longer and thicker than the prokaryotic flagellum. The eukaryotic flagellums work by waving up and down like a whip. In higher animals, the sperm cell uses a flagellum to swim toward the female egg for fertilization.
 Movement in eukaryotes is also accomplished with cilia, short, hairlike proteins built by centrioles, which are barrel-shaped structures located in the cytoplasm that assemble and break down protein filaments. Typically, thousands of cilia extend through the plasma membrane and cover the surface of the cell, giving it a dense, hairy appearance. By beating its cilia as if they were oars, an organism such as the paramecium propels itself through its watery environment. In cells that do not move, cilia are used for other purposes. In the respiratory tract of humans, for example, millions of ciliated cells prevent inhaled dust, smog, and microorganisms from entering the lungs by sweeping them up on a current of mucus into the throat, where they are swallowed. Eukaryotic flagella and cilia are formed from basal bodies, small protein structures located just inside the plasma membrane. Basal bodies also help to anchor flagella and cilia.
 Still other eukaryotic cells, such as amoebas and white blood cells, move by amoeboid
motion, or crawling. They extrude their cytoplasm to form temporary pseudopodia, or false feet, which actually are placed in front of the cell, rather like extended arms. They then drag the trailing end of their cytoplasm up to the pseudopodia. A cell using amoeboid motion would lose a race to a euglena or paramecium. But while it is slow, amoeboid motion is strong enough to move cells against a current, enabling water-dwelling organisms to pursue and devour prey, for example, or white blood cells roaming the blood stream to stalk and engulf a bacterium or virus.
 An amoeba, a single-celled organism lacking internal organs, is shown approaching a much smaller paramecium, which it begins to engulf with large outflowings of its cytoplasm, called pseudopodia. Once the paramecium is completely engulfed, a primitive digestive cavity, called a vacuole, forms around it. In the vacuole, acids break the paramecium down into chemicals that the amoeba can diffuse back into its cytoplasm for nourishment.
 All cells require nutrients for energy, and they display a variety of methods for ingesting them. Simple nutrients dissolved in pond water, for example, can be carried through the plasma membrane of pond-dwelling organisms via a series of molecular pumps. In humans, the cavity of the small intestine contains the nutrients from digested food, and cells that form the walls of the intestine use similar pumps to pull amino acids and other nutrients from the cavity into the bloodstream. Certain unicellular organisms, such as amoebas, are also capable of reaching out and grabbing food. They used a process known as endocytosis, in which the plasma membrane surrounds and engulfed the food particle, enclosing it in a sac, called a vesicle, that is within the amoeba’s interior.
 Cells require energy for a variety of functions, including moving, building up and breaking down molecules, and transporting substances across the plasma membrane. Nutrients contain energy, but cells must convert the energy locked in nutrients to another form - specifically, the ATP molecule, the cell’s energy battery - before it is useful. In single-celled eukaryotic organisms, such as the paramecium, and in multicellular eukaryotic organisms, such as plants, animals, and fungi, mitochondria is responsible for this task. The interior of each mitochondrion consists of an inner membrane that is folded into a mazelike arrangement of separate compartments called cristae. Within the cristae, enzymes form an assembly line where the energy in glucose and other energy-rich nutrients is harnessed to build ATP; thousands of ATP molecules are constructed each second in a typical cell. In most eukaryotic cells, this process requires oxygen and is known as aerobic respiration.
 Some prokaryotic organisms also carry out aerobic respiration. They lack mitochondria, however, and carry out aerobic respiration in the cytoplasm with the help of enzymes sequestered there. Many prokaryote species live in environments where there is little or no oxygen, environments such as mud, stagnant ponds, or within the intestines of animals. Some of these organisms produce ATP without oxygen in a process known as anaerobic respiration, where sulfur or other substances take the place of oxygen. Still other prokaryotes, and yeast, a single-celled eukaryote, build ATP without oxygen in a process known as fermentation.
 Almost all organisms rely on the sugar glucose to produce ATP. Glucose is made by the process of photosynthesis, in which light energy is transformed to the chemical energy of glucose. Animals and fungi cannot carry out photosynthesis and depend on plants and other photosynthetic organisms for this task. In plants, as we have seen, photosynthesis takes place in organelles called chloroplasts. Chloroplasts contain numerous internal compartments called thylakoids where enzymes aid in the energy conversion process. A single leaf cell contains 40 to 50 chloroplasts. With sufficient sunlight, one large tree is capable of producing upwards of two tons of sugar in a single day. Photosynthesis in prokaryotic organisms - typically aquatic bacteria - is carried out with enzymes clustered in plasma membrane folds called chromatophores. Aquatic bacteria produce the food consumed by tiny organisms living in ponds, rivers, lakes, and seas.
 A typical cell must have on hand, about.  30,000 proteins at any-one time. Many of these proteins are enzymes needed to construct the major molecules used by cells - carbohydrates, lipids, proteins, and nucleic acids - nor to aid in the breakdown of such molecules after they have worn out. Other proteins are part of the cell’s structure - the plasma membrane and ribosomes, for example. In animals, proteins also function as hormones and antibodies, and they function like delivery trucks to transport other molecules around the body. Hemoglobin, for example, is a protein that transports oxygen in red blood cells. The cell’s demand for proteins never ceases.
 Before a protein can be made, however, the molecular directions to build, it must be extracted from one or more genes. In humans, for example, one gene holds the information for the protein insulin, the hormone that cells need to import glucose from the bloodstream, while at least two genes hold the information for collagen, the protein that imparts strength to skin, tendons, and ligaments. The process of building proteins begins when enzymes, in response to a signal from the cell, bind to the gene that carries the code for the required protein, or part of the protein. The enzymes transfer the code to a new molecule called messenger RNA, which carries the code from the nucleus to the cytoplasm. This enables the original genetic code to remain safe in the nucleus, with messenger RNA delivering small bits and pieces of information from the DNA to the cytoplasm as needed. Depending on the cell type, hundreds or even thousands of molecules of messenger RNA are produced each minute.
 Once in the cytoplasm, the messenger RNA molecule links up with a ribosome. The ribosome moves along the messenger RNA like a monorail car along a track, stimulating another form of RNA - transfer RNA - to gather and link the necessary amino acids, pooled in the cytoplasm, to form the specific protein, or section of protein. The protein is modified as necessary by the endoplasmic reticulum and Golgi apparatus before embarking on its mission. Cells teem with activity as they forge the numerous, diverse proteins that are indispensable for life. For a more detailed discussion about protein synthesis, When there are a hundred or more cells, they formed a hollow ball of cells, called a blastula, surrounding a fluid-filled cavity. Later divisions produce three layers of cells - endoderm (inner), mesoderm (middle), and ectoderm (outer) - from which the principal features of the animal will differentiate.
 Most cells divide at some time during their life cycle, and some divide dozens of times before they die. Organisms rely on cell division for reproduction, growth, and repair and replacement of damaged or worn out cells. Three types of cell division occur: Binary fission, mitosis, and meiosis. Binary fission qualifies in its method used by prokaryotes, produces two identical cells from one cell. The more complex process of mitosis, which also produces two genetically identical cells from a single cell, is used by many unicellular eukaryotic organisms for reproduction. Multicellular organisms use mitosis for growth, cell repair, and cell replacement, in the human body, for example, an estimated 25 million mitotic cell divisions occur every second in order to replace cells that have completed their normal life cycles. Cells of the liver, intestine, and skin may be replaced every few days. Recent research indicates that even brain cell, once thought to be incapable of mitosis, undergo cell division in the part of the brain associated with memory.
 In a landmark intersection of science and fiction, cloning leapt from the world’s imagination to its front page in February 1997. It arrived in the innocent form of a sheep named Dolly: The first exact genetic duplicate of an adult mammal due to genetic engineering. Scottish scientists had created Dolly from deoxyribonucleic acid (DNA) - the basic unit of heredity - taken from a single adult sheep cell. The accomplishment threw open the door too profoundly ethically as well as scientific controversy over the potential uses and abuses of cloning. ‘However the debate is resolved,’ wrote Los Angeles Times science reporter Thomas H. Maugh II, ‘the genie is irretrievably out of the bottle.’
 The type of cell division required for sexual reproduction is meiosis. Sexually reproducing organisms include seaweeds, fungi, plants, and animals - including, of course, human beings. Meiosis differs from mitosis in that cell division begins with a cell that has a full complement of chromosomes and ends with gamete cells, such as sperm and eggs, that have only half the complement of chromosomes. When a sperm and egg unite during fertilization, the cell resulting from the union, called a zygote, contains the full number of chromosomes.
 The story of how cells evolved remains an open and actively investigated question in science. The combined expertise of physicists, geologists, chemists, and evolutionary biologists has been required to shed light on the evolution of cells from the nonliving matter of early Earth. The planet took to its solidifying crusturalear form about 4.5 billion years ago, and for millions of years, violent volcanic eruptions blasted substances such as carbon dioxide, nitrogen, water, and other small molecules into the air. These small molecules, bombarded by ultraviolet radiation and lightning from intense storms, collided to form the stable chemical bonds of larger molecules, such as amino acids and nucleotides - the building blocks of proteins and nucleic acids. Experiments indicate that these larger molecules form spontaneously under laboratory conditions that simulate the probable early environment of Earth.
 Scientists speculate that rain may have carried these molecules into lakes to create a primordial soup - the breeding ground for the assembly of proteins, the nucleic acid RNA, and lipids. Some scientists postulate that these more complex molecules formed in hydrothermal vents rather than in lakes. Other scientists propose that these key substances may have reached Earth on meteorites from outer space. Regardless of the origin or environment, however, scientists do agree that proteins, nucleic acids, and lipids provided the raw materials for the first cells. In the laboratory, scientists have observed lipid molecules joining to form spheres that resemble a cell’s plasma membrane. As a result of these observations, scientists postulate that millions of years of molecular collisions resulted in lipid spheres enclosing RNA, the simplest molecule capable of self-replication. These primitive aggregations would have been the ancestors of the first prokaryotic cells.
 Fossil studies indicate that Cyanobacteria, bacteria capable of photosynthesis, were among the earliest bacteria to evolve, an estimated 3.4 billion to 3.5 billion years ago. In the environment of the early Earth, there were no oxygen, and cyanobacteria probably used fermentation to produce ATP. Over the eons, cyanobacteria performed photosynthesis, which produces oxygen as a byproduct; The result was the gradual accumulation of oxygen in the atmosphere. The presence of oxygen set the stage for the evolution of bacteria that used oxygen in aerobic respiration, a more efficient ATP-producing process than fermentation. Some molecular studies of the evolution of genes in archaebacteria suggest that these organisms may have evolved in the hot waters of hydrothermal vents or hot springs slightly earlier than cyanobacteria, around 3.5 billion years ago. Like cyanobacteria, archaebacteria probably relied on fermentation to synthesize ATP.
 Eukaryotic cells may have evolved from primitive prokaryotes about 2 billion years ago. One hypothesis suggests that some prokaryotic cells lost their cell walls, permitting the cell’s plasma membrane to expand and fold. These folds, ultimately, may have given rise to separate compartments within the cell - the forerunners of the nucleus and other organelles now found in eukaryotic cells. Another key hypothesis is known as endosymbiosis. Molecular studies of the bacteria-like DNA and ribosomes in mitochondria and chloroplasts indicate that mitochondrion and chloroplast ancestors were once free-living bacteria. Scientists propose that these free-living bacteria were engulfed and maintained by other prokaryotic cells for their ability to produce ATP efficiently and to provide a steady supply of glucose. Over generations, eukaryotic cells situated with mitochondria - the ancestors of animals - or with both mitochondria and chloroplasts - the ancestors of plants - evolved.
 The first observations of cells were made in 1665 by English scientist Robert Hooke, who used a crude microscope of his own invention to examine a variety of objects, including a thin piece of cork. Noting the rows of tiny boxes that made up the dead wood’s tissue, Hooke coined the term cell because the boxes reminded him of the small cells occupied by monks in a monastery. While Hooke was the first to observe and describe cells, he did not comprehend their significance. At about the same time, the Dutch maker of microscopes Antoni van Leeuwenhoek pioneered the invention of one of the best microscopes of the time. Using his invention, Leeuwenhoek was the first to observe, draw, and describe a variety of living organisms, including bacteria gliding in saliva, one-celled organisms cavorting in pond water, and sperm swimming in semen. Two centuries passed, however, before scientists grasped the true importance of cells.
 Many advances have been made in microscope technology. This article from the 1994 Collier’s Year Book begins with the microscope most young students are familiar with and tracks the breakthroughs in the development of new types of microscopes - including those that use ultrasonic imaging and those that ‘feel’ an object’s surface.
 Modern ideas about cells appeared in the 1800s, when improved light microscopes enabled scientists to observe more details of cells. Working together, German botanist Matthias Jakob Schleiden and German zoologist Theodor Schwann recognized the fundamental similarities between plant and animal cells. In 1839 they proposed the revolutionary idea that all living things are made up of cells. Their theory gave rise to modern biology: a whole new way of seeing and investigating the natural world.
 By the late 1800s, as light microscopes improved still further, scientists were able to observe chromosomes within the cell. Their research was aided by new techniques for staining parts of the cell, which made possible the first detailed observations of cell division, including observations of the differences between mitosis and meiosis in the 1880s. In the first few decades of the 20th century, many scientists focused on the behavior of chromosomes during cell division. At that time, it was generally held that mitochondria transmitted the hereditary information. By 1920, however, scientists determined that chromosomes carry genes and that genes transmit hereditary information from generation to generation.
 During this period, scientists began to understand some of the chemical processes in cells. In the 1920s, the ultracentrifuge was developed. The ultracentrifuge is an instrument that spins cells or other substances in test tubes at high speeds, which causes the heavier parts of the substance to fall to the bottom of the test tube. This instrument enabled scientists to separate the relatively abundant and heavy mitochondria from the rest of the cell and study their chemical reactions. By the late 1940s, scientists were able to explain the role of mitochondria in the cell. Using refined techniques with the ultracentrifuge, scientists subsequently isolated the smaller organelles and gained an understanding of their functions.
 The deoxyribonucleic acid (DNA) molecule is the genetic blueprint for each cell and ultimately the blueprint that determines every characteristic of a living organism. In 1953 American biochemist James Watson, left, and British biophysicist Francis Crick, right, described the structure of the DNA molecule as a double helix, somewhat like a spiral staircase with many individual steps. Their work was aided by X-ray diffraction pictures of the DNA molecule taken by British biophysicist Maurice Wilkins and British physical chemist Rosalind Franklin. In 1962 Crick, Watson, and Wilkins received the Nobel Prize for their pioneering work on the structure of the DNA molecule.
 While some scientists were studying the functions of cells, others were examining details of their structure. They were aided by a crucial technological development in the 1940s, the invention of the electron microscope, which uses high-energy electrons instead of light waves to view specimens. New generations of electron microscopes have provided resolution, or the differentiation of separate objects, thousands of times more powerful than that available in light microscopes. This powerful resolution revealed organelles such as the endoplasmic reticulum, lysosomes, the Golgi apparatus, and the cytoskeleton. The scientific fields of cell structure and function continue to complement each other as scientists explore the enormous complexity of cells.
 The discovery of the structure of DNA in 1953 by American biochemist James D. Watson and British biophysicist Francis Crick ushered in the era of molecular biology. Today, investigation inside the world of cells - of genes and proteins at the molecular level - constitutes one of the largest and fastest moving areas in all of science. One particularly active field in recent years has been the investigation of cell signaling, the process by which molecular messages find their way into the cell via a series of complex protein pathways in the cell.
 Another busy area in cell biology concerns programmed cell death, or apoptosis. Millions of times per second in the human body, cells commit suicide as an essential part of the normal cycle of cellular replacement. This also seems to be a check against disease: When mutations build up within a cell, the cell will usually self-destruct. If this fails to occur, the cell may divide and give rise to mutated daughter cells, which continue to divide and spread, gradually forming a growth called a tumor. This unregulated growth by rogue cells can be benign, or harmless, or cancerous, which may threaten healthy tissue. The study of apoptosis is one avenue that scientists explore in an effort to understand how cells become cancerous.
 Scientists are also discovering exciting aspects of the physical forces within cells. Cells employ a form of architecture called tensegrity, which enables them to withstand battering by a variety of mechanical stresses, such as the pressure of blood flowing around cells or the movement of organelles within the cell. Tensegrity stabilizes cells by evenly distributing mechanical stresses to the cytoskeleton and other cell components. Tensegrity also may explain how a change in the cytoskeleton, where certain enzymes are anchored, initiates biochemical reactions within the cell, and can even influence the action of genes. The mechanical rules of tensegrity may also account for the assembly of molecules into the first cells. Such new insights - made some 300 years after the tiny universe of cells was first glimpsed - show that cells continue to yield fascinating new worlds of discovery.
 The Nervous System signifies of those elements within the animal organism that are concerned with the reception of stimuli, the transmission of nerve impulses, or the activation of muscle mechanisms.
 The reception of stimuli is the function of special sensory cells. The conducting elements of the nervous system are cells called neurons; these may be capable of only slow and generalized activity, or they may be highly efficient and rapidly conducting units. The specific responses of the neuron - the nerve impulse - and the capacities for being to enable the cell to be stimulated, are at which point, made this cell a receiving and transmitting unit capable of transferring information from one part of the body to another.
 Each nerve cell consists of a central portion containing the nucleus, known as the cell body, and one or more structures referred to as axons and dendrites. The dendrites are rather short extensions of the cell body and are involved in the reception of stimuli. The axon, by contrast, is usually a single elongated extension, it is especially important in the transmission of nerve impulses from the region of the cell body to other cells.
 Although all many-celled animals have some kind of nervous system, the complexity of its organization varies considerably among different animal types. In simple animals such as jellyfish, the nerve cells form a network capable of mediating only a relatively stereotyped response. In more complex animals, such as shellfish, insects, and spiders, the nervous system is more complicated. The cell bodies of neurons are organized in clusters called ganglia. These clusters are interconnected by the neuronal processes to form a ganglionated chain. Such chains are found in all vertebrates, in which they represent a special part of the nervous system, related especially to the regulation of the activities of the heart, the glands, and the involuntary Vertebrate animals have a bony spine and skull in which the central part of the nervous system is housed; The peripheral part extends throughout the remainder of the body. That part of the nervous system located in the skull is referred to as the brain that found in the spine is called the spinal cord. The brain and the spinal cord are continuous through an opening in the base of the skull; Both are also in contact with other parts of the body through the nerves. The distinction made between the central nervous system and the peripheral nervous system is based on the different locations of the two intimately related parts of a single system. Some of the processes of the cell bodies conduct sense impressions and others conduct muscle responses, called reflexes, such as those caused by pain.
 In the skin are cells of several types called receptors; each is especially sensitive to particular stimuli. Free nerve endings are sensitive to pain and are directly activated. The neurons so activated send impulses into the central nervous system and have junctions with other cells that have axons extending back into the periphery. Impulses are carried from processes of these cells to motor endings within the muscles. These neuromuscular endings excite the muscles, resulting in muscular contraction and appropriate movement. The pathway taken by the nerve impulse in mediating this simple response is in the form of a two-neuron arc that begins and ends in the periphery. Many of the actions of the nervous system can be explained on the basis of such reflex arcs, which are chains of interconnected nerve cells, stimulated at one end and capable of bringing about movement or glandular secretion at the other.
 The cranial nerves connect to the brain by passing through openings in the skull, or cranium. Nerves associated with the spinal cord pass through openings in the vertebral column and are called spinal nerves. Both cranial and spinal nerves consist of large numbers of processes that convey impulses to the central nervous system and also carry messages outward; the former processes are called afferent, and the latter are called efferent. Afferent impulses are referred to as sensory; efferent impulses are referred to as either somatic or visceral motor, according to what part of the body they reach. Most nerves are mixed nerves made up of both sensory and motor elements.
 The cranial and spinal nerves are paired; The number in humans are 12 and 31, respectively. Cranial nerves are distributed to the head and neck regions of the body, with one conspicuous exception: the tenth cranial nerve, called the vagus. In addition to supplying structures in the neck, the vagus is distributed to structures located in the chest and abdomen. Vision, auditory and vestibular sensation, and taste is mediated by the second, eighth, and seventh cranial nerves, respectively. Cranial nerves also mediate motor functions of the head, the eyes, the face, the tongue, and the larynx, as well as the muscles that function in chewing and swallowing. Spinal nerves, after they exit from the vertebrae, are distributed in a band-like fashion to regions of the trunk and to the limbs. They interconnect extensively, thereby forming the brachial plexus, which runs to the upper extremities, and the lumbar plexus, which passes to the lower limbs.
