Previously published: (2023). The power of exclusion (an ode to Sheldon Bach and Sandor Ferenczi). Psychoanalytic Psychology, 40(1), 43–49.
This paper is a tribute to my teacher, supervisor and mentor Sheldon Bach who would have been so happy to have heard me present this paper in 2021. Since Bach was one of the few analysts giving Ferenczi some of the recognition he deserved by calling him one of his “great influences on his thinking” (Bach, 2016, pp. xxvi) this would have given him such pleasure to see this tribute in print.1
Trying to follow the journey that started with my first conference in 1996 at NYU (where 365 people attended) and led to a book in 1998 called The Modern Freudians (Ellman, C. S., 1998), I have been trying to make sense of what it means to be a Contemporary Freudian. The original conference covered many areas of technique, and I found it interesting in writing this paper to look back at what I thought Freudian psychoanalysis looked like in 1996. I wrote at the time:“The importance of the relationship to the analyst has been stressed by Freudians for years (Greenson, 1965, Loewald, 1960, Stone 1961). What is new is how much it is being stressed, how much or how little one concentrates on surface versus unconscious material, and how important are intrapsychic conflicts versus the emerging transference-countertransference dialogues (with a particular focus on the analyst's inner life, (p. xiii).
An earlier version of this paper was given by Carolyn Ellman as the annual Bert Freedman Memorial Lecture on November 7, 2021, at the Institute for Psychoanalytic Research and Training
I also quoted Freud:
“Psychoanalysis is not, like philosophies, a system starting out from a few sharply defined basic concepts, seeking to grasp the whole universe with the help of these and, once it is completed, having no room for fresh discoveries or better understanding. On the contrary, it keeps close to the facts in the field of study, seeks to solve the immediate problems of observation, gropes its way forward by the help of experience, is always incomplete and always is ready to correct or modify its theories (Freud, 1923, p. 253).
By the time I worked on the New Freudian Synthesis (15 years after The Modern Freudians), we had the task of trying to understand not only the new role of the analyst but how much our colleagues were influenced by Klein, Winnicott, Bion and others and yet still called themselves Freudian. We asked them, what still makes you a Freudian?
Having lived through many changes in how we look at ourselves, it was only when I started reading Ferenczi with my Freud reading group in 2017, that I realized something that had been bothering me for many years. It was what I was grappling with in these two books: the strange disconnect between theory and technique. I didn't know at the time that Ferenczi was already thinking this way when he and Rank wrote their book on technique (Ferenczi and Rank, 1925). I knew in 1966 during my internship at Montefiore Hospital (a hotbed of New York Psychoanalytic analysts at the time) that the way my supervisor Sheldon Bach thought about patients had nothing to do with what they were teaching at Grand Rounds.
I didn't know Shelly was the type of clinician that Ferenczi was . He listened so intensely to the patient's experience and tried to enter their world and understand why they might have difficulty relating (whether it was due to early trauma and narcissistic problems). His approach wasn't dictated by theory alone. But when my study group started reading the Freud-Ferenczi correspondence I think that every one of us (6 people besides myself who had been studying together for 25 years) had the same distorted notions that had been perpetrated for years. Even though we had read Ferenczi's 1913 paper on “Stages in the development of the sense of reality” in our training as Freudians, we
knew very little about him as a clinician. In fact, we had some notion that he was quite disturbed because he had an affair with his patient Elma who was the daughter of his mistress Gisella. We thought that he slept with many patients, and we thought that he had an infantile attachment to Freud. We thought that Freud turned his back on him because he slept with patients. It turned out that very little of this (other than the affair) was historically true.
I would like to go over some of the actual facts of the case before I put forth some hypotheses about why I think the Freudians turned their back on Ferenczi after he died in 1933 and why the contemporary Freudians did the same thing in the 1980s when the Clinical Diary was published and then the correspondence in the 1990s. Balint said that the fight between Freud and Ferenczi was one of the great tragedies of psychoanalysis because many people felt Ferenczi was one of the most important figures in the movement (Balint, 1968, p. 152). His patients included Ernest Jones, Melanie Klein, John Richman, Franz Alexander, Sandor Rado, Géza Róheim, Clara Thompson, Margaret Mahler, René Spitz, Alice and Michael Balint, Otto Rank and Sandor Lorenz.
