Freud, “The Aetiology of Hysteria” (1896) (I)
Freud distinguishes two procedures for approaching hysteria and identifying its causes. The “method of anamnestic investigation” (191) credits the views of the patients, and those of the patient’s acquaintances, regarding the hysteria’s origin. “[W]e question the patient or those about him in order to find out to what harmful influences they themselves attribute his having fallen ill and developed these neurotic symptoms” (191). These attributions are doubtful, however, often reflecting the patient’s various blind spots — scientific ignorance, logical blundering, and psychological defense — and contradicted, further, by evidence yielded by the “second method of arriving at the aetiology of hysteria” (191). This second approach, which Freud likens to those of the dermatologist (191) and forensic physician (192), disregards the patient’s own conjectures about the hysteria, at least to a point, in favor of directly “penetrating from the symptoms to a knowledge of their causes” (192).
Now, I have softened this contrast slightly — ‘at least to a point’ — since the patient’s testimony concerning the illness remains indispensable in the second approach: namely, in the form of his or her memories and associations. Indeed, the process of eliciting this testimony evidently constitutes the better part of “Breuer’s method,” as it is now named. The therapist “lead[s] the patient’s attention back from his symptom to the scene in which and through which that symptom arose” (193), hence demands the patient’s cooperative “reproduction of the traumatic scene” (193). Nevertheless, compared to “the older method of anamnestic enquiry” (192), the new one has little use for the patient’s self-attributions, while his or her “symptoms” themselves are elevated in importance.
With the patient’s assistance, then, the analyst deciphers these symptoms for their “meanings.” In Freud’s words, the second method, but not the first, “induce[s] the symptoms of a hysteria to make themselves heard” (192) and, following this inducement, the symptoms appear as “witnesses to the history of the origin of the illness” (192). Thus the second method — symptom decipherment — rests on the premise that “symptoms of hysteria…are determined by certain experiences of the patient’s which have operated in a traumatic fashion and which are being reproduced in his psychical life in the form of mnemic symbols” (192-3). In this way, analysis uncovered the “efficient causes of hysteria” (193) — its aetiology — in certain “traumatically operative scenes” (193).
Freud now allows that, while the new “method” is fundamentally sound, “the difficult technique of this therapeutic procedure” (193) is not easily implemented. This hedge is repeated several times. Freud cautions the reader that “general doubt about the reliability of the psycho-analytic method can be appraised and removed only when a complete presentation of its technique and results is available” (204) — so implying that such a complete presentation is as yet impossible. And in the article’s concluding paragraph, while welcoming “the attention you give to the procedure I have employed,” Freud reminds us again that the “procedure is new and difficult to handle” (220).
In particular, “the path from the symptoms of hysteria to its aetiology” is, as a rule, “laborious” (193). The path is laborious, not only because of the sophistication and subtlety demanded of the analyst by the method, but because of the “material” itself. In general, the analysis unfolds sequentially, in stages that cannot be abridged or accelerated. The initial “stage” is especially apt to discourage, since it confronts the analyst with unexpected and perplexing data. Why is this?
Freud’s methodological premise, recall, is that the hysterical symptom (say, vomiting, or leg paralysis) expresses (symbolically) an unconscious memory of some traumatic scene. Yet the first “scene” reproduced by the patient frequently lacks the desiderata of a traumatic experience:
“Tracing a hysterical symptom back to a traumatic scene assists our understanding only if the scene satisfies two conditions; if it possesses the relevant suitability to serve as a determinant and if it recognizably possesses the necessary traumatic force” (193)
In other words, to adequately explain a symptom, a “scene” — whose unconscious memory is preserved in and as that symptom — must satisfy qualitative and quantitative criteria. Qualitatively, the ostensibly traumatic event must be of the correct type, or “suitable.” In Freud’s example, a symptom expressing disgust, like vomiting, must be indexed to the memory of an experience meriting disgust — and not, say, “fright” (193-4). Quantitively, the recollected experience must surpass some threshold of affective intensity, a magnitude of “traumatic force.” Otherwise this affect, too, will fail to account for the emergence and persistence of a “symptom” in lieu of its original “discharge.”
