the elasticity of psychoanalytic technique

V I I I

T H E E L A S T I C I T Y O F P S Y C H O - A N A L Y T I C

T E C H N I Q U E 1

(1928)

Lecture given to the Hungarian Psycho-Analytical

Society, 1927

EFFORTS to make the technique which I use in my psycho

analyses available to others have frequently brought up the

subject of psychological understanding. I f it were true, as so

many believe, that understanding of the mental processes in a

third person depends on a special, inexplicable, and therefore

untransferable faculty called knowledge of human nature, any

effort to teach my technique to others would be hopeless. For

tunately it is otherwise. Since the publication of Freud's

'Recommendations' (1912-15)2 on psycho-analytic technique,

we have been in possession of the first foundations for a methodi

cal investigation of the mind. Anyone who takes the trouble to

follow the master's instructions will be enabled, even if he is not

a psychological genius, to penetrate to unsuspected depths the

mental life of others, whether sick or healthy. Analysis of the

parapraxes of everyday life, of dreams, and in particular of free

associations, will put him in a position to understand a great

deal about his fellows which was previously beyond the range

of any but exceptional human beings. T h e human predilection

for the marvellous will cause this transformation into a kind of

craft of the art of understanding human nature to be received

with disfavour. Artists and writers in particular appear to

regard it as a kind of incursion into their domain and, after

showing initial interest, summarily reject and turn their backs

on it as an unattractive and mechanical technique. This anti

pathy causes us no surprise. Science is a process of progressive

1 German original in Int. Z-f- ?sa* (!928) 14> l91> First English translation.

2 Reprinted in Collected Papers, Vol. II.

87

88 FINAL CONTRIBUTIONS TO PSYCHO-ANALYSIS VIII

disillusionment; it displaces the mystical and the miraculous by universally valid and inevitable laws, the monotony and ineluctability of which provoke boredom and displeasure. However, it may serve as a partial consolation that among the practitioners of this craft, as of all others, artists will from time to time appear to whom we may look for progress and new perspectives.

From the practical point of view, however, it is an undeniable advance that analysis has gradually succeeded in putting tools for the more delicate investigation of the kind into the hands of the physician and student of only average gifts. A similar development occurred in regard to surgery; before the discovery of anaesthesia and asepsis it was the privilege of only a favoured few to exercise that 'healing art'; in the conditions of the time the art of working cito, tuto, etjucunde was confined to them alone. True, artists in the technique of surgery still exist to-day, but the progress that has taken place enables all the thousands of physicians of average ability to exercise their useful and often life-saving activity.

A psychological technique had, of course, been developed outside the field of mental analysis; I refer to the methods of measurement used in psychological laboratories. This kind of technique is still in vogue, and for certain simple, practical purposes it may be sufficient. But analysis has much more farreaching aims: the understanding of the topography, d y n a m i c s , and economy of the whole mental apparatus, undertaken without impressive laboratory apparatus, but with ever-increasing claims to scientific certainty and, above all, with incomparably greater results.

Nevertheless, there has been, and still is, a great deal in psycho-analytic technique which has created the impression that it involves a scarcely definable, individual factor. This has been chiefly due to the circumstance that in analysis the 'personal equation* has seemed to occupy a far more important place than we are called on to accept in other sciences. I n his first essays on technique Freud himself left open the possibility that there was room in psycho-analysis for methods other than his own. But that expression of opinion dates from before the crystallizing out of the second fundamental rule of psycho

89 I928 THE ELASTICITY OF PSYCHO-ANALYTIC TECHNIQUE

analysis, the rule by which anyone who wishes to undertake analysis must first be analysed himself. Since the establishment of that rule the importance of the personal element introduced by the analyst has more and more been dwindling away. Anyone who has been thoroughly analysed and has gained complete knowledge and control of the inevitable weaknesses and peculiarities of his own character will inevitably come to the same objective conclusions in the observation and treatment of the same psychological raw material, and will consequently adopt the same tactical and technical methods in dealing with it. I have the definite impression that since the introduction of the second fundamental rule differences in analytic technique are tending to disappear.

