Technique with Adults, Psychoanalytic
TECHNIQUE WITH ADULTS, PSYCHOANALYTIC
The difficulties Freud experienced in writing the General Method of Psychoanalysis ("Allgemeine Methodik der Psychoanalyse"), which he had announced in 1908 to Carl G. Jung, Sándor Ferenczi, Karl Abraham, and Ernest Jones, are well known. The need for such a manual had become more urgent by 1906, as more students and colleagues showed interest in being initiated into the new method of treatment. Scattered in cities across the world—Zurich, Budapest, London, New York, and Toronto—these followers were busy with their professional responsibilities, and so were unable to complete an apprenticeship under the personal tutelage of the sole master of psychoanalysis.
Freud did not get much past page 36, and it was only after 1910 that he decided to publish the few articles that, until 1915, were generally grouped under his "technical writings." These involved merely a few recommendations, generally of the nature of what should not be done during treatment, lessons learned from years of slow and progressive elaboration of the psychoanalytic method.
The history of Freud's method was marked by some important turning points, especially the progressive abandonment of hypnosis, the substitution of free association for the technique of concentration (1898a), the stress on the interpretation of dreams (1900a), and the emphasis on the analysis of resistance rather than the forced search for "primal scenes," in addition to the primordial role eventually accorded to transference neurosis.
Although the framework of the treatment was in place from 1903, at least in its formal aspect (1904a , 1905a ), it was only in October 1907, with the treatment of the "Rat Man" (1909d) that the last great technical recommendation was announced: "The technique of analysis has changed to the extent that the psychoanalyst no longer seeks to elicit material in which he is interested, but permits the patient to follow his natural and spontaneous trains of thought" (Nunberg and Federn, p. 227).
While questions were raised concerning possible modifications of technique to include psychotic patients, the First World War and its social implications led Freud to anticipate the need to mix the practical aspects of psychotherapy with the ideals of classical psychoanalysis (1919a ), paving the way for multiple modifications in technique, which appeared one after another in the years to come.
Salient among the first modifications were Ferenczi's experiments with "active technique," which, following Freud's example, he pushed at first to an extreme, in opposition to what he denounced as the "fanaticism of interpretation." The work which he published in 1924 with Otto Rank, Perspectives de la psychanalyse (Perspectives on psychoanalysis), was less shocking for the public than the theory that Rank espoused shortly afterwards in The Trauma of Birth, but both Rank and Ferenczi aimed at reducing the length of treatments, and bringing to greater prominence the maternal role of the analyst in the transference. In April, 1926, Rank distanced himself even further from Freud with his book Technik der Psycho-analyse (Technique of psychoanalysis), and in the 1930s, Ferenczi did likewise, especially with his emphasis on [sexually] gratifying behavior, and his experiments with "reciprocal analysis."
On the other hand, Abraham, Ernst Simmel, and Max Eitingon, at the Berlin Polyclinic and Institute, which they created in 1920, codified the technical rules that were to be taught to candidates in psychoanalytic training, based on a "didactic analysis" and supervision. These continue to constitute the basis of teaching at most psychoanalytic institutes.
Among the significant technical "innovations" was doubtless "character analysis," which Wilhelm Reich developed in 1933, and which marked the last great discussions contemporaneous with Freud, apart from the debates concerning analytical technique with children that took place between the disciples of Anna Freud and Melanie Klein. After the war, Jacques Lacan's suggestion to permit sessions varying in length was severely censured by the members of the International Psychoanalytic Association, without discussion, its originator not having supplied sufficient supporting materials for such a proposal.
In the area of classic analytic treatment, modifications multiplied, along with the creation of new techniques loosely connected with psychoanalysis: "psychoanalytically oriented psychotherapy," psychodrama, group psychoanalysis, and so forth.
Freud himself never established rules that were fixed and absolute, commenting even, in introducing his "Recommendations": "The technical rules that I am putting forward here have been arrived at from my own experience in the course of many years, after unfortunate results had led me to abandon other methods. . . . I must however make it clear that what I am asserting is that this technique is the only one suited to my individuality; I do not venture to deny that a physician quite differently constituted might find himself driven to adopt a different attitude to his patients and to the task before him" (1912e, p. 111).
A reading of the memoirs of his analysands well illustrates the liberties he constantly allowed himself in the analysis of his daughter and that of Ferenczi, whom he advised, on June, 1, 1916: "As you've wanted, if your fates allow, I'll save two sessions for you every day. I hope to see you a lot otherwise, and would like you to dine with us at least once a day. Technical rules demand, however, that, outside of the sessions nothing personal be mentioned."
In 1928, at the Hague Conference, Ferenczi, in his presentation on tact, mentioned that "Freud had said 'negative' and 'positive' things about 'tact'; with the result that obedient subjects did not understand how elastic the conventions were, submitting to them as if they were written in stone."
