Sándor Ferenczi, “Confusion of Tongues between Adults and the Child: The Language of Tenderness and of Passion” (1933) (I)

Ferenczi’s article renews an “emphatic stress on the traumatic factor in the pathogenesis of the neuroses” (156). As an “exogenous factor,” trauma has been “unjustly neglected” by psychoanalytic theory, in favor of endogenous causes, or “explanations…in terms of ‘disposition’ and ‘constitution’” (156). In this context — and in light of the argument he unfolds — concepts like disposition and constitution seem to indicate an inborn tendency to “fantasy” grounded in drives, whose nature finally accounts for psychic health and illness. On this view, it is not the traumatic incursion of reality into the developing mind per se that puts it on the neurotic path. Instead, it is the developing mind’s “constitutional” endowment of sexual and aggressive drives, shaped into fantasy — which trauma may, but need not, precipitate — that ultimately causes trouble.

In his exhortations to a “deep[er] exploration of the exogenous factor” (156), then, Ferenczi is redirecting the analytic focus to reality-incursion as irreducibly significant. That is, the significance of trauma cannot be reduced to an essentially contingent catalyst for autonomous, drive-based fantasizing. What exactly this independent significance is we do not yet know. But already it is clear that, whatever it is, the presence or absence of trauma will matter greatly, will likely mean the difference between health and neurosis — even in the case of a mind that is constitutionally predisposed towards one or the other.

The reflections in this article originated, Ferenczi tells us, in clinical experiences of confusion, disappointment, and failure, experiences that strained his “orthodox” theoretical framework. In particular, this (Freudian) framework predicted that the “repetitions of traumatic experiences” (156) undergone by his patients in analysis would yield an “abreaction” — a kind of cathartic emotional discharge — so that “large quantities of repressed affects might obtain acceptance by the conscious mind” (156) and bring to an end “the formation of new symptoms” (156).

Yet this was not Ferenczi’s experience. Despite efforts to “conscientiously” analyze the meaning of the symptoms, the “expected permanent success failed to materialize” (157). Indeed, some symptoms worsened and new ones sprung up, “while in the analytic session, repetition of the trauma occurred” (157). Ferenczi summarizes this situation with irony: “The repetition, encouraged by the analysis, turned out to be too good” (157). In other words, in these patients, the repetition would not take the form of a controlled regression, a temporary transference neurosis, and a resulting cathartic “abreaction.” Instead, the repetition was merely a repetition — an unaltered reproduction of the original episode.

Ferenczi’s initial explanations for this result were self-exculpating: he blamed his patients’ “forceful resistance” and “severe repressions” (157) for their deterioration. But these explanations became finally unpersuasive when, “even after a considerable time,” the patients’ condition “did not change in essentials” (157). At this point, once the old framework no longer seemed to apply, Ferenczi began to view these scenes of repetition in a different light:

“I started to listen to my patients when, in their attacks, they called me insensitive, cold, even hard and cruel, when they reproached me with being selfish, heartless, conceited, when these shouted at me: ‘Help! Quick! Don’t let me perish helplessly!’ Then I began to test my conscience in order to discover whether, despite all my conscious good intentions, there might after all be some truth in these accusations” (157)

Now, precisely this last scruple — that “there might after all be some truth in these accusations” — is forestalled by the old, Freudian framework. The general conceit of that approach is that these accusations are in principle ungrounded, functions of “transference,” for which the face-less analyst is a mere receptacle. To seriously inquire into their “truth” is to invest the patient’s projective fantasies with an integrity they lack, or to collude in the distortions of a regressed, infantile mind.

But in raising his “suspicion” and, indeed, in deciding to credit the patients’ accusations as something more than transferences, Ferenczi is able to perceive a characteristic in these patients that is otherwise obscured:

“Gradually…I came to the conclusion that the patients have an exceedingly refined sensitivity for the wishes, tendencies, whims, sympathies and antipathies of their analyst, even if the analyst is completely unaware of this sensitivity.  Instead of contradicting the analyst or accusing him of errors and blindness, the patients identify themselves with him; only in rare moments of an hysteroid excitement, i.e. in an almost unconscious state, can they pluck up enough courage to make a protest” (157-158)

In this respect, Ferenczi’s patients are not the self-enclosed, fantasizing monads predicted by orthodoxy, projecting faces from their past onto an arbitrary placeholder (the analyst), but rather emotional-interpersonal virtuosi who, both in un-regressed and regressed states, are profoundly attuned to the other person as such. At “un-regressed” times, this preternatural attunement takes the form of a self-effacing, compliant “identification”: I unconsciously sound out the analyst’s will and, equally unconsciously, adapt myself to it — say, by accepting his demeanor and interpretations without conscious resistance and excluding from awareness any “critical” impulse I might harbor. But at nominally “regressed” moments, in which “almost hallucinatory repetitions of traumatic experiences” (156) are undergone, the defenses against the awareness and the expression of these critical impulses are lifted: I now give vent to all the accusations that, under normal circumstances, my “identification” conceals both from the analyst and myself.

