General Information

My next presentation: Dialogue of Minds: Ferenczi’s Mutual Analysis Reconsidered will be on May 3, 2024 at Borough of Manhattan Community College. It is a critique of both traditional psychoanalysis and behavioralism, as both trend to pith patients onto a procrustean bed of psychopathology. My presentation states that Ferenczi's mutual analysis was an attempt to revivify the genre with an emphasis on duet of listening and hearing, mutually. At present, obviously it fails to meet modern ethical standards. That doesn't mean we psychologists should not be incorporating aspects of listening/hearing into the room. But alas, just as in Europe, psychologists are insufficiently analyzed and most have not been gifted a therapy where they are listened to with empathy and heard.

Dialogue of Minds: Ferenczi’s Mutual Analysis Reconsidered

A norm of altruistic care is abolished when anomie reigns. Psychotherapeutic systems arose as an attempt to alleviate emotional agonies of angst, through such diverse techniques as Freud’s psychoanalysis and Watson’s behavioralism. However, each technique ossified into an untraversable hierarchy where the therapist could not listen without pithing the patient into some Procrustean bed. Ferenczi formulated a new version of psychoanalysis which aimed to cure through unconditional empathic listening. This technique, known as mutual analysis, was viewed with condescension and Ferenczi was pithed on the pinions of psychopathology, labelled in stone as “demented.”

An influx of anomie, foretold by Emile Durkheim (1897) now envelops America. The social system has broken down. Social civilities and general niceties are little known nor much expected. The norm of altruistic care for those who cannot work or cannot care for themselves safely has been derogated, disregarded, denied., and dismantled. Authoritarian personalities are admired as role models of relatedness. Not for the first time. There are parallels to a century ago in post WWI Europe.

This presentation will posit that psychoanalysis and behavioral therapies, which developed in opposition to rigid social norm-based societies were meant as disruptive techniques to liberate anxious angst within these societies. Each posited new norms of liberations, with Behavioralism posited as a more efficient, quicker picker-upper. To name who oppressed you and to consciously state what you need to move forward causes optimism. However, as various authoritarian regimes became normalized, psychotherapies ossified as well and projected rigid social norms back to their patients. Lost was the idea of any analytic reflection or that an analyst stands outside of society. In some cases, therapists jumped on the bandwagon and enthusiastically engaged in and imposed groupthink, at the expense of their patients’ narratives.

But it was not always thus. Psychotherapy began with pulling back a curtain the price paid by individuals forced to adhere to social norms with which they did not agree. Modern psychotherapy must be said to begin with Freud, who was fascinated by Josef Breuer’s patient, Anna O (Breuer & Freud, 1895). Breuer even brought Freud in as a consultant. Breuer would later write: “ Some ten days after her father’s death a consultant was brought in, whom….she ignored while I demonstrated all her peculiarities to him. ‘That’s like an examination,’ she said. (Breuer & Freud, 1895 p. 27)” In other words, the condition under which psychotherapy is conducted are mutually decided, and any parallels to a ticketed sporting event is unfortunate.

Anna O self-hypnotized. When Breuer was on vacation, she refused to “confide what she had to say to anyone but me.” [Breuer] (Breuer & Freud, 1895). Anna’s symptoms began after the death of her father, a complicated bereavement made up of sorrow, self-loathing, sacrifice and disgust. Her monotonous family life and the absence of adequate intellectual occupation ( Breuer & Freud, 1895, p.41) which happened to meet the social norms of employment for a dutiful, doting daughter of the bourgeois.

Instead of throwing herself into domestic duties, Anna O auto-hypnotized. But this was insufficient to effect a cure. She needed a chosen other to listen to her and empathize. While Freud was not whom she chose, he got it right when he stated, “Hysterics suffer from reminiscences.” (Breuer & Freud, 1895). And in order to effect her cure, she needed to “chimney sweep.” And she needed to control the sweeping. Those seeds formed the basis for psychoanalysis, for what else is chimney sweeping but “free association.”

Freud, as scientists of the time did, utilized introspection to test the outcome of free association, as around this time his father died and he mourned through a process of self-analysis. We don’t know exactly what this entailed. Subsequent practitioners record themselves free-associating into a mike for 45 minutes, then listening to it and interpreting it after.

