Transference phenomena in medical practice: being whom the patient needs.

Transference is a process in which individuals displace patterns of behavior that originate through interaction with significant figures in childhood onto other persons in their current lives. It is a powerful determinant of patient behavior in medical encounters. Transference can affect the kind of physician-patient relationship a patient seeks and his or her response to interventions prescribed by physicians. The relationship is also strongly affected by the physician's own transference or countertransference. Rather than approach every patient in a uniform way, tailoring the approach to fit the relationship needs of the individual patient is advocated. Such tailoring would affect whether the physician is collaborative or prescriptive, how much personal information he or she shares, and how close or distant he or she is. Transference issues can also affect level of somatization and patient adherence to medical regimens. We discuss other problems with transference, such as the seductive patient and gift giving. By paying attention to the transference needs of patients, physicians can enhance the therapeutic alliance in which patients optimally participate in fulfilling their medical needs.