Here we will observe in Ferenczi’s account an intriguing “inversion” of the relative epistemic values of un-regressed and regressed states of mind. Traditionally, the function of regression, of inducing the transference neurosis, is to elicit the patients’ unconscious distortions in all their undisguised intensity. Normally muted and under control, these illusory transferences, which correspond to nothing “real” in the present, are then experienced in their purest form, whereupon interpretive insight can dissolve the illusion by restoring them to their original, “appropriate” object. (‘I do not really hate the analyst, after all, but rather my father,’ and the like.)

According to Ferenczi’s theoretical revisions, however, the path to truth runs in nearly the opposite direction.  Only when the patient is regressed, that is, “in rare moments of an hysteroid excitement,” does the “truth” actually emerge. What emerges is not merely the patient’s truth, or the presence of an unconscious, distorting lens that applies — if it ever really applied — to a past object that no longer exists. In fact, the truth that finally surfaces in the patient’s hysteroid excitement is the accurate perception of reality as it is — for instance, of the analyst’s imperfections. This is a “perception” from which the patient had protected both the analyst and herself. Briefly stated: on the old view, regression isolates the infantile illusion, which interpretation can then uproot; whereas, on Ferenczi’s view, regression isolates — even liberates — a faculty of reality-perception, of truth, which for reasons having to do with the original trauma the patient had vigorously disavowed.

The analyst is understandably reluctant to acknowledge the patient’s (mainly disguised) hostility or, even more, the objective warrant for that hostility. Yet the hypothetical analyst really does possess a number of “unpleasant external and internal characters traits” (158), often insufficiently uncovered in his or her own analysis, and the mainly compliant patient encourages the analyst’s self-delusions about them. And when, in the hysteroid state, the patient finally does express the criticisms that she otherwise withheld, the analyst may defend against them with the axiom that it is, after all, only transference. (At the time of the article, relatively little personal analysis was required of psychoanalytic candidates. This would sometimes present an “impossible situation” in which some patients, more thoroughly analyzed than their analysts, are more sensitive to their own mental lives, and the analyst’s, than the latter is to either one. Because of their compliant disposition, though, the patient is unable to articulate the insights afforded by this “superiority” (158) of attunement.)

Now Frenczi identifies a more specific object to the patient’s critical, but essentially justified accusations: “hypocrisy” in the analytic setting. This hypocrisy is not an imperfection of this or that analyst, but rather a structural feature of psychoanalysis in its traditional guise. It is, in Ferenczi’s words, a “professional hypocrisy” (158) that looks like this:

“We greet the patient with politeness when he enters our room, ask him to start with his associations and promise him faithfully that we will listen attentively to him, give our undivided interest to his well-being and to the work needed for it. In reality, however, it may happen that we can only with difficulty tolerate certain external or internal features of the patient, or perhaps we feel unpleasantly disturbed in some professional or personal affair by the analytic session” (158-159)

There are inevitable discrepancies in psychoanalysis between word and deed, or between the attitude advertised — unfailingly benevolent attention and interest — and the analyst’s conduct in practice, which must to some degree fail to realize these values. The imperfect analyst, that is, every analyst, will feel some irritation, dislike, or intolerance towards the patient, which sits uneasily with the professed attitude of unconditional benevolence, and the patient, Ferenczi claims, registers this discrepancy as hypocrisy (at least unconsciously).

Now, the way to improve the patient, under these conditions, is surely not to entrench this structural hypocrisy. And yet, Ferenczi argues, this is precisely what analysts, including himself before his discoveries, had attempted. The patient’s condition naturally worsened as a result. This worsening is a logical response to the re-entrenched hypocrisy — the latent indifference or even malice that the analyst tries to conceal with the same assurances of dispassionate benevolence.

