Sándor Ferenczi

Contrary to Freud's opinion of therapeutic abstinence, Ferenczi advocated a more active role for the analyst. For example, instead of the relative "passivity" of a listening analyst encouraging the patient to freely associate, Ferenczi used to curtail certain responses, verbal and non-verbal alike, on the part of the analysand so as to allow suppressed thoughts and feelings to emerge. Ferenczi (1980) harvtxt error: no target: CITEREFFerenczi1980 (help) described in a case study how he used a kind of behavioral activation (uncommon in the psychoanalytic therapy at that time) when he asked an opera singer with performance anxiety to “perform” during a therapy session and in this way to struggle with her fears (Rachman 2007).

Ferenczi believed the empathic response during therapy was the basis of clinical interaction. He based his intervention on responding to the subjective experience of the analysand. If the more traditional opinion was that the analyst had the role of a physician, administering a treatment to the patient based upon diagnostic judgment of psychopathology, Ferenczi wanted the analysand to become a co-participant in an encounter created by the therapeutic dyad. This emphasis on empathic reciprocity during the therapeutic encounter was an important contribution to the evolution of psychoanalysis. Ferenczi also believed that self-disclosure of the analyst is an important therapeutic reparative force. The practice of including the therapist's personality in therapy resulted in the development of the idea of mutual encounter: the therapist is allowed to discuss some content from his/her own life and thoughts, as long as it is relevant to the therapy. This is in contrast to the Freudian therapeutic abstinence according to which the therapist should not involve his/her personal life with the therapy, and should remain neutral (ibid.). The mutual encounter is a precedent for the psychoanalytic theory of two-person psychology.

Ferenczi believed that the persistent traumatic effect of chronic overstimulation, deprivation, or empathic failure (a term further elaborated by Heinz Kohut) during childhood is what causes neurotic, character, borderline and psychotic disorders (ibid.). According to this concept, trauma develops as a result of the sexual seduction of a child by a parent or authority figure. The confusion of tongues occurs when the child pretends to be the spouse of the parent. The pathological adult interprets this infantile and innocent game according to his adult "passion tongue" and then forces the child to conform to his passion tongue. The adult uses a tongue the child does not know, and interprets the child's innocent game (his infantile tongue) according to his disturbed perspective. For example, a father is playing with his little girl. During their common game, she offers him the role of her husband and wants him to sleep with her just as he sleeps with her mother. The pathological father misinterprets this childish offer, and touches his daughter in an inappropriate manner while they are in bed together. Here, the child spoke her innocent childish tongue, and the father interpreted her offer with his passionate adult sexual tongue. The adult also attempts to convince the child that the lust on his part is really the love for which the child yearns. Ferenczi generalized the idea of trauma to emotional neglect, physical maltreatment, and empathic failure. The prominent manifestation of these disturbances would be the sexual abuse.[5]

Left to right, seated: Sigmund Freud, Sándor Ferenczi, and Hanns Sachs. Standing; Otto Rank, Karl Abraham, Max Eitingon, and Ernest Jones. Photo 1922

In Thalassa: A Theory of Genitality (German: Versuch einer Genitaltheorie, 1924),[6] Ferenczi suggested that the wish to return to the womb (Latin: regressus ad uterum)[7] and the comfort of its amniotic fluids symbolizes a wish to return to the origin of life, the sea.[8][9] This idea of an "uterine and thalassal regression"[10] became a feature of the so-called Budapest School, up to the disciple Michael Balint and his 1937 paper on "Primary [Object-]Love".[11] According to Ferenczi, all forms of human practice, especially sex, were an attempt to reestablish genitalia with the intrauterine experience – a theory which resonated with architect Richard Neutra and may have inspired, or supplemented, Neutra's fascination with uterine suspension.[12]