 Among the motor’s fibers may be found groups that carry impulses to viscera. These fibers are designated by the special name of autonomic nervous system. That system consists of two divisions, more or less antagonistic in function, that emerge from the central nervous system at different points of origin. One division, the sympathetic, arises from the middle portion of the spinal cord, joins the sympathetic ganglionated chain, courses through the spinal nerves, and is widely distributed throughout the body. The other division, the parasympathetic, arises both above and below the sympathetic, that is, from the brain and from the lower part of the spinal cord. These two divisions control the functions of the respiratory, circulatory, digestive, and urogenital systems.
 Consideration of disorders of the nervous system is the province of neurology; Psychiatry deals with behavioral disturbances of a functional nature. The division between these two medical specialties cannot be sharply defined, because neurological disorders often manifest both organic and mental symptoms.
 Diseases of the nervous system include genetic malformations, poisonings, metabolic defects, vascular disorders, inflammations, degeneration, and tumors, and they involve either nerve cells or their supporting elements. Vascular disorders, such as cerebral hemorrhage or other forms of a stroke, are among the most common causes of paralysis and other neurologic complications. Some diseases exhibit peculiar geographic and age distribution. In temperate zones, multiple sclerosis is a common degenerative disease of the nervous system, but it is rare in the Tropics.
 The nervous system is subject to infection by a great variety of bacteria, parasites, and viruses. For example, meningitis, or infection of the meninges investing the brain and spinal cord, can be caused by many different agents. On the other hand, one specific virus causes rabies. Some viruses causing neurological ills affect only certain parts of the nervous system. For example, the virus causing poliomyelitis commonly affects the spinal cord, as Viruses manufacturing encephalitis attack the brain.
 Inflammations of the nervous system are named according to the part affected. Myelitis is an inflammation of the spinal cord; Neuritis is an inflammation of a nerve. It may be caused not only by infection but also by poisoning, alcoholism, or injury. Tumors originating in the nervous system usually are composed of meningeal tissue or neuroglia (supporting tissue) cells, depending on the specific part of the nervous system affected, but other types of a tumors may metastasize to or invade the nervous system. In certain disorders of the nervous system, such as neuralgia, migraine, and epilepsy, no evidence may exist of organic damage. Another disorder, cerebral palsy, is associated with birth defects.
 Pain, an unpleasant sensory and emotional experience caused by real or potential injury or damage to the body or described in terms of such damage. Scientists believe that pain evolved in the animal kingdom as a valuable three-part warning system. First, it warns of injury. Second, pain protects against further injury by causing a reflexive withdrawal from the source of injury. Finally, pain leads to a period of reduced activity, enabling injuries to heal more efficiently.
 Pain is difficult to measure in humans because it has an emotional, or psychological component as well as a physical component. Some people express extreme discomfort from relatively small injuries, while others show little or no pain even after suffering severe injury. Sometimes pain is present even though no injury is apparent at all, or pain lingers long after an injury appears to have healed.
 The signals that warn the body of tissue damage are transmitted through the nervous system. In this system, the basic unit is the nerve cell or neuron. A nerve cell is composed of three parts: a central cell body, a single major branching fiber called an axon, and a series of smaller branching fibers known as dendrites. Each nerve cell meets other nerve cells at certain points on the axons and dendrites, forming a dense network of interconnected nerve fibers that transmit sensory information about touch, pressure, or warmth, as well as pain.
 Sensory information is transmitted from the different parts of the body to the brain via the spinal cord, which is a complex set of nerves that extend from the brain down along the back, protected by the bones of the spine. About as wide as a finger, the spinal cord is like a cable packed with many bundles of wires. The bundles are nerve pathways for transmitting information. But the spinal cord is more than just a message transmitter, it is also an extension of the brain. It contains neurons that process incoming sensory information, and generates messages to be sent back down to cells in other parts of the body.
 In the nervous system, a message-carrying impulse travels from one end of a nerve cell to the other by means of an electrical impulse. When it reaches the terminal end of a nerve cell, the impulse trigger’s tiny sacs called presynaptic vessicles to release their contents, chemical messengers called neurotransmitters. The neurotransmitters float across the synapse, or gap between adjacent nerve cells. When they reach the neighboring nerve cell, the neurotransmitters fit into specialized receptor sites much as a key fits into a lock, causing that nerve cell to ‘fire,’ or generate an electric message-carrying impulse. As the message continues through the nervous system, the presynaptic cell absorbs the excess neurotransmitters, and repackages them in presynaptic versicles in a process called neurotransmitter reuptake.
 Information being transmitted between and within the brain and spinal cord travels through the nervous system using both chemical and electrical mechanisms. A message-carrying impulse travels from one end of a nerve cell to another by means of an electric signal. When the electric signal reaches the terminal end of a nerve cell, a gap called a synapse prevents the electric signal from crossing to the next cell. The electric signal triggers the cell to release chemicals called neurotransmitters, which float across the synapse to the neighboring nerve cell. These neurotransmitters fit into specialized receptors found on the adjacent nerve cell, much as a key fits into a lock, generating an electric impulse in the neighboring cell. This new impulse travels to the end of the long cell, in turn triggering the release of neurotransmitters to carry the message across the next synapse. Not all neurotransmitters initiate a message in a neighboring nerve cell. Some specialize in preventing neighboring cells from generating an electrical signal, while others function as helpers, facilitating the message's journey to the brain.
 While most of the sensory nerves in the skin and other body tissues have special structures covering their nerve endings, those nerves that signal injury have free nerve endings. These simple nerve endings specialize in detecting noxious stimuli - a catchall term for injury-causing stimuli such as intense heat, extreme pressure, or sharp pricks or cuts. The nerve endings that detect pain are called nociceptors, and the process of transmitting pain signals when harmful stimulation occurs is called nociception. Several million nociceptors are interlaced through the tissues and organs of the body.
 When a person experiences an injury, such as a stubbed toe, specialized cells called nociceptors sense potential tissue damage (1) and send an electric signal, called an impulse, to the spinal cord via a sensory nerve (2). A specialized region of the spinal cord known as the dorsal horn (3) processes the pain signal, immediately sending another impulse back down the leg via a motor nerve (4). This causes the muscles in the leg to contract and pull the toe away from the source of injury (6). At the same time, the dorsal horn sends another impulse up the spinal cord to the brain. During this trip, the impulse travels between nerve cells. When the impulse reaches a nerve ending (7), the nerve released chemical messengers, called neurotransmitters, which carry the message to the adjacent nerve. When the impulse reaches the brain (8), it is analyzed and processed as an unpleasant physical and emotional sensation.
 An injury triggers pain signals in two types of nociceptors, one with large, insulated axons known as A-delta fibers and one with small, uninsulated axons known as C fibers. The large A-delta fibers conduct signals quickly, and the smaller C fibers transmit information slowly. The difference in the functions of these two fibers becomes obvious to a person who stubs a toe. At first the injured person is aware of a sharp, flashing pain at the point of injury. Generated by the A-delta fibers, this short-lived pain intrudes upon the thoughts and perceptions occurring in the brain. Just as this first pain subsides, a second pain begins that is vague, throbbing, and persistent. This sensation is derived from the C fibers.
 Pain information from the A-delta and C fibers travels through the spinal cord to the brain. When it receives the pain message, the spinal cord generates impulses that travel back down to muscles, which lead to a reflexive contraction that pulls the body away from the source of injury. Other reflexes may affect skin temperature, blood flow, sweating, and other changes.
 While this reflex action is underway, the pain message continues up the spinal cord to relay centers in the brain. The sensory information is routed to many other parts of the brain, including the cortex, where thinking processes occur
 Like all other cells, neurons contain charged ions: Potassium and sodium (positively charged) and chlorine (negatively charged). Neurons differ from other cells in that they are able to produce a nerve impulse. A neuron is polarized - that is, it has an overall negative charge inside the cell membrane because of the high concentration of chlorine ions and low concentration of potassium and sodium ions. The concentration of these same ions is exactly reversed outside the cell. This charge differential represents stored electrical energy, sometimes referred to as membrane potential or resting potential. The negative charge inside the cell is maintained by two features. The first is the selective permeability of the cell membrane, which is more permeable to potassium than sodium. The second feature is sodium pumps within the cell membrane that actively pump sodium out of the cell. When depolarization occurs, this charge differential across the membrane is reversed, and a nerve impulse is produced.
 Depolarization is a rapid change in the permeability of the cell membrane. When sensory input or any other kind of stimulating current is received by the neuron, the membrane permeability is changed, allowing a sudden influx of sodium ions into the cell. The high concentration of sodium, or action potential, changes the overall charges within the cell from negative too positive, that is to say, by its interiorization flowing and the negativity that posits the permeability in positivity, only finding that its exteriorized positivity seems greater in sodium levelling charges. The local changes in ion concentration triggers similar reactions along the membrane, propagating the nerve impulse. After a brief period called the refractory period, during which the ionic concentration returned to resting potential, the neuron can repeat this process.
 Nerve impulses travel at different speeds, depending on the cellular composition of a neuron. Where speed of impulse is important, as in the nervous system, axons are insulated with a membranous substance called myelin. The insulation provided by myelin maintains the ionic charge over long distances. Nerve impulses are propagated at specific points along the myelin sheath; These points are called the nodes of Ranvier. Examples of myelinated axons are those in sensory nerve fibers and nerves connected to skeletal muscles. In non-myelinated cells, the nerve impulse is propagated more diffusely.
 The nervous system has two divisions: The somatic, which allow voluntary control over skeletal muscle, and the autonomic, which is involuntary and controls cardiac and smooth muscle and glands. The autonomic nervous system has two divisions: The sympathetic and the parasympathetic. Many, but not all, of the muscles and glands that distribute nerve impulses to the larger interior organs possess a double nerve supply; in such cases the two divisions may exert opposing effects. Thus, the sympathetic system increases heartbeat, and the parasympathetic system decreases heartbeat. The two nervous systems are not always antagonistic, however. For example, both nerve supplies to the salivary glands excite the cells of secretion. Furthermore, a single division of the autonomic nervous system may both excite and inhibit a single effector, as in the sympathetic supply to the blood vessels of skeletal muscle. Finally, the sweat glands, the muscles that cause involuntary erection or bristling of the hair, the smooth muscle of the spleen, and the blood vessels of the skin and skeletal muscle are actuated only by the sympathetic division.
 Voluntary movement of head, limbs, and body is caused by nerve impulses arising in the motor area of the cortex of the brain and carried by cranial nerves or by nerves that emerge from the spinal cord to connect with skeletal muscles. The reaction involves both excitation of nerve cells stimulating the muscles involved and inhibition of the cells that stimulate opposing muscles. A nerve impulse is an electrical change within a nerve cell or fiber; Measured in millivolts, it lasts a few milliseconds and can be recorded by electrodes.
 The human brain has three major structural components: The large dome-shaped cerebrum, the smaller somewhat spherical cerebellum, and the brainstem. Prominent in the brainstem is the medulla oblongata (the egg-shaped enlargement at the center) and the thalamus (between the medulla and the cerebrum). The cerebrum is responsible for intelligence and reasoning. The cerebellum helps to maintain balance and posture. The medulla is involved in maintaining involuntary functions such as respiration, and the thalamus act as a relay center for electrical impulses traveling to and from the cerebral cortex. Lack of blood flow to any part of the brain results in a stroke, permanent damage that interferes with the functions of the affected part of the brain.
 Movement may occur also in direct response to an outside stimulus, thus, a tap on the knee causes a jerk, and a light shone into the eye makes the pupil contract. These involuntary responses are called reflexes. Various nerve terminals called receptors constantly send impulses into the central nervous system. These are of three classes: exteroceptors, which are sensitive to pain, temperature, touch, and pressure; interoceptors, which react to changes in the internal environment; and proprioceptors, which respond to variations in movement, position, and tension. These impulses terminate in special areas of the brain, as do of those special receptors concerned with sight, hearing, smell, and taste.
 Whereas most major nerves emerge from the spinal cord, the 12 pairs of cranial nerves project directly from the brain, as do all but 1 pair electrical relay motor or sensory information (or both), the tenth, or vagus nerve, affects visceral functions such as heart rate, vasoconstriction, and contraction of the smooth muscle found in the walls of the trachea, stomach, and intestine.
 Muscular contractions do not always cause actual movement. A small fraction of the total number of fibers in most muscles is usually contracting. This serves to maintain the posture of a limb and enables the limb to resist passive elongation or stretch. This slight continuous contraction is called muscle tone.
 In 1946 Axelrod joined the laboratory of American pharmacologist Bernard Brodie at Goldwater Memorial Hospital in New York. The pair conducted research on pain-relieving drugs called analgesics. They identified a pain-relieving chemical known as acetaminophen. This drug was later developed and marketed by the drug company Johnson & Johnson under the brand-name Tylenol.
 In 1949 Axelrod took a position at the National Heart Institute, a branch of the National Institutes of Health (NIH). Their Axelrod studied how the body processes certain drugs that cause behavioral changes, including amphetamines, ephedrine, and mescaline. He identified a group of enzymes that help these drugs break down in the body. These enzymes, called cytochrome-P450 monoxygenases, have been studied extensively by other scientists, particularly in cancer research.
 Realizing that career advancement in the sciences requires a doctoral degree, in 1954 Axelrod took a leave of absence from his job at the National Heart Institute to attend The George Washington University. He earned his doctorate in pharmacology in 1955. That same year he was named chief of pharmacology at the National Institute of Mental Health (NIMH) another branch of NIH.
 At NIMH, Joseph Axelrod began research on neurotransmitters. A nerve cell releases a neurotransmitter to spur a neighboring cell into action. In the 1950s most scientists believed that a neurotransmitter became inactive once it stimulated a neighboring cell. But Axelrod’s research found that the neurotransmitter returns to the first nerve cell, in a process known as reuptake, where it is broken down by enzymes or repackaged for reuse. This research led to the creation of a number of drugs that prevent the reuptake process, enabling a neurotransmitter to remain active for a longer period of time.
 Axelrod’s research revolutionized the understanding of many mental-health disorders, including depression, anxiety, and schizophrenia. Prior to his research, psychiatry focused on the relationship of life experiences to mental health problems. But Axelrod's research proved that mental-health disorders were often the result of complicated brain chemistry. His research spurred the development of new drugs that advanced the treatment of mental-health conditions. Among these are selective serotonin reuptake inhibitors, including the antidepressants fluoxetine, sold under the brand name Prozac, sertraline(Zoloft) and paroxetine (Paxil).
 The study of the biochemistry of memory is another exciting scientific enterprise, but one that can only be touched upon here. Scientists estimate that an adult human brain contains about 100 billion neurons. Each of these is connected to hundreds or thousands of other neurons, forming trillions of neural connections. Neurons communicate by chemical messengers called neurotransmitters. An electrical signal travels along the neuron, triggering the release of neurotransmitters at the synapse, the small gap between neurons. The neurotransmitters travel across the synapse and act on the next neuron by binding with protein molecules called receptors. Most scientists believe that memories are somehow stored among the brain's trillions of synapses, rather than in the neurons themselves.
 Scientists who study the biochemistry of learning and memory often focus on the marine snail Aplysia because its simple nervous system allows them to study the effects of various stimuli on specific synapses. A change in the snail's behavior due to learning can be correlated with a change at the level of the synapse. One exciting scientific frontier is discovering the changes in neurotransmitters that occur at the level of the synapse.
 Other researchers have implicated glucose, a sugar and insulin(a hormone secreted by the pancreas) as important to learning and memory. Humans and other animals given these substances show an improved capacity to learn and remember. Typically, when animals or humans ingest glucose, the pancreas responds by increasing insulin production, so it is difficult to determine which substance contributes to improved performance. Some studies in humans that have systematically varied the amount of glucose and insulin in the blood have shown that insulin may be the more important of the two substances for learning.
 Scientists also have examined the influence of genes on learning and memory. In one study, scientists bred strains of mice with extra copies of a gene that helps build a protein called N-methyl-D-aspartate, or NMDA. This protein acts as a receptor for certain neurotransmitters. The genetically altered mice outperformed normal mice on a variety of tests of learning and memory. In addition, other studies have found that chemically blocking NMDA receptor impairs learning in laboratory rats. Future discoveries from genetic and biochemical studies may lead to treatments for memory deficits from Alzheimer's disease and other conditions that affect memory.
 Alzheimer's Disease, progressive brain disorders that causes a gradual and irreversible decline in memory, language skills, perception of time and space, and, eventually, the ability to care for oneself. First described by German psychiatrist Alois Alzheimer in 1906, Alzheimer's disease was initially thought to be a rare condition affecting only young people, and was referred to as prehensile dementia. Today late-onset Alzheimer's disease is recognized as the most common cause of the loss of mental function in those aged 65 and over. Alzheimer's in people in their 30s, 40s, and 50s, called early-onset Alzheimer's disease, occurs less frequently, accountings for less than 10 percent of the estimated 4 million Alzheimer's put into case, as only been situated in the United States.
 Although Alzheimer's disease is not a normal part of the aging process, the risk of developing the disease increases as people grow older. About 10 percent of the United States population over the age of 65 is affected by Alzheimer's disease, and nearly 50 percent of those over age 85 may have the disease.
 Alzheimer's disease takes a devastating toll, not only on the patients, but also on those who love and care for them. Some patients experience immense fear and frustration as they struggle with once commonplace tasks and slowly lose their independence. Family, friends, and especially those who provide daily care suffer immeasurable pain and stress as they witness Alzheimer's disease slowly agonizing freedom of its constraints taking to encumber their loved one from them.
 The onset of Alzheimer's disease is usually very gradual. In the early stages, Alzheimer's patients have relatively mild problems learning new information and remembering where they have left common objects, such as keys or a wallet. In time, they begin to have trouble recollecting recent events and finding the right words to express themselves. As the disease progresses, patients may have difficulty remembering what day or month it is, or finding their way around familiar surroundings. They may develop a tendency to wander off and then be unable to find their way back. Patients often become irritable or withdrawn as they struggle with fear and frustration when once commonplace tasks become unfamiliar and intimidating. Behavioral changes may become more pronounced as patients become paranoid or delusional and unable to engage in normal conversation.
 Eventually Alzheimer's patients become completely incapacitated and unable to take care of their most basic life functions, such as eating and using the bathroom. Alzheimer's patients may live many years with the disease, usually dying from other disorders that may develop, such as pneumonia. Typically the time from initial diagnosis until death is seven to ten years, but this is quite variable and can range from three to twenty years, depending on the age of the onset, other medical conditions present, and the care patients receive.
 The brains of patients with Alzheimer's have distinctive formations - abnormally shaped proteins called tangles and plaques - that are recognized as the hallmark of the disease. Not all brain regions show these characteristic formations. The areas most prominently affected are those related to memory.
 Tangles are long, slender tendrils found inside nerve cells, or neurons. Scientists have learned that when a protein-called tau becomes altered, it may cause the characteristic tangles in the brain of the Alzheimer’s patient. In healthy brains provides structural support for neurons, but in Alzheimer's patients this structural support collapses.
 Plaques, or clumps of fibers, form outside the neurons in the adjacent brain tissue. Scientists found that a type of protein, called amyloid precursor protein, forms toxic plaques when it is cut in two places. Researchers have isolated the enzyme beta-secretes, which is believed to make one of the cuts in the amyloid precursor protein. Researchers also identified another enzyme, called gamma secretes, that makes the second cut in the amyloid precursor protein. These two enzymes snip the amyloid precursor protein into fragments that then accumulate to form plaques that are toxic to neurons.
 Scientists have found that tangles and plaques cause neurons in the brains of Alzheimer's patients to shrink and eventually die, first in the memory and language centers and finally throughout the brain. This widespread neuron degeneration leaves gaps in the brain's messaging network that may interfere with communication between cells, causing some of the symptoms of Alzheimer’s disease.
 Alzheimer's patients have lower levels of neurotransmitters, chemicals that carry complex messages back and forth between the nerve cells. For instance, Alzheimer's disease seems to decrease the level of the neurotransmitter acetylcholine, which is known to influence memory. A deficiency in other neurotransmitters, including somatostatin and corticotropin-releasing factor, and, particularly in younger patients, serotonin and norepinephrine, also interferes with normal communication between brain cells.
