Psychoanalytic History—Sketches

A kluger farshtait fun ain vort tsvai

A wise man hears one word and understands two (Yiddish expression)

Intersubjectivity in History

Intersubjectivity concerns a subject or a self-embedded in interaction. Freud's mental agencies, on the other hand, were more objective and about an individual.

The concept of intersubjectivity originated in philosophy. Names like Husserl, Heidegger, Buber and Binswanger are associated with it. Merleau-Ponty (1968) and Kraus and Derrida (2004) used the term “invagination” to describe a dynamic differentiation between the self and the other dating back to Kant's Critique of Judgment. Detailed histories of intersubjectivity in psychoanalysis (Thompson, Kirshner) trace its roots to German phenomenology (Hegel), French linguistics (Lacan) and a combination of both of these (Laing). Ferenczi's “dialogue of the

unconsciouses” is an important milestone in the development of inter-subjectivity in psychoanalysis.

Binaries and Utraquism

Psychoanalysis sprang from a cultural environment on two continents suffused with mysticism and religious movements, including Transcendentalism, Emmanuelism, and Christian Science. Sandor Ferenczi (1873–1933) was writing about Spiritism (1899) before he ever met Sigmund Freud in 1908. William James published a paper entitled “A Suggestion about Mysticism” in 1910, one year after his walk with Freud from Clark University to the then new Union Station in Worcester, Massachusetts. After joining Freud on that same visit to America in 1909 and writing outlines for Freud's contemporaneous talks, Ferenczi returned to Europe and visited the Berlin psychic Frau Seidler. Ferenczi wrote to Freud on November 11, 1910, that he was “a great soothsayer… I am reading my patients' thoughts (in my free associations). The future methodology of psychoanalysis must make use of this.” (Freud and Ferenczi, 1993, p. 235).

The tension (within the friendship) between Freud and Ferenczi over many years is emblematic of a tension in medicine (and especially in the mental health disciplines) between science and humanities. These categories were described by Dilthey (1907/2010) as naturwissenschaften and geisteswissenschaften. The former uses the method of erklaren (no-mothetic or law-governed explanations). The latter uses the method of verstehen (idiographic interpretations of meaning, sometimes called hermeneutics). Aron and Starr (2015) warned that these domains are not complete binaries. In fact, Freud, the objectivist, was also interested in what he termed “thought transference”. He just wanted his interest kept secret so as not to delegitimize the reputation of psychoanalysis as a science. And Ferenczi was nothing if not empirical in his serial experiments in activity, elasticity, relaxation and mutuality. Ferenczi was motivated and guided by feeling his way into helping the individual patient in front of him.

Intersubjectivity requires a bridge to the wider world of mental health treatment. Ferenczi (1933) called such a bridge between science and psychology “utraquistic”. Utraquism comes from the Latin sub utraque specie meaning “in both kinds”, or as Joni Mitchell sang “from both sides

now”. Utraquism in the Christian church meant that both the bread and wine should be served in the Eucharist sacrament and to all the laity, not just the priests. Ferenczi, perhaps uniquely, bridged the ideas of Janet, Jung and Freud (Cassullo).

Ackerman (2017) creatively compared psychoanalysis to a voyage at sea. She explored Freud's resistance to Rolland's “oceanic feeling”, seeing in it mortal dangers, an expression of the death instinct that Freud wrote about. Yet Rolland's own “oceanic” experience gave him a feeling of expansiveness and “vital renewal”. Ackerman then uses Melville's novel Moby Dick to further explore this difference in response to going to sea in all its metaphors- e.g. the uncanny, the unconscious, birth, bonding, danger, and death. She contrasts Captain Ahab's “monomaniacal goal” of killing the great white whale Moby Dick with Ishmael's contemplative meditation from the ship's masthead. Again, without falling into a false binary, it is not hard to see Captain Ahab in Freud, the Conquistador, determined to plumb the secrets of nature (Barron et al). In like manner, Ferenczi, like Ishmael, is more open to feelings and to adapting himself to the wider world including difficult patients on their own terms.

Dialogue of the Unconsciouses

Ferenczi coined the term “dialogue of the unconscious” in 1910 when he treated a 24-year-old man for impotence. The patient lived with his widowed mother who accompanied him to Ferenczi's office. He spoke in two voices, a high soprano and a baritone. Ferenczi understood the soprano voice to be an unconscious communication between the young man and his mother that was used as a “prohibition of the incestuousness”. Other manifest symptoms were bedwetting, a phobia of mice, and cross-dressing for entertainment. A second similar case in a 17-year-old was seen by Ferenczi in 1914. He wrote both cases up in a paper published in 1915. The title was Psychogenic Anomalies of Voice Production. Ferenczi wrote, “This is one of the so frequent cases which I call the “dialogue of the unconscious,” where the unconscious of two persons fully understand each other, without the consciousness of either having any inkling of it.” (Ferenczi, 1915, p. 28).