He influenced object relations theory through the work of the Balints, Klein, and Winnicott. He influenced the interpersonal tradition through Fromm and Thompson, self-psychology, Lacanian theory and more. Many of his analysands started institutes in the U.S. Ferenczi was considered by his colleagues to be one of the best analysts of his time and everyone was sent to him including the most difficult patients; thereby, his influence affected the whole field (Aron and Harris, 1993). However, after his death hardly anyone (with a few exceptions) mentioned his work for over 50 years. The lack of attention, malicious rumors, active silencing and deliberate repression of Ferenczi's work—and other non-desirable early participants in Freud's circle—was called Totschweigen, “death by silence” by Esther Menaker (Rachman, 2017).
In reading the history of the conflict between Freud and Ferenczi, it is important to understand correctly why Freud was so upset with the
contents of Ferenczi's paper on the “Confusion of tongues” and why this led to such an extreme disruption to their relationship. It is particularly important to make it clear to people that don't know the history of their relationship, that their falling out had nothing to do with his affair with his patient (which happened in 1911 and Ferenczi had been married to Gisella since ). Nor did it have to do with Ferenczi not accepting the presidency of the International Psychoanalytic Association in his later years, which Ferenczi had helped form in 1910 and which he was the president from 1918 to 1920. Freud, after he had been diagnosed with cancer in 1923, gave the mantle over to Rank and Ferenczi to work on technique (see ). He said he had total trust in Ferenczi's ability with patients. In fact, he encouraged Ferenczi to try various techniques such as cutting the analysis short (following some ideas of Rank related to birth trauma) and then his relaxation techniques (Haynal, 1989). Freud was upset however when Clara Thompson told him that she had kissed Ferenczi; he worried that Ferenczi's relaxation techniques could go too far, and he wrote him in 1931 the so called “kissing letter” . This deeply hurt Ferenczi who felt that the Thompson episode had been contrived by Thompson out of jealousy for his patient RN and was upset that Freud didn't trust him more.
Even though no one condones what happened with Ferenczi and Elma, I think it is important to know that Ferenczi had already brought up to Freud in 1910 that he needed more analysis and couldn't do it himself (Lugrin, 2021). He was a very big advocate for a long analysis for people practicing psychoanalysis. Ferenczi was convinced that his psychosomatic problems were related to his love life. He had been having an affair for many years with Gisella, an older woman who was married and whose husband wouldn't give her a divorce. She had two daughters and one of them, Elma, got very depressed. Her mother suggested that Elma see Ferenczi. In the history of this tragic story, one should understand that when Ferenczi realized he was falling in love with Elma, he asked Freud to see her since he knew he couldn't analyze her anymore. To add to this, when Freud had met Ferenczi in 1908 he was so taken with this young man that he had wanted Ferenczi to meet one of his own daughters (Haynal, 1992). Ferenczi's wish for analysis with Freud
was about his confusion about Gisella and Elma with Freud having very complex feelings about Ferenczi wanting him as his analyst. He wanted Ferenczi to get on with his life and lead the psychoanalytic movement. It is not clear in reading about the analysis that Freud finally consented to, which was off and on during the war years between 1914 and 1916, how much of Ferenczi's desperation was about Elma and how much about his conflict of wanting love and admiration from Freud while at the same time wanting to separate from him [For clarification see ]. However, if you read Yves Lugrin's 2021 book Ferenczi on Freud's Couch and you read about the torture Ferenczi felt about his love life, this was not a man who just “slept with patients.”
The other point that needs to be clarified is about mutuality. It is often stated that Ferenczi was the first analyst to understand the importance of a two-person mutually open relationship between patient and analyst and therefore the mother of relational therapy. In point of fact, Ferenczi did believe in honesty and trust as crucial to the analytic relationship (especially with traumatized patients) but his experiment with actual mutual analysis with his patient RN was very much against his will. He fought her for one year before he gave into mutual analysis and after a year of trying it he stopped it (much to her dismay) since he realized how much it was interfering with his other patients (many of whom like Thompson were jealous) and he couldn't be totally honest without betraying his other patients. He also realized his patients could hide behind mutual analysis and not stay focused on themselves. More than anything, Ferenczi was looking for honesty in the relationship and, like Winnicott later on, Ferenczi was willing to try many techniques to reach very traumatized patients.
