The Analyst's Murder of the Patient

Of the radical and innovative ideas put forward by Ferenczi during his last years none is perhaps more startling than the suggestion in his 1932 Clinical Diary that although the analyst “may take kindness and relaxation as far as he possibly can, the time will come when he will have to repeat with his own hands the act of murder previously perpetrated against the patient” (1985, 52). In what follows I propose to use the Diary to explore not only the theoretical and clinical implications of this idea but also its autobiographical dimension and its bearing on Ferenczi’s relationship to Freud.

It must be said immediately that the murder of which Ferenczi speaks is not literal, but rather emotional or psychic. As he goes on to explain, “analytic guilt consists of the doctor not being able to offer full maternal care, goodness, self-sacrifice; and consequently he again exposes the people under his care, who just barely managed to save themselves before, to the same danger, by not providing adequate help” (52–53). Once this is understood, it becomes clear that Ferenczi is referring to the way in which the inevitable imperfections and limitations of the analyst trigger the memory of childhood traumas experienced by the patient, which must be relived during analysis in order to be exorcised. As I have previously noted (1991, 27–29), this model of the psychotherapeutic process proposed by Ferenczi is very similar to that articulated independently by D. W. Winnicott in his posthumously published paper “Fear of Breakdown,” where he sets forth the way that agony of the patient “experienced in the transference, in relation to the analyst’s failures and mistakes,” enables the patient to recollect “the original failure of the facilitating environment” (1974, 91).

Even from this brief summary, it is evident that the view of psychