Active Therapy in the Analysis of Stammering

In a previous publication1 certain observations were made concerning the value of active therapy in the analytical treatment of stammerers, particularly in prohibiting the tic-like movements associated with speech, without elaborating the more general practical and theoretical details. Further experience has led to more extensive formulations, and the purpose of this communication is to call attention to this phase of psychoanalytical therapy to other analytical workers in the field of speech disturbances, thus supplementing the methods already utilized. The technical innovation first introduced by Ferenczi under the designation of “active therapy”2 has become of increasing value in stammering as in other neurotic disorders.

The willingness of stammerers to be cured and the compliance with the analysis may be only apparent, acting as a cover for resistances which are often reinforced through a mobilization of physiological habits relating to the oral libido. These habits automatically stimulate the oral apparatus through the pathway of the ego when a compulsive necessity arises for oral libidinal discharge. As the analysis is an attack upon the stammerer's narcissism, the battle against these modes of libidinal satisfaction is active therapy, because what the stammerer can achieve therapeutically depends in part on overcoming the external circumstances which activate and strengthen his oral libido.

The technique of active therapy in the analysis of stammerers is a deprivation of various external forms of oral gratification or rather an abstinence from those external factors which tend to prolong the gratification or to reinforce it. To sit back and passively wait for improvement in the speech tends to unnecessarily prolong the treatment, as the patient has other means of oral satisfaction at his command which act as resistances, even when the original substratum