Yet Freud tells us that the first “trauma” that surfaces in analysis, to which the patient associatively links the symptom, typically lacks these characteristics: the recollected scene is either qualitatively unsuitable, or quantitively negligible, or both, and so cannot explain the symptom. How, then, does Freud reconcile (a) the theory that symptoms express memories of trauma with (b) the observation that these symptoms appear to originate in emphatically non-traumatic, or unsuitably traumatic experiences? In fact, the patient’s reproduction of such explanatorily “insufficient” scenes neither seems to comport with the theory of hysteria nor delivers any real relief — it “fail[s] to secure any therapeutic gain; the patient retains his symptoms unaltered” (195).
Freud continues, however, that the perceived discrepancy between theory and evidence, as well as the therapeutic disappointment, are both overcome by pressing on with the analysis. The problem is not the theory of hysteria or the associative-recollective method predicated upon it; rather, the analyst and patient have arrived at a premature result. The first “scene” uncovered in analysis, while perhaps the proximate cause or catalyst for the symptom, is neither its “origin” nor underlying explanation. To discover these, says Freud — that is, to find a scene that in the patient’s life does satisfy the traumatic desiderata of suitability and force — one must look further into the past:
“If the memory which we have uncovered does not answer our expectations, it may be that we ought to pursue the same path a little further; perhaps behind the first traumatic scene there may be concealed the memory of a second, which satisfies our requirements better and whose reproduction has a greater therapeutic effect” (195)
The first scene, then, is as a rule not the “final” one — hence fully illuminating and therapeutic — but “behind it there must be hidden a more significant, earlier, experience; and we direct his attention by the same technique to the associative thread which connects the two memories” (195-6). By applying the recollective-associative method in this consistent, thoroughgoing way, analysis arrives, first, at memories dating to puberty of uniformly sexual scenes that are by appearance more likely to warrant a traumatic reaction. Yet because these pubescent scenes also frequently fail to satisfy the Freud’s stated traumatic “desiderata,” analysis continues on to a second cluster of unconscious memories — this time, of infantile sexual scenes. So emerges the notorious “thesis” of the article:
“I therefore put forward the thesis that at the bottom of every case of hysteria there are one or more occurrences of premature sexual experience, occurrences which belong to the earliest years of childhood but which can be reproduced through the work of psycho-analysis in spite of the intervening decades” (203)
Earlier in the article, and in preparation for this thesis, Freud had introduced a “conclusion” reached through “analytic work along these chains of memory” (197). This conclusion seems to anticipate the psychoanalytic doctrine of ‘retroactive trauma’:
“We have learned that no hysterical symptom can arise from a real experience alone, but that in every case the memory of earlier experiences awakened in association to it plays a part in causing the symptom” (197)
In summary, the claim is that “hysterical symptoms can only arise with the co-operation of memories” (197), and that, “even in such instances” where a trauma that is suitable and forceful is located, nevertheless “there exists a chain of operative memories which stretches far back behind the first traumatic scene” (197).
Harry Stack Sullivan, “The Data of Psychiatry” (1938)
I want to comment on the article’s opening, metapsychological remarks. Here Sullivan identifies the proper “object” of that branch of science called psychiatry: a constellation indicated by the cognates “person,” “personal,” “personality,” and — as it happens — “interpersonal.” With these remarks, Sullivan reveals something about his theoretical position regarding, not only the differentia of psychiatry and its special object, but scientific inquiry more generally.
The article’s first sentences stipulate: “Psychiatry as a science is concerned with the thinking and doings of persons, real and illusory. Everything personal is data for psychiatry, and relevant exactly to the extent that it is personal” (7). We will immediately note several peculiarities of Sullivan’s technical language, which is often introduced without elaboration. First, by “personal” Sullivan appears simply to mean, ‘pertaining to persons,’ and emphatically not the term’s colloquial associations. In many contexts, that is, the “personal” connotes what is most private — ‘That’s too personal to discuss in public’ — and, as a rule, idiosyncratic to the person in question. But just these associations must be kept to one side, since for Sullivan they are precisely not the objects with which his science deals. As he will emphasize, psychiatry is in this respect no exception to the rule of every science, since it, too, investigates objects in their universality. The physicist and biologist treat their electron and cat, not under the aspect of their non-fungible uniqueness, but as vehicles of universal types, structures, and laws (8).
Second, when Sullivan writes that data is “relevant” to psychiatry “exactly to the extent that it is personal,” he is suggesting that even ostensibly non-personal factors — say, the “subpersonal” (7) of human biology, or the “impersonal” (7) of culture — fall under psychiatry’s purview inasmuch as they inform, or follow from, the “personal” in the strict sense. The biological substrate of human beings — the direct concern of biology — nevertheless bears in predictable ways on “personal” thoughts and behavior, while also “signifying” personal states to the observer. (Later in the article, Sullivan illustrates these connections by imagining the subtle biological and physiological changes undergone by the subject of a hypothetical clinical case, “Mr. A,” in response to an interaction with his wife, “Mrs. A” (15-16).) Likewise, the structures and patterns examined by social scientists will connect with the “personal” — the characteristics of “persons” — in ways that psychiatry may isolate. Institutions and culture are, after all, in the first instance products of “persons” and the enduring arena of the “personal” — even if they also enjoy a kind of autonomy with respect to their participants, or “persons.”
Third, we are told that psychiatry’s content is “the thinking and doings of persons, real and illusory.” Here again, Sullivan uses a common word — illusory — in ways that depart from convention. I may dip a straight rod into a pool of water and create the illusion that it is bent — a distorting perception that misrepresents reality as it is, or at least as it’s normally perceived. Other types of illusion, too — the desert mirage, the outright hallucination — share this property of misrepresenting reality, since they are perceptions that either correspond to nothing real, or correspond to something real in a questionable way. Yet when Sullivan contrasts “real and illusory” in his opening stipulation, it is unclear whether he has these conventional meanings in mind.
In fact, the “illusory” phenomena that recur in the article are not always, or even usually agents of reality-misrepresentation of the kind the word may lead us to expect. The “illusory persons” in Mr. A’s mind, each of which represents to Mr. A one “face” of someone with whom he has a manifestly vital, “real” relationship — these are hardly figments of imagination, at least in most scenarios, but rather the normal ways in which individuals appear to one another. Indeed, we must appear to one another in this way: as “parts” of ourselves based on histories of specific interpersonal configurations. If “illusion” is nevertheless an apt expression in this context, it is perhaps to the extent that these self- and other-images, which may legitimately capture a side, or several, of the dramatis personae in our interpersonal lives, are on occasion construed as the total truth. These persons are illusory in a quite restricted sense: the illusion consists in our mistaking “part” of the experience or person for the “whole.”
After introducing these stipulations, however, Sullivan further restricts the focus of psychiatry to its proper object: “The primary concern of psychiatry as a science…is relatively narrow. Psychiatry seeks to discover and formulate the laws of human personality” (8). The third of our cognates, following “person” and “the personal,” human “personality” appears to designate the abstract structure, organization, or pattern common to all persons, the functioning of which is fundamentally “lawful.” This does not mean, of course, that all persons are the same, or that this shared structure appears in each instance as identical. But it does mean that the same universal ingredients, mechanisms, and principles of personality will apply in every individual. To introduce an analogy: though bodies in space are uniquely constituted — this stone is rather unlike that table — each submits to the same gravitational laws.
While his approach to the subject has been novel — including the uncommon use of common vocabulary — Sullivan has not yet, as far as I can tell, departed much from precedent. I imagine the typical psychiatrist — or rather, the psychologist — could with a little effort recognize her method, activities, and object in Sullivan’s descriptions of the science. At this point, however, Sullivan re-describes the psychiatric arena in a way that probably would strike his contemporaries as innovative. What are the “laws of personality,” after all, and where are they to be found? Psychiatry’s “peculiar field,” Sullivan writes, “is the study of interpersonal phenomena. Personality is made manifest in interpersonal situations, not otherwise. It is to the elucidation of interpersonal relations, therefore, that psychiatry applies itself” (8).
Both the balance of his metapsychological remarks and the hypothetical clinical vignette that follows help to clarify the content and implications of this innovate re-description of psychiatry. That psychiatry investigates “persons” and the “personal,” and that the “laws of personality” are in this way uncovered — this is essentially uncontroversial. But that this program involves us necessarily in the interpersonal, and, beyond this, exclusively in the interpersonal — this is controversial. And the meaning, let alone the validity of this amendment are far from self-evident.
