The Analyst's Murder of the Patient

Of the radical and innovative ideas put forward by Ferenczi during his last years none is perhaps more startling than the suggestion in his 1932 Clinical Diary that although the analyst “may take kindness and relaxation as far as he possibly can, the time will come when he will have to repeat with his own hands the act of murder previously perpetrated against the patient” (1985, 52). In what follows I propose to use the Diary to explore not only the theoretical and clinical implications of this idea but also its autobiographical dimension and its bearing on Ferenczi's relationship to Freud.

It must be said immediately that the murder of which Ferenczi speaks is not literal, but rather emotional or psychic. As he goes on to explain, “analytic guilt consists of the doctor not being able to offer full maternal care, goodness, self-sacrifice; and consequently he again exposes the people under his care, who just barely managed to save themselves before, to the same danger, by not providing adequate help” (52-53). Once this is understood, it becomes clear that Ferenczi is referring to the way in which the inevitable imperfections and limitations of the analyst trigger the memory of childhood traumas experienced by the patient, which must be relived during analysis in order to be exorcised. As I have previously noted (1991, 27-29), this model of the psychotherapeutic process proposed by Ferenczi is very similar to that articulated independently by D. W. Winnicott in his posthumously published paper “Fear of Breakdown,” where he sets forth the way that agony of the patient “experienced in the transference, in relation to the analyst's failures and mistakes,” enables the patient to recollect “the original failure of the facilitating environment” (1974, 91).

Even from this brief summary, it is evident that the view of psychoanalysis held by Ferenczi and Winnicott stresses the need for humility on the part of the analyst and the indispens