Freud realized as a young boy he held feelings of lust for his mother and rivalry with his father. He believed if this was true for him, this reflected a universal tendency. Hence, the Oedipal phase, which became a lodestar of psychoanalysis. And so, psychoanalysis veered away from science and into dogma. Freud said it was so and thus Oedipus was a litmus test of loyalty within the group, instead of a hypothesis to be tested As Freud said, “ A man who has been his mother’s undisputed darling…retains throughout his life the triumphant feeling, the confidence in success, which not seldom brings actual success along with it.” (Freud, 1917). Freud was not beset with self-doubt. Psychoanalysis became a one-person, one-up, one-down analysis. Furthermore, as anomie ensued post-World War I Austria, Freud concluded that some problems could only be resolved by the emperor’s gold. Psychoanalysis was not seen as a cure for larger societal disruptions, which Freud was equally afflicted by—inflation, heating shortages, illness, deaths, fascism, the rise of Hitler.

Simultaneously, across the pond, John Watson found psychoanalysis personally annoying. This was not how a scientific psychology went. Psychology needed to be overt, repeatable, verifiable. And so, he based his psychological science on Pavlov and psychology soon went straight to the dogs. Behavioralism may fit the 20^th Century norm of how science is conducted, but this is not based on norms of equity. Subjects never consented to be in the early experiments—neither Pavlov’s dogs nor Watson’s babies. Stimuli were imposed on them. They had no choice and without choice, there is no motivation to change their behaviors outside of the laboratory. There is no equity here. Watson, like Freud, was not beset with any self-doubt. (Watson, 1930).

It is interesting that after almost a century of behavioralism, only recently have psychologists begun to listen to the patients and give credence to their pain. Two recent issues of The Behavioral Therapist were devoted to iatrogenesis in the behavioral therapy realms.

CBT…focuses on the interconnection between thoughts, emotions and behaviors as they related to a client’s presenting problem…However, there is a growing evidence that the misapplication of CBT principles can, at the least, invalidate, and at the worst, perpetuate oppressive systems and actively harm minoritized individuals…One example…ABCT apologized for the field of behavior therapy’s role in the development of ….’conversion therapies’…no longer endorsed…continue to be used today…our field’s involvement in harming sexual and gender minority individuals…how the misapplication of CBT has harmed certain client groups…people with disabilities and people undergoing weight-management programs… (Van Dyk & Miller, 2023, pp1,2)

Let me make it clear—the therapy may be good—but the practice of it may be based on a fallacy of expertise. The patient knows where to go and the therapist has tools that may prove useful along the road. If the patient rejects these tools or finds the tools insufficient, the therapist cannot blame the patient for the insufficiency of the tools. The therapist needs to listen. But when therapists have not experienced true listening themselves, how can they hear? Listening can be a powerful gift. CBT programs can help teach new skills—but people only apply them after they feel heard.

Sandor Ferenczi was an admirer of Freud and ultimately one of his grand viziers, complete with the signet ring. Freud’s invention of psychoanalysis was derived from listening to Breuer’s cases and then seasoned by his self-analysis. Ferenczi came to psychoanalysis from his need to please and give pleasure to his lover. His earliest analytically-oriented paper public. shed in 1908 is titled, “The effect on women of premature ejaculation in males.”

It is only the selfishness of the male and of physicians has made

it possible to overlook….the female sex has subjected itself to the male

viewpoint…no desire…indecent…distasteful…gladly forego if only

her husband did not demand it.” [Thus],happy marriages are so rare

(Ferenczi, 1908, p. 294).

This is where Ferenczi begins prior to Freud and this where he came to an end: the duality of mutuality. From mutual orgasms to mutual analysis As Ferenczi evolved in his praxis of psychoanalysis, his technique strode further away from Freudian recommendations. His earlier innovations, Active therapy and frustration techniques were not so alien from Freud’s methodology. It did not deny the centrality of the Oedipal myth. In the absence of a listening ear, he too began a self- analysis in the form of a clinical diary and began to reflect on how Freud’s techniques were antithetical to a therapeutic analysis, asking, “Who is crazy, us or the patient.” (Ferenczi, 1932/1988, p. 92). He further mused, “Is Freud really convinced, or does he have a compulsion to cling to theory?” (Ferenczi, 1932/1988, p. 92). If Ferenczi was a vizier, then Freud is the Sultan—viziers serve, they do not liberate. But the self-analysis needed more—it needed an other to encounter, to filter, to reflect, to empathize.