The personality whose laws we wish to identify is neither “observed directly” (8) nor, as we already indicated, a “unique individuality” (8). Again, this description applies per definition to scientific objects: the researcher is not interested in (a) the “sensible” or (b) the suis generis “particular,” except as bearers of lawful regularities that are themselves neither sensible nor particular. The personality is in these respects no different from any other scientific object, which the “correct view of personality” (8) recognizes as a “hypothetical entity” that psychiatry “postulates to account for the doings of people, one with another, and with more or less personified objects” (8). (“Personification” now enters Sullivan’s account as another cognate.)
Here Sullivan flags the error that overtakes psychiatry — “the very mother of illusions” (8) — the moment it ignores these stipulations: it loses itself in “the traditionally emphasized individuality of each of us” (8), an approach entangled with “preconceptions that invalidate almost all our efforts to understand other people” (8). These “delusions of unique individuality” (8) include centrally the false notion of a person as “a self-limited unit that alternates between a state of insular detachment and varying degrees of contact with other people and with cultural entities” (8). (In these lines, Sullivan deviates from his pattern and restores to the words “illusion” and “delusion” the more common meaning of “false belief.”)
The last assertion, taken as the culmination of even a loose argument, strikes me as a logical non sequitur. We may agree entirely with the position that (a) scientific knowledge abstracts from the particularities of sense-experience; hence (b) psychiatry as a science treats its object, personality, as a hypothetical, non-sensible postulate governed by universal laws; and still imagine — as least in principle — that (c) “personality” entails persons as “self-limited unit[s]” who behave with others, and culture more generally, in the way Sullivan facetiously describes. Both the atomism of individual partes extra partes and the holism of Sullivan’s dynamic configurations may involve postulating a non-sensible, generic “personality.” In other words, Sullivan’s conceptions of the person, the personal, and personality do not perforce demand the “interpersonal” turn that he now gives to all three — even if his language presents it as a sound inference. Better, then, to receive the comment not as the culmination of an argument, but as an assertion to be illustrated — though not, perhaps, deduced — in the article.
Sándor Ferenczi, “Confusion of Tongues between Adults and the Child: The Language of Tenderness and of Passion” (1933) (II)
In the article’s second half, Ferenczi “report[s] on some new ideas” (161) occasioned by his basic discovery in technique and the heightened intimacy it nourished. These new ideas relate above all to “sexual trauma…as the pathogenic factor” (161) — a restriction of Ferenczi’s focus from “trauma” in some more generic sense. He begins, in fact, simply by reiterating the reality of this abuse: “children…fall victim to real violence or rape much more often than one had dared to suppose” (161). And this, of course, is a revival of Freud’s original “seduction theory,” later discarded in favor of a theory of the child’s “fantasy” life. Ferenczi address the controversy directly:
“The immediate explanation — that these are only sexual fantasies of the child, a kind of hysterical lying — is unfortunately made invalid by the number of such confessions, e.g. of assaults upon children, committed by patients actually in analysis” (161)
After insisting on the reality, and unsuspected frequency, of sexual abuse, Ferenczi continues to specify the characteristics of this abuse — of the adult and child in their interaction — and in a way that gradually enriches the proposed analogy between the traumatic setting and the (orthodox) analytic one.
It is here, in fact, that the “confusion of tongues” named in the article’s title makes its first appearance. Ferenczi represents sexual abuse as substantially, though not exclusively, a type of mutual misunderstanding or “confusion” based on two, incommensurable languages or “tongues”: the child’s and the adult’s. The child’s language is defined by “playful fantasy” and, though this fantasy “may assume erotic forms,” the whole production “remains…on the level of tenderness” (161). Ferenczi provides only one illustration here: the child’s commonplace “fantasy of taking the role of the mother to the adult” (161). He does not elaborate upon the “erotic forms” taken by this tender-minded play, but they presumably include fantasies of physical contact and intimacy.
By contrast, the adult’s language of “passion” does not remain at this level of tenderness; nor does he construe the child’s language as essentially tender play, but as a “dialect” of his own, passionate language. These disturbed adults “mistake the play of children for the desires of a sexually mature person” (161), and catastrophically act upon that mistake .