So, what happened when Ferenczi wrote in 1932 the “Confusion of tongues” paper and wanted to present it to the 12th International Psychoanalytical Congress in Wiesbaden, Germany that year? What was in that paper that led to a break between two very close friends and collaborators, especially since a few years before in January 1928 Freud had written to Ferenczi, “[your work] testifies to the preeminent maturity you have acquired during past years and which remains unequalled” (Grubrich-Simitis, 1986, p. 271). In the “Confusion of tongues” paper,
Ferenczi summarized all his work of the past several years with traumatized patients (which was fully explicated in the Clinical Diary that he had just written) and concluded: (1) that not everything was drive related and that early sexual trauma had severe consequences such as severe dissociation, denial, and identification with the aggressor.
2) that sexual abuse does happen; (3) that the seducer convinces the victim that what is being given in the relationship is affection, love, tenderness and support, whereas the seducer is actually aggressing against the victim, intruding their needs into the experience of their partner which then allows for full domination, control and power over the victim; and (4) that the relationship with the aggressor was crucial. Therefore, if something awful has happened the aggressive person's denying it can be the real trauma (and by implication, the analyst's denying the trauma can also be re-traumatizing). Thus, the real confusion of tongues is what leads the victim to a deep loss of self and reality. Freud apparently felt Ferenczi was going back to his original seduction hypothesis and throwing out intrapsychic conflict and denying the worth of so many of his ideas that had developed from 1923 on in terms of defense analysis and the structural theory; whereas Ferenczi felt he was talking about what he had discovered with his very traumatized patients in the Clinical Diary (and what he had discovered about himself), where he understood that these patients had to reexperience their trauma in a safe environment. As many have felt, there was a true confusion of tongues between these two men. Since Ferenczi was very sick with pernicious anemia and using all of his energy to care for his deeply disturbed patients, Freud seemed to take this as his withdrawing and showing hostility towards him. Both of them were primed to misinterpret the other. Freud felt that all his work was being attacked, and Ferenczi felt that his deeply-felt work was being dismissed as nonsense or at best as going back to an old theory. Freud actually tried to prevent Ferenczi from presenting his paper at the Congress that year (which was unheard of in psychoanalytic circles) and was so distressed that he told Jones that Ferenczi was not of sound mind. These words would be used many years later to demonize Ferenczi. I believe that Freud may have felt attacked on a much more personal level since his reaction was so unusually intense. Since the main point in Ferenczi's paper had to do with the authority's using and misusing the
child and then denying it, I wonder if Freud may have felt that Ferenczi was saying that Freud was one of those analysts that retraumatizes their patients since he had denied Ferenczi the care he needed, and in his mutual analysis Ferenczi had discovered his own sexual abuse. If you read the Clinical Diary there is a sense that Ferenczi felt that Freud was destroying him by his lack of understanding and had a desperate need for his help.
Freud clearly felt attacked and lashed out. Nevertheless, in the obituary Freud gave upon Ferenczi's death, Freud said that Ferenczi was the analyst to all analysts (Freud, 1933) and in Analysis Terminable and Interminable (one of Freud's last technique papers) he was still trying to justify why he didn't help Ferenczi more (Freud, 1937). In his explanation he states that one can't analyze a conflict that isn't present in the treatment, referring to Ferenczi's unconscious hostility towards him.
After Ferenczi died in 1933, many of Ferenczi's analysands went to England before and after the war. Balint wanted to publish Ferenczi's work and the correspondence, but it was tabled by Anna Freud who thought there were too many sensitive things to have it published. The “Confusion of Tongues between the Adults and the Child” paper was published in 1933 in the International Zeitschrift für Psychoanalyse, in German, and in English in 1949 in the IJP (not as early as had been promised to Ferenczi by Jones, the editor of the International Journal of Psychoanalysis) but not the Diary or the correspondence, which Balint insisted had to be published together. What made matters worse was that Jones (an ex-patient of Ferenczi) wrote in his biography of Freud (Jones, 1957) that all the papers that were written by Ferenczi at the end of his life were by a man who was suffering a psychosis induced by his illness.