 The causes of Alzheimer's disease remain a mystery, but researchers have found that particular groups of people have risk factors that make them more likely to develop the disease than the general population. For example, people with a family history of Alzheimer's are more likely to develop Alzheimer's disease.
 Some of the most promising Alzheimer's research is being conducted in the field of genetics to learn the role a family history of the disease has in its development. Scientists have learned that people who are carriers of a specific version of the apolipoprotein E gene (apoE genes), found on chromosome 19, are several times more likely to develop Alzheimer's than carriers of other versions of the apoE gene. The most common version of this gene in the general population is apoE3. Nearly half of all late-onset Alzheimer’s patients have the fewer in common apoE4 versions, however, and research has shown that this gene plays a role in Alzheimer's disease. Scientists have also found evidence that variations in one or more genes located on chromosomes 1, 10, and 14 may increase a person’s risk for Alzheimer's disease. Scientists have identified the gene variations on chromosomes 1 and 14 and learned that these genes produce mutations in proteins called presenilins. These mutated proteins apparently trigger the activity of the enzyme gamma secretase, which splices the amyloid precursor protein.
 Researchers have made similar strides in the investigation of early-onset Alzheimer's disease. A series of genetic mutations in patients with early-onset Alzheimer's has been linked to the production of amyloid precursor protein, the protein in plaques that may be implicated in the destruction of neurons. One mutation is particularly interesting among geneticists because it occurs on a gene involved in the genetic disorder Down syndrome. People with Down syndrome usually develop plaques and tangles in their brains as they get older, and researchers believe that learning more about the similarities between Down syndrome and Alzheimer's may further our understanding of the genetic elements of the disease.
 Some studies suggest that one or more factors other than heredity may determine whether people develop the disease. One study published in February 2001 compared residents of Ibadan, Nigeria, who eat a mostly low-fat vegetarian diet, with African Americans living in Indianapolis, Indiana, whose diet included a variety of high-fat foods. The Nigerians were less likely to develop Alzheimer’s disease compared to their U.S. counterparts. Some researchers suspect that health imposes on high blood pressure, atherosclerosis (arteries clogged by fatty deposits), high cholesterol levels, or other cardiovascular problems may play a role in the development of the disease.
 Other studies have suggested that environmental agents may be a possible cause of Alzheimer's disease; for example, one study suggested that high levels of aluminum in the brain may be a risk factor. Several scientists initiated research projects to further investigate this connection, but no conclusive evidence has been found linking aluminum with Alzheimer's disease. Similarly, investigations into other potential environmental causes, such as zinc exposure, viral agents, and food-borne poisons, while initially promising, have generally turned up inconclusive results.
 Some studies indicate that brain trauma can trigger a degenerative process that results in Alzheimer's disease. In one study, an analysis of the medical records scribed upon veterans of World War II (1939-1945) linked serious head injury in early adulthood with Alzheimer's disease in later life. The study also looked at other factors that could possibly influence the development of the disease among the veterans, such as the presence of the apoE gene, but no other factors were identified.
 Alzheimer’s disease is only positively diagnosed by examining brain tissue under a microscope to see the hallmark plaques and tangles, and this is only possible after a patient dies. As a result, physicians rely on a series of other techniques to diagnose probable Alzheimer's disease in living patients. Diagnosis begins by ruling out other problems that cause memory loss, such as stroke, depression, alcoholism, and the use of certain prescription drugs. The patient undergoes a thorough examination, including specialized brain scans, to eliminate other disorders. The patient may be given a detailed evaluation called a neuropsychological examination, which is designed to evaluate a patient’s ability to perform specific mental tasks. This helps the physician determine whether the patient is showing the characteristic symptoms of Alzheimer's disease - progressively worsening memory problems, language difficulties, and trouble with spatial direction and time. The physician also asks about the patient's family medical history to learn about any past serious illnesses, which may give a hint about the patient's current symptoms.
 Evidence shows that there is inflammation in the brains of Alzheimer's patients, which may be associated with the production of amyloid precursor protein. Studies are underway to find drugs that prevent this inflammation, to possibly slow or even halt the progress of the disease. Other promising approaches center on mechanisms that manipulate amyloid precursor protein production or accumulation. Drugs are in development that may block the activity of the enzymes that cut the amyloid precursor protein, halting amyloid production. Other studies in mice suggest those vaccinating animals with amyloid precursor protein can produce a reaction that clears amyloid precursor protein from the brain. Physicians have started vaccination studies in humans to determine if the same potentially beneficial effects can be obtained. There is still much to be learned, but as scientists better understand the genetic components of Alzheimer’s, the roles of the amyloid precursor protein and the tau protein in the disease, and the mechanisms of nerve cell degeneration, the possibility that a treatment will be developed is more likely.
 The responsibility for caring for Alzheimer's patients generally falls on their spouses and children. Care givers must constantly be on guard for the possibility of Alzheimer's patients wandering away or becoming agitated or confused in a manner that jeopardizes the patient or others. Coping with a loved one's decline and inability to recognize familiar face causes enormous pain.
 The increased burden faced by families is intense, and the life of the Alzheimer's care giver is often called a 36-hour day. Not surprisingly, care givers often develop health and psychological problems of their own as a result of this stress. The Alzheimer's Association, a national organization with local chapters throughout the United States, was formed in 1980 in large measure to provide support for Alzheimer's care givers. Today, national and local chapters are a valuable source for information, referral, and advice.
 Some of the most promising Alzheimer's research is being conducted in the field of genetics to learn the role a family history of the disease has in its development. Scientists have learned that people who are carriers of a specific version of the apolipoprotein E gene (apoE genes), found on chromosome 19, are several times more likely to develop Alzheimer's than carriers of other versions of the apoE gene. The most common version of this gene in the general population is apoE3. Nearly half of all late-onset Alzheimer’s patients have the fewer in common apoE4 versions, however, and research has shown that this gene plays a role in Alzheimer's disease. Scientists have also found evidence that variations in one or more genes located on chromosomes 1, 10, and 14 may increase a person’s risk for Alzheimer's disease. Scientists have identified the gene variations on chromosomes 1 and 14 and learned that these genes produce mutations in proteins called presenilins. These mutated proteins apparently trigger the activity of the enzyme gamma secretase, which splices the amyloid precursor protein.
 Researchers have made similar strides in the investigation of early-onset Alzheimer's disease. A series of inherent genetic mutations in patients with early-onset Alzheimer's has been linked to the production of amyloid precursor protein, the protein in plaques that may be implicated in the destruction of neurons. One mutation is particularly interesting to geneticists because it occurs on a gene involved in the genetic disorder Down syndrome. People with Down syndrome usually develop plaques and tangles in their brains as they get older, and researchers believe that learning more about the similarities between Down syndrome and Alzheimer's may further our understanding of the genetic elements of the disease.
 Some studies suggest that one or more factors other than heredity may determine whether people develop the disease. One study published in February 2001 compared residents of Ibadan, Nigeria, who eat a mostly low-fat vegetarian diet, with African Americans living in Indianapolis, Indiana, whose diet included a variety of high-fat foods. The Nigerians were less likely to develop Alzheimer’s disease compared to their U.S. counterparts. Some researchers suspect that health imposes on high blood pressure, atherosclerosis (arteries clogged by fatty deposits), high cholesterol levels, or other cardiovascular problems may play a role in the development of the disease.
 Other studies have suggested that environmental agents may be a possible cause of Alzheimer's disease; for example, one study suggested that high levels of aluminum in the brain may be a risk factor. Several scientists initiated research projects to further investigate this connection, but no conclusive evidence has been found linking aluminum with Alzheimer's disease. Similarly, investigations into other potential environmental causes, such as zinc exposure, viral agents, and food-borne poisons, while initially promising, have generally turned up inconclusive results.
 Some studies indicate that brain trauma can trigger a degenerative process that results in Alzheimer's disease. In one study, an analysis of the medical records scribed upon veterans of World War II (1939-1945) linked serious head injury in early adulthood with Alzheimer's disease in later life. The study also looked at other factors that could possibly influence the development of the disease among the veterans, such as the presence of the apoE gene, but no other factors were identified.
 Alzheimer’s disease is only positively diagnosed by examining brain tissue under a microscope to see the hallmark plaques and tangles, and this is only possible after a patient dies. As a result, physicians rely on a series of other techniques to diagnose probable Alzheimer's disease in living patients. Diagnosis begins by ruling out other problems that cause memory loss, such as stroke, depression, alcoholism, and the use of certain prescription drugs. The patient undergoes a thorough examination, including specialized brain scans, to eliminate other disorders. The patient may be given a detailed evaluation called a neuropsychological examination, which is designed to evaluate a patient’s ability to perform specific mental tasks. This helps the physician determine whether the patient is showing the characteristic symptoms of Alzheimer's disease - progressively worsening memory problems, language difficulties, and trouble with spatial direction and time. The physician also asks about the patient's family medical history to learn about any past serious illnesses, which may give a hint about the patient's current symptoms.
 Evidence shows that there is inflammation in the brains of Alzheimer's patients, which may be associated with the production of amyloid precursor protein. Studies are underway to find drugs that prevent this inflammation, to possibly slow or even halt the progress of the disease. Other promising approaches center on mechanisms that manipulate amyloid precursor protein production or accumulation. Drugs are in development that may block the activity of the enzymes that cut the amyloid precursor protein, halting amyloid production. Other studies in mice suggest those vaccinating animals with amyloid precursor protein can produce a reaction that clears amyloid precursor protein from the brain. Physicians have started vaccination studies in humans to determine if the same potentially beneficial effects can be obtained. There is still much to be learned, but as scientists better understand the genetic components of Alzheimer’s, the roles of the amyloid precursor protein and the tau protein in the disease, and the mechanisms of nerve cell degeneration, the possibility that a treatment will be developed is more likely.
 The responsibility for caring for Alzheimer's patients generally falls on their spouses and children. Care givers must constantly be on guard for the possibility of Alzheimer's patients wandering away or becoming agitated or confused in a manner that jeopardizes the patient or others. Coping with a loved one's decline and inability to recognize familiar face causes enormous pain.
 The increased burden faced by families is intense, and the life of the Alzheimer's care giver is often called a 36-hour day. Not surprisingly, care givers often develop health and psychological problems of their own as a result of this stress. The Alzheimer's Association, a national organization with local chapters throughout the United States, was formed in 1980 in large measure to provide support for Alzheimer's care givers. Today, national and local chapters are a valuable source for information, referral, and advice.
 Defining understanding of the states of consciousness is not at all simple, is agreed-upon definition of consciousness exists. Attempted definitions tend to be tautological (for example, consciousness defined as awareness) or merely descriptive (for example, consciousness described as sensations, thoughts, or feelings). Despite this problem of definition, the subject of consciousness has had a remarkable history. At one time the primary subject matter of psychology, consciousness as an area of study, that the idea that something conveys to the mind, from which of critics has endlessly debated the meaning of the ascribing interactions that otherwise to ascertain the quality, mass, extent or degree of terminological statements that its standard unit or mixed distributive analysis, is such, that a conceptualized form of its reasons to posit of a direct interpretation whose interference became of the total demise, even so, there is the  result reemerging to become a topic of current interests.
 Most of the philosophical discussions of consciousness arose from the mind-body issues posed by the French philosopher and mathematician René Descartes in the 17th century. Descartes asked: Is the mind, or consciousness, independent of matter? Is consciousness extended (physical) or unextended (nonphysical)? Is consciousness determinative, or is it determined? English philosophers such as John Locke equated consciousness with physical sensations and the information they provide, whereas European philosophers such as Gottfried Wilhelm Leibniz and Immanuel Kant gave a more central and active role to consciousness.
 The philosopher who most directly influenced subsequent exploration of the subject of consciousness was the 19th-century German educator Johann Friedrich Herbart, who wrote that ideas had quality and intensity and that they may suppress  or may facilitate or place of one another. Thus, ideas may pass from ‘states of reality’ (consciousness) to ‘states of tendencies’ (unconsciousness), with the dividing line between the two states being described as the threshold of consciousness. This formulation of Herbart clearly presages the development, by the German psychologist and physiologist Gustav Theodor Fechner, of the psychophysical measurement of sensation thresholds, and the later development by Sigmund Freud of the concept of the unconscious.
 The experimental analysis of consciousness dates from 1879, when the German psychologist Wilhelm Max Wundt started his research laboratory. For Wundt, the task of psychology was the study of the structure of consciousness, which extended well beyond sensations and included feelings, images, memory, attention, duration, and movement. Because early interest focussed on the content and dynamics of consciousness, it is not surprising that the central methodology of such studies was introspection; that is, subjects reported on the mental contents of their own consciousness. This introspective approach was developed most fully by the American psychologist Edward Bradford Titchener at Cornell University. Setting his task as that of describing the structure of the mind, Titchener attempted to detail, from introspective self-reports, the dimensions of the elements of consciousness. For example, taste was ‘dimensionalized’ into four basic categories: sweet, sour, salt, and bitter. This approach was known as structuralism.
 By the 1920's, however, a remarkable revolution had occurred in psychology that was to essentially remove considerations of consciousness from psychological research for some 50 years: Behaviourism captured the field of psychology. The main initiator of this movement was the American psychologist John Broadus Watson. In a 1913 article, Watson stated, ‘I believe that we can write of some psychology and never use the term’s consciousness, mental states, mind . . . imagery and the like.’ Psychologists then turned almost exclusively to behaviour, as described in terms of stimulus and response, and consciousness was totally bypassed as a subject. A survey of eight leading introductory psychology texts published between 1930 and the 1950's found no mention of the topic of consciousness in five texts, and in two it was treated as a historical curiosity.
 Beginning in the later part of the 1950s, are, however, the grounded interests in the foundational subject of consciousness, for returning from its absence were subjects and techniques relating to altered states of consciousness: sleep and dreams, meditation, biofeedback, hypnosis, and drug-induced states. Much in the surge in sleep and dream research was directly fuelled by a discovery relevant to the nature of consciousness. A physiological indicator of the dream state was found: At roughly 90-minute intervals, the eyes of sleepers were observed to move rapidly, and at the same time the sleepers' brain waves would show a pattern resembling the waking state. When people were awakened during these periods of rapid eye movement, they almost always reported dreams, whereas if awakened at other times they did not. This and other research clearly indicated that sleep, once considered a passive state, were instead an active state of consciousness.
 American psychiatrist William Glasser developed reality therapy in the 1960s, after working with teenage girls in a correctional institution and observing work with severely disturbed schizophrenic patients in a mental hospital. He observed that psychoanalysis did not help many of his patients change their behaviour, even when they understood the sources of it. Glasser felt it was important to help individuals take responsibility for their own lives and to blame others less. Largely because of this emphasis on personal responsibility, his approach has found widespread acceptance among drugs - and alcohol-abuse counsellors’, correction’s workers, school counsellors, and those working with clients who may be disruptive to others.
 Reality therapy is based on the premise that all human behaviour is motivated by fundamental needs and specific wants. The reality therapist first seeks to establish a friendly, trusting relationship with clients in which they can express their needs and wants. Then the therapist helps clients explore the behaviours that created problems for them. Clients are encouraged to examine the consequences of their behaviour and to evaluate how well their behaviour helped them fulfill their wants. The therapist does not accept excuses from clients. Finally, the therapist helps the client formulate a concrete plan of action to change certain behaviours, based on the client’s own goals and ability to make choices.
 During the 1960's, an increased search for ‘higher levels’ of consciousness through meditation resulted in a growing interest in the practices of Zen Buddhism and Yoga from Eastern cultures. A full flowering of this movement in the United States was seen in the development of training programs, such as Transcendental Meditation, that were self-directed procedures of physical relaxation and focussed attention. Biofeedback techniques also were developed to bring body systems involving factors such as blood pressure or temperature under voluntary control by providing feedback from the body, so that subjects could learn to control their responses. For example, researchers found that persons could control their brain-wave patterns to some extent, particularly the so-called alpha rhythms generally associated with a relaxed, meditative state. This finding was especially relevant to those interested in consciousness and meditation, and a number of ‘alpha training’ programs emerged.
 Another subject that led to increased interest in altered states of consciousness was hypnosis, which involves a transfer of conscious control from the character interpretation belonging in the dependent sector,  whose occasions, as basic of an idea or the principal object of attention, in the course of its immediate composition, and like the substance to a particular individual finds to the subject that the modification as when of transferring to that of another person. Hypnotism has had a long and intricate history in medicine and folklore and has been intensively studied by psychologists. Much has become known about the hypnotic state, relative to individual suggestibility and personality traits; the subject has now been largely demythologized, and the limitations of the hypnotic state are fairly well known. Despite the increasing use of hypnosis, however, much remains to be learned about this unusual state of focussed attention.
 Finally, many people in the 1960's experimented with the psychoactive drugs known as hallucinogens, which produce deranging disorder of consciousness. The most prominent of these drugs is lysergic acid diethylamide, or LSD; mescaline; and psilocybin; the latter two have long been associated with religious ceremonies in various cultures. LSD, because of its radical thought-modifying properties, was initially explored for its so-called mind-expanding potential and for its psychotomimetic effects (imitating psychoses). Little positive use, however, has been found for these drugs, and their use is highly restricted.
 Scientists have long considered the nature of consciousness without producing a fully satisfactory definition. In the early 20th century American philosopher and psychologist William James suggested that consciousness be a mental process involving both attention to external stimuli and short-term memory. Later scientific explorations of consciousness mostly expanded upon James’s work. In the article from a 1997 special issue of Scientific American, Nobel laureate Francis Crick, who helped determine the structure of DNA, and fellow biophysicists Christof Koch explains how experiments on vision might deepen our understanding of consciousness.
 As the concept of a direct, simple linkage between environment and behaviour became unsatisfactory in recent decades, the interest in altered states of consciousness may be taken as a visible sign of renewed interest in the topic of consciousness. That persons are active and intervening participants in their behaviour has become increasingly clear. Environments, rewards, and punishments are not simply defined by their physical character. Memories are organized, not simply stored, an entirely new area called cognitive psychology has emerged that centre on these concerns. In the study of children, increased attention is being paid to how they understand, or perceive, the world at different ages. In the field of animal behaviour, researchers increasingly emphasize the inherent characteristics resulting from the way a species has been shaped to respond adaptively to the environment. Humanistic psychologists, with a concern for self-actualization and growth, have emerged after a long period of silence. Throughout the development of clinical and industrial psychology, the conscious states of persons in terms of their current feelings and thoughts were of obvious importance. The role of consciousness, however, was often de-emphasised in favour of unconscious needs and motivations. Trends can be seen, however, toward a new emphasis on the nature of states of consciousness.
 We have used the term ‘transference’ several times, in that we attributed the therapeutic results to the transference without further definition of the word. We will now consider more closely the emotional relationship that is thus designed. During a psychoanalytic treatment, the patient allows the analyst to play a predominating role in his emotional life. This is of great importance in the analytic process. After his treatment is over, this situation is changed. The patient builds up feelings of affection for and resistance to his analyst that, in their ebb and flow, so exceed the normal degree of feeling that the phenomenon has long attracted the theoretical interest of the analyst. Freud studied this phenomenon thoroughly, explained it, and gave it the name ‘transference’, we most probably will understand the significance of the transference phenomenon impressed Freud so profoundly that he continued through the years to develop his ideas about it.
 In all afforded efforts, to refuse to consider the demise of forebears as too merely disdain, that we cannot reproduce of all Freud’s research about transference but for an instance of obligation, would be used to indicate the requirement by the immediate need or purpose upon such condition that might  point beyond a normal or acceptable limit, as to an excessive amount of  which something does not or cannot extend to their essentials. When we speak of the transference in connexion with social reeducation, we mean the emotional responses of the education or counsellor or therapist, as the case maybe, without meaning that it takes place in the same way as in an analysis. The ‘countertransference‘ is emotional aptitude of the teacher toward the pupil, the counsellor toward his charge, the therapist toward the patient. The feeling that the child develop for the mentor is conditioned by a much earlier relationship to someone else. We must take cognisance of this fact in order to understand these relationships. The tender relationships that go to up the child’s love life are no longer strange to us. Many of these have already been touched upon in the foregoing literature. We have learned how the small boy takes the father and mother as love objects. We have followed the strivings that arise out of this relationship, the Oedipus situation, we have seen how this runs its course and terminates in an identification with the parents. We have also had opportunity to consider the relationship between brothers and sisters, how their original rivalry is transformed into affection through the pressure of their feeling for the parents. We know that the boy at puberty must give up his first love object within the family and transfers his libido to individuals outside the family.