Ferenczi’s revisions to technique follow from this recognition. For if the objective, non-fantasied hypocrisy of analysis inflames the patient’s neurosis, then perhaps the rectification of this hypocrisy will alleviate the same condition. What the patient evidently requires from the analyst is honesty, the “truth.” Or rather, since on some level the patient already posses this truth — regarding the analyst’s underlying ambivalence and its deviation from the official benevolence — what is required is the analyst’s frank admission of this truth. He must openly acknowledges the facts of the situations, rather than, as before, virtually compelling the patient to participate in the hypocrisy. This change in approach produced just the desired result:

“[S]uch renunciation of the ‘professional hypocrisy’…instead of hurting the patient, led to a marked easing off in his condition…Something had been left unsaid in the relation between physician and patient, something insincere, and its frank discussion freed, so to speak, the tong-tied patient; the admission of the analyst’s error produced confidence in his patient” (159, my italics).

Such natural ingredients of human relationships as disclosure, confession, and apology are virtually excluded by the analytic technique Ferenczi had until then practiced. Yet these ingredients must be allowed into the analytic situation if the patient is going to be helped, since — as we will see shortly — their absence is what caused the neurosis in the first place. The analyst’s healing honesty — for example, an admission of dislike, or of an error in judgment — seems to give permission to the patient to accept true “perceptions” until then debarred from awareness.

As we just hinted, this discovery in “technique” suggests an intriguing possibility concerning the genesis of the patient’s neurosis. For Ferenczi now introduces an homology between (a) the analytic situation, as experienced by the patient, and (b) the conjectured original situation, in which the patient was first traumatized.

“The analytical situation — i.e. the restrained coolness, the professional hypocrisy and — hidden behind it but never revealed — a dislike of the patient which, nevertheless, he felt in all his being — such a situation was not essentially different from that which in his childhood had led to the illness” (159).

Not only does analysis, thus practiced, resurrect the “content” of the trauma, since the patient is asked to recall the original episode and so re-experience it “in thought.” Analysis also reproduces the “form” of that trauma, the structure of the original relation between adult and child, whose roles are now redistributed to analyst and patient:

“When, in addition to the strain caused by this analytical situation, we imposed on the patient the further burden of reproducing the original trauma, we created a situation that was indeed unbearable. Small wonder that our effort produced no better results than the original trauma”(159-160)

Only once this relational structure is reformed, so that its “form” no longer resembles the original, traumatic one — only then can the “content,” the memories, be recalled without the emotional conflation of present and past, hence re-traumatization. And as we have seen, this structural reformation is achieved through the “honesty” that both situations, original and analytic, had conspicuously lacked. Ferenczi’s word for the salutary effect achieved by this honesty is “confidence”:

“The setting free of his critical feelings, the willingness on our part to admit our mistakes and the honest endeavor to avoid them in future, all these go to create in the patient a confidence in the analyst. It is this confidence that establishes the contrast between the present and the unbearable traumatogenic past, the contrast which is absolutely necessary for the patient in order to enable him to re-experience the past no longer as hallucinatory reproduction but as an objective memory” (160)

In making these prescriptions in technique, Ferenczi is, he insists, simply taking orthodoxy at its word. For he is only accepting the implications of an idea, “regressions into the infantile,” that orthodoxy itself promotes. If the patient really has regressed to an infantile state, and the person in the room really is, for a time, a child, then the traditional analyst’s “cool, educational attitude” (160) can only be experienced as abuse. “The patient gone off into his trance is a child indeed who no longer reacts to intellectual  explanations, only perhaps to maternal friendliness” (160). In addition to hypocrisy, then, the orthodox analyst shares with the adult of the “traumatogenic past” a number of other qualities — coolness, aloofness, imperiousness — which not only prevent him from reaching the patient, but actually “tear to shreds the last thread that connects him to us” (160). The contrasting attitude of “maternal friendliness” or “real sincere sympathy” (161) is a precondition of clinical usefulness in these, and maybe in all cases.

On the face of things, the availability of real sincere sympathy seems to contradict what Ferenczi has just underscored: that the analyst’s benevolence is as a rule ambivalent, tinged by ideas and feelings that are less-than-benevolent. So we must assume that the required “sympathy” needn’t be perfect, unconditional, and unequivocal in order to be effective. This sympathy, on Ferenczi’s assumptions, will be imperfect. What does matter, though, is that this imperfect sympathy is sincere and honest, and not disfigured by “theatrical phrases” (161) which compound the hypocrisy. In any event, patients are undeceived by attempts to simulate this sympathy: they know, through whatever means, whether the sympathy is sincere, “show[ing] a remarkable, almost clairvoyant knowledge about the thoughts and emotions that go on in the analyst’s mind” (161).