While many people including Balint, Ferenczi's wife, Gisella, her daughters, and especially Erich Fromm, who interviewed many people who had been with Ferenczi at the time of his death (Bonomi, 1998), verified that none of this was true, the fact that Anna Freud stood by Jones kept this myth alive. This was particularly ironic since Anna Freud, a
lay analyst, was one of the people Ferenczi fought for (since he was a big proponent of lay analysis). Jones, who had never been a favorite son to Freud (and was actually distrusted by Freud), clearly revenged himself on his ex-analyst. As Judith Dupont (, p. 250) said in the introduction to the Clinical Diary,
“It is astonishing to realize how the entire psychoanalytic community, with few exceptions, readily accepted Jones declaration that Ferenczi was insane during the last three years of his life. Jones supported his assertion on the basis of statements of a witness of Ferenczi's last days, a witness whose name Jones refused to reveal and who to this day, has never been found. Yet most known witnesses deny categorically this so-called madness of Ferenczi. This can be seen as a symptom, a sign of resistance by the psychoanalytic world to something Ferenczi would have wanted to introduce to psychoanalysis.”
It was interesting in my exploration of the problem of lay analysis in the U.S. that I found notes from the meetings of the New York Psychoanalytic Society on December 18, 1963, when Sandor Lorand (who had been an analysand of Ferenczi's in 1923–24) presented parts of the book he was writing on pioneers in psychoanalysis in order to correct distortions and inaccuracies from the Jones biography (which had come out a few years earlier). He “reiterated that from 1908, when Ferenczi met Freud for the first time, Sándor Ferenczi played a heroic part, second only to Freud, in building psychoanalysis into a branch of science”. Turning to his terminal illness, Dr. Lorand felt there was not a shred of evidence to indicate that Ferenczi ever suffered from personality impairment or mental illness, with the exception of the last weeks of his life, when his spinal cord and perhaps his brain were attacked in the terminal phase of pernicious anemia. In conclusion, Dr. Lorand remarked that “among the contributors to psychoanalysis, there is no one with the exception of Freud himself who contributed so many valuable and original ideas, no one who did as much as Ferenczi to develop psychoanalysis and bring it to the status it enjoys today.” Dr. Ludwig Eidelberg then stood up and said that Ferenczi was the most charming man he had ever met and the best lecturer (Ferenczi had been in New York in ). He recalled the advice of Nietzsche that great men should disguise their greatness to avoid the envy of those who work hard and produce little (Lorand, 1964, p. 469).
Was he referring to Jones? I never heard anyone comment on these remarks that were made at New York Psychoanalytic Institute in 1963, and I'm sure people are surprised to learn about this given all the institutional silence that followed.
This brings me to the main point of this paper, which is to question why the contemporary Freudians in the 80s didn't rejoice when the Clinical Diary and the correspondence finally came out. Other groups quickly claimed Ferenczi as their own. It is a tragic story to see how his ideas were concealed for so long by the analytic community in Europe and more so in the US. Adrienne Harris and Lew Aaron made a major contribution by publishing their 1993 book on the legacy of Sándor Ferenczi, which included many of the people that had helped to preserve Ferenczi's work, especially Judith Dupont (Aron & Harris, 1993).
I will try to show that we don't have to go back to 1933, and the strong reaction Freud had to the “Confusion of tongues” paper to see psychoanalytic politics at work. During the 80s and 90s, when the Ferenczi papers were finally published, Freudian thinking was already changing a great deal, as evidenced by papers by Stone (1961) and Jacobs (1986). And the reaction to Ferenczi could have easily been very welcoming. Instead, the relational movement, which basically started with Greenberg and Mitchell's 1983 book Object Relations in Psychoanalytic Theory and Stephen Mitchells 1988 book Relational Concepts in Psychoanalysis, quickly acknowledged Ferenczi's contributions and ran with them (even if they did exaggerate his emphasis on mutuality and used it to attack the classical Freudian model). I maintain that for some Freudians (whom Steve Ellman has called “the self and object” Freudians in The Modern Freudians and then later named the Contemporary Freudians) their position about the role of the analyst was already changing but the battlegrounds were drawn up between the role of the analyst and the role of interpretation and intrapsychic conflict.
My growing-up years in psychoanalytic training were definitely a study in being in or out. I will try to show that certain people who were somewhat outside the Freudian system (like Winnicott) were forgiven many transgressions because the Freudians didn't target him as a traitor. Nor did he threaten their power structure within the psychoanalytic situation or in their institutes. His personality wasn't an object of scrutiny.