 Our present purpose is to consider the effects of these first experiences from a certain angle. The child’s attachment to the family, the continuance and the subsequent dissolution of these love relationships within the family, not only leave a deep effect on the child through the resulting identifications, they determine at the same the actual forms of this love relationships in the future. Freud compares these forms, without implying too great a rigidity, to copper plates for engraving. He has shown that in the emotional relationships of our later life we can do nothing but makes an imprint from one or another of these patterns that we have established in early childhood.
 Why Freud explicitly chose the confines that which of his sociological conditions of sociol-cultural relationships or relative position, such that the term ‘transference’ held firmly for the emotional relationship between patient and analyst is easy to understand. The feelings that arose long ago in another situation are transferred upon the analyst. To the counsellor of the child, the knowledge of the transference mechanism is indispensable. In order to influence the dissocial behaviour, he must bring his charge into the transference situation. The study of the transference in the dissocial child shows regularly a love life that has been disturbed in early childhood by a lack of affection or an undue amount of affection. A satisfactory social adjustment depends on certain conditions, among them an adequate constitutional endowment and early love relationships that have been confined within certain limits. Society determines these limitations, just as definitely as the later love life of an individual is determined by early form his libidinal development. The child develops normally and assumes his proper place in society, if he can cultivate within the privacy to such relationships as can favourably be carried over into the schools and from there into the ever-broadening world around him. His attitude toward his parents must be such that it can be carried over onto the teacher, and that toward his brothers and sisters must be transferred to his schoolmates. Every new contact, according to the degree of authority or maturity that the person represents, repeats a previous relationship with very little deviation. People whose early adjustment to succeed or supervene from such a normative course have no difficulties in their emotional relations with others, and they are able to form new ties, to deepen them, or to break them off without conflict when the situation demands it.
 We can easily see why an attempt to change the present order of society always meets with resistance and where the radical reformer will have to use the greatest leverage. Our attitude to society and its members has a certain standard form. It gets its imprint from the structure of the family and the emotional relationships set up within the family, therefore, the parents, especially the father, assume overwhelming responsibility for the social orientation of the child. The persistent, ineradicable libidinal relationships carried over from childhood are facts with which social reformers must reckon. If the family represents the best preparation for the present social order, which seems to be the case, then the introduction of a new order means that the family must be uprooted and replaced by a different personal world for the child. It is beyond our scope to attempt a solution of this question, which concerns those who strive to build up a new order of society. We are remedial educators and must recognize these sociological relationships. We can ally ourselves with whatever social system will, but we have the path of our present activity well marked out for us, to bring dissocial youth into the line with present-day society.
 If the child is harmed through too great disappointment or too great indulgence in his early life, he builds up reaction patterns that are damaged, incomplete, or too delicate to support the wear and tear of life. He is incapable of forming libidinal object relationships that are considered normal by society. His unpreparedness for life, his inability to regulate his conscious and unconscious libidinal striving and to confine his libidinal expectations within normal bounds, creates an insecurity in relation to his fellow men and constitute one of the first and most important condition’s fo r their development of delinquency. Following this point of view, we look for the primary causes of dissocial behaviour in early childhood, where the abnormal libidinal ties are established. The word ‘delinquency’ is an expression used to describe a relationship to people and things that are at variances with what society approve in the individual.
 It is not immediately clear, from which are pointed from the particular form of the delinquency, just what libidinal disturbances in childhood have given rise to the dissocial expression. Until we have a psychoanalytically construed scheme for the diagnosis of delinquency, we may content ourselves by separating these forms into two groups: (1) Borderline neurosis cases with dissocial symptoms, and (2) dissocial cases for which are in part, the ego giving to develop of the dissocial behaviour, and showing no trace of neurosis. In the first type, the individual finds himself in an inner conflict because of the nature of his love relationships, a part of his own personality forbids the indulgence of libidinal desires and strivings. The dissocial behaviour results from this conflict. In the second type, the individual finds himself in open conflict with his environment, because the outer world has frustrated his childish libidinal desires.
 The differences in the forms of dissocial behaviour are important for many reasons. At present, they are significant to us because of the various ways in which the transference is established in these two types, we know that with a normal child the transference takes place of itself through the kindly efforts of the responsible adult. The teacher in his attitude repeats the situations long familiarly to the child, and thereby evokes a parental relationship. He does not maintain this relationship at the same level, but continually deepens it as long as he is the parental substitute.
 When a neurotic child with symptoms of delinquency comes into the institution, the tendencies to transfer his attitude toward his parents to the persons in authority are immediately noticeable. The worker will adopt the same attitude toward the dissocial child as to the normal child, and bring him into positive transference, if he acts toward him in such a way as to prevent a repetition with the worker of the situation with the parents that led to the conflict. In psychoanalysis, on the other hand, it is of greatest importance to let this situation repeat itself. In a sense the worker becomes the father or the mother, but still not wholly so, he represents their claims, but in the right moment he must let the dissocial child know that he has insight into his difficulties and that he will not interpret the behaviour in the same way as do the parents. He will respond to the child’s feeling of a need for punishment, but he will not completely satisfy it.
 He will conduct in himself be entirely differently in the case of the child who in open conflict with society. In this instance he must take the child’s part, be in agreement with his behaviour, and in the severest cases even give the child to understand that in his place he would behave just the same way. The guilt feelings found so clearly in the neurotic cases with dissocial behaviour are present in these cases also. These feelings do not arise, however, from the dissocial ego, but have another source.
 Why does the educator conduct himself differently in dealing with this second type? These children, too, he must draw into a positive transference to him, but what is applicable and appropriate for a normal or a neurotic child would achieve opposite results. Otherwise the worker would bring upon himself all the hate and aggression that the child bears toward society, thus leading the child into a negative instead of positive transference, and creating a situation in which the child is not amenable to training.
 Nevertheless, what was said about psychoanalysis theory is only a bare outline, that much deeper study of the transference is necessary to anyone interested in re-educational work from the psychoanalytic point of view. The practical application of this theory is not easy, since we deal mostly with mixed types, such that the attitude of the counsellor cannot be as uniform as having enough verbal descriptions for evincing of individual forms of dissociated behaviour to enable us to offer detailed instructions about how to deal with them. At present our psychoanalytic knowledge is such that a correct procedure cannot be stated specifically for each and every dissocial individual.
 The necessity for bringing the child into a good relationship to his mentor is of prime importance. The worker cannot leave this to chance, he must deliberately achieve it and he must  face the fact thus no effective work is possible without it. It is important for him to grasp the psychic situation of the dissocial child in the very first contact he makes with him, because only this can be known in what attitude to adopt. There is a further difficulty in that the dissocial child takes pains to hide his real nature: He misrepresents himself and lies. This is to be taken for granted, it should not surprise or upset us. Dissocial children do not come to us of their own volition but are brought to us, very often with the threat, ‘You will soon find out what is going to happen to you.’ Generally parents resort our help only after every other means, including corporal punishment, have failed. To the child, we are only another form of punishment, an enemy against whom he must be on his guard, not a source of help to him. There is a great difference between this and the psychoanalytic situation, where the patient comes voluntarily for helping. To the dissocial child, we are a menace because we represent society, with which he is in conflict. He must protect himself against this terrible danger and be careful what he says in order not to give himself away. It is hard to make some of these delinquent children talk, remain unresponsive and stubborn. One thing they all have in common: They do not tell the truth. Some lie stupidly, pitiably, others, especially the older ones, show great skill and sophistication. The extremely submissive child, the ‘dandly’, the very jovial, or the exaggeratedly sincere, some especially hard to reach. This behaviour is so much to be expected that we are not surprised or disarmed by it, the inexperienced teacher or adviser is easily irritated, especially when the lies are transparent, but he must not let the child be aware of this. He must deal with the situation immediately without telling the child that he can see that coming through was warrantably attributive value about his attitudinal behaviours.
 There is nothing remarkable in the behaviour of the dissocial, but it differs only quantitatively from normal behaviour. We all hide our real selves and use a great deal of psychic energy to mislead our neighbours. We masquerade more or less, according to necessity. Most of us learn in the nursery the necessity of presenting ourselves in accordance with the environmental demands, and thus we consciously or unconsciously build up a shell around ourselves. Anyone who has had experience with young children must have noticed how they immediately begin to dissimulate when a grown-up comes into the room. Most children succeed in behaving in the manner that they think is expected of them. Thus they lessen the danger to themselves and at the same time they are casting the permanent moulds of their mannerisms and their behaviour. How many parents really bother themselves about the inner life of their children? Is this mask necessarily for life? I do not know, but it often seems that the person on whom childhood experiences have forced the dissocial individual masquerades to a greater extent, and more consciously, then the normal. He is only drawing logical deductions from his unfortunate disagreeable authority? Why should he be sincere with those people who represent disagreeable authority? This is an unfair demand.
 We must look further into the differences between the situation of social retraining and the analytic situation. The analyst expects to meet in his patient unconscious remittances that prevent him from being honest or make him silent: But the treatment is in vain when the patient lies persistently. Those who work with dissocial children expect to be lied to. To send this child away because he lies are only giving in to him. We must wait and hope to penetrate this mask that covers the really psychic situation. In the institution it does not matter if this is not achieved immediately, it means merely that the establishment of the transference is postponed. In the clinic, however, we must work more quickly. Taking with the patient does not always suffice, and we must introduce other remedial measures. Generally, we see the delinquent child, only, in at least as infrequent to a smattering of times, but we are forced to take some steps after the first few interviews, to formulate some tentative conception of the difficulty and to establish a positive transference as quickly as possible. This means we must get at least a peek behind the mask. If the child is not put in an institution, he remains in the old situation under the same influences that caused the trouble. In such cases we wish to establish the transference as quickly as possible, to intensify the child`s positive feelings for us that are aroused while the child is with us, and to bring them rapidly to such a pitch that they can no longer be easily disturbed by the old influences. To carry on such work successfully presupposes a long experience.
 Let us now, in violation of our theoretical concern and considerations and see how the analyst and the patient seek to grasp upon a try to solve situational thoughts for which the transference, and, moreover, its mask on which can be understood that feelings and a better understanding the differentiation that intentionality that allies with others and exclusively its need to achieve to some end.
 Even so, there are few current problems concerning the problem of transference that Freud did not recognize either implicitly or explicitly in the development of the theoretical and clinical framework. For all essential purposes, moreover, his formulations, in spite of certain shifts in emphasis, remain integral to contemporary psychoanalytic theory and practice. Recent developments mainly concern the impact of an ego-psychological approach, the significance of object relations, both current and infantile, external and internal, the role of aggression in mental life, and the part played by regression and the repetition compulsion in the transference. Nevertheless, analysis of the infantile Oedipal situation in the setting of a genuine transference neurosis is still considered as a primary goal of psychoanalytic procedure.
 Originally, transference was ascribed to displacement on the analyst of repressed wishes and fantasies derived from early childhood. The transference neurosis was viewed as a compromise formulation similar to dreams and other neurotic symptoms. Resistance, defined as the clinical manifestation of repression, could be diminished or abolished by interpretation mainly directed toward the content of the repressed. Transference resistance, both positive and negative, was inscribed to the threatened emergence of repressed unconscious material in the analytic situation. Presently, as with the development of a structural approach, the superego had been portrayed as the heir to the genital Oedipal situation, also was the recognition as playing a leading role in the transference situation. The analysis was subsequently viewed not only as the object by displacement of infantile incestuous fantasies, but also as the substitute by projection for the prohibiting parental figures that had been internalized as the definitive superego. The effect of transference interpretation in mitigating undue severity of the superego has, therefore, been emphasized in many discussions of the concept of transference.
 Certain expansions in the structural approach related increasingly to the recognition of the role that had earlier objective relations, in the development of the superego. This had affected the current concepts of transference, in that this connection, the significance of the analytic situation as a repetition of the early mother-child relationship has been stressed from different points for viewing to such equally important developments related to Freud’s revised concept of anxiety that can only lead to theoretical developments in the field of ego psychology. However, this brought about their related clinical changes in the work of many analysts. As a result, attention was no longer the main attraction that had focussed on the content of the unconscious. In addition, increasing importance was attributed to the defence processes by means of which the anxiety that would be engendered if repression and other related mechanisms were broken down, was avoided in the analytic situation. Differences in the interpretation of the role of the analyst and the nature of transference developed from emphasis, on the one hand, on the importance of early object relations, and on the other, from primary attention to the role of the ego and its defences. These defences first emerged clearly in discussion of the technique of child analysis, in which Melanie Klein and Anna Freud, the pioneers in the fields of thought as playing the leading roles.
 From a theoretical point of view, discussion foreshadowing the problems that face us today was presented in 1934 in a well-known paper by Richard Sterba and James Strachey, and further elaborated at the Marienbad Symposium at which Edward Bibring made an important contribution. The importance of identification with, or introjection of the analyst in the transference situation of identification with, or introjection of, the analysts in the transference situation were clearly indicated. The therapeutic results were attributed to the effect of this process In mitigating the need for pathological defences. Strachey, however, considerably influenced by the work of Melanie Klein, regarded transference as essentially a projection onto the analyst of the patient’s own superego. The therapeutic process was attributed to subsequent introjection of a modified superego as a result of ‘mutative’ transference. Sterba and Bibring, on the other hand, intimately involved with development of the ego-psychological approach, reemphasised the central role of the ego, postulating a therapeutic split and identification with the analyst as an essential feature of transference. To some extent, this difference of opinion may be regarded as semantic. If the superego is explicitly defined as the heir of the genital Oedipus conflict, then earlier intra-systematic conflicts within the ego, although they may be related retrospectively to the definite superego, much, nevertheless, are defined as contained within the ego. Later divisions within the ego of the type indicated by Sterba and very much expanded by Edward Bibring in his concept of therapeutic alliance between the analyst and the healthy part of the patient’s ego, must also be excluded from superego significance. In contrast, those whom attribute pregenital intra-systemic conflicts within the ego primarily to the introjection of objects, consider that the resultant state of internal conflict appears like the dynamic idea that something conveys to the mind as having an endless meaning attached to the coherence of the therapeutic situation and seen in the later conflicts between ego and superego. They, therefore, believe that these structures developed simultaneously and suggest that no sharp distinction should be made between pre-oedipal, oedipal, and post-oedipal superego.
 The differences, however, are not entirely verbal, since those whom attribute superego formations to the early months of life tend to attribute significantly too early object relation that differs from the conception of those who stress control and, neutralization of instinctual energy as primary functions of the ego. This theoretical difference necessarily implies some disagreement as how the dynamic situation both in childhood and in adult life, inevitably reflected in the concept of transference and in hypotheses as to the hidden nature of the therapeutic process. From one point of view, the role of the ego is central and crucial at every phase of analysis. A differentiation is made between transference as therapeutic alliance and the transference neurosis, which, on the whole, is considered a manifestation of resistance. Effective analysis depends on a sound and stable therapeutic alliance, a prerequisite for which is the existence, before analysis, of a degree of mature superego functions, the absence of which in certain severely disturbed patients and in young children may preclude traditional psychoanalytic procedure. Whenever indicated, interpretation’s manifestations, which means, in effect, that the transference must be analysed. The process of analysis, however, is not exclusively ascribed to transference interpretation. Other interpretations of unconscious material, whether related to defence or to early fantasies, will be equally effective provided they are accurately timed and provide a satisfactory therapeutic alliance has been made. Those, in contrast, whom stress the importance of early object relations emphasizes the crucial role of transference as an object relationship, distorted though this may be of a variety of defences against primitively unresolved conflicts. The central role of the ego, both in the early stages of development and in the analytic process, are definitely accepted. The hidden nature of the ego is, however, considered at all times to be determined by its external and internal objects. Therapeutic process whose changes in ego function results, therefore, primarily from a change in object relations though interpretation of the transference situation, finds of less differentiation as made between transference as for being the therapeutic alliance and transference neurosis as a manifestation of resistance. Therapeutic progress depends almost exclusively on transference interpretation. Other interpretations, although at times, are not, in general, considered an essential feature of the analytic process. From this point of view, the preanalytic maturity of the patient’s ego is not stressed as considered potentially suitable for traditional psychoanalytic procedure.
 These differences in theoretical orientation are not only reflected in the approach to children and disturbed patients. They may also be recognized in significant variations of technique in respect to all clinical groups, which inevitably affect the opening phases, understanding of the inevitable regressive features of the transference neurosis, and handling of the germinal phases of analysis. By its emphasis as drawn on or upon the main problems, and, by contrast, rather than similarity, our efforts will be to avoid to detailed discussions of controversial theory regarding the hidden nature of early ego development by a somewhat arbitrary differentiation between those who relate ego analysis to the analysis of defences and those who stress the primary significance of object relations both in the transference, and in the development and definitive structure of the ego. Needless to say, this involves some oversimplification, where I hope that it may, at the same time, clarify certain important issues. To take, on or upon the analysis of patients we are generally agreeing to be suitable for classical analytic procedure, the transference neurosis. Those which emphasis the role of the ego and the analysis of defences, not only maintain Freud’s conviction that analysis should proceed from surface to depth, but also consider that early material in the analytic situation derives, that, in general, from defensive processes rather than from displacement onto the analyst of early instinctual fantasies. Deep transference interpretation in the early instinctual fantasies. Deep transference interpretation in the early phases of analysis will, therefore, rather be meaningless to the patient since its unconscious significance is so inaccessible, or, if the defences are precarious, will lead to premature and possibly intolerable anxiety. Premature interpretation of the equally unconscious automatic defensive processes by means of which instinctual fantasy kept unconscious is also ineffective and undesirable. There are, nonetheless, differences of opinion within this group, as to how far analysis of defence can be separated from analysis of content. Waelder, for example, has stressed the impossibility of such separation. Fenichel, however, considered that at least theoretical separation should be made and indicated that, as far as possible, analysis of defence should precede analysis of unconscious fantasy. It is, nevertheless, generally agreed that the transference neurosis develops, as a rule after ego defences have been sufficiently undermined to mobilize previously hidden instinctual conflict. During both the early stages of analysis, and at frequent points after development of the transference neurosis, defences against the transference will become a main feature of the analytic situation.
 This approach is based on certain definite premises regarding the hidden natures and function of the ego in respect to the control and neutralization of instinctual energy and unconscious fantasies, while the importance of early object relations is not neglected, the conviction that early transference interpretation is ineffective and potentially relations are not neglected, the conviction and unconscious fantasy. The conviction that early transference interpretation is ineffective and potentially dangerous is related to the hypothesis  that the instinctual energy available to the mature ego has been neutralized from unconscious fantasies, meaning at the beginning of analysis, for all effective purposes, relatively or absolutely divorced from its unconscious fantasy, as yet, there are a number of analysts of differing theoretical orientation of ego function from unconscious sources, but consider that unconscious fantasy continues to operate in all conscious mental activity. The analysts also construct upon the whole of their existing in the emphasis to the crucial significance of primitive fantasies, in respect to the development of the transference situation. The individual entering analysis will inevitably have unconscious fantasies concerning the analyst derived from primitive sources. This material, although deep in a  sense, is, nevertheless, strongly current and accessible to interpretation. Klein, in addition, creates the development and definitive structure of the superego to unconscious fantasy determined by the earliest phases of object relationships. She emphasizes the role of early introjective and projective processes in relation to primitive anxiety ascribed to the death instinct and related aggression drive fantasies. The unresolved difficulties and conflict of the earliest period continue to colour object relations throughout life. Failure to achieve an essentially satisfactory object relationship in this early period, and failure to master relative loss of that object without retaining its good internal representative, will not only affect all object relations and definitive ego function, but more specifically determine the nature of anxiety-provoking fantasies on entering the analytic situation. According to this point of view, therefore, early transference uninterpreted, even thought it may relate to fantasies derived from an early period of life, should result not in an increase, but a decrease of anxiety
 In considering next problems of transference in relation to analysis of the transference neurosis, two main points must be kept in mind. First, as already indicated, those who emphasize the analysis of defence tend to make a definite differentiation between transference as therapeutic alliance and the transference neurosis as a compromise formation that serves the purposes of resistance. In contrast, those who emphasize the importance of early object relations view the transference primarily as a revival or repetition, sometimes attributed to symbolic processes of early struggles in respect to objects. Still, there is no sharp differentiation made between the early manifestations of transference and the transference neurosis. In view, moreover, of the weight given to the role of unconscious fantasy and internal objects in every phase of mental life, healthy and pathological functions, though differing in essential respect, do not differ with regard to their direct dependence on unconscious sources.