Years later, on 12 April 1932, Ferenczi noted in his Clinical Diary that the idea of a “dialogue of the unconsciouses” (now used in the plural to emphasize that two people were involved) had been “launched if I

remember correctly, by me”. Here is how Ferenczi described this dialogue- “When two people converse, not only a conscious dialogue takes place but an unconscious one, from both sides. In other words, next to the attention-cathected conversation, or parallel to it, a relaxed dialogue is also pursued.” (Ferenczi, 1932, p. 84).

Schismatic Year and Paradigm Shift in Psychoanalysis

1923–24 was a “schismatic” year resulting in a “paradigm shift in psychoanalysis”. (Bokay; Rudnytsky, 2002, p. 141; Hoffer, P.; Poster, 2009, p. 197) In that year, Freud wrote The Ego and the Id which was the beginning of ego psychology. In the same year, 1923, Georg Groddeck, a German physician who had befriended Freud in 1917 by writing letters to him, wrote a book of letters, The Book of the It, which English professor and psychoanalyst, Peter Rudnytsky, described as “the greatest masterpiece of psychoanalytic literature”. (Rudnytsky, 2002, p.163) In 1924, on commission by Freud to combine psychoanalytic theory with practice, Ferenczi and Otto Rank wrote The Development of Psychoanalysis which emphasized erlebnis (experience) in the here-and-now, rather than remembering. Thus began the schism between objective ego psychology and experiential, later relational, psychoanalysis.

Groddeck used what he called Das Es, or the It, to described “an undefinable force we are all lived by.” Groddeck had adapted the concept Das Es from Carl Gustav Carus and Naturphilosophie. (Balenci) Groddeck listened intently for this force in his patients to “whisper” to his own Das Es to try to understand his patients, and especially their physical symptoms. This intersubjective treatment technique was very similar to Ferenczi's clinical use of his concept of “dialogue of the unconsciouses”. Freud recognized the similarity in “artistico-intuitive” style and predilection for the occult of both Ferenczi and Groddeck. In addition, Ferenczi had numerous physical symptoms, and Groddeck was very successful at curing them. Accordingly, Freud immediately introduced Ferenczi to Groddeck. They became lifelong friends. (Poster, 2009) Groddeck helped Ferenczi separate from Freud's “crushing paternalism” and find his own voice. (Fortune, p. 92).

Freud (following Plato and Heinroth) adapted Groddeck's Das Es to be the wild Id of his tripartite model. (Poster, 1997) Groddeck wrote to his wife on May 15, 1923, that Freud “disregards the constructive aspect of

my It (Das Es).” (Groddeck, 1977, p. 13) “Since Freud revised and narrowed the scope of Groddeck's It (Das Es), later psychoanalytic theories were generated to fill the experiential void.” (Poster et al, 2016, p. 172). Nevertheless, some Freud scholars claim that the interpersonal was “always implicit” (Lothane, 1997) in Freud's work, and that Freud was already an inter-subjectivist before he “lost sight of the intersubjective when he tried to locate and date the origin of sexual drives within the individual.” (House).

Ferenczi had his own utraquistic ideas that he termed “bio-analysis” and, with Elizabeth Severn, an Orpha that he described as “an omnipotent intelligence…an ad hoc tele-plastic organ (that)…tracked me down to be of service to her.” (Ferenczi, 1933, p. 121) According to Galina Hristeva, “Orpha—who is definitely of the same origin as Groddeck's Das Es—is only a fragment and thus lacks the totality and monumental indivisibility typical of Groddeck's concept. Ferenczi places a stronger accent on the fragmentation but still preserves the connection to the big Whole, to the Weltseele (World-soul)—or from his historic perspective to the “protopsyche”. The Weltseele is a dynamic and creative forming principle in the universe. Being a productive, “indefatigable” force, the Weltseele does not cease to be active in each fragment. It is also active both in the analysand and the analyst. Besides, fragmentation allows for more creativity and freedom when re-structuring the individual soul and its links to the Weltseele after trauma and a catastrophe. Because of our kinship to the World-Soul we are able to participate in cosmic forces, in the Universal Soul of the World, the Weltseele. Orpha is a “supra-individual” entity (Ferenczi, 1932, p. 13) precisely due to her connection to the World-Soul. (Hristeva, 2019, 529–530).