I f one attempts to weigh up the unresolved residue of this personal equation, and if one is in a position to see a large number of pupils and patients who have been analysed by others, and if, like me, one has to wrestle with the consequences of one's own earlier mistakes, one can claim the right to express a comprehensive opinion about the majority of these differences and mistakes. I have come to the conclusion that it is above all a question of psychological tact whether or when one should tell the patient some particular thing, when the material he has produced should be considered sufficient to draw conclusions, in what form these should be presented to the patient, how one should react to an unexpected or bewildering reaction on the patient's part, when one should keep silent and await further associations, and at what point the further maintenance of silence would result only in causing the patient useless suffering, etc. As you see, using the word 'tact' has enabled me only to reduce the uncertainty to a simple and appropriate formula. But what is 'tact'? The answer is not very difficult. I t is the capacity for empathy. If, with the aid of the knowledge we have obtained from the dissection of many minds, but above all from the dissection of our own, we have succeeded in forming a picture of possible or probable associations of the patient's of which he is still completely unaware, we, not having the patient's resistances to contend with, are able to conjecture, not only his withheld thoughts, but trends of his of which he is unconscious.


At the same time, as we are continuously aware of the strength of the patient's resistance, we should not find it difficult to decide on the appropriateness or otherwise of telling him some particular thing or the form in which to put it. This empathy will protect us from unnecessarily stimulating the patient's resistance, or doing so at the wrong moment. I t is not within the capacity of psycho-analysis entirely to spare the patient pain; indeed, one of the chief gains from psycho-analysis is the capacity to bear pain. But its tactless infliction by the analyst would only give the patient the unconsciously deeply desired opportunity of withdrawing himself from his influence.

A l l these precautions give the patient the impression of good will on the analyst's part, though the respect that the latter shows for the former's feelings derives solely from rational considerations. I n my subsequent observations I shall try in a certain sense to justify the creation of this impression upon the patient. T h e essence of the matter is that there is no conflict between the tact which we are called upon to exercise and the moral obligation not to do to others what in the same circumstances we should not desire to have done to ourselves.

I hasten to add that the capacity to show this kind of 'good will ' represents only one side of psycho-analytic understanding. Before the physician decides to tell the patient something, he must temporarily withdraw his libido from the latter, and weigh the situation coolly; he must in no circumstances allow himself to be guided by his feelings alone.

I now propose to give a few brief examples to illustrate this general point of view.

Analysis should be regarded as a process of fluid development unfolding itself before our eyes rather than as a structure with a design pre-imposcd upon it by an architect. The analyst should therefore in no circumstances be betrayed into promising a prospective patient more than that, if he submits to the analytic process, he will end by knowing much more about himself, and that, if he persists to the end, he will be able to adapt himself to the inevitable difficulties of life more successfully and with a better distribution of his energies. He can also


be told that we know of no better and certainly of no more radical treatment of psychoneurotic and character difficulties; and we should certainly not conceal from him that there are other methods which hold out quicker and more definite prospects of a cure; and, if patients then reply that they have already submitted for years to treatment by suggestion, occupational therapy, or methods of strengthening the will, we may feel pleased. I n other cases we may suggest that they try one of these much-promising methods before coming to us. But we cannot allow to pass the objection usually made by patients that they do not believe in our methods or theories. I t must be explained to them at the outset that our technique makes no claim to be entitled to such unmerited confidence in advance, and that they need only believe in us if or when their experience of our methods gives them reason to do so. T o another objection, namely that in this way we repudiate in advance any responsibility for a possible failure of the analysis and lay it squarely upon the patient and his impatience, we have no reply, and we have to leave it to the patient himself to decide whether or not to accept the risk of undertaking analysis under these difficult conditions. I f these questions are not definitely settled in advance, one is putting into the hands of the patient's resistance a most dangerous weapon, which sooner or later he will not fail to use against us and the objective of the analysis. Even the most alarming question must not divert us from firmly establishing this basis for the analysis in advance. Many prospective patients ask with visible hostility whether the analysis may not last for two, three, five, or even ten years. We have to reply that it is possible. 'But a ten-year analysis would in practice be equivalent to a failure', we have to add. 'As we can never