In his Clinical Journal on March 13, 1932, he wrote:

Certain phases of mutual analysis represent the complete

renunciation of….authority on both sides; they give the impression

of two equally terrified children….who compare their experiences and

because of their common fate, understand each other completely and

instinctually try to comfort each other. Awareness of this shared fate

allows the partner to appear….as someone one can trust with confidence.

(Ferenczi, 1932/1988, p.56).

Collaboration, cooperation, and, coaxing will create a cosmos where resistance is routed by analytic responsivity. Around this time, Freud wrote to a friend, “Isn’t Ferenczi a cross to bear. …He is insulted because one isn’t delighted by the fact that he is plahing mother and child with his…pupils.” (Frued 1932, p. 431).

Mutual analysis was created amid a time of terror, tyranny, and annihilation. In other words, anomie. After World War I, the Austro-Hungarian Monarchy, where freedom of religion and equality of all citizens were codified came the collapse of the republic and the Horthy Fascist Terror, with its anti-Semitism and quotas for Jewish students. Hungary, an axis nation, ceded 2/3 of it’s territory during the post-war reconstruction. And yet, during that time, Ferenczi still managed to maintain his passion for social justice in the creation of a low-fee psychoanalytic out-patient clinic.

All Central Europe witnessed mass migrations from areas of destructions to areas of hostility. And yet, even amidst the political and economic instability, American females came to Ferenczi for psychoanalysis. Elizabeth Severn, Ferenczi’s most challenging patient, like Breuer’s Anna O, had a knack for self-hypnosis within the analytic setting. She led Ferenczi back to the roots of chimney sweeping. She did not want a surgeon, she wanted an encounter, one who would not be repulsed by her story but stay with her as she tried to knit a cohesive narrative out of the fragments of memory. Severn remembered markedly traumatic childhood experiences with adults who would not maintain appropriate sexual boundaries. Ferenczi wrote in 1932:

Where the first shock occurred at the age of one and a half years

(a promise by an adult…to give her ‘something good,’ instead of which,

drugged and sexually abused…At the age of five, renewed, brutal attack;

genitals artificially dilated, insistent suggested to be compliant…stimulating

intoxicants administered…suffering…helplessness…despair of any outside help, propel her toward death; but as conscious thought is lost, or abandoned, the organizing life instincts…awaken. (Ferenczi, 1932/1988, p. 8)

She wanted empathy. She wanted reassurance. She wanted within Ferenczi’s consulting room a therapeutic reconciliation of the core trauma: authority figures who created what Ferenczi was to call a confusion of tongues: the child wants adult nurturance and affection but is sexually violated in return; the analysand wants analytic empathy and validation, but is emotionally violated via analytic austerity, analytic abstinence, and the analytic mirror, which only reflects back what it receives. This can be iatrogenic for patients who, as Severn repeatedly said, “still don’t know whether it all really happened.” This model was no better than American behavioralism, which would demand “observable, verifiable, repeatable” proof. The patient comes enters in pieces, dissociative. Experiences with authority figures were toxic, tortuous, leading to physical and emotional destruction. (Ferenczi, 1932/1988, p10). She wanted tolerance and she wanted to choose what techniques would be therapeutic for her. Ferenczi wanted to provide a curative setting for the patient. As opposed to “learning” from them or “making money” off them, or fearing being made insane from the mere exposure to them.

Severn persuaded Ferenczi that a mutual analysis, offered curative elements for the patient. That this way the only way forward for her to trust him completely. Originally, this meant a literal role-reversal, with back-to-back sessions, one with him as analyst to the patient; one with him as analysand for the patient

Mutual analysis is a therapeutic remediation of the core trauma: authority figures

who created what Ferenczi was to call a confusion of tongues: the child wants adult nurturance and affection but is sexually violated in return; the analysand wants analytic empathy and validation, but is emotionally violated via analytic austerity and skepticism. The patient comes enters in pieces, dissociative. Experiences with authority figures were toxic, tortuous, leading to physical and emotional destruction. (Ferenczi, 1932).

It is not the treatment but the training which is lacking. Ferenczi could both listen to and hear her, as his personal life was now marked by both external and internal suffering. He lost his university position, he lost the freedom of the café society, and he lost peace of mind due to the pogroms. He blamed Freud for his toxic and triangulated relationships with Fraus Gizella, his wife and Elma, his muse. He grew more distant from Freud and his followers, refusing as they did to give credence to his “two terrified children” theories. And internally, he suffered from pernicious anemia, which sapped his strength and his intellect.

Rejecting Oedipus, Ferenczi believed Mrs. Severn and empathized with her experiences:

….before the trauma…atmosphere of trust between …..child…and adults…which is destroyed by an extreme rise in tension in the relationship….The child seeks help from precisely that person…responsible for this rise…If this help is not forthcoming…there will be a split…one part which suffers….another which observes unemotionally and as from a distance and offers comfort…“The involvement of the analyst, the ‘CT’

becomes an important tool.” (Ferenczi, 1932/1988, p. 13).

This countertransference elevates the patient from a one down position into an equal. Instead of the patient the problem, they become the solution. Ferenczi’s solution was to ally with his patients and support their indictments against wrong-doing authority figures. Conquerors do not apologize to the conquered. Oedipus never faced trial for killing Laius.

Ferenczi would not interpret her material via an Oedipal legend.

For Ferenczi, it is a logical next step from collaboration with the patient to the idea of a two children analysis, where the analyst is as vulnerable as the patient. The analyst does not blame the patient for making him reexperience vulnerability. Ferenczi eventually wondered if mutual analysis would “blossom into gangsterism.” (Ferenczi, 1932/1988, p. 74). However, this too could be a positive step, leading to “a founding of a new social order, in which all hypocrisy is absent, receives a new or different kind of support in the extension of mutuality.” He did not view this gangsterism in the sense of lawlessness, but in sense of an altruistic collective. To the very end, he saw the best analysis as that which fostered collaboration and cooperation There is nothing in either behaviorism or psychoanalysis which prevents the psychologist from listening to the patient. And that may be because psychologists may not have experienced being listened to themselves. Listening and actually being heard—not just one person silent for a set amount of time. Listening is active. Both parties are changed by the interaction. Being heard after being listened to is a powerful gift. One can learn new skills in a CBT program. But people only apply them if they feel heard.

That is why analysts need to personally experience an emotional training analysisThe climate created within analysis is one which retraumatizes the patient. “The analytic situation, with its reserve and coolness, professional hypocrisy, and the dislike of the patient ist masks….” (Ferenczi, 1933, p.287Therapist: Empathy, honesty, admission of mistakes. Therapist is natural and sincere, an authority figure who is willing to admit to mistakes. Ferenczi’s confusion of tongues: actual child sexual abuse is more common than was believed and is the ontological precursor to the later onset of borderline and multiple personality disorders. The two terrified children analysis annihilated the eminence of the Oedipal phase. The reason for this terror was caused by the Confusion of tongues: Child wants nurturance (tenderness) and receives sexual assault from the caregiver. Adult sex expressions are confused as nurturant caregiving. An then, adult psychopathology later on—due to the caregiver’s denial of the trauma and blaming the child or threatening severe consequences if the child reveals. The child has to role reverse in secrecy. Not the trauma but the subsequent cover up.

Ferenczi challenged the model of therapy, both Freudian or behavioralism, as a one-up, one-down one is the imparter of wisdom, the other the vessel to which the wisdom is imparted. In mutuality, one listens and is heard and the psychotherapist uses their emotional sensitivity as their lodestar.

Ferenczi: Optimistic. Hypo in re development of consciousness, self-understanding, and object-relationships. Psychoanalysis furthers the ability of the individual to expand their consciousness and language skills, to communicate in a direct and constructive fashion. It is easy to bridge the gap between anomie and altruism. One needs to be heard, the other to listen. Only dotards maintain the mantra that the psychologist must remain aloof is alien to the best praxis. If you cannot use your emotional sensitivities with each encounter, you are rubbish.

Both parties are changed by their encounters. But before change can occur, people must have access. And in America, infamous for its lack of access and private equity control of medicine and psychology, this can, for now, remain only a a hypothesis.

References:

Breuer, J & Freud, S. (1895). Studies on hysteria. Standard Edition, 2. London:

Hogarth Press.

Durkheim, E (1897). Suicide: A study in sociology. Translated J. Spaulding.

NY: (1979) The Free Press.

Falzeder, E. Brabant, E, & Giampieri-Deutsch, P. (Eds.) (2000).The

correspondence of Sigmund Freud and Sandor Ferenczi, Volume 3, 1920-

1933. Cambridge: Harvard University Press.

Ferenczi, S. (1908). The effect on women of premature ejaculation in males. In

Final Contributions to the problems and methods of psycho-analysis.

London: Karnac

Ferenczi, S. (1932). The confusion of tongues between adults and the child.