I am not trying to demonize Winnicott but just trying to show how one overlooks certain things if they don't threaten the status quo. It is disturbing and frightening that one can be trained to try and know the truth and yet never question the depths of one's distortions about the other. In fact, when the relational movement began in the 1980s and Ferenczi's Clinical Dairy came out (the same year as Mitchell's book), followed by the 4 volumes of the correspondence starting in 1993 and ending in 2000, psychoanalysis was in a state of flux. Ferenczi's papers were allowed to be published after Anna Freud's death on October 9, 1982, and the first Ferenczi conference was in 1991. The Ferenczi Center was started at the New School in 2008 (where Ferenczi had taught during the six months he was in the U.S.).
1988 was also the time when a Federal anti-trust class action lawsuit was decided in favor of the four psychologist plaintiffs who had sued the American Psychoanalytic Association, the International Psychoanalytical Association, and two institutes affiliated with these associations for restraint of trade. It was in 1991 that the APsaA finally modified its by-laws to eliminate the waiver process for full clinical psychoanalytic training for doctoral level psychologists and social workers. It was an amazing time in psychoanalysis. What you may not know is that Ferenczi tried to start a group of lay analysts when he was here in 1927, much to the dismay of the analysts at the New York Psychoanalytic Institute, and it was disbanded in 1929. Their objection to his passionate stand on lay analysis was the reason he didn't stay in the U.S. Yet many of them went to him for treatment when he was here .
What could have been so disturbing to the Freudians about Ferenczi's ideas? I will give a little summary of the papers that were coming out in the 70s and 80s in the Freudian literature for you to have some feeling for what the background was when the Ferenczi papers surfaced. The most important part of Ferenczi's ideas, besides his extraordinary work on trauma and the identification with the aggressor, had to do with the therapeutic relationship, the early development of the self and how to make a safe environment, especially for patients who had early maternal deprivation, and his focus on process analysis. I will get to more of his contributions later but for the Freudians long before 1988, we already
had Leo Stone's 1961 book The Psychoanalytic Situation, which had an enormous impact on my thinking. It is noteworthy that I read that book several times because of my interest in the classical Freudian view of the blank screen, which led to my paper on anonymity (C. Ellman, 2011). I never noticed until I read Ferenczi that Stone was fascinated with all the techniques that Ferenczi had used and spent a great deal of that book in dialogue with some of Ferenczi's ideas. In 1968, we had Racker's book Transference and Countertransference (Racker, 1968) followed by Joseph Sandler's very important paper on role responsiveness (Sandler, 1976). In 1981, we had McLaughlin's paper “Transference, psychic reality and countertransference,” followed by his 1991 paper “Clinical and theoretical aspects of enactment” (McLaughlin, 1981, 1991). We had Grunes's 1984 paper “The therapeutic object relationship” and then Ted Jacobs's important 1986 paper “On countertransference enactments,” followed by his 1991 book The Use of the Self. In 1991, Judith Chused wrote “The evocative power of enactments” (Chused, 1991). All of these papers ushered in the understanding of the importance of the role of the analyst in the process of working through unconscious fantasies that can't be worked through by interpretation alone and how important the analyst's role was in the process.
At the same time that these important ideas were coming out, the therapeutic relationship, the emphasis on early development, and the treatment of narcissistic pathology were being discussed in Kohut's papers in 1968 and 1971 on the treatment of the narcissistic personality (Kohut, 1968, 1971) and of course in Sheldon Bach's extraordinary work starting in 1985 with Narcissistic States and the Therapeutic Process (Bach, 1985). Loewald's papers had already come out starting in the 60s and culminating in 1980 with his collected papers (Loewald, 1980), which strongly emphasized the developmental model in treatment and the role of the analyst, who was no longer a blank screen. Equally important was the 1975 publication of The Psychological Birth of the Human Infant by Mahler, Pine and Bergmann (Mahler, Pine, Bergmann, 1975). Our thoughts were shifting more and more to early deficits and trauma.
You can see from the papers I am citing that already in the 70s and 80s before the Freud-Ferenczi letters came out and the Clinical Diary, for some Freudians the technique was already changing. When relational psychoanalysis came about, not only were many Freudians writing
about enactment (e.g., Jacobs, 1986; Sandler, 1976) but some like Mahler (1975) were writing about the importance of the early mother-child relationship.