Ferenczi now identifies some of the reasons that, contrary to our natural expectations, the child does not resist the adult’s violation or express “hatred, disgust and energetic refusal” (161). Instead, “paralyzed by enormous anxiety” and feeling “physically and morally helpless,” mentally and emotionally undeveloped children will “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” (162). Some such experience, we gather, explains that emotional-interpersonal virtuosity Frerenczi ascribed earlier to certain patients. This virtuosity now appears in a new light: as the particular survival skill demanded of that patient by the original trauma. So far as the child inuits, only such a strategy — of comprehensive subordination to an adult “will” which must, for that reason, be immediately deciphered in all its sophistication — will save his or her life.
There is evidently a logical sequence involved. (a) Sensing danger, I realize that, to survive, I must make myself a function of the adult will. But (b) this is impossible for me to the degree that this adult will — the mature language of “passion” — remains opaque. Therefore, under this pressure, I (c) spontaneously unseal the suite of abilities that ordinarily do not emerge until adulthood. Later, Ferenczi canvasses this phenomenon as
“the sudden, surprising rise of new faculties after a trauma…Great need, and more especially mortal anxiety, seem to possess the power to waken up suddenly and to put into operation latent dispositions which, un-cathected, waited in deepest quietude for their development” (164-165)
He grounds these actions in “identification” and “introjection”: two operations that make the overwhelming trauma emotionally manageable and thus permit the needed adaptation. On the one hand, once introjected or absorbed as as an inner, “intrapsychic” object, the threatening adult can be confront and controlled “in fantasy,” an option unavailable “in realty,” while “as a rigid external reality” (162) the adult “ceases to exist” (162). On the other hand, the child “identifies” with the adult. She does this not, in the first instance, in the sense of “imitating” the adult’s demeanor. (After all, if the adult is aggressive and menacing, it would hardly make existential sense for a child to embody these qualities, given the context.) Rather she identifies with the adult, again, in the sense of conforming to the adult’s will, thus feeling and behaving in ways that “correspond” to those of the adult (without necessarily “mimicking” them). Once again, this adaptation explains, years afterwards, the intuitive “powers” of Ferenczi’s patients:
“The fear of an uninhibited, almost mad adult changes the child, so to speak, into a psychiatrist and, in order to become one and to defend himself against the dangers coming from people without self-control, he must know how to identify himself completely with them” (165)
Among the devastating psychological consequences of this trauma for the child and future-patient, two in particular stand out. First, Ferenczi cites “the introjection of the guilt feelings of the adult” (162), an action enabled by the child’s magnified sensitivity and induced, it seems, by the adult’s need to delegate his own intolerable guilt to the victim. Second, the child’s “confidence in the testimony of his own senses is broken” (162). This consequence again throws light on the situation of Ferenczi’s patients, who seemed unaware either of their critical perceptions of the analyst (his coldness and cruelty) or their feelings in reaction to these perceptions (fear, anger, and hurt). Only in regressed states would the patient gain access to these.
To survive, then, the traumatized child disavowed her own perceptions and feelings: only those consistent with the adult’s will, with which she now identified, “counted” for anything. Ferenczi’s patient has, it seems, conserved into adulthood this systematic mistrust of her own experience and, conversely, a systematic deference to those of the “adult,” or analyst. Indeed, Ferenczi’s very language here, that trauma has broken the child’s “confidence,” echos his earlier description of his new clinical desideratum: “the admission of the analyst’s error produced confidence in his patient.” In other words, it is experiential “confidence” that the traumatized child has lost; and it is just this confidence that well-conducted, honest analysis restores.
Unsurprisingly, Ferenczi roots the article’s heterodoxy in Freud’s own thought, albeit from an early phase: “Here we must revert to some of the ideas developed by Freud a long time ago according to which the capacity for object-love must be preceded by a stage of identification” (163). Ferenczi conceives this initial “identification” stage — through which children must pass on their way to mature, sexual, and “passionate” object-love — as marked by “passive object-love or of tenderness” (163, my italics). But in calling this necessary childhood experience a tender “stage of identification,” Ferenczi qualifies an impression left (at least in this reader) earlier in the article. For initially, Ferenczi seems to present “identification” as a suis generis defense mechanism activated in the child by traumatic experience. According to this recent qualification, however, “identification” rather names the child’s first, basic orientation towards the world — not necessarily a defensive one — in all situations. Thus the child’s spontaneous “identification with the aggressor” in threatening moments is not some new existential strategy, but an extreme, pathological instance of her basic comportment.
