Neuro-Psychoanalysis, 2006 8 (2 ) 199 The Developing Transference in Amnesia: Changes in Interpersonal Relationship, Despite Profound Episodic-Memory Loss Oliver H. Turnbull (Bangor, U.K.), Evangelos Zois (Bangor, U.K.), Karen Kaplan-Solms (Cape Town), & Mark Solms (Cape Town) Recently there has been revived interest in the ability to learn emotion-related material—even material of great complexity—despite profound episodic amnesia. In psychoanalysis, this finding is especially important due to the possible role of such a dissociation in infantile amnesia and as a possible account of the neurobiological basis of the transference relationship. However, there have been few investigations of neurological patients with amnesia in psychoanalysis, and we are not aware of any published accounts of the development of the transference relationship in profound amnesia. In this paper, we briefly review the content of a series of psychoanalytic psychotherapy sessions of a profoundly amnesic patient, Mr. N, reported in unpublished form by Kaplan (1994). This patient showed changes in the content of his associations that appeared to be emotion-related, and he appeared able to learn from the dynamic interaction with the analyst, despite his inability to consciously recall previous encounters with the analyst or even to recognize her when they met for subsequent sessions. Such findings offer the opportunity for a better understanding of the neurologi- cal underpinnings of the transference relationship, including linking clinical psychoanalytic findings with a developing neuroscientific literature on this topic. Oliver H. Turnbull: Centre for Cognitive Neuroscience, School of Psychology, University of Wales, Bangor, Wales; Evangelos Zois: Centre for Cognitive Neuroscience, School of Psychology, University of Wales, Bangor, Wales; Karen Kaplan-Solms: private practice, Cape Town; Mark Solms: Departments of Psychology and Neurology, University of Cape Town. Correspondence to: Oliver H. Turnbull, Centre for Cognitive Neuroscience, School of Psychology, University of Wales, Bangor, Wales, LL57 2AS, UK (email: o.turnbull@bangor.ac.uk). Acknowledgements: Oliver Turnbull’s research is supported by grants from the Wellcome Trust, the Philoctetes Center, and the National Association for Research on Schizophrenia and Depression (NARSAD). There has long been an interest in the preserved abili- ties of amnesics. Some of the early work involved, for example, preserved abilities in the domain of proce- dural learning (Schachter, 1987; Squire & Zola, 1996, 1997). Recently there has been revived interest in the ability to learn emotion-related material despite se- vere amnesia. Early examples date back to Claparède (1911), where a severely amnesic patient developed a dislike for her physician after a negative encounter with him, despite not recalling having met him be- fore. More recently, Tranel and Damasio (1993) and Johnson, Kim, and Risse (1985) have investigated this topic systematically, showing that amnesics are able to acquire feelings of emotional valence in relation to people they do not consciously recall, not only for neg- ative but also for positive emotions (for a more general review on this topic in relation to psychoanalysis, see Yovell, 2000). The neurobiological basis for this remarkable dis- sociation in memory performance appears to relate to an anatomical separation between two memory sys- tems. Notably, conscious episodic recall appears to be mediated by the hippocampus and related structures (see Eichenbaum & Cohen, 2001), whereas emotion- related memory has a separate neurobiological sub- strate from upper brainstem to medial-frontal lobes (e.g., Bechara, Damasio, Damasio, & Anderson, 1994; Damasio, 1994; Panksepp, 1998). This finding of preservation of emotion-related memory in amnesia may even extend to the learning of complex emotion-related material (Turnbull & Evans, 2006). For example, the profoundly amnesic patient SL was never able to consciously recall, or even identify as familiar, the experimenters he regularly visited for his assessments (Turnbull & Evans, 2006). However, his emotional responses to the experimenters changed