 In the role of regression in the transference situation is subject to wide differences of opinion. It was, of course, one of Freud’s earliest discoveries that regression had of its earliest points of fixation, and is a cardinal feature, not only in the development of neurosis and psychosis, but also in the revival of earlier conflicts in the transference situation. With the development of psychoanalysis and its application to an ever increasing range of received increased attention. The significance of the analytic situation as a means of fostering regression as a prerequisite for the therapeutic work has been emphasized by Ida Macapline in a recent paper. Differing opinions as to the significance, value, and technical handling of regressive manifestoes from the basis of important modifications of analytic technique, which will be considered, however, in respect to the transference neurosis, the view recently expressed by Phyllis Greenacre, that regression, and indispensable features would be generally accepted. It is also a matter of generally based agreement that a prerequisite for successful analysis is revival and repetition in the analytic situation of the struggle of primitive stages of development. Those who emphasize defence analysis, however, tend to view regression as a manifestation of resistance, as a primitive mechanism of defence employed by the growth sets of the transference neurosis. Analysis of these regressive manifestations with their potential dangers depends on the existing and continued functioning of adequate ego strength to maintain therapeutic alliance at an adult level. Those, in contrast, who stress the significance of transference as a revival of the early mother-child relationship does not emphasize regression as an indication of resistance or defence, the revival of these primitive experiences in the transference situation is, in fact, regarded as can essential prerequisite for satisfactory psychological maturation and true geniality. The Kleinian school, as already indicated features the continued activity of primitive conflicts in determining essential features of the transference at every stage of analysis. Their increasing overt revival in the analytic situation, therefore, signifies a reopening of the analysis, and in general, is regarded as an indication of diminuation rather than increase of resistance. The dangers involved according to this point of view and are determined more but to the failure to mitigate anxiety by suitable transference interpretation. By this failure to obtainably achieve, in the early phases of analysis, a sound and stabling therapeutic alliance is based on the maturity of the patient’s essential ego characteristics.
 In considering, briefly, the terminal phases of analysis, many unresolved problems concerning the goal of the therapy and definition of a completed psychoanalysis must be kept in mind. Distinction must also be made between the technical problems of the terminal phase and evaluation of transference after the analysis has been terminated, there is widespread agreement as to the frequent revival in the terminal phases of primitive transference manifestations apparently resolved during the early phases of primitive transference manifestation, apparently resolved during the early phase of analysis has been terminated. Balint, and those  who accept Ferenczi’s concept of primary passive love, suggest that some gratification of primitive passive needs may be essential for  successful termination. To Klein, the terminal phases of analysis also represent a repetition of important features of the early mother-child relationship. According to her point of view, this period represents, in essence, a revival of the early weaning situation. Completion depends on a mastery of early depressive struggles culminating in successful introjection of the analysis as a good object. Although, in this connection, emphasis differs considerably, it should be noted that those who stress the importance of identification with the analyst as a basis for therapeutic alliance, also accept the inevitability of some permanent modifications of a similar nature. Those, however, who make a definite differentiation between transference of the transference neurosis as a main prerequisite for successful termination. The identification based on therapeutic alliance must be interpreted and understood, particularly with reference to the reality aspects of the analyst’s personality. In spite, therefore, of significant important differences there are, as already indicated in connection with the earlier papers of Sterba and Strachey, important points of agreement in respect to the goal of psychoanalysis.
 The differences already considered indicate some basic current problems of transference. So far, however, discussion has been limited to variations within the framework of a traditional technique. We must consider problems related to overt  modifications, so as the essential expanding context of use between variations introduced in respect to certain clinical conditions. Often as a preliminary to classical psychoanalysis, and modifications based on changes on basic approach that lead to significant alterations with regard both to the method and to the aim of therapy. It is generally agreed that some neurosis, borderline patients and the psychosis. The nature and meaning of such changes are, however,  viewed differently according to the relative emphasis placed on the ego and its defences, on underlying unconscious conflicts, and on the significance and handling of regression in the therapeutic situation.
 In ‘Analysis Terminable and Interminable’, Freud suggested that certainly inaccessible to psychoanalytic procedure. Hartmann has suggested that in addition to these primary attributes, other ego characteristics, originally develop for defensive purposes, and the related neutralized instinctual energy at the disposal of the ego, may be relatively or absolutely divorced from unconscious fantasy. This not only explains the relative inefficacy of early transference interpretation, but also hints of possible limitations in the potentialities of analysis attributable to secondary autonomy of the ego that is considered to be relatively irreversible. In certain cases, moreover, it is suggested that analysis of precarious or seriously pathological defences - particularly those concerned of aggressive impulses - may be not only ineffective, but dangerous. The relative failure of ego development in such cases not only precludes the development of a genuine therapeutic alliance, but also raises the risk of a serious regressive, often predominantly hostile transference situation. In certain cases, therefore, preliminary period of psychotherapy is recommended in order to explore the capacities of the patient to tolerate traditional psychoanalysis. In others, as Robert Knight in his paper on borderline states, and as many analysts’ working with psychotic patients have suggested, psychoanalytic procedure is not considered applicable. Instead, a therapeutic approach based on analytic understanding that, in essence, utilizes an essentially implicit positive transference  as a means of reinforcing, rather than analysing the precarious defences of the individual, is advocated. In contrast, Herbert Rosenfeld approached even severely disturbed psychotic patients with minimal modifications of psychoanalytic techniques. Only changes that the severity of the patient’s condition enforces are introduced. The dangers of regression in therapy are not emphasized since primitive fantasy is considered to be active under all circumstances. The most primitive period is viewed in terms of early object relations with special stress on prosecutory anxiety related to the death instinct. Interpretation of this primitive fantasy in the transference situation, is best offered the opportunity of strengthening the severity-threatened psychosis mainly to serve traumatic experiences, particularly of deprivation in early infancy. According to this point of view, profound regression offers an opportunity to fulfil, in the transference situation, primitive needs that had not been met at the appropriate level of development. Similar suggestions have been proposed by Margolin and others, in the concept of anaclitic treatment. Serious psychosomatic diseases, that approach the premise that the inevitable regression is shown by certain patients and should be utilized in therapy, as a means for gratifying, in their extremely permissive transference situation. Having distinctive or certain limits in the burdensome instant for demanding to that which has not been met in infancy, as this must, in the connection of being taken to understand that the gratifications recommended in the treatment of severely disturbed patients are determined by their conviction. Of these patients are incapable of developing transference as we understand it, in the connection with neurosis and must therefore be handled by a modified technique.
 The opinions so far considered, however, much of them, as mine  differ in certain respects, are, nonetheless, all based on the fundamental premise that an essential difference between analysis and other methods of therapy depends on whether or not interpretation of transference is an integral feature of technical procedure. Results based on the effects of suggestions are to be avoided, as far as possible, whenever traditional technique is employed. This goal has, however, tp establish a point by appropriate objective means, that corroborated evidence that proved the need for better a state of being even more difficult to achieve than Freud expected when he first discerned the significance of symptomatic recovery based on positive transference. The importance of suggestion, even in the most strict analytic methods, has been repeatedly stressed by Edward Glover and others. Widespread and increasing emphasis as to the part played by the analyst’s personality in determining the nature of the individual transference also implies recognition of unavoidable suggestive tendencies in the therapeutic process. Many analysts today believe that the classical conception of analytic objectivity and anonymity cannot be maintained. Instead, thorough analysis of reality aspects of the therapist’s personality and point of view is advocated as an essential feature of transference analysis and an indispensable prerequisite for the dynamic changes already discussed in relation to the termination of analysis. It thus remains the ultimate goal of psychoanalyst’s whenever their theoretical orientation, to avoid, as far as is humanly possible, results based on the unrecognized or unanalysed action of suggestion, and to maintain, as a primary goal, the resolution of such results through consistent and careful interpretation.
 There are, however, a number of therapists, both within and outside the field of psychoanalysis, who consider that the transference situation should not be handled only or mainly as a setting for interpretation even in the treatment or analysis of neurotic patients. Instead, they advocate utilization of the transference relationship for the manipulation of corrective emotional experience. The theoretical orientation of those utilizing this concept of transference may be closer to, or more distant form, a Freudian point of view according to the degree to which current relationships are seen as determined by past events. At one extreme, current aspects and cultural factors are considered of predominant importance, at the other, mental development is viewed in essentially Freudian terms and modifications of technique are ascribed to inherent limitations of the analytic method rather than to essentially changed conceptions of the early phases of mental development. Of this group, Alexander is perhaps the best example. It is thirty years since, in his Salzburg paper, he indicated the tendency for patients to regress, even after apparently successful transference analysis of the oedipus situation to narcissistic dependent pregenital levels that prove stubborn and refractory to transference interpretation. In his more recent work, the role of regression in the transference situation has been increasingly stressed. The emergence and persistence of dependent, pregenital commands for something as or is if one’s right or due requirements are challenged in measuring moderations of a wide range of clinical conditions. It is argued, that its indications that the encouragement of a regressive transference situation is undesirable and therapeutically ineffective. The analyst, therefore, should when this threatens adopt a definite role explicitly differing from the behaviour of the parents in early childhood in order to bring about therapeutic results through a corrective emotional experience in the transference situation. This, it is suggested, will obviate the tendency to regression, thus curtailing the length of treatment and improving therapeutic results. Limitations of regressive manifestations by active steps modifying traditional analytic procedure in a variety of ways are also frequently indicated, according to this point of view.
 It will be clear that to those who maintain the conviction that interpretation of all transference manifestations remain an essential feature of psychoanalysis, the type of manifestation as described, even though based on a Freudian reconstruction of the early phases of mental developments, and represent a major modification. It is determined by a conviction that psychoanalysis, as a therapeutic method, has limitations related to the tendency to regression, which cannot be resolved by traditional technique. Moreover, the fundamental premises on which, and the conception of corrective emotional experience is based minimizing the significance of insight and recall. It is essentially, suggested that corrective emotional experience alone may bring about qualitative dynamic alterations in mental structure, which can lead to a satisfactory therapeutic goal. This implies a definite modification on the analytic hypothesis whose current problems are determined by their defences against the direct opposition to the instinctual impulses and the intentional object, to which had been set up during the decisive periods of early development. An analytic result therefore depends on the revival, repetition and mastery of earlier conflict in the current experience of the transference situation with insight an indispensable feature of an analytic goal.
 Since certain important modifications are related to the concept of regression in the transference situation, it should be considered that this concept is in relation to the repetition compulsion, that transference, essentially is a revival of earlier emotional experience, must be regarded as a manifestation of the repetition compulsion is generally accepted. It is, however, necessarily to distinguish between repetition compulsion as an attempt to master traumatic experience and repetition compulsion as an attempt to return to a real or fantasized earlier state of rest or gratification. Lagache, in a recent paper, has connected by or as if by the affirming relatedness as associated to the corresponding divergence in the repetition compulsion to an inherent need to appear in the problems that had previously been left unsolved. From this point of view, the regressive aspects of the transference situation are to be regarded as a necessary preliminary to the mastery of unresolved conflict, as too, the regressive aspects of transference are mainly attributed to a wish to return to an earlier state of rest or narcissistic gratification, to the maintenance of the status quo in preference to any progressive action, to which Freud’s original conception of the death instinct. There is a good deal to suggest that both aspects of the repetition compulsion may bee seen in self-destructive forces tend to be stronger that progressive libidinal impulses, the potentialities of the analytic approach will inevitably appear to be limited. In those, in contrast, in whom that regard the reappearance in the transference situation of earlier conflicts as an indication of tendencies to master and progress will continue to feel that the classical analytic method remains the optimal approach to psychological illness wherever it is applicable.
 Clarifications maintain the position as peculiarly occupying a particular point in space and time. Whereas in  absence or termination must reflect on or upon the fearing analysis if the transference, as compelling of a generally acknowledged focal point, this itself may debase the appropriate factor that generates, in every degree. The exemplifying analytic technique that would react upon the discipline needed to utilize the new values, whereby, they can be ascribed as the commonality in holding the services to a  suspicious self-direction and comprehensive understanding, in that of whatever is humanly affiliated to the best as can be, and yet, the advocacy to the analysis of the transference is generally acknowledged as the central feature of analytic technique? Freud regarded transference and resistance as facts in the observational conceptuality for which of representing the state of inventions. He writes, . . . that the theory of psychoanalysis in an attempt to account for two striking and unexpected facts of observation that emerge whenever an attempt is made. Evidently the symptoms of a neurotic source, may in his past life, inhabit the sources of experiential recall to the past or the introspective reflections. In the state of affairs, in that for being the latent characterizations announced as the factoring responsibility for the transference and of resistance . . . one that takes the other side of the problem, while accepting as such, to the latencies and the hidden values non-accepting for new interactions as brought through a hypothesis that will hardly escape the charge of misappropriation of properties by attempting endeavour to re-associate the essentially established personalization, that if the pursuit in calling them a psychoanalyst’. Rapaport (1967) argued, in his posthumously published paper on the methodology of psychoanalysis, that transference and resistance inevitably follow from the fact that the analytic situation is interpersonal.
 Despite this general agreement on the centrality of transference and resistance in technique, in that, the analysis of transference is not pursued as systematically and comprehensively affirmed, however, it could be and should be. The relative privacy for which psychoanalytic work makes it impossible for one or of that of any-other, to skilfully improve upon the attemptive conceptual representation as comprehended of issues, its assumption to state this view as anything more that impressions, involving on that of what in the analysis of the transference and to states awareness in the number of reasons that an important aspect in the analysis of the transference of the transference, namely in the resistance, by the awareness of the transference is especially, and often adhering to the analytic procedures that interact among cultural inhibitors, but that  will be distinguished as such, that its ranging manifold of distancing non-localities as founded of the analyst’s.
 However, it must first be to distinguish between two types of interpretation of the transference.  That one is an interpretation of resistance to the awareness of transference, the other, is an interpretation of resistance to the resolution of transference. The distinction has clearly been best spelled out in the form from which copies or reproductions can be produced, as to cause to make its awareness and yielding values as grounded in the cognisance to Greenson (1967) and Stone (1967). The first kind of resistance may be called decence transference, although this term emphases the terminological characterization by its term is mainly employed to refer to a phrase of analysis and carried within the  general resistance to the transference of wishes, it can also be used for a more isolated instance of transference of defence. With some oversimplification, one might say that in resistance to the awareness of transference, the transference, the transference is what does the resisting.
 Another connected description of stating this distinction between resistance and the awareness of transference and resistance to the resolution of transference is between implicit and indirect references to the transference and explicitly or directly referential to the transference. The interpretation of resistance to awareness of the transference is intended to make the implicit transference explicit. While the interpretation of resistance to the resolution of transference is intended to make the patient realize that the already explicit transference does indeed include a determinant from the past.
 It is also important to distinguish between the general concept of an  interpretation of resistance to the resolution of transference and a particular variety of such an interpretation, namely, a genetic transference interpretation - that is, an interpretation of how an attitude in the present is an inappropriate carry-over from the past. While there is a tendency among analysts to deal explicit references to the transference primarily among analyses to deal explicitly the references to the transference as primarily by a genetic transference interpretation, there are other ways of working toward a revolution of the transference. However, this argument does so implicate that not only is not enough emphasis being given to interpretation of the transference in the therapeutic attentions to the existing instant of here and now, that is, to the interpretation of implicit manifestations of the transference, but also that interpretations intended to resolve the transference as manifested in explicit references to the transference should be primarily of having independent reality in actuality within the here and now, rather than genetic transference interpretation.
 A patient’s statement that he feels the analyst is harsh, for example, is, at least to begin with, likely best dealt with not by interpreting that this is a displacement from the patient’s feeling that his father was harsh, but by as elucidation of another aspect of this here and now attitude, such as what has gone on in the analytic situation that seems to the patient to justify his feeling or what was the anxiety that made it so difficult for him to express his feelings. How the patient experiences the actual situation is an example of the role of the actual situation in a manifestation of transference, which will be a major point of relevant significance.
 Of course, both interpretations of the transference in the here and now and genetic transference interpretations are valid and constitute a sequence. We presume that a resistance to the transference ultimately rests on the displacement onto the analysts of attitudes from the past.
 Because Freud’s case histories focus much more on the yield of analysis than on the details of the process, they are readily but perhaps incorrectly construed as emphasizing work outside the transference much more than work within the transference, and, even within the transference, emphasizing genetic transference interpretations much more than work with the transference in the here and now (Muslin and Gill, 1978). The example of Freud’s case reports may have played a role in what is to be considered as the common maldistribution of emphasis in these two respects - not enough on the transference and, within the transference, not enough on the here and now.
 Transference interpretations in the here and now and genetic transference interpretations are, of course, exemplified in Freud’s writings and are in the repertoire of every analyst, but they are not distinguished sharply enough.
 Both participants in the analytic situation are motivated to avoid these interactions. Flight away from the transference and to the past can be a relief to both the patient and the analyst.
 These aligning measures have been divided into five categorical divisions and placed into the following parts: (1) The principle that the transference should be encouraged to expand as much as possible within the analytic situation because the analytic work is best done within the transference. (2) the interpretation of disguised allusion to the transference as a main technique for encouraging the expansion of the transference within the analytic situation, (3) the principle that all transference has a connection with something in the present actual analysis situation, (4) how the connection between transference and the actual analytic situation is used in interpreting resistance to the awareness of transference, and (5) the resolution of transference within the here and now and the role of genetic transference interpretation.
 The importance of transference interpretations will surely be agreeing to by all analysts, the greater effectiveness of transference interpretations than interpretations outside the transference will be agreeing to by many, but what of the relative roles of interpretation of the transference and interpretation outside the transference?
 Freud can be interpreted as either of saying that the analysis of the transference in auxiliary to the analysis of the neurosis or that the analysis of the transference is equivalent to the analysis of the neurosis. The first position is stated in his saying (1913) that the disturbance of the transference has to be overcome by the analysis of transference resistance in order to get on with the work of analysing the neurosis. It is also implied in his reiteration that the ultimate task of analysis is to remember the past, to fill in the gap in memory. The second position is stated in his saying that the victory must be won on the field of the transference (1912) and that the mastery of the transference neurosis ‘coincides with getting rid of the illness which was originally brought to the neurosis (1917). In this second view, he says that after the resistance is overcome, memories appear relatively without difficulty.
 These two different positions also find expression in the two different ways in which Freud speaks of the transference. In `Dynamics of Transference` he refers to the transference, on the one hand, as `the most powerful resistance to the treatment`(1912) but, on the other hand, as doing us the inestimable service of making the patient’s . . . , immediate impulses and manifests, when all is said and done, it is impossible to destroy anyone in absentia or in effigie (1912).
 It can be agreed that his principal emphasis fails on the second position. He wrote once, in summary, ‘Thus our therapeutic work falls into two phases in the first, all the libido is forced from the symptoms into the transference and concentrated there, in the second, the struggle is waged around this new object and the libido is liberated from it`(1912).
 The detailed demonstration that he advocated that the transference should be encouraged to expand as much as possible within the analytic situation lies in clarification that resistance is primarily expressed by repetition, and repetition takes place both within and outside the analytic situation, but that the analyst seeks to deal with it primarily within the analytic situation, that repetition can be not only in the motor sphere (acting) but also in the psychical sphere, and that the psychical sphere is not confined to remembering but includes the present, too.
 Freud`s emphasis that the purpose of resistance is to prevent remembering can obscure his point that resistance shows itself primarily by repetition, whether inside or outside the analytic situation. `The greater the resistance, to a greater or higher degree of widely ranging differentiating comprehension, as do, the application whose attentions are extensively but will act out (repetition)replace remembering`. Similarly in `The Dynamics of Transference` Freud said that the main reason that the transference is so well suited to serve the resistance is that the unconscious implies does not want to be remembered . . . but endeavour to reproduce themselves . . . (1918), the transference is a resistance primarily insofar as it is a repetition.
 The point can be restated in terms of the relation between transference and resistance. The resistance expresses itself in repetition, that is, in transference both inside and outside the analytic situation. To deal with the transference. Therefore, is equivalent to dealing with the resistance. Freud emphasized  transference within the analytic situation so strongly that it has come to mean only repetition within the analytic situation, even though, conceptually speaking, repetition outside the analytic situation is transference too, and Freud once used the term that way. `We soon perceive that the transference is itself only a piece of repetition and that the repetition is a transference of the forgotten past not only onto the analyst but also onto all the other aspects of the current situation. We . . .  find . . . the compulsion to repeat, which now replaces the impulsion to remember, not only in his personal attitude to his analyst but also in every other activity and relationship which may occupy his life at the time . . . (1914).
 It is important to realize that the expansion of the repetition inside the analytic situation, whether or not in a reciprocal relationship to repetition outside the analytic situation, is the avenue to control the repetition: `The main instrument . . . for curbing the patient’s compulsion to repeat and for turning it into a motive for remembering lies in the handling of the transference. We render the compulsion harmless, and indeed useful, by giving it the right to assert itself in a definite field`(1914).
 Kanzer has discussed this issue well in his paper on ‘The Motor Sphere of the Transference’ (1966). He writes of a ‘double-pronged stick-and-carrot’ technique by which the transference is fostered within the analytic situation and discouraged outside the analytic situation. The ‘stick’ is the principle of abstinence as exemplified in the admonition against making important decisions during treatment, and the ‘carrot’ is the opportunity afforded the transference to expand within the treatment, ‘in almost complete freedom’ as in a ‘playground’ (Freud, 1914). As Freud put it, ‘Provided only that the patient shows compliance enough to respect the necessary conditions of the analysis, we regularly succeed in giving all the symptoms of the illness a new transference meaning, and in replacing his ordinary neurosis by a ‘transference neurosis’ of which he can be cured by the therapeutic work’ (1914).
 The reason it is desirable for the transference to be expressed within the treatment is that there, it `is at every point accessible to our intervention`(1914). In a later statement he made the same point this way. `We have followed this new edition - the transference-neurosis - of the old disorder from its start, we have observed its origin and growth, and we are especially well able to find our way about in it since, as its object, we are situated at it’s very centre, (1917), it is not that the transference is forced into the treatment, but that it is spontaneously but implicitly present and is encouraged to expand there and become explicit
 Freud emphasized acting in the transference so strongly that one can overlook the repetition in the transference, but does not of necessity for its enactment or recognition that gives validity to acts of a subordinate conformation as ratified in support of explicit authoritative permission. Repetition need not go as far as motor behaviour, it can also be expressed in attitudes, feelings, and intentions, and, indeed, the repetition often does take such form rather than motor action. The importance of making this clear is that Freud can be mistakenly read to mean that repetition in the psychical sphere can only mean remembering the past, is when he writes that the analyst as prepared for a perpetual struggle with his patient to keep in the psychical sphere all the impulse that the patient would like to direct into the motor sphere, and he celebrates it as a triumph for the treatment if he can bring it about that something the patient wishes to discharge in action are disposed if through the work of remembering (1914).
 It is true that the analyst’s efforts are to convert acting in the motor sphere into awareness in the psychical sphere, but transference may be in the psychical sphere to begin with, even if disguised. The psychical sphere includes awareness in the transference as well as remembering.
 One of the objections one hears, from both analysts and patient, to a heavy emphasis on interpretation of associations about the patients real life primarily in terms of the transference is that it means the analyst is disregarding the importance of what goes on in the patients real life. The criticism is not judiciable. To emphasize the transference meaning is not to deny or belittle other meanings, but to focus on the one of several meanings of the content that is the most important for the analytic process, for the reasons of positing the addition for one coming to any falsifiable conclusion.
 Another way in which interpretations of resistance to the transference can be, or at lease appear to the patient to be, a belittling of the importance of the patients outside life is to make the interpretation as though the outside behaviour is primarily an acting out of the transference. The patient may undertake some actions in the outside world as an expression of and resistance to the transference, that is, acting out. But the interpretation of associations about actions in the outside world as having implications for the transference needs mean only that the choice of outside action to figure in the associations is co-determined by the need to express a transference indirectly. It is because of the resistance to awareness of the transference that the transference to be disguised. When the disguise is unmasked by interpretation, it becomes clear that, despite the inevitable differences between the outside situation and the transference situation, the content is the same for the analysis of the necrosis that coincides (Freud wrote that the mastering of the transference neurosis only coincides with getting rid of the illness that was originally brought to the treatment (1917)).
 The analytic situation itself fosters the development of attitudes with primary determinants in the past, i.e., transference. The analyst’s reserve provides the patient with few and equivocal cues. The purpose of the analytic situation fosters the development of strong emotional responses, and the very fact that the patient has a neurosis means, as Freud said, that’ . . . it is a perfectly normal and intelligible thing that the libidinal cathexis [we would now add negative feelings] of someone who is partly unsatisfied, a cathexes that are held ready in anticipation, should be directly as well to the figure of the analyst (1912).
 While the analytic setup itself fosters the expansion of the transference within the analytic situation, the interpretation of resistance to the awareness of transference will further this expansion.
 There are important resistances on the part of both patient and analyst to awareness of the transference. On the patient’s part, this is because of the difficulty in recognizing erotic and hostile impulses toward the very person to whom they have to be disclosed. On the analyst’s part, this is because the patient is likely to attitude the very attitudes to him that are most likely to cause him discomfort. The attitudes the patient believes the analysts have toward him are often the ones the patient is least likely to voice, in a general sense because of a feeling that it is impertinent for him to concern himself with the analyst’s feelings, and in a more specific sense because the aptitudes as held by the analyst are often attitudes the patient feels the analyst will be comfortable about having ascribed to him. It is for this reason that the analyst must be especially alert to the attitudes the patient believes he has, not only to the attitudes the patient does have toward him. If the analyst is able to see himself as a participant in an interaction, as he will become much more attuned to this important area of transference, which might otherwise escape him.
 The investigations of attitudes are ascribed to the analyst makes easier the subsequent investigation of the intrinsic factors in the patient that played a role in such ascription. For example, the exposure of the fact that the patient ascribes sexual interests in him to the analyst, and generally to the patient, alternatively the subsequent exploration of the patient’s sexual wish toward the analyst, and genetically the parent.
 The resistance to the awareness of these attitudes is responsible for their appearing in various disguises in the patient’s manifested associations and for the analyst’s reluctance to unmask the disguise. The most commonly recognized disguise is by displacement, but identification is an equally important one. In displacement, the patient’s attitudes are narrated for being toward a third party. In identification, the patient attitudes to himself attitudes he believes the analyst has toward him.
 To encourage the expansion of the transference within the analytic situation, the disguises in which the transference appears have to be interpreted in the case of displacement the interpretation will be of allusions to the transference in association not manifestly about the transference. This is a kind of interpretation every analyst often makes. In the case of identifications, the analyst interprets the attitudes that  the patient ascribes to himself the identification with which an attitude and subsequently attributed to the analyst. Lipton (1977) has recently described this form of disguise allusion in the transference with illuminating illustration.
 In his autobiography, Freud wrote, ‘The patient remains under the influence of the analytic situation as hopefully  of a latter position or a period of decline, as though he is not directing responsibly for the mental activities onto a particular subject. Justly in assuming that nothing will occur, as not of some reference to the situation (1925). Since associations are obviously often not directed about the analytic situation, the interpretation of Freud’s remark rests on what he meant by the ‘analytic situation’.
 It is believed that Freud’s meaning can be clarified by reference to a statement he made in, ‘The Interpretation of Dreams’. He said that when the patient is told to say whatever comes into his mind, his associations become directed by the ‘purposive ideas inherent in the treatment’ and that there are two such inherent regressive themes, one relating to the illness and the other - concerning which, Freud said, the patient has ‘no suspicion’; - relating to other analyst’s (1900), if the patient has ‘’no suspicion’ of the theme relating to the analyst (1900). If the patient has ‘no suspicions’ - relating to the analyst (1900). If the patient has ‘no suspicions’ of the theme relating to the analyst, such that the theme appears only in disguise, the patient ‘s associations, it is contended that Freud’s remark not only specifies the themes inherent in the patient ‘s identifications’, but means that the associations are simultaneously directed by these two purposive ideas, not something by one and sometimes by the other.
 One important reason that the early and continuing presence of the transference is not always recognized in that it is considered to be absent in the patient who is talking recognized is that it is considered to be absent in the patient  who is talking freely and apparently without resistance. As (Muslin and Gill, 1976) pointed out in a paper on the early interpretation of transference resistance, to the transference is probably present from the beginning, even if the patient is talking apparently freely. The patient may be talking about issues not manifestingly about the transference that are nevertheless, also allusions to the transference, but the analyst has to be alert to the pervasiveness of such allusory discernment about them.
 The analyst should progress on the working assumption, that the patient’s associations have transference implications pervasively, that with which this assumption is not to be confused with denial or neglect of the current aspects of the analytic situation. It is theoretically always possible to give precedence to a transference interpretation if one can only discern it through its disguise by resistance. This is not to dispute the desirability of learning as much as one can about the patient, if only to be a position to make correct interpretations of the transference. One therefore, does not interfere with an apparently free flow of associations, especially early, unless the transference threatens the analytic situation to the point where its interpretation is mandatary rather than optional.
 With the recognition that evens apparently freely associating patient may also be showing resistance to awareness of the transference, this formulation should not interfere as long a useful information being gathered should relace Freud’s dictum that the transference should not be interpreted until it becomes a resistance (1913).
 It can be argued that every transference has some connection to some aspect of the current analytic situation, in the sense that the past can exert an influence only insofar as it exists in the present. Of course, all the determinants of a transference are current in the sense that what I am distinguishing is the current reality of the analytic situation, that is, what actually goes on between patient and analyst in the situation from how the patient is currently constituted as a result of his past.
 All analysts would dubiously agree that there are both current and transferential determinants of the analytic situation, and probably no analyst would argue that a transference of the analytic situation, and probably no analyst would argue that a transference idea can be expressed without contamination, as it was, that is, without any connection to anything current in the patient-analyst relationship. Nevertheless, the implications of this fact for technique are often neglected in practice, as my next point is only to argue for the connection.
 Several authors, e.g., Kohut 1959 and Loewald 1960, have pointed out that Freud`s early application by the act or practice of using something or the state of being used, this, however, employ of the quality of being appropriate or valuable to some end as to accommodate the accountable or warrant the use of the term transference. In `The Interpretation of Dreams, in a connection not immediately recognizable as related to the present day use of the term, reveals the fallacy of considering that transference can be expressed free of any connection to the present. That early use was to refer to the fact that an unconscious idea cannot be expressed as such, but only as it becomes connected to a preconscious o r conscious content. In the phenomenon with which Freud was then concerned, the dream transference took place from an unconscious wish to a day residue. In `The Interpretation of Dreams, `Freud used the term transference both for the general rule that an unconscious content is expressible only as it becomes transferred to a preconscious or conscious content and for the specific application of this rule to a transference to the analyst. Just as the day residue is the point of attachment of the dream wish, so must there be an analytic-situation residue, though Freud did not use that term, as the point of attachment of the transference.
 Analysts have always limited their behaviour, both in variety and intensity, to increase the extent to which the patient‘s behaviour is determined by his idiosyncratic interpretation of the analyst’s behaviour. In fact, analysts unfortunately sometimes limit the behaviour so much as to compare with such an expression or unpiled standard or absolute approximation, that the entire relationship with the patient matter of technique, with no nontechnical personal relation, as Liptop (1977) has pointed out.
 But no matter how far the analyst attempts to carry this limitation of his behaviour, the very existence of the analytic situation provides the patient with innumerable cues that can enviably become his rationale for his transference responses. In other words, the current situation cannot be made to disappear - that is, the analytic situation is real. It is easy to forget this truism in one’s zeal to diminish the role of the current situation in determining the patient ‘s responses. One can try to keep past and present determinants relatively perceptible from one another, but one cannot obtain either ‘pure culture‘. Freud wrote: ‘I insist on this procedure [the couch], however, for its purpose and result are to prevent the transference from mingling with the patient’s associations imperceptibly, to isolate the transference and to allow it to come forward in due course sharply defined as a resistance’ (1913). Even ‘isolate’ is too strong a word in the light of the inevitable intertwining of the transference with the current situation.
 If the analyst remains under the illusion that the current cues he provides to the patient can be reduced to the vanishing point, he may be led into a silent withdrawal, which is not too distant from the caricature of an analyst as someone who does refuse to have any personal relationship with the patient. What happens then is that silence has become a technique rather than merely an indication that the analyst is listening. The patient’s responses under such conditions can be mistaken fo uncontaminated transference when they are in fact transference adaptions to the actuality of the silence.
 The recognition, from which it takes its point of departure, as it was, has a crucial implications for the technique of interpreting resistance to the awareness of transference, in that, if, the analyst becomes persuaded of the centrality of transference and the importance of encouraging the transference to expand within the analytic situation, he has to find the presenting and plausible interpretation of resistance to the awareness of transference he should make. Is that, his most reliable guide is the cues offered by what is actually going on in the analytic situation? : On the one hand, the events of the situation, such as change in time of session, or an interpretation made by the analyst, and, on the other hand,  how the patient is experiencing the situation as reflected in explicit remarks about it, however, fleeting these may be. This is the primary yield for technique of the recognition that any transference must have a link to the actuality of the analytic situation. The cue points to the nature of the transference, just as the day residue for a dream may be a quick pointer of the latent dream thoughts. Attention to the current situation for a transference elaboration will keep the analyst from making mechanical transference interpretation, in which he interprets that there are allusions to the transference in association not manifestly about the transference, but without offering any plausible bias for the interpretation. Attention to the current stimulation offers some degree of protection against the analyst’s inevitability whose tendency to project his own views onto the patient, either because of countertransference or because of a preconceived theoretical bias about the content and hierarchical relationships in psychodynamics.
 The analyst may be very surprised at what in his behaviour the patient finds important or unimportant, for the patient’s responses will be idiosyncratically determined by the transference, the patient’s responses may seem to be something the patient as well as the analysts consider trivial, because, as in displacement to a trivial aspect of the day residue of a dream, displacement can better serve resistance when it is to something trivial. Because it is connected to conflict-laden material, the stimulus to the transference may be difficult to find. It may be quickly disavowed, so that its presence in awareness is only transitory. With the discovery of the disavowed, the patient may also gain insight into how it repeats as disavowed earlier in his life. In his search for the present stimuli that the patient is responding transferentially, as the analyst must therefore remain alert to both fleeting and apparently trivial manifested reference to himself as well as in the events of the analytic situation.
 If the analyst interprets the patient’s attitudes in a spirit of seeing their possible plausibility in the light of what information the patient does have, rather than in the spirit of either affirming or denying the patient’s views, the way is open for their further expression and elucidation. The analyst will be respecting the effort to be plausible and realistic, rather than manufacturing his transference attitudes out of whole bodied material.
 Importantly, is to make a transference interpretation plausible to the patient in terms of as current stimulus that, if the analyst is persuaded that the manifest content has important implications for the transference but he is unable to see a current stimulus for the attitude, he should explicitly say so if he decides to make the transference interpretation anyway. The patient himself may then be able to say what the current stimulus is.
 It is sometimes argued that the analyst’s attention to his own behaviour is a precipitant for the transference, will increase the patient’s resistance to recognizing the transference. That, on the contrary, that because of the inevitable interrelationship of the current and transferential determinants, it is only through interpretation that they can be disentangled.
 It is also argued that one must wait until the transference has reached optimal intensity before it can be advantageously interpreted. It is true that too hasty and interpretation of the transference can serve as a defensive function for the analyst and deny him the information he needs to make a more appropriate transference interpretation. But it is true that delay in interpreting transference interpretation, but it is also true that delay in interpreting runs the risk of allowing an unmanageable transference to develop. It is also true that deliberate delay can be a manipulation in the service of abreaction rather than analysis, and, like silence, can lead to a response to the actual situation that is mistaken for uncontaminated transference. Obviously important, is assumed in the issues of timing are involved, whereas an important clue to when a transference interpretation is apt and which one to makes lies in whether the interpretation can be made plausibly in terms of the determinant, namely, as something in the current analytic situation. Such as, in the approaching transference in the spirit of seeing how it appears plausibly realistic to the patient, it paves the way toward its further elucidation and expression.
 Freud’s emphasis on remembering as the goal of the analytic work implies that remembering is the principal avenue to the resolution of the transference. But the delineation of the successive steps in the development of the analytic technique (1920) makes clear that he saw this development as a change from an effort to reach memories directly to the utilization of the transference as the necessary intermediacy to reaching the memories.
 In contrast to remembering as the way the transference is resolved, Freud also described resistance for beings primarily overcome in the transference, with remembering following relatively easily afterwards, ‘From the repetitive reactions that are exhibited in the transference we are led along the familiar paths to the awakening of the memories, which appear without difficulty, as it was, after the resistance has been overcome’ (1914), and ‘This revision of the process of repetition can be accomplished only in part in connection with the memory traces of the process that led to repression. The decisive part of the work’s achieved by creating in the patient’s relation to the analyst - in the ‘transference‘ new editions of the old conflicts . . . Thus, the transference becomes the battlefield on which all the mutually struggling forces should meet one another’ (1917). This is the primary indication for which Strachey (1934) classified in his seminal paper on the therapeutic action of psychoanalysis.
 There are two main ways in which resolution of the transference can take place through work with the transference in the here and now. The first lies in the clarification of what are the clues in the current situation that are the patient‘s point of departure force a transference elaboration. The exposure of the current point of departure at once raises the question of whether it is adequate to the conclusion drawn from it. The relating of the transference to a current stimulus is, after all, parts of the patient‘s effort to make, the transference attitude plausibly determined by the present. The reverse and ambiguity of the analyst’s behaviour are what increases the ranges of apparently plausible conclusions the patient may draw. If an examination of the basis for the conclusion makes clear that the actual situation to which the patient responds is subject to other meanings than the one the  patient has reached, he will more reality consider his pre-existing bias, that is to say, in that of transference.
 Another critic of an earlier version of this paper suggested that, in speaking of the current relationship and the relation between the patient’s conclusion and the information on which they seem plausibly based, such in some absolute conception of what is real in the analytic situation, of which the analyst is the final arbiter. That is not the case, that what the patient must come to see is that the information he has is subject to other possible interpretations implies the very contrary to an absolute conception of reality. In fact, analyst and patient engage in a dialogue in a spirit of attempting to arrive at a consensus about reality, not about some factious absolute reality.
 The second way in which resolution of the transference can take place within the work with the transference in the here and now is that in the very interpretation of the transference the patient had a new experience. He is being treated differently  from how he expected to be. Analysts seem reluctant to emphasize his new experience, as though it endangers the role of insight and argue for interpersonal influence as the significant factor in change. Strachey’s emphasis on the new experience in the mutative transference interpretation has unfortunately been overshadowed by his views on introjection, which have been mistaken to advocate manipulating the transference. Strachey meant introjection of the more benign superego of the analyst only as a temporary strep on the road toward insight. Not only is the new experience not to be confused with the interpersonal influence of a transference gratification, but the new experience occurs together with insight into both the patient’s biassed expectation and the new experience. As Strachey points out, what is unique about the transference interpretation is that insight and the new experience take place in relation to the very person who was expected to behave differently, and it is this that gives the work in the transference, its immediacy and effectiveness. While Freud did stress the effective immediacy of the transference, he did not make the new experience explicit.
 It is important to recognize that transference interpretation is not a matter of experience, in contrast to insight, but a joining of the two together, both are needed to bring about and maintain the desired changes in the patient. It is also important to recognize that no new techniques of intervention are required to provide the new experience. It is an inevitable accompaniment of interpretation of the transference in the here and now. It is often overlooked that, although Strachey said that only transference interpretations are outside the transference.
 Rosenfeld (1972) has pointed out that clarification of material outside the transference is often necessary to know what is the appropriate transference interpretation, and that both genetic transference interpretations and extratransference interpretation taking to consider an inclination as marked by or indication of notable worth or simply the consequence based upon the role in working through. Strachey said relatively little about working through, but surely nothing against the necessary provision with which  every thing needfully is explicitly recognized as the role for the recovery of the past in the resolving dissection of the purposiveness determined by the transference.
 In taking positions, as to emphasis the role of the analysis of the transference in the here and now, both in interpreting resistance to the awareness of transference and in working toward its resolution by relating to the actuality of the situation. In that of opinion or purpose with the evidence that extratransference and genetic transference interpretation and, of course, working through is important too, that the matter is one of emphasis. Also, interpretation of resistance to awareness of the transference should figure in the majority of sessions, and that if this is done by relating the transference to the actual analytic situation, the very same interpretation is a beginning of work to the resolution of the transference. To justify this view more persuasively would require detailed case material.