In the concluding pages, Ferenczi deepens his account of the difference between the child’s tenderness and the adult’s passion — their distinct causes and qualities. While we may detect intimations of adult object-love in the child’s original identifications, these are in fact present “only in a playful way in fantasies” (163). This early fantasizing is unmistakably Oedipal, “the hidden play of taking the place of the parent of the same sex in order to be married to the other parent” (163). Nevertheless, “it must be stressed that this is merely fantasy; in reality the children would not want to, in fact, they cannot do without tenderness” (163-164). Inseparable from the “tenderness” of this stage, then, is the place of fantasy in opposition to reality. This tenderness can survive only where adults honor this opposition, or insulate child’s free fantasizing from real “consequences.” Here Ferenczi cites harsh punishment as one way in which adults dishonor this vital opposition:
“The playful trespasses of the child are raised to serious reality only by the passionate, often infuriated, punitive sanctions and lead to depressive states in the child who, until then, felt blissfully guiltless” (164).
This last quote enlarges our understanding of tenderness. For it is not merely any reality from which the child’s tender fantasies must be protected. It is specifically the adult’s “passion” — which, on the evidence, involves converting fantasy into reality, “enacting” it — that traumatizes the child by, among other things, introducing the awareness of guilt. Though Ferenczi doesn’t put things in just this way, the idea seems to be: so long as the child’s fantasy is insulated from reality, no real “guilt” can arise. In this context, guilt presupposes an awareness that fantasy can and does incur negative, potentially destructive consequences — precisely the awareness from which adults ordinarily protect the child. Similarly, sexual abuse involves “the precocious super-imposition of love, passionate and guilt-laden on an immature guiltless child” (164). In either case, traumatic contact with adult “passion” robs the child of her tender “innocence.” It does this, first, by suspending the boundary separating fantasy and reality that otherwise protected her; and second, by inducing the child to “introject” the adult’s guilt-feelings related to the abuse.
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).
Freud, “Charcot” (1893)
Freud’s early tribute to Jean-Martin Charcot serves well as an introduction to Freud himself. The obituary conveys Freud’s “style”; his scientific and philosophical values; his self-understanding as an experimenter and innovator; his perceived challenges and opposition; and, more concretely, his program as a psychological researcher.
We may roughly distinguish between form and content in this — mainly laudatory — piece. By “form,” I mean those general attributes, capacities, and tendencies in Charcot that Freud plainly admires and will gradually attempt to embody himself. By “content,” I have in mind those particular ideas, theories, and positions at which Charcot, the scientist, arrives — and towards which Freud’s praise is comparatively equivocal.
In these reflections I will emphasize the “form.” This includes Charcot’s personal, “human” qualities: charisma, warmth, accessibility, and a fundamentally egalitarian ethos. (Freud cites his “kindly openness” and “life-long loyalty” towards pupils, but also the “magic that emanated from his looks and from his voice” (16.) It includes, too, Charcot’s values as a researcher: scientific probity and humility, dedication to empiricism, and skepticism of theory-building unmoored from observation — all combined with a a bold, experimental spirit. And Freud especially praises the “type” of Charcot’s achievements: imparting scientific legitimacy to formerly-maligned subjects (paradigmatically hysteria), overturning traditional dogma (even if succumbing, Freud indicates, to several of his own), and, where necessary, courageously incurring the opposition of the conservative establishment.
Foremost among the man's “special gifts” — and a perfect illustration of the “formal” side of Freud’s admiration — was an essentially non-theoretical, “intuitive” approach to the object of research. “He was not a reflective man, not a thinker: he had the nature of an artist — he was, as he himself said, a ‘visuel,’ a man who sees” (12). This quasi-aesthetic intuition, Freud writes, was based on an immersive empiricism.