So why didn't some Freudians also claim Ferenczi as a mentor the way the relational group did? And why did the relational group attack the Freudian model at the time as if it wasn't changing at all? Why did we in 1989 rush to read Shengold's Soul Murder (Shengold, 1989) and not Ferenczi's Clinical Diary, which had appeared the year before, even though both publications were about severe trauma? Plus, in our work weren't we already talking about the importance of the relationship, the early holding that needed to occur with disturbed patients, the need for role responsiveness? Didn't I say in my introduction to The Modern Freudians in 1998 that the role of the analyst was now an important part of technique? We were happy to let the other groups claim this brilliant clinician and cling to mistaken ideas (that few of us knew were just rumors and distortions) of what he really said and did with patients and of why Freud and he had parted ways. I will argue that psychoanalytic politics has always looked for scapegoats in order to make their group more cohesive and that we are constantly reinventing ourselves while we try and demonize the other, often to find that some of their points (including the relational challenge) were important and needed to be integrated into our work.
Something was also threatening about Ferenczi's ideas. Partly, they were threatening because you had to be very present in the room with the patient, the way Shelly Bach taught me to try and enter their world. Ferenczi searched for a long time (trying many different techniques) to try and work with difficult patients. He realized he had to pay attention to some things that went beyond words (such as projective identifications, enactments, the need for an early holding environment). He was very sensitive to anything about the analyst's role that might recreate the trauma of childhood by treating everything as intrapsychic, when someone had been abused. In reading his work, I don't think he was a self-psychologist or a relational analyst or a Kleinian or a Contemporary Freudian (although he always thought there was a strong need to get to unconscious fantasy when the patient was capable of that). When I think about why he was demonized for so long, I don't think it was only his so-called disloyalty to Freud, but I think his model of treatment was a
threat in and of itself. Teaching students to listen without dogma is very difficult. The schools that were created after the war were very dominated by theory (which is exactly what Ferenczi disliked). Besides, the trauma of Ferenczi's death, the trauma of Freud's death in 1939, and the dissolution of psychoanalysis as it was known before the war, left everyone looking for someone to identify with and to try and keep psychoanalysis alive. Many theories (and schools) developed that were very far from looking at the clinical data. It took more than 30 years for Kleinians to start realizing that patients with narcissistic defenses cannot hear deep interpretations, for Freudians to incorporate not only unconscious fantasy but the important role of the early environment and the analyst as more than a blank screen, for relational therapists to start realizing that everything wasn't about the relationship but that patients also came with unconscious conflicts, etc. Not only did Ferenczi feel that one had to look at process, and look at one's own deep reactions to patients, he was determined to try and cure people and if they weren't getting better, he was willing to try something else. He was a clinician who had a complex way of listening and that is why the most difficult cases were sent to him. Martin Bergmann, one of the few analysts in America who were writing about Ferenczi, said in a 1996 paper, “The tragic encounter between Freud and Ferenczi,” “Ferenczi…offered his analysands unconditional understanding and a right to find their own path to cure. In my view, it is hard enough to be a creative analyst on Freud's model; it is next to impossible to live up to Ferenczi's.” (Bergmann, 1996, p. )
I maintain that most theories of technique simplify what the analyst should do (be a blank screen, always interpret the aggression, reflect empathic failures, only interpret the transference, etc.). For Ferenczi, establishing trust (as S. Ellman, 2007 emphasizes) was crucial across techniques. He knew establishing trust with patients with early deprivation was very difficult. Freud actually knew he couldn't be that type of clinician , and my guess is that many of Ferenczi's colleagues knew that they couldn't either.
I don't think in the 80s many Freudians (especially the more classically trained) were embracing their own genius clinicians such as Stone and Kohut and Bach. Because of the threat of the relational movement, they had to define themselves as analysts that (1) do not indulge their patients, (2) are much stricter and disciplined with their patients, (3)
are much better analyzed than their colleagues in other groups, and (4) believe in the unconscious and transference which made them the true heirs of Freud. While the relational group was constantly focusing on the classical Freudian position, which did have its vulnerabilities, I think many Freudians who were paying attention to object relations theory still had an idealization of classical technique and had their own identity crisis about who they were and who they were becoming. The paper I wrote in 2011 on anonymity (C. Ellman, 2011) had many positions that Stone and Bach proposed, but people still asked me if I was relational? There seemed to be a threat to one's identity to focus on the relationship and not just on intrapsychic conflict.