 The concern and considerations that the Kleinian annalists whom, many analysts feel, are in error in giving the analysis of the transference too great if not even as exclusive role in the analytic process. It is true that Kleinians emphasize the analysis of the transference more, in their writing at least, than does the general run of analysts. As, Anna Freud (1968) complained that the concept of transference has become overexpanded seems to be directed against the Kleinians. One of the reasons the Kleinians consider themselves the true followers of Freud in technique are precisely because of the emphasis they put on the analysis of the transference. Hanna Segal (1967), for example, writes, `Too say that all communications are seen as communications about the patent’s phantasy as well as current external life is equivalent to saying that all communications contain something relevant to the transference situation.  In Kleinian technique, the interpretation of the transference is often more central than in the classical technique.
 Affirmly held point of view or way of regarding that Freud and transference had accedingly connected by simulating observations that we can only offer, that Freud wrote briefly about transference, and did so, to sustain the way in which, is, as a whole, that his actions were justly taken in and around 1917. Another observation that can rarely be made about Freud’s works, and which everyone may not agree with, is that, with one or two exceptions, what he did write on transference did not reach the high level of analytical thought that has come to be regarded as standard for him. Some indication of what his contribution consists of is given by the editors of the Standard Edition, who list them in several places. One of the longer lists, in a footnote on page 431 of Volume 16, includes six references: ‘Studies of Hysteria’ with Breuer (1895), the Dora paper (1905), ‘The Dynamics of Transference’ (1912), ‘Observations on Transference-Love’ (1915), the chapter on transference in the Introductory Lectures (1917), and ‘Analysis Terminable and Interminable’ (1937). Although the editors, in no sense suggest that these six papers include everything Freud wrote on the subject. It does seem evident that, considering the essential importance of transference to analysis, he wrote, ‘The Dynamics of Transference’, ‘Transference-Love’, and the transference chapter in the Introductory Lectures, came across, as, perhaps, his least significant contribution.
 Freud’s first direct mention of transference comes upon the pages ascribed within the ’Studies of Hysteria’ (1895), his first significant reference to it, however did not appear until five years later, when, in a letter to Fliess on April 16, 1900, he said (Freud, 1887-1902) he was ‘beginning to see that the apparent endlessness of the treatment is something of an inherent feature and is connected with the transference’. In a footnote to this letter the editors said that, ‘This was the first insight into the role of transference in psychotherapy.’
 Despite these early references, it seems correct to say that yet another five years were to go by before the phenomenon of transference was actually introduced. Even so, the introduction was far from prominent, for it was tacked on like an afterthought as a four-page portion of a postscript to what was perhaps Freud’s most fascinating case history to date, the case of Dora (1905).
 Using data from Dora’s three-month-long, unexpectedly terminated analysis, and especially from her dramatic transference reaction that had taken him quite unawares, Freud now gave to transference its first distinct psychological entity and for the first time indicated its essential role in the analytic process. His account, although in general more than adequate  -  in the elegant fact and unmistakably ‘finished’ - was brief, and almost to the point, and perhaps not an entirely worthy introduction so much more a truly great discovery. What was uniquely great was his recognizing the usefulness of transference. In his analysis of Dora he had noted not only that transference feelings existed and were powerful, but, much to his dismay, he had realized what a serious, perhaps, even insurmountable obstacles that objectively would be. Then, in what seems like a creative leap, Freud made the almost unbelievable discoveries that transference was in fact, the key to analysis, that by properly taking the patient’s transference and therapeutic force was added to the analytic method.
 The impact on analysis of this startling discovery was actually much greater and much more significant than most people seem to appreciate. Although the role of transference as the sine quo non of analysis and is widely accepted, and was stated by Freud from the first, it has almost never been acclaimed for having brought about an entire change in the nature of analysis. The introduction of free association to analysis, a much lesser change, receives and still receives much more recognition.
 One of the reasons for the relatively unheralded entry of transference into analysis may have been for circumstances of its discovery. Although Freud’s new ideas were recorded as if they arose as sudden inspiration during the Dora analysis, they may in fact have developed somewhat later. In the paper‘s precatory remarks, for instance, Freud said he had not discussed transference with Dora at all, and in the postscript, he said he had been unaware of her transference feelings. Also, pointing to a later discovery date is the extraordinary delay in the paper’s publication. According to the editor’s note, the paper had been completed and accepted for publication by late January 1901, but this date was then actually set back more than four and a half years until October 1905. The editors said, ‘We have no information as to how it happened that Freud, . . . deferred publication.’ It readily seems that for reasons to have been that only during those four and a half years, as a consequence to his own self-analysis, that he came to a better understanding of the relevantly significant as the applicable reason to posit of the transference. Only then may it have been possible for him to turn again to the Dora case, to apply to it of what he had learned in himself, to write this essay as part of the postscript, and at last to release the paper for publication.
 Freud’s self-analysis has been considered from many angles, but not significantly, as can be of valuing measure, in at least from the standpoint of transference. Opponents of the idea that there is such a thing as definite self-analysis, some of whom say it is impossible, generally an object on grounds that without any analyst there can be no transference neurosis. Freud clearly demonstrated, as, perhaps, that the situation that may be necessary to fill this need: Self-analysis may require that, at least a halfway satisfactory transference object. In Freud`s case, the main transference object at this time seems to have been Fliess, who filled the role rather well. As with any analysis, the authenticity as known in the unfeigned design as if existing or having no illusions and facing reality squarely, by which the  ‘real’ impact on Freud was slight, he was essentially a neutral figure, relatively anonymous and physically separates. All of this, and Fliess`s own reciprocal transference reactions, made it possible for Freud to endow Fliess with whatever qualities and whatever feelings were essential to the development of Freud`s transference, and, it should be added, his transference neurosis. In the end, of course, the transference was in part resolved. Freud`s eventual awakening of its self realization in its presence within him of such strange and powerful psychological forces must have come to the conclusion as a stupefied disilluionary dejection toward Fliess, however, his subsequent working out of some of these transference attachments must have been both an intellectual triumph and an immensely healing and releasing of actions, operations or motions involved in the accomplishment of an ending that makes from its process.
 In the years following this revolutionary discovery, the central role of transference in analysis increased in remarkable acceptance, and it has easily held this central position ever since. What the substance of this central position distinctfully composes in having or be capable of having within the constructs to which is something of a mystery, for, it seems as nothing about analysis and is, of least to be, the well known than how individual analysis actually uses transference in their day-to-day work with patients. As a guess, as, perhaps of each analysts concept of transference derives variably but significantly from his own inner experience, transference probably means many and varying differentiations to things as to different analysts.
 In the same differentiated individuals, as that Freud’s own pupils must have differed on this issue, not only from him but from each other. Although some of their differences may have been slight, others, my have contributed significantly to later analytic developments. A question could be raised, for instance, whether differences in handling the transference that at first were the property of one analyst gradually develop into formal clinical methods used by many, and whether these clinical methods, after having been conceptualized, serve as the beginning of variously divergent schools of analysis. Such occurrences, consistent with certain beliefs that analytic ideas do arise in this way, primarily out of transference experiences in the analytic situation, would lead to the question whether the history of the ideological differences in what was actually said and done in response to transference reactions that to any other factor. Whatever the case, many differences and divergencies did occur among the early analysts, and all of that is supposed to have had to do in some major way with differences in the handling of the transference.
 Strangely, Freud himself seems to have taken little part in influencing this rapid and divergent period of growth. Usually accused of being too dominating in such matters, Freud seems to have done just the opposite  during the development  of this most critical aspect of analysis, the process itself, and, for reasons unknown, detached himself from it.
 What was needed, one might be inclined to say, was not leadership in the form of domination, but leadership in trying to provide what was lacking, and still lacking, namely an analytical rationale for transference phenomena. The question must be asked, of course, whether in fact this would have been a good thing at that particular time in psychoanalytic history. Perhaps not. The exercise of closure, to which Freud’s structuring might have amounted. But although adding to understanding and stability at ceratin theoretical levels, could at another level, so such closures have often done, have placed many obstacles in the way of further analytical developments. Thus, his leaving the matter of transference wide open, even though it led to confusion and uncertainty, may have been just as well.
 In many ways the closest Freud ever came to establishing a formal analytical rationale for transference was his first attempt, in the postscript to the case of hysteria (1905). These few pages are and among the most important of all Freud’s writings, outweighing by far the paper to which they are appended. Yet, in the case of Dora has always been taught as an entity rather than the ancillary to the essay on transference. In that essay Freud was clear: His ideas revealed tremendous insights and promised more to come, and that, the powers of the neurosis are occupied in creating a new edition of the same disease. Just think of the analytic implications of his saying that this new edition consists of a special class of mental structures, for the most part unconscious, having the peculiar characteristic of being able to replace earlier persons with that of the person of the analyst, and in the fashion applying all components of the original neurosis to the person of the analytical at the present time. Surely as profound a statement as any he ever made.
 He then goes on to say that there is no way to avoid transference, that this ‘latest creation of the desire must be combatted like all the earlier ones’, and that, although this is by far the hardest part of analysis, only after the transference has been resolved can a patient arrive at a sense of conviction of the validity of the connection that have been constructed during analysis.
 He concludes by saying, ‘In psychoanalysis . . . all the patients’ tendencies, including hostile ones, are aroused, they are then turned to account for reasons to explain or the internalization of justification, and by the same measure was to purposively give a sensible reason for the proposed change in the analysis by which of being made conscious. That, in this way, the transference is constantly being put-down, however, transference, which seems ordained to be the greatest obstacle to psychoanalysis, becomes it’s most powerfully . . .
 These remarkable observations, in conveying a sense of deep conviction that could arise, one feels, only from Freud’s own hard-won inner experience, that nowhere is there a suggestion that transference is a mere technical matter. Far from it, as Freud announces that he has come upon as new and exciting kind of mental function, or, as it is to believe, that a new and exciting kind of ego function.
 Very quickly, however, Freud’s conviction sees to have failed him. Nothing he wrote afterwards about transference was at this level, and most of his later references were a retreat from it, for instance, he never did develop the promising idea that the mind constantly creates new editions of the original neurosis and meaningfully inclines the minded inclusion in them, an ever-changing series of persons. Instead, he tended to become less specific, even referring to transference at times in a broad terms as if it were no more than rapport between patient and analysts, or as if it was an  interpersonal or psychosocial relationship, concepts that, of course, a great many analysts have since adopted, but which were not part of Freud’s original ideas.
 Perhaps his most persistent deviation was an on-and-off tendency to regard transference merely as a technical matter, often writing of it as an asset to analysis when positive and a liability when negative.
 Significantly, because it indicated that an active struggle was still going on within him, Freud occasionally expressed once again, even though briefly his earlier insights, particularly his ideas that transference is an essential although unexplored part of mental life. An example of this appears in his alternative obtainments such that is gainfully to appear of as quality of being pleasant or agreeable to a feature that makes for pleasantness or ease, among the amenities of the central geniality, otherwise, the prevailing indifference account for the transference in ‘An Autobiographical Study’ (1925). Transference, he says, ‘is a universal phenomenon of the human mind. And in fact dominated the whole of each person’s relations to his human environment. In these few words’ Freud again made the point, and in declarative fashion, that transference is a mental structure of the greatest magnitude, but he never really followed it up.
 Rather extensive evidence of his departure from the original concept and his continuing struggle with that concept is seen most clearly, wherein, the ‘Analysis Terminable and Interminable’ is much more than a courageous, brilliant, and pessimistic, appraisal of the difficulties and limitations of analysis, although transference is briefly mentioned in its content, yet a great deal about it comes through, some quite directly, some by easy inference. When looked at in this way, two themes stand out: Freud’s personal frustration with the enigmas of transference and his tacit placing of transference in the centre of success and failure in analysis, both as a therapy and as a developing science. What also comes through, is the perplexing realization of how far Freud had, by now, seemingly moved away from his original concepts. Or had he?
 All the same, even if it is insufficient for exclusive reliance in relations to the complicated neurosis, for which it would be fallacious to assign to the recall and reconstruction of the past an exclusively explanatory value (in the intellectual sense), important though that functions be, and difficult as its full-blown emotional correlate may be to come by. There is no doubt that, even in complicated neurosis, equivalently complicated transference neurosis, the genuine complex and complicated transference neurosis, the genuinely experienced linking of the past and present can have, at times, a certain uniquely specific dynamic effect of its own, a type of telescoping or merging of common elements in experience, which must be connected with the meaninglessness of time in unconscious life, compared with its stern authority in the life of consciousness and adaptation to everyday reality. Contributing decisively to such experiences as to whatever degree it occurs,  is of course, the vivid currency of the transference neurosis, and central in this, the reincarnations of old objects in an actual person, the analyst.
 Thus, an allied problem in the general sphere of transference is the fascination and often enigmatic interplay of past and present. If one wishes to view this interplay  in terms of a stereotyped formulation, the matter can remain relatively uncomplicated - as a formulation. Unfortunately. , This is too often the case. The phenomenon, however, retains some important obscurities, which cannot thoroughly dispel, but to which I would like to call attention. To concentrate on the dimension of time, it seems in reference to the complication and immediate aspects of technique, nonetheless, essential. For example, we can assume that the transference neurosis re-enacts the essential conflicts of the infantile neurosis in a current setting. If a reasonable degree of awareness of transference is established, the next problem is the genetic reduction of the neurosis to its elements in the past, through analysis of the transference resistance and allied intrapsychic resistances, ultimately genetic interpretations, recollections and reconstructions and working through. Such that the transference is related to its genetic origins, the analyst thereby emerges in his true, i.e., real, identity to the patient, the transference is putatively ‘resolved’. To the extent that one follows the traditional view that all resistances, including the transference itself, is ultimately directed against the restoration of early memories as such, this is a convincing formulation. Is that, only to say,  that in his own right as having to a certain tightly logical quality? However, we know that it this is not so readily accomplished, apart from the special intrapsychic considerations described afterward by Freud in ‘Analysis Terminable and Interminable’. Although in a favourable case, much of the cognitive interpretative work can be accomplished, there remains the fact that cognition responsibility, in its bare sense, does not necessarily lead to the subsidence of powerful dynamism, to the withdrawal of ‘cathexes’ from importantly real objects. For, as mentioned, a short while ago, the analyst is a real and living object, apart from the representations with which the transference invests him, and which are interpretable as such, for which there is no, at any time a seldom, a confusing interrelations and commonly of the emergent responses, due to the same old seeking, and this is directed toward a new individual in his own right, both are important, furthermore, there are large and important ones of overlapping. Apart from such considerations, even the explicitly incestuous transference is currently experienced (as, at least in good part) by a full-grown adult (like the original oedipus), instead of a totally and actually helpless child. To be sure, the latter state is reflected  in the emergent transference elements of instinctual striving, but it is subject to analysis, and the residual is something significant, if not totally different. It is these residual sexual wish, presumably directed toward the person of the analyst, as such, which must be displaced to others, if, as generally agreed, the revival of infantile fantasies and strivings in the biologically mature adolescent presents a new and special problem, one must assume distinctiveness of experience for the adult, although it is true that in the majority of instances, adequate solution is favoured by the adult state. There is, in any case, a residual relationship between persons who have worked together in a prolonged, arduous and intimate relationship, which, strictly speaking, are reversibly disconnected  or divorced of services, in that the transference merely ushers out the retirement for which its rendering retreat of that state of mind or feeling by an inner avoidance of something usually felt as unpleasant or pronounced for it’s adverse but mutual colouration. Blending to some confusion between the two spheres of feeling. The general tendency is that both components are fully gratified to some degree. But, there is the ubiquitous power of the residual primordial transference, yet, argue to cling to an omnipotent partisan to resist the displacement of its ‘sublimated’ anaclitic aspects, even if the various representation of the wishes for bodily intimacy has been thoroughly analysed and successfully displaced. The outcome is largely the transference of the transference, as mentioned earlier, in a different context. For everyday reality can provide no actual answer to such cravings. In this connection, note, Freud’s genial envy of Pfister. If the man of faith finds this gratification in revealing religion, others in a wide range of secular beliefs and ‘leaders’ the modern rational and sceptical intellectual is less fortunate in this respect. Presumably free, he is prone to invest even intellectual disciplines or the proponents with inappropriate expectations and partisan passions, but, least of mention, that within these fields of analytical and theoretical thought, is not to provide exceptions to this tendency.
 Though if one is to maintain and beneficially confine its bothering of reservations about the clarity of conceptualization, the explanatory discussion of Kohut and Seitz, is a very useful contribution to the direct complication or which by some understanding the awkwardness of oneself. Both Loewald and Kohut have deliberately associated a special but the different use of one of Freud’s three conceptions of transference, i.e., the transference from the unconscious to the preconscious.
 Yet, to furthering comments on primordial transference, at least potentially, are largely psychological (mental) component, the concept of ‘transference of the transference’ would be applicable to this component. For it does appear that certain aspect of the search for the omnipotent and omniscient caretaking parents are implicitly practical as virtually capable for being turned to use or account for its functional practicability for something of a process or the procedure for being all but the essential purpose to come to or tend toward a common point, for which are the knowledgeable information or ideas, is nothing but causative effectuality. As suggested earlier, there are important  qualitative and quantitative distinctions in the mode of persistence and such strivings, however, even to the extent that they are detached from the analyst and carried into some reasonably appropriate expression in everyday life, they retain at least a subtle quality that contravenes reality, one that derives from earliest infancy, and remains - to this extent  - a transference. ‘Santa Claus’ lives on, where one might least expect to meet him,  whether as a donor of miracle drug or of far more complex panaceas.
 If one prescribes to this parasymbiotic transference drive, a true primordial origin, it is necessary to take cognizance of certain important concepts dealing with the earliest period of life. If we assume a powerful original organismic drive toward an original ‘object’, a striving to nullify separation from the beginning, how does this make something legally valid or operative usually by formal approval or sanctioned with concepts such as ‘primary narcissism’ or the ‘objectless phase’ or ‘the primary psycho physiological self’ (We note in passing that there are those who do not accept these as usually construed in the technique of Balint), for example, or Fairbairn or - conspicuously - Melanie Klein. These are states, variously defined or conceived, which apply to the earliest neonatal period, in which life, to state more simply, exists only as the potential in physiological processes. Since there is (we postulate) no clear awareness of self-withdrawal from the mother, there can be no ‘mentally’ represented or experienced drive to obliterate the separation (concerning oneself and object, conceiver of a conventional orientation where its separately in a continuing sense). There are, of course, discharge phenomena, the precursors of purposive activity, and there are urgent physiological needs, directed toward fulfilment or relief, rather than toward an object as such. However, in relation to these physiological needs as archaistic precursors of object relationships, it must be noted that in all, except respiration and spontaneous sphincter relief (even in these instances, not without exception or reservation), the need fulfilment must be mediated by the primordial object (or her surrogate). There is also, of course, the uniquely important requirement for ‘holding’, in a literal expression, from the outset. The material partner in human symbiosis that supplies what the neonate cannot seek by ‘clinging’, as for Bowlty and Murphy, in the sense that must be experienced to the physiological ebb and flow of tension, even if restricted to the kinaesthetic, connected with a peripheral sensory registration, which is the protophase of the recognition of separation from the object or nonpresence of the object, as a painful instance of, her presence in apposition the converse? That the general context may be only in which the sense of unity is preponderant, or, more accurately, that there is no general awareness of ‘separation’ as such, means that the drive for union does not exist in a general psychological sense. It is, so to speak, satisfied. That object constancy, with its cognate ‘longing’, is quite a different experience from the urgencies of primitive need fulfilment is true, however, regardless of what may be added by maturational and developmental considerations, instinctual and perceptual, there is no reason to assume other than a core of developmental continuity from the earliest needs and their fulfilment to the later state, and some continuing degree of contingency based on them.
 There is a very rough parallel in the way certain analytic patients, before a firm relationship with the analyst is established, signal certain primitive experiences  and tendencies in special reactions to the end of the hour, to the nonvisibility of the analyst, to interruption of their association, to failure of the analyst to talk, and similar matters. We must note that in the basic formation of the ego is evident between the  primitive reactions and beyond to separations, in the form of very early identifications as based on care taking functions. Certainly in the very development of autonomous ego of the mother’s investment in a decisive role in the character of the their development. And in the case of object constancy, in its connotation of libidinal cathexis, where is no need whatsoever (emotional or otherwise) is needed for prolonged periods.  The importance of the object is, to put it mildly, liable to deteriorate, or to differ complicating aggressive change. Probably the characteristic feature of later developing relations to the object (love and the wish for love), as separate if not always separated from demonstrable primitivity, in the need fulfilment, have a special relationship to those ‘ancillary’ aspects of neonatal nurture, whose lack has been shown to be an actual threat to life in some instances, not to speak of sound emotional development. So that from the first, regardless of the assumed state of libidinal (and aggressive) economy, or the assumed state of psychological nondifferentiation between self and potential object, there are critical percussive phenomena, objectively observed, and probably prototypic subjective experiences of separation, which are the forerunners of all subsequent experiences of the kind. One may generalize to the effect that, with maturation and development, secondary identifications, and the various other processes of ‘internalization’ in its broadest sense, the problem of separation and its mastery becomes correspondingly more complex, and changes with the successive phase of life, but never entirely disappears.