Indeed, Freud dedicates a couple of colorful passages to underscoring, illustrating, and — it seems — justifying Charcot’s radical empiricism. In these passages, Freud draws the invidious comparison between the “reflective man” or “thinker” and Charcot, whose “method of working” consisted rather in “look[ing] again and agin at the things he did not understand, to deepen his impression of them day by day, till suddenly an understanding dawned on him” (12). The “things” about which Charcot, after this prolonged exposure, came to sudden illumination, were the “great number of chronic nervous patients at his disposal” (12). Charcot’s first-hand contact with these patients was, Freud implies, to an unusual degree “pure” — that is, unclouded by theoretical prejudice. “Concept” followed “intuition,” the primacy and authority of the senses. Once the repetition of sense-experience reached a certain threshold, the immanent structure of Charcot’s object would present itself spontaneously to his intelligence:
“In his mind’s eye the apparent chaos presented by the continual repetition of the same symptoms then gave way to order: the new nosological pictures emerged, characterized by the constant combination of certain groups of symptoms” (12)
Again, this would occur without any specifically theoretical effort on Charcot’s part — say, in the form of reflection upon logical chains of inference and deduction. The conclusion — the “new nosological pictures” — appeared rather to spring fully formed from a pre-reflective level. Freud’s subsequent self-identifications as a man of science, his unyielding characterizations of psychoanalysis as a legitimate branch of science, as well as the care he took to distinguish his program from the empty cogitations of “philosophy” — all echo these early comments on Charcot’s principles and method.
In “this kind of intellectual work,” writes Freud, Charcot “had no equal,” and it yielded to him “the greatest satisfaction” he could conceive: namely, “to see something new,” or, more precisely, “to recognize it as new” (12). Implied in these descriptions, I suppose, is the idea that, wherever it is authentic, scientific discovery is conditioned by these quasi-aesthetic experiences and values. In fact, it is only by virtue of the type of intellectual intuition cultivated by Charcot that the scientist, and science generally, are able to “advance” at all, since they are otherwise encumbered by theoretical preconceptions that obstruct access to the object as it is. In this way, Charcot transcended the myopia of a “medicine [in which] people only see what they have already learned to see” (12).
Intellectual intuition becomes both the method and aim of science, so interpreted: an approach to the world that (as far as possible) brackets one’s ideas about it; and also the end result, the final disclosure of the “new” in the midst of the old. In this respect, Charcot’s scientific conduct purportedly evokes Adam, in Genesis, before whom “God brought the creatures…to be distinguished and named (13), thus providing him with precisely “that intellectual enjoyment which Charcot praised so highly” (13). The substance of this comparison is the undiluted experience of an object — the animals of creation, nervous disorders — as something utterly new. Mythically speaking, Adam is the first to perceive, name, classify, and grasp the world — and so he must invent the names, concepts, and categories with which to organize that experience. So Charcot, adhering in his way to intellectual intuition, approaches a similar convergence between discovery and creation — for he can capture the new object, formerly unseen or ignored, only by evolving a new framework that is equal to its features.
To reiterate the distinction I drew above: Freud directs most of his praise, not towards Charcot’s conclusions, the particular scientific views he held — here Freud’s praise is tempered — but towards the values, ideals, and principles that guided him in his vocation. Charcot embodied an unprejudiced receptivity to experience; took seriously a phenomenon, hysteria, previously scorned by scientists; expressed humility regarding his uncertainties, but also ambition, disregarding doxa and defending convictions, once reached, even when it inspired antagonism: “The construction of this great edifice was naturally not achieved without violent opposition…the sterile opposition of an old generation who did not want to have their views changed” (21). These qualities and patterns of Charcot’s life, after which Freud can unreservedly model himself — the “how” — appear more important than the “what,” the content itself, or the doctrine which, by the time of the obituary, scientific criticism had already substantially weakened and which, in the closing paragraphs, Freud predicts will continue its decline.