. estimate in advance the magnitude of the difficulties to be overcome, we can promise you nothing, and can only say that in many cases the time needed is much shorter. But, as you probably believe that physicians like making favourable prognoses, and as you have probably heard, or will soon hear, many adverse opinions about the theory and technique of psycho-analysis, it will be best, from your point of view, if you will regard analysis as a bold experiment, which will cost you a great deal


of toil, time, and money; and you must decide for yourself whether or not the amount of suffering which your difficulties are causing you is sufficient to make the experiment worth while in spite of ail that. I n any case, think it over carefully before beginning, because without the earnest intention to persist, even in spite of inevitable aggravations of your condition, the only result will be to add one more to the disappointments you have already suffered.'

I believe this preparation, which certainly errs on the side of pessimism, is certainly the better; in any case it is in accordance with the requirements of the 'empathy rule*. For, behind the prospective patient's often all-too-excessive display of faith in us, there is nearly always concealed a strong dose of distrust, which he is trying to shout down by his passionate demands on us for promises of a cure.'A characteristic question that is often put to us by a prospective patient, after we have spent perhaps an hour trying to explain to him that we regard his case as suitable for analysis, is: 'But, doctor, do you really think that analysis would help me?' It would be a mistake to reply by simply saying yes. It is better to say that we do not believe in offering further assurances. Even if the prospective patient professes the most glowing opinion of analysis, this does not eliminate his concealed suspicion that the physician is, after all, a business man with something to sell. T h e patient's concealed incredulity is even more manifest in the question: 'But, doctor, don't you think that your methods might make me worse?' I generally reply to this with a counter-question. 'What is your occupation?' I ask. Suppose the answer is: ' I ' m an architect.' 'Well, what would you say,' I reply, ' if you laid the plan for a new building before a client, and he asked you whether it wouldn't collapse?' This generally puts an end to further demands for assurances, because it dawns on the patient that the practitioner of any craft is entitled to a certain amount of confidence on his own speciality, though that does not, of course, exclude disappointments.

Psycho-analysis is often reproached with being remarkably concerned with money matters. My own opinion is that it is far too little concerned with them. Even the most prosperous in

I928 THE ELASTICITY OF PSYCHO-ANALYTIC TECHNIQUE 93

dividual spends money on doctors most unwillingly. Something in us seems to make us regard medical aid, which in fact we all first received from our mothers in infancy, as something to which we are automatically entitled, and at the end of each month, when our patients are presented with their bill, their resistance is stimulated into producing all their concealed or unconscious hatred, mistrust, and suspicion over again. T h e most characteristic example of the contrast between conscious generosity and concealed resentment was given by the patient who opened the conversation by saying: 'Doctor, if you help me, I ' l l give you every penny I possess!' ' I shall be satisfied with thirty kronen an hour,' the physician replied. 'But isn't that rather excessive?' the patient unexpectedly remarked.

I n the course of the analysis it is as well to keep one eye constantly open for unconscious expressions of rejection or disbelief and to bring them remorselessly into the open. I t is only to be expected that the patient's resistance should leave unexploited no single opportunity for expressing these. Every patient without exception notices the smallest peculiarities in the analyst's behaviour, external appearance, or way of speaking, but without previous encouragement not one of them will tell him about them, though failure to do so constitutes a crude infringement of the primary rule of analysis. We therefore have no alternative but to detect ourselves from the patient's associations when we have offended his aesthetic feelings by an excessively loud sneeze or blowing of the nose, when he has taken offence at the shape of our face, or when he feels impelled to compare our appearance with that of others of more impressive physique.

I have on many other occasions tried to describe how the analyst must accept for weeks on end the role of an Aunt Sally on whom the patient tries out all his aggressiveness and resentment. I f we do not protect ourselves from this, but, on the contrary, encourage the only-too-hesitant patient at every opportunity that presents itself, sooner or later we shall reap the welldeserved reward of our patience in the form of the arrival of the positive transference. Any trace of irritation or offence on the part of the physician only prolongs the duration of the resistance


period; if, ho.wever, the physician refrains from defending himself, the patient gradually gets tired of the one-sided battle and, when he has given full vent to his feelings, he cannot avoid confessing, though hesitantly, to the friendly feelings concealed behind his noisy defence; the result being deeper access into latent material, in particular into those infantile situations in which the foundation was laid (generally by non-understanding educators) for certain spiteful character traits.