Such a mystical force would be very foreign to Freud. Freud did, however, recommend in 1912 that the analyst “must bend his own unconscious like a receptive organ to the transmitting unconscious of the patient”. And in 1915 Freud noted, “It is a very remarkable thing that the unconscious of one human being can react upon that of the other, without passing through the conscious mind.” Note that the quote above from Freud about unconscious communication is from the same year —1915—that Ferenczi had published a report of two cases and coined the term “dialogue of the unconscious”.

Mutual Analysis

Much like Ferenczi, Groddeck wrote to Freud in June 1917, “Everything with me ultimately gets channeled into the treatment of patients.” (Groddeck, 1977, p. 40).

Ferenczi experimented with mutual analysis with both Georg Groddeck and then Elizabeth Severn. While this experiment was considered to be successful by and for both Ferenczi and Severn, Ferenczi advised, “Mutual analysis: only a last resort!” (Ferenczi, 1932, p. 115) The mutual analysis between Ferenczi and Severn is described by Peter Rudnytsky as “the paradigm for the contemporary shift to a two-person conceptualization of clinical work, just as Freud's self-analysis was paradigmatic for the one-person perspective of classical theory. Both of these epochal events are paradoxically at once unique and unrepeatable foundational acts of psychoanalysis…” (Rudnytsky, 2022, p. 8) Mutual analysis was also “the fountainhead of self-psychology as well as of relational psychoanalysis.” (Rudnytsky, 2022, p. 15).

Two-Person Psychoanalysis

In one of his very last papers, Freud stated in a matter-of-fact manner, “But at this point we are reminded that the work of analysis consists of two quite different portions, that it is carried on in two separate localities, that it involves two people, to each of whom a distinct task is assigned. It may for a moment seem strange that such a fundamental fact should not have been pointed out long ago; but it will immediately be perceived that there was nothing being kept back in this, that it is a fact which is universally known and, as it were, self-evident…” (italics added). Notwithstanding the above statement, Freud's emphasis throughout his career had been on a one-person interpretive technique.

Following up on his landmark book with Rank (1924), Ferenczi “developed his conception of the transference-countertransference interaction, understood not only as a therapeutic instrument, but as the central kernel of the analytic work” (Cabre). Among the many two-person psychoanalytic theories that followed are countertransference identification with “intuitive… (and) complementary attitude” (Deutsch, H.), interpersonal psychiatry (Sullivan), listening with a third ear (Reik), countertransference as unconscious perception (Heimann), concordant and

complementary countertransference (Racker), projective counter- identification (Grinberg), reciprocal free association (Isakower), intersubjectivity (Lacan), role responsiveness (Sandler), a child with a mother (Mahler, Winnicott, Stern, Beebe), countertransference and mutual enactments (Jacobs, Renik), affective engagement at the intimate edge (Ehrenberg), interpsychic communication (Bolognini), implicit knowing (BPCSG), the analytic third (Ogden), complexity theory (Galatzer-Levy), field theory (Barangers, Ferro), intersubjective systems theory (Stolorow), reciprocal recognition (Benjamin), intersubjective ego psychology (Chodorow), dramatology (Lothane, 2009), intersubjective Bionian theory (Brown), and more (Bohleber). Beyond these examples of theories of two-person, or intersubjective, psychoanalysis, more will be described. Indeed, as Arnold Modell has said (personal communication), “The possibilities for what two people can say to each other in a room are almost infinite.”

The paradigm shift to two-person psychoanalysis was begun with Ferenczi's “dialogue of the unconsciouses” and is complete. Indeed, it is likely that all analysts today consider themselves to be “two-person” psychoanalysts. While some relational psychoanalysts still refer disparagingly to “one-person, classical analysts”, I have yet to hear anyone identify themselves as such. Yet, evidence-based, short-term therapy remains the standard used by third-party payers. While minimally effective in drug-like studies measured against placebo, such treatments have low rates of compliance and low long-term efficacy in naturalistic settings. (Shedler).

Conclusion

Ferenczi was a classical and contemporary psychoanalyst (Borgogno). He was a pioneer of trauma treatment (Bonomi), object relations and mutuality (Haynal), and an “ancestor” of the relational movement (Harris and Kuchuk). Ferenczi viewed mutual analysis as a technique of “last resort”. Nevertheless, Peter Rudnytsky (personal communication) considers Freud's self-analysis and Ferenczi and Severn's mutual analysis to be “the iconic twin foundational pillars in the history of psychoanalysis”. Ferenczi's “dialogue of the unconsciouses” was an important milestone on the road to the now prevalent psychoanalytic modes and schools of intersubjectivity. It is also an utraquistic bridge between the

science of evidence-based psychotherapy and the humanism of intersubjective models of psychoanalysis.