In fact, the technical rules that Freud initially wanted to make more flexible gradually became rigid; his early flexibility was shown by his remark recorded in the Minutes of February 8, 1910: "It is inconsistent to say: I must not impart this or that. This simply cannot be said in such a general way. It is evident that the technique can be practiced with understanding and tact, or otherwise" (Nunberg and Federn, p. 417). Smiley Blanton, his patient, recalls that Freud said, in March 1930: "Now in the matter of papers on technique, I feel that they are entirely inadequate. I do not believe that one can give the methods of technique through papers. It must be done by personal teaching. Of course, beginners probably need something to start with. Otherwise they would have nothing to go on. But if they follow the directions conscientiously, they will soon find themselves in trouble. Then they must learn to develop their own technique" (p. 48).
All the same, freedom is not license, and Freud was clear about this in a letter to René Laforgue, dated July 2, 1928: "If you want to give the beginner the feeling of being a free man, of not being obliged to stick submissively to the rule, to trust his intuition and give free rein to his humanity, I fear that the results will be quite disappointing. His intuition will lead him, unfailingly, in the wrong direction, and as far as his humanity is concerned, any position is closer to this than the analytic position" (1977h [1923-33]).
Since then, hundreds of articles and many books have been published on this subject; among them Edward Glover's (1955) and Ralph Greenson's (1967). The variety and the diversity of their positions show the need to distinguish, in psychoanalytic practice, between a simple "procedure," whether on a trial basis or in an emergency, and a "method" that qualifies as properly psychoanalytic, within which such a procedure will find a place, or not (Mijolla). Processes recognized as effective, along with the theoretical goals that structured them when they were initiated, as well as the definitions of the goals and means of psychoanalysis, all changed as Freud continued to discover things, and were subject to further modification after his death. There is no "method," except one based on a theory of analysis. Method and theory enrich each other in a permanent process of evolution, one that absorbs the lessons of experiments with sometimes ephemeral procedures, together with particular attention to their favorable or unfavorable consequences.
Alain de Mijolla
See also: Action-language; Analyzability; Analysand; Fourth analysis; "Analysis Terminable and Interminable"; Analytic psychodrama; Anticipatory ideas; Attention; Balint, Michael (Bálint [Bergsmann], Mihály); Bion, Wilfred Ruprecht; Character Analysis ; Construction/reconstruction; "Constructions in Analysis"; Cryptomnesia; Evenly-suspended attention; Face-to-face situation; Five Lectures on Psycho-Analysis ; Free association; Fundamental rule; Glover, Edward; Interpretation; "Lines of Advance in Psycho-Analytic Therapy"; Money in the psychoanalytic treatment; Narcissistic injury; Neutrality/benevolent neutrality; Psychoanalyst; Psychotherapy; Racker, Heinrich; "Recommendations to Physicians Practicing Psychoanalysis"; Reich, Wilhelm; "Remembering, Repeating and Working-Through"; Supervised analysis (control case); Termination of treatment; Therapeutic alliance; Tomasi di Palma di Lampedusa-Wolff Somersee, Alessandra; Training analysis; Training of the psychoanalyst; "'Wild ' Psycho-Analysis"; Word association.
Blanton, Smiley. (1971). Diary of my analysis with Freud. New York: Hawthorn.
Ferenczi, Sándor. (1955). The elasticity of psycho-analytic technique. In Final contributions to the problems and methods of psycho-analysis. London: Hogarth and the Institute of Psycho-Analysis. (Original work published 1928)
Freud, Sigmund. (1898a). Sexuality in the aetiology of the neuroses. SE, 3: 259-285.
——. (1900a). The interpretation of dreams. Parts I and II. SE, 4-5.
——. (1904a ). Freud's psycho-analytic procedure. SE, 7: 247-254.
——. (1905a ). On psychotherapy. SE, 7: 255-268.
——. (1909d). Notes upon a case of obsessional neurosis. SE, 10: 151-318.
——. (1912e). Recommendations to physicians practising psycho-analysis. SE, 12: 109-120.
——. (1919a ). Lines of advance in psycho-analytic therapy. SE, 17: 157-168.
Freud, Sigmund, and Laforgue, René. (1977h [1923-33]).
Correspondance Freud-Laforgue, préface d'André Bourguignon. Nouvelle Revue de psychanalyse, 15, 235-314.
Glover, Edward. (1955). The technique of psycho-analysis. London: Bailliere, Tindall & Cox.
Greenson, Ralph. (1967). The technique and practice of psychoanalysis. New York: International Universities Press.
Mijolla, Alain de. (1987). Unconscious identification fantasies and family prehistory. International Journal of Psychoanalysis, 68, 397-403.
Nunberg, Hermann, and Federn, Ernst. (1962-1975). Minutes of the Vienna Psych. Society (Vol. 1: 1906-1908). New York: International Universities Press.