It has been fascinating to me to contrast the way many Freudians accepted Winnicott (who in many ways was more in a direct line to Ferenczi in his desire to cure). It's not that the Freudians at the New York Psychoanalytic Institute treated Winnicott kindly in 1968 when he presented his paper “The use of an object” and was treated with such scorn (Baudry, 2009), but for the rest of us trained with a somewhat more object relational background, we were intrigued by Winnicott's ideas, but we overlooked the following facts. Winnicott's role with Masud Kahn is fairly well known now in terms of how he used him to edit his papers, didn't really analyze the narcissistic transference, and didn't help with his deep destructiveness (Hopkins, 2006). But more than anything, many of the ways that Winnicott worked with patients such as Margaret Little are similar to Ferenczi's work in the Clinical Diary, where he encouraged regression. As Margaret Little says in her book about her analysis with Winnicott:
Literally through many long hours he held my two hands clasped between his almost like an umbilical cord, while I lay often hidden beneath the blanket, silent, inert, withdrawn, in panic, rage or tears, asleep and sometimes dreaming. Sometimes, he would become drowsy, fall asleep and wake with a jerk, to which I would react with anger, terrified and feeling as if I had been hit (Little, 1991, p. 44).
He also adapted himself to her rhythm, extending sessions to ninety minutes when he became aware that nothing happened for the first portion of the session. Patients often slept in the other room until they
could continue the work. Many of the things we see Ferenczi doing for his regressed patients were actually very much followed by Winnicott. Winnicott, however, would reveal many things to patients about his health and his depression. What is interesting reading some accounts of Winnicott's work (and many of his patients were extremely attached to him and his caring ways) is that there is no indication that Winnicott analyzed himself in the same way Ferenczi did. Winnicott had many failed treatments, but we don't read about the constant corrections that Ferenczi kept making. Ferenczi worried all the time whether he was doing the right thing and left us a diary which Winnicott didn't (as far as I know). The other difference, as far as I can tell, is that we had access to all of Winnicott's writings and could think about his ideas and therefore hardly dwelt on his personal faults. Whereas Ferenczi's writings were hidden and we were flooded with false rumors about him as a person. The “Confusion of tongues” paper came out in 1949. Winnicott clearly picked up where Ferenczi left off. But we do not know what he knew of Ferenczi's ideas from Balint, Rickman or Klein who were Ferenczi's patients, since Winnicott rarely referenced his sources. I do believe however that if one studies the history of ideas many things come together at the same time making it hard to pinpoint the exact source.
Some of the ideas in Ferenczi's papers include:
He radically challenged the relatively safe attitude of the analyst as a blank screen, and he saw analysis as an emotionally taxing, involving enterprise. He felt analysts often choose an intellectualized approach, not always according to the needs of the therapy, but often according to their own needs.
He drew attention to the communicative value of dreams, postures, and all movements in the analytic space in addition to verbal content.
He drew attention to the countertransference problems in training analyses and even though he helped to start the IPA, he worried that institutes could rigidly serve the analyst's own needs and not the patients.
He stressed the central role of intuition, empathy, and trust, especially with the most difficult cases and wanted to add techniques which would allow the treatment of cases until then unreachable by psychoanalysis.
He thought one must think in terms of analytic process and a new way of listening to material where everything happening in the room was important.
He recognized the importance of mourning and the effects of a maternal object that wasn't good enough so that one had to take into consideration problems of abandonment when one saw narcissistic withdrawal in patients.
He started to understand the analyst's contribution to creating a working environment to help the patient symbolize, anticipating some of Bion's thoughts.
Most of all, his work on trauma is exemplary; not only did he highlight the power of witnessing and accepting the patient's story but the identification with the aggressor and loss of self that Jay Frankel has highlighted so beautifully in his articles which should be required reading.
If one reads the Clinical Diary, one realizes that Ferenczi predated all the analysts that felt that early attachment led to the foundation of a sense of self and a capacity for trust. Without a good holding environment, Ferenczi felt, one couldn't sustain a sense of agency, and one was prone more to falseness and submission. He didn't use the term false self, and he was more interested in the fragmented self, but his emphasis on how the self develops through containment and holding anticipates Winnicott.