Intriguingly, the scientific “hypothesis” that Freud expounds in this text with the greatest care and apparent interest did not belong to the man he is ostensibly eulogizing. It is Freud’s. In particular, it is an early intimation of his eventual theory of unconscious mental life, which — on a questionable pretext — he manages to insert into the obituary. Whereas Charcot “treated hysteria as just another topic in neuropathology” (20) — an attitude belied, it seems, by his own famous experiments in hypnosis — for Freud the “picture” looks at least potentially much different. I want to quote this hypothetical picture at length, not only on account of its value as an early anticipation of a mature doctrine, but because it helps clarify the limits Freud perceives even in Charcot’s “greatest achievement” (22), his experiments with hysterics under hypnosis. Freud outlines his own explanation — “the theory of a splitting of consciousness as a solution to the riddle of hysteria” (20) — as follows:
“[T]he question could arise as to what method of approach would lead most quickly to a solution of the problem. A quite unbiassed observer might have arrived at this conclusion: if I find someone in a state which bears all the signs of a painful affect — weeping, screaming and raging — the conclusion seems probable that a mental process is going on in him of which those physical phenomena are the appropriate expression. A healthy person, if he were asked, would be in a position to say what impression it was that was tormenting him; but the hysteric would answer that he did not know. The problem would at once arise of how it is that a hysterical patient is overcome by an affect about whose cause he asserts that he knows nothing. If we keep to our conclusion that a corresponding psychical process must be present, and if nevertheless we believe the patient when he denies it; if we bring together the many indications that the patient is behaving as though he does know about it; and if we enter into the history of the patient’s life and find some occasion, some trauma, which would appropriately evoke precisely those expressions of feeling — then everything points to one solution: the patient is in a special state of mind in which all his impressions or his recollections of them are no longer held together by an associate chain, a state of mind in which it is possible for a recollection to express its affect by means of somatic phenomena without the group of the other mental processes, the ego, knowing about it or being able to intervene to prevent it…Charcot, however, did not follow this path towards an explanation of hysteria” (19-20)
Now, what “method of approach,” exactly, is reflected in Freud’s solution to the puzzle of hysteria? The quoted passage is bookended by statements of two, contrasting “methods.” One method belongs to Charcot, who “did not follow this path towards an explanation of hysteria” (20), but instead, Freud continues, “treated hysteria as just another topic in neuropathology” (20), with its tools of description, classification, and through these the identification of “uniformities” and “laws” — thus providing the eventual basis for diagnosis. But these last do not seem to be the methodological “tools” either of the “quite unbiassed observer” or of Freud (whose avatar, of course, this “observer” unquestionably is). What, then, is this observer’s “path toward an explanation of hysteria”?
As a first approximation, we might say that the approach indicated is “psychological” rather than “nosological.” Later, Freud himself will express one basic doctrinal disagreement with Charcot in these terms: “But the exclusively nosographical approach adopted at the School of the Salpêtrière was not suitable for a purely psychological subject” (22). In that case, however, we must inquire: what is the meaning of this distinction, at least in the context of the passage I’ve extensively quoted? Simply put: in what respect or respects does Freud’s unbiassed observer manifest a “psychological” approach to the object — the phenomenon of hysteria — either instead of, or in addition to, the “nosological”?
I will suggest two possible differentia to the psychological method — on the evidence, in any case, of the observer’s conduct in the passage. On the one hand, and most obviously, one’s attention is narrowed to a range of phenomena that are themselves psychological: in the first instance, to a person’s thoughts, beliefs, desires, and feelings, and then, beyond these, to the person’s outward behavior inasmuch as it expresses — or seems to express — those “inner” mental contents. Whereas Charcot’s nosology pertained broadly — notwithstanding his experiments in hypnosis — to the “outer,” especially the organic and anatomical, the example Freud considers is inseparable from the “inner” and its seeming manifestations. So the unbiassed observer who approaches the object “psychologically” does not attend to all outer phenomena indiscriminately (say, to physiological deterioration), but specifically to the sort that is redolent of the “mental” — in Freud’s illustration, to “signs of a painful affect — weeping, screaming and raging” that evince “a mental process…going on in him.”
On the other hand, and closely related to the puzzle of hysteria, the psychological method seems in the nature of things to involve a form of inferential, “depth” analysis that is both unnecessary and inappropriate in the application of nosology. Not only, that is, does the psychological method presuppose a specifically psychological object — thoughts, feelings, and the like. It also presupposes a form of analysis, interpretation, and reflection that are commensurable with that object. In comparison, Charcot’s nosology begins to resemble a “zoological” program: description and classification suffice, since there is no “inner” to which he need infer. The unbiassed observer’s approach to hysteria rests on the intuition of a distinctively psychological puzzle: the perceived discrepancy between (a) the hysteric’s behavior, and (b) the hysteric’s conscious mental state, which does not seem compatible with that behavior. Our registration of this discrepancy — by definition unnoticed in nosology —forces an “inductive” movement: if otherwise intelligible behavior, such as weeping, does not express the hysteric’s conscious mental state, then it must express a mental state — “mental process,” “impression,” “psychical process,” “recollections” — that is unconscious, but nonetheless gives rise to the observed behavior.