Nothing is more harmful to the analysis than a schoolmasterish, or even an authoritative, attitude on the physician's part. Anything we say to the patient should be put to him in the form of a tentative suggestion and not of a confidently held opinion, not only to avoid irritating him, but because there is always the possibility that we may be mistaken. It is an old commercial custom to put ( E . & O . E . ' ('errors and omissions excepted') at the bottom of every calculation, and every analytic statement should be put forward with the same qualification. O u r confidence in our own theories should be only conditional, for in every case we may be presented with a resounding exception to to the rule, or with the necessity of revising a hitherto accepted theory. I recall, for instance, an uneducated, apparently quite simple, patient who brought forward objections to an interpretation of mine, which it was my immediate impulse to reject; but on reflection not I , but the patient, turned out to be right, and the result of his intervention was a much better general understanding of the matter we were dealing with. Thus the analyst's modesty must be no studied pose, but a reflection of the limitations of our knowledge. Incidentally this may suggest the point from which, with the help of the lever of psychoanalysis, an alteration in the attitude of the doctor to the patient may be brought about. Compare our empathy rule with the lofty attitude to the patient generally adopted by the omniscient and omnipotent doctor.

O f course I do not mean that the analyst should be overmodest. He is fully justified in expecting that in the great majority of cases his interpretations, being based on experience, will sooner or later turn out to be correct, and that the patient will end by accepting the accumulation of evidence. But the


analyst must wait patiently until the patient makes up his own mind; any impatience on the physician's part costs the patient time and money and the physician a great deal of work which he could very well spare.

A patient of mine once spoke of the 'elasticity of analytic technique', a phrase which I fully accept. The analyst, like an elastic band, must yield to the patient's pull, but without ceasing to pull in his own direction, so long as one position or the other has not been conclusively demonstrated to be untenable.

One must never be ashamed unreservedly to confess one's own mistakes. It must never be forgotten that analysis is no suggestive process, primarily dependent on the physician's reputation and infallibility. Al l that it calls for is confidence in the physician's frankness and honesty, which does not suffer from the frank confession of mistakes.

Analysis demands of the physician, not only a firm control of his own narcissism, but also a sharp watch on his emotional reactions of every kind. It used to be held that an excessive degree of'antipathy' was an indication against undertaking an analysis, but deeper insight into the relationship has caused us to regard such a thing as unacceptable in principle, and to expect the analysed analyst's self-knowledge and self-control to be too strong for him to yield to such idiosyncrasies. Such 'antipathetic features' are in most cases only fore-structures, behind which quite different characteristics are concealed; dropping the patient in such cases would be merely leaving him in the lurch, because the unconscious aim of intolerable behaviour is often to be sent away. Knowledge of these things gives us the advantage of being able coolly to regard even the most unpleasant and repulsive person as a patient in need of help, and even enables us not to withhold our sympathy from him. T h e acquisition of this more than Christian humility is one of the hardest tasks of psycho-analytic practice, and striving to achieve it may incidentally lead us into the most terrible traps. I must once more emphasize that here too only real empathy helps; the patient's sharp wits will easily detect any pose.

One gradually becomes aware how immensely complicated


the mental work demanded from the analyst is. He has to let the patient's free associations play upon him; simultaneously he lets his own fantasy get to work with the association material; from time to time he compares the new connexions that arise with earlier results of the analysis; and not for one moment must he relax the vigilance and criticism made necessary by his own subjective trends.

One might say that his mind swings continuously between empathy, self-observation, and making judgements. T h e latter emerge spontaneously from time to time as mental signals, which at first, of course, have to be assessed only as such; only after the accumulation of further evidence is one entitled to make an interpretation.

Above all, one must be sparing with interpretations, for one of the most important rules of analysis is to do no unnecessary talking; over-keenness in making interpretations is one of the infantile diseases of the analyst. When the patient's resistance has been analytically resolved, stages in the analysis are reached every now and then in which the patient does the w6rk of interpretation practically unaided, or with only slight prompting from the analyst.