Aron and Harris said in 2010, “The rediscovery of Ferenczi has been the recognition of an appalling familiar and institutional tragedy, ridden with Oedipal disappointment and struggles and fratricidal battles. It is to unearth a buried trauma. The presentation and publication of Ferenczi's ‘Confusion of tongues’ paper on the powerful traumatizing effect of incest and families' collusive silence must rank among the oldest and most tragic moments in the history of psychoanalysis” (Aron and Harris, 2010). I would add that the Contemporary Freudians' not embracing Ferenczi as their forefather/mother in terms of the contemporary understanding of the importance of the therapeutic relationship to enable trust and his deep understanding of early developmental ruptures is just as sad, since many people writing at that time (Loewald, Sandler, Bach, Stone) were telling us the very same thing. Analysis cures by a certain type of love that means an engagement and caring for the patient and flexibility with more disturbed patients. It is these elements that help the patient get to their deeper unconscious conflicts. Sheldon Bach would also pick up this theme of love in the analytic situation later on in his work (Bach, 2006).
Apparently Ferenczi was a loveable person, rich in vitality and zest for living. Many (even in New York) considered him the warmest, most human, most sensitive of the early psychoanalytic group. But more than anything he cared so deeply about his patients, and that quality is what drew me to him. After I read Ferenczi I understood identification with the aggressor in a whole new way. His ability to take you into the experience of a needy dependent child/person who is being abused and how that person can slowly surrender their self to the other is something that I have used over and over in my work with patients that have suffered such devastation. His ability to describe their pain is unlike any other writer since he writes from the inside not as an observer. Eve Ensler's (2019) The Apology is the only thing that I have read that comes as close to living it with the person.
Finding an answer to the most perfect technique is an ongoing process. Perfect for whom and which therapist. I remember when I wrote my anonymity paper, I asked supervisees whether they really knew that a blank screen led to the most associations for all patients? I gave many examples and asked them never to accept something as dogma unless it was clear it was based on what they observed and was clearly best
for that particular patient. When I read Stone and I worked with Shelly Bach, I knew they were thinking about what made patients safe when they talked about technique. When I read Ferenczi, I knew most of all he wanted to help his patients even if he went to extremes with his most disturbed patients. He experimented, he changed his methods when they didn't work, and he knew when he reached blind spots. He knew he needed more analysis because he deeply appreciated the depths of the unconscious, but Freud his analyst wasn't there for him.
I am going to end with a passage from the “Confusion of tongues” paper for you to hear Ferenczi's voice in describing the reaction to abuse:
“One would expect the first impulse [to abuse] to be that of rejection, hatred, disgust and energetic refusal. ‘No, no, I do not want it, it is much too violent for me, it hurts, leave me alone’, this or something similar would be the immediate reaction if it would not be paralyzed by enormous anxiety. These children feel physically and morally helpless, their personalities are not sufficiently consolidated in order to be able to protest, even if only in thought, for the overpowering force and authority of the adult makes them dumb and can rob them of their senses. The same anxiety, however, if it reaches a certain maximum, compels them to subordinate themselves like automata to the will of the aggressor, to divine each one of his desires and to gratify these; completely oblivious of themselves they identify themselves with the aggressor. […] In any case, the attack as a rigid external reality ceases to exist and in the traumatic trance the child succeeds in maintaining the previous situation of tenderness.
The most important change, produced in the mind of a child by the anxiety-fear-ridden identification with the adult partner, is the introjection of the guilt feelings of the adult which makes hitherto harmless play appear as a punishable offense.
When the child recovers from such an attack, he feels enormously confused, in fact, split—innocent and culpable at the same time—and his confidence in the testimony of his own senses is broken” (Ferenczi, , p. 227) (italics in the original).
Psychoanalysis is an amazing field—especially the understanding of the unconscious and the psychoanalytic situation that Freud invented—but just like any other human endeavor, it has its flaws. What happened with Ferenczi not only showed how human we are but how envy, belonging, scapegoating, and the will to power are such basic human drives that even the best of us is privy to such primitive needs to find pleasure in exclusion. When I worked with Sheldon Bach I knew I was finding my way back to what was lost when Ferenczi's words and spirit were banned.
He also felt that when a treatment reached an impasse, he insisted on the analyst searching himself for negative countertransference and, more than anything, on his being honest. Dupont says that he tried to give his wounded, hypersensitive patients with fragmented selves the means to locate their analyst, to identify with him, and to be able to feel to what extent they could count on him.