 In the view of the psychoanalytic situation the latent mobilization of experiences of separation stimulated by the situational structure awakens the driving primordial urge to undo or to master the painful separations that it represents, usually embodied in the various forms of clinical transference that which we are familiar. One legitimate gratification that tends to mitigate superfluous transference regression is the transmission of understanding that at times, are thought that by the ‘mature transference’, in effect, the ‘therapeutic alliance’ or a group of mature ego functions that enter such an alliance. Now, there is one blurring and overlapping at the conceptual edges in both instances, but the concept as such is largely distinct from either one, as it is from the primitive transference, which we have been discussing. Whether the concept is thought by others to comprehend a demonstrable actuality, which is a further question. This question, of course, can only follow on conceptual clarity. This in saying, of a nonrational urge, not directly dependent on the perception of immediate clinical purposes, a true transference in the sense that it is displaced (in currently relevant form) from the parent of early childhood to the analyst. Its content is not anti-sensational, but largely non-sensual of sometimes transitional, as the child’s pleasure in the assemblages of  ‘dirty words’ and encompasses a special and not minuscule sphere of the object relationship: The wish to understand, and to be understood, the wish to be given understanding, i.e., teaching, specifically by the parent (or later surrogate); the wish to be taught to use ingenuity in making or doing o r achieving an end through the actions in a nonpunitive way, corresponding to the growing perception of hazard and conflict and very likely the implicit wish to be provided with and taught channels of substitutional drive discharge. With this, there may be a wish, corresponding to that element in Loewald’s description of therapeutic process, to be seen in terms of one’s developmental potentialities by the analyst. No doubt, the list could be extended into many subtleties, details, and variations. However, one should not omit to specify that, in its peak development, it would include the wish for increasingly accurate interpretations and the wish to facilitate such interpretations by providing adequate material ultimately, of course, by identification, to participate in, or even be the author of the interpretations. The childhood system of wishes that underlie the transference is a correlate of biological maturation, and the latent (i.e., teachable) autonomous ego function, appearing with it, however, there is a drive-like quality in the participation phenomena, which disqualifies any conception of the urge’s identical with the functions. No one who has ever watched a child importunes a parent with questions, or experiment with new words, or solicit her interests in a new game, or demand a storytelling or reading, can doubt this. That this powerful support and integration in the ego identification with a loved parent are undoubtedly true, just as it is true of the identification with an analyst toward whom a positive relationship has been established. That ‘functional pleasure ‘ inscribes the part, where certain ego energies, perhaps very likely the ego’s own urge to extend its hegemony in the personality. However, it can be stressed in the derive element, even the special phase configurations and colourations, and with its importance of object relations, libidinal and aggressive, for a specific reason. For just as the primordial transference seeks to undo separation, in a sense to obviate object relationships as we know them, the ‘mature transference’, tends toward separation and individuation, and increasing contact with the environment, optimally with a large affirmative (increasing neutralized) relationship toward the original object toward whom (or her surrogates) a different dynamic of demands is now increasingly directed. The further consideration that has led to the emphasis that the drive-like elements in these attitudes are integrated phenomena, as examples of ‘multiple functional’ rather than the discrete exorcise of function or functions, are the conviction that there is a continuing dynamic relation of relative interchangeability between the two series, at least based on the response to gratifications in a significant zone of complicated energetic overlap, possibly including the phenomenon of neutralization. That the empirical ‘interchangeability’ is limited, and that goes without saying, that in no way diminishes its decisive importance. The linguistic communications as in mention, that the excessive transference neurosis regression, which can seriously vitiate the affirmative psychoanalytic process, finds a prototype in the regressive behaviour and demands of certain children, who do not receive their share of teaching, ‘attention’, play, nonseductive, affectionate demonstration, as to use the quality of being appropriate or valuable to some end, even the act or practice of using something or the state of being used to which of responsible interests in development, and similar matters, from their parents. In the psychnalytic situation, both the gratifications offered by the analyst and the freedom of expression by the patient, are diversely limited and concentrated, practically entirely (in the every day demonstrable sense) in the sphere of linguistic expression, on the analyst’s side, further, in the transmission of understanding.
 Whereas, the primordial transference exploits the primitive aspects of linguistic communication, by expressing the mature transference as to advocate the seeking mastery of the outer and inner environments, a mastery to which the mature elements in speech contribute importantly, for which these are stressed upon the clear-cut genetic prototype for the free associating its interpretative dialogue is the original learning and teaching of speech, the dialogue between child and mother. It is interesting to note that just as the profundities of interests between people who often include - in the service of the ego - transitory introjection and identifications, of the very word ‘communication’, representing the central ego function of speech, from which is a closely intimate relation to the etymologically certain, in actual usages, to the word chosen for that major of religious sacrament for that which is the physical ingestion of the body and blood of the Deity. Perhaps, this is just another suggestion that the oldest of individual problems does, after all, continue to seek its solution, in its own terms if only in a minimal sense, and in channels so remote as to be unrecognizable.
 The mature transference is a dynamic and integral part of the therapeutic alliance, alone with the tender aspect of the erotic transference, evens more attenuated (and more dependable) friendly feeling of adult type, and the ego identification with the analyst. Indispensable, of course, are the genuine adult need for help, the crystallizing rational and intuitive appraisal of the analyst, the adult sense of confidence in him, and innumerable other nuances of adult thought and feeling. With these, giving a driving momentum and power to the analytic process, but always, by its very nature, a potential source of resistance, and always requiring analysis, is the primordial transference and its various appearances in the specific therapeutic transference. That it is, if well managed, not only a reflection of the repetition compulsion in its menacing sense, but a living presentation from the id, seeking new solutions, and trying again, so to speak, to find a place in the patient’s conscious and effective life, has important affirmative potentialities. This has been specifically emphasized by Nunberg, Lagache and Loewald among others. Loewald has recently elaborated very effectively the idea of ‘ghosts’ seeking to become ‘ancestors’ based on an early figure of speech of Freud. The mature transference, in its own infantile right, provides some of the unique qualities of propulsive force, which comes from the world of feeling, rather than the world of thought. If one views it in a purely figurative sense, that fraction of the mature transference that derives from ‘conversion’ is somewhat like propulsive fraction as the wind in a boats sailing to windward currents into motion, the strong headwind, the ultimate source of both resistance and propulsion, is the primordial transference.  This view, however, should not displace the original and independent, if cognate, a favourable tide or current would also be required. It is not that the mature transference is itself entirely exempt from analytic clarification and interpretation. For one thing, in common with other childhood spheres of experience, there may have been traumas in this sphere, punishments, serious defects or lacks of parental communication, Listening, attention or interest. In general, this is probably far more important than has hitherto appeared in our prevalent paradigmatic approach to adult analysis, even taking into account the considerable changes due to the growing interest in ego psychology. ‘Learning’ in the analysis can, of course, be a troublesome intellectualizing resistance. Furthermore, both the patient’s communications and his receptions and utilization of interpretations may exhibit only too clearly, as sometimes in the case of other ego mechanisms, their origin in and tenacious relation to instinctual or anaclitic dynamism; the longing implement out of silence for which the analyst is to override the uncritical acceptance (or rejection) of interpretations, in that the patient revealingly is to mention the unmindful assimilation, fluently, rich, endlessly detailed associations without spontaneous reflection or integration. In the direct demands for solution of moral and practical probability for an entirely intellectual scope, and a variety of others. It may and always be easy to discriminate between the utilization of speech by an essentially instinctual demand, and an intellectual or linguistic trait  or having to be determined by specific factors in their own developmental sphere, however, the underlying and essentially genuine dynamism that have to continue to be placed for a notable interval or remain arbitrary or conventional character most favoured to the purposes of processes of analysis, as it was to the original processes of maturational development, communication, and benign separation. Lagache, on the desirability of separating the current unqualified usage, ‘positive’ and ’negative’ transference, as based on the patient‘s immediate state of feeling, from a classification based on the essential effect on analytic processes. Yet, the later of mature transference is, in general, a ‘positive transference’.
 Concerning considerations in the transference neurosis, and the problem of transference interpretation, may be offered at this point. The whole situational structure of analysis (in contrast with other personal relationships), its dialogue of free association and interpretation, and its deprivations as to most ordinary cognitive and emotional interpersonal drives that tend toward the separation of discrete transferences from their synthesis with one another and with defences in character or symptoms, and with deepening regression, toward a continuative enactment of the essential of the infantile neurosis, in the transference neurosis. In other relationships, the ‘give and take’ aspects - gratifying aggressive, punitive or otherwise actively responsive, and the open mobility of searching for alternative or greater satisfaction - exert a profound dynamic and economic influence, so that only extraordinary situations, or transference of pathological character, or both, occasion to comparable regression.
 It is a curious fact, whereas the dynamic meaning to the importance of the transference neurosis has been well established since Freud gave this the phenomenon a central position in his clinical thinking, the clinical reference, when the term is used, remains variable and somewhat ambiguous. For example, Greenson, in his excellent recent paper, speaks of it as appearing, ‘when the analyst and the analysis become the central concern in the patient’s life’. However, previous remarks in this connection, for which it is worthwhile to specify certain aspects of Greenson’s definition, for the term ‘central’ is somewhat ambiguous, as to its specific reference. Certainly, the term could apply to the symbolic position of the analyst in relation to the patient’s experiencing ego and the symbolically decisive position that he correspondingly assumes in the relation to the other important figures in the patient’s current life. However, while the analysis is in any case, and for multiple reasons, exceedingly important the seriously involved patient, there is a free observing portion of is ego, also involved, not in the same sense as that involved in the transference regression and revived in infantile conflicts. And here is here being, of course, always the integrated adult personalty, however diluted in may seem at times, of its rarity, although certainly does occur, that the analysis actually exceeds the quality or state of being of notable worth or influence that the other major concerns, attachments, and responsibilities of the patient’s life, nor is it desirable that his should occur, on the other hand, if construed with proper attention to the economic considerations as mentioned, the concept is important, both theoretically and clinically. In the theoretical direction to the assumption that there is a continuing system of object relationships and conflict situations, most important in the unconscious representations, but participating to some degree in all others, deriving in a successive series of transference from the experiences  of separation from the original object, the mother. In this sense, the analyst’s applicability to a uniquely important portion of the patient‘s personality, the portion that ‘never grew up’, to maintain a central figure. In the clinical sense, to call or direct attention especially to a supposed cause, source, or to refer to the importance of the transference neurosis as outlining for the essential and central analytic task, providing by its very currency and demonstrability a relatively secure cognitive base for procedural duties. By its inclusion of the patient’s essential psychopathological processes and tendencies, in their original functional connection, it offers, in its resolution or marked reduction, the most formidable lever for analytic cure. Nonetheless,  transference neurosis must be seen in its interweaving with the patient’s extra-analytic system of personal contacts. The relationship to the analyst may influence the course  of relationships to others, in the same sense that the clinical neurosis did, except that the former is alloplastic, relatively exposed, and subject to constant interpretation.  It is also an important fact that, except in those rare instances where the original dyadic relationship appears to turn, the analyst, even in the strict transference sphere, cannot be assigned all the transference role simultaneously. Other actors are required. He may at times oscillate with confusing rapidity between the status of mother and father, but he is usually predominantly in one of the roles for long periods, someone else representing the other. Furthermore, apart from ‘acting out’, complicated and mutually inconsistent attitudes of the anterior apprehensions for realizing often about something not generally realized in the verbalization, may require the seeking of other transference objects, i.e., The husband or wife, friend, another analyst and so forth. Children, even the patient’s own children, may be invested with strivings of the patient, displaced from the analysis, even experience the impulses that they would wish to call forth in the analyst. The range is extensive, varied, and complicated, requiring constant alertness. Transference interpretation therefore often has a necessarily paradoxical inclusiveness, which is an important reality of technique. There is another aspect, and that is the dynamic and economic impact of the intimate and actual dramatist personate of the transference neurosis in the progress of the analysis as such, and on the patient ‘s motivation, as well as his real lifer avenues for recovery. For the persons in his milieu may fulfill their ‘positive’ or ‘negative ‘ roles in transference drama, which may facilitate or impede interpretative effectiveness, they provide the substantial and dependable real life gratification that ultimately facilitates the analysis of the residual analytic transference, or their capacities or attitudes may occasion overload of the anaclitic and instinctual needs in the transference that renders the same process far more difficultly. In the most unhappy instances, there can be a serious undercounting of the motivation for basic change.
 There is also the fundamental question of the role of the transference  interpretation. At the Marienbad Symposium most of Strachey’s colleagues appeared to accept the essential import of his contribution and thus  unique significance of the transference interpretations, despite the various reservations as to detail and emphasis on other important aspects of the therapeutic process. Nevertheless, there are still many who, if not in doubt regarding the great value of transference interpretations are inclined to doubt their uniqueness, and to stress the importance of economic considerations in determining the choice as to whether transference or extratransference interpretations may be indicated. Now, apart from the realistic considerations mentioned in the preceding passage (in a sense the necessarily ‘distributed’ character of a variable fraction of transference interpretation). There is in fact  that the extra-analytic life of the patent often provides indispensable data fo the understanding of detailed complexities of his psychic functioning, because of the sheer variety of its references, some of which cannot be reproduced  in the relationship to the analyst. For example, there is no repartee (in the ordinary sense ) in the analysis. The way the patient handles the dialogue with an angry employee may be importantly revealing. The same may be true of the quality of his reaction to a real danger of dismissal. There are not only the realities, but the ‘formal’ aspects of this responses. These expressions of personality remain important, even though his ‘acting out‘ of the transference (assuming this was this was the case) may have been more important, and, of course, requiring transference interpretation. Furthermore, they remain useful, if discriminatingly and conservatively treated, even if they are inevitably always subject that epistemological reservations, which haunts so much of analytic data. Of course, the ‘positive’ transference has a role in the  utilization of such interpretations that what enables the patent to listen to them  and them seriously.
 In an operational sense, it would seem that extratransference interpretations cannot set aside, or underestimated in importance, but the unique effectiveness of transference interpretations is not thereby disestablished. No other interpretation is free, within reason, of the doubt introduced by not really knowing the ‘other person’s’ participation in love, or quarrel or criticism or whatever the issue. And no other situation provides the patient the combined sense of cognitive acquisition, with the experience of complete personal tolerance and acceptance, that is implicit in an interpretation by an individual who is an object of the emotion, drive, or even defences, which are active at the time. There is no doubt that such interpretations must not only (in common with all others) include personal tact, but must be offered with special care as to their intellectual reasonability, in relation to the immediate context, lest they defeat their essential purpose. It is not too often likely that a patient who has just been jilted in a long-standing love affair, and suffering exceedingly, will find an immediate interpretation that his suffering  is due to the fact that the analyst does not reciprocate his love, even though a dynamism in this general sphere may be ultimately demonstrable, and acceptable to the patient. On the other hand, once the transference neurosis is established, with accompanying subtle (sometime gross) colouration of the patient’s life, th n more far-reaching anticipatory, transference interpretations are indicated, for, if all of the patient’s libidinal and aggression is not, in fact, invested in the analyst, he has at least an unconscious role in all important emotional transactions, and, if the assumption is correct that the regressive drive, mobilized by the analytic situation, is in the direction of restoration of a single all-encompassing relationship, specified pragmatically in the individual case by the actually attained level of development, then there is a dynamic factor at work, importantly meriting interpretation as such, to the extent that available material supports it. This would be the immediate clinical application on the material regarding the ‘cognitive lag’ or ‘cognitive fall-back’.
 Post-Traumatic Stress Disorder, resides in a mental illness that some people develop after experiencing traumatic or life-threatening events. Such events include warfare, rape and other sexual assaults, violent physical attacks, torture, child abuse, natural disasters such as earthquakes and floods, and automobile or aeroplane crashes. People who attest of the traumatic events may also develop the disorder.
 Post-traumatic stress disorder in war veterans is sometimes called shell shock or combat fatigue. In victims of sexual or physical abuse, the disorder has been called rape trauma or battered woman syndrome. The American Psychiatric Association (APA) adopted the current name of the disorder in 1980.
 In the late 1960's and early 1970's, mass demonstrations erupted throughout the United States protesting US involvement in the Vietnam War (1959-1975). Thousands of veterans joined in a national organization, Vietnam Veterans Against the War, that supported and influenced the antiwar movement. In this transcript from an April 22, 1971, hearing before the Senate Committee on Foreign Relations, committee chairman Senator J. William Fulbright indicated his sympathy for the antiwar movement. Fulbright’s comments were followed by the testimony of Vietnam veteran John Kerry, who called for an end to the war. Kerry also detailed what he believed to be the war’s negative effect in both Vietnam and the United States. Kerry became a Democratic senator from Massachusetts in 1985.
 People with this disorder relive the traumatic event again and again through nightmares and disturbing memories during the day. They sometimes have flashbacks, in which they suddenly lose touch with reality and relive images, sounds, and other sensations from the trauma. Because of their extreme anxiety and disruptive opposition to events, they try to avoid anything that reminds them of it. They may seem emotionally numb, detached, irritable, and easily startled. They may feel guilty about surviving a traumatic event that killed other people. Other symptoms include trouble concentrating, depression, and sleep difficulties. Symptoms of the disorder usually begin shortly after the traumatic event, although some people may not show symptoms for several years. If left untreated, the disorder can last for years.
 Post-traumatic stress disorder can severely disrupt one’s life. Besides the emotional pain of reliving the trauma, the symptoms of the disorder may cause a person to think that he or she is ‘going crazy.’ In addition, people with this disorder may have unpredictable, angry outbursts at family members. At other times, they may seem to have no affection for their loved ones. Some people try to mask their symptoms by abusing alcohol or drugs. Others work very long hours to prevent any ‘down’ periods when they might relive the trauma. Such actions may delay the onset of the disorder until these individuals retire or become sober.
 Studies have set or to bring into a new found control from 1 to 14 percent of people that suffer from post-traumatic stress disorder at some point during their lives. The findings vary widely due to differences in the populations studied and the research methods used. Among people who have survived traumatic events, the prevalence appears to be much higher. The disorder may be particularly prevalent among people who have served in combat. For example, one study of veterans of the Vietnam War (1959-1975) found that veterans exposed to a high level of combat were nine times more likely to have post-traumatic stress disorder than military personnel who did not serve in the war zone of Southeast Asia.
 Post-traumatic stress disorder is an extreme reaction to extreme stress. In moments of crisis, people respond in ways that allow them to endure and survive the trauma. Afterward those responses, such as emotional numbing, may persist even though they are no longer necessary.
 Not everyone who experiences a traumatic event develops post-traumatic stress disorder. Several factors influence whether people develop the disorder. Those who experience severe and prolonged traumas are more likely to develop the disorder than people who experience less severe trauma. Additionally, those who directly witness or experience death, injury, or attack is more likely to develop symptoms.
 People may also have been existing biological and psychological vulnerabilities that make them more likely to develop the disorder. Those with histories of anxiety disorders in their families may have inherited a genetic predisposition to react more severely to stress and trauma than other people. In addition, people’s life experiences, especially in childhood, can affect their psychological vulnerability to the disorder. For example, people whose early childhood experiences made them feel that events are unpredictable and uncontrollable have a greater likelihood than others of developing the disorder. Individuals with a strong, supportive social network of friends and family members seem somewhat protected from developing post-traumatic stress disorder.
 Treatment of post-traumatic stress disorder may involve psychotherapy, psychoactive drugs, or both. Psychotherapists help individuals confront the traumatic experience, work through their strong negative emotions, and overcome their symptoms. Many people with post-traumatic stress disorder benefit from group therapy with other individuals suffering from the disorder. Physicians may prescribe antidepressants or anxiety-reducing drugs to treat the mood disturbances that sometimes accompany the disorder.