And now let us return for a moment to the subject of my much-praised and much-blamed 'activity'. 1 I believe I am at last in a position to give the details on timing for which I was rightly asked. Y o u know, perhaps, that I was originally inclined to lay down certain rules of behaviour, in addition to free association, so soon as the resistance permitted such a burden. Experience later taught me that one should never order or forbid any changes of behaviour, but at most advise them, and that one should always be ready to withdraw one's advice if it turned out to be obstructive to the analysis or provocative of resistance. M y original conviction that it was always the patient and never the physician who must be 'active' finally led me to the conclusion that we must content ourselves with interpreting the patient's concealed tendencies to action and supporting his feeble attempts to overcome the neurotic inhibitions to which he had hitherto been subject, without pressing or even advising

1 See my papers on technique in Further Contributions,

1928 THE ELASTICITY OF PSYCHO-ANALYTIC TECHNIQUE 97

him to take violent measures. I f wc arc patient enough, the patient will himself sooner or later come up with the question whether he should risk making some effort, for example to defy a phobic avoidance. I n such a case we shall certainly not withhold our consent and encouragement, and in this way wc shall make all the progress expected from activity without upsetting the patient and falling out with him. I n other words, it is the patient himself who must decide the timing of activity, or at any rate give unmistakable indications that the time is ripe for it. I t remains true, of course, that such attempts by the patient produce changes of tension in his psychical system and thus prove to be a method of analytic technique in addition to the associations.

I n another technical paper 1 I have already drawn attention to the importance of working through, but I dealt with it rather onesidedly, as a purely quantitative factor. I believe, however, that there is also a qualitative side to working through, and that the patient reconstruction of the mechanism of the symptom and character formation should be repeated again and again at every forward step in the analysis. Every important new insight gained calls for a revision of all the material previously produced, and may involve the collapse of some essential parts of what may have been thought to be a complete structure. T h e more subtle connexions between this qualitative working through and the quantitative factor (discharge of affect) must be left to a more detailed study of the dynamics of analytical technique.

A special form of this work of revision appears to occur, however, in every case; I mean the revision of the emotional experiences which happened in the course of the analyses. T h e analysis itself gradually becomes a piece of the patient's life-history, which he passes in review before bidding us farewell. I n the course of this revision it is from a certain distance and with much greater objectivity that he looks at the experiences through which he went at the beginning of his acquaintanceship with us and the subsequent unravelling of the resistance and transference, which at the time seemed so immediate and im

1 'The Problem of the Termination of the Analysis*, this vol., p. 77.


portant to him; and he then turns his attention away from analysis to the real tasks of life.

I n conclusion I should like to hazard some remarks about the metapsychology of our technique.1 I t has often been said, by myself among others, that the process of recovery consists to a great extent of the patient's putting the analyst (his new father) in the place of the real father who occupies such a predominant place in his super-ego, and his then going on living with the analytic super-ego thus formed. I do not deny that such a process takes place in every case, and I agree that this substitution is capable of producing important therapeutic effects. But I should like to add that it is the business of a real character analysis to do away, at any rate temporarily, with any kind of super-ego, including that of the analyst. The patient should end by ridding himself of any emotional attachment that is independent of his own reason and his own libidinal tendencies. Only a complete dissolution of the super-ego can bring about a radical cure. Successes that consist in the substitution of one super-ego for another must be regarded as transference successes; they fail to attain the final aim of therapy, the dissolution of the transference.

I should like to mention, as a problem that has not been considered, that of the metapsychology of the analyst's mental processes during analysis. His cathexes oscillate between identification (analytic object-love) on the one hand and self-control or intellectual activity on the other. During the long day's work he can never allow himself the pleasure of giving his narcissism and egoism free play in reality, and he can give free play to them in his fantasy only for brief moments. A strain of this kind scarcely occurs otherwise in life, and I do not doubt that sooner or later it will call for the creation of a special hygiene for the analyst.

Unanalysed ('wild') analysts and incompletely cured patients are easily recognizable by the kind of 'compulsive analysing' from which they suffer; in contrast to the unhampered mobility

1 By metapsychology we mean, of course, the sum-total of the ideas about the structure and dynamics of the psychical apparatus which our psychoanalytic experiences have caused us to adopt. See Freud's papers on metapsychology in his Collected Papers, Vol. IV .


of the libido which is the result of a complete analysis, which makes it possible to exercise analytic self-knowledge and selfcontrol when necessary, but in no way hampers free enjoyment of life. T h e ideal result of a completed analysis is precisely that elasticity which analytic technique demands of the mental therapist. This is one more argument for the necessity of the second fundamental rule of psycho-analysis.

Having regard to the great importance of any new technical recommendation, I could not make up my mind to publish this paper before submitting it to a colleague with a request for criticism.

' T h e title ["Elasticity"] is excellent/ he replied, 'and should be applied more widely, for Freud's technical recommendations were essentially negative. He regarded it as his most important task to emphasize what one should not do, to draw attention to all the temptations and pitfalls that stand in the way of analysis, and he left all the positive things that one should do to what you called " t a c t " . T h e result was that the excessively docile did not notice the elasticity that is required and subjected themselves to Freud's "don't 's " as if they were taboos. This is a situation that requires revision, without, of course, altering Freud's rules,

'True though what you say about tact is, the concessions you make to it seem to me to be questionable i n the form i n which you have put them. Those who have no tact will find in what you say a justification for arbitrary action, i.e. the intervention of the subjective element (i.e. the influence of their own unmastered complexes). What in reality we undertake is a weighing upgenerally at the preconscious levelof the various reactions that we may expect from our intervention, and the most important aspect in this is quantitative assessment of the dynamic factors in the situation. Rules for making such an assessment can naturally not be given. T h e decisive factors are the analyst's experience and normality. But tact should be robbed of its mystical character,'

I entirely share my critic's view that these technical precepts of mine, like all previous ones, will inevitably be misused and


misunderstood, in spite of the most extreme care taken in drafting them. There is no doubt that manyand not only beginners, but all who have a tendency to exaggerationwill seize on what I have said about the importance of empathy to lay the chief emphasis in their handling of patients on the subjective factor, i.e. on intuition, and will disregard what I stated to be the allimportant factor, the conscious assessment of the dynamic situation. Against such misinterpretations repeated warnings are obviously useless. I have even discovered that, in spite of the caution with which I put it forwardand my caution in the matter increases as time goes onsome analysts have used 'activity' as an excuse to indulge their tendency to impose on their patients entirely unanalytic rules, which sometimes border on sadism. I should therefore not be surprised if one day I heard my views on the patience required of an analyst used to justify a masochistic technique. Nevertheless the method which I follow and recommendthe method of elasticityis not equivalent to non-resistance and surrender. True, we try to follow the patient i n all his moods, but we never cease to hold firm to the viewpoint dictated to us by our analytic experience.

M y principal aim in writing this paper was precisely to rob 'tact' of its mystical character. I agree, however, that I have only broached the subject and have by no means said the last word about it. I am, perhaps, a little more optimistic than my critic about the possibility of formulating positive advice on the assessment of certain typical dynamic conditions. For the rest, his belief that the analyst should be experienced and normal more or less corresponds to my own belief that the one dependable foundation for a satisfactory analytic technique is a complete analysis of the analyst himself. T h e processes of empathy and assessment will obviously take place, not in the unconscious, but at the pre-conscious level of the well-analysed analyst's mind.

Obviously under the influence of the above warnings, I feel it necessary to clarify one of the ideas put forward in this paper. I refer to my suggestion that a sufficiently deep character analysis must get rid of any kind of super-ego. An over-logical mind might interpret this as implying that my technique aimed at

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robbing people of all their ideals. I n reality my objective was to destroy only that part of the super-ego which had become unconscious and was therefore beyond the range of influence. I have no sort of objection to the retention of a number of positive and negative models in the pre-conscious of the ordinary individual. I n any case he will no longer have to obey his preconscious super-ego so slavishly as he had previously to obey his unconscious parent imago.

the elasticity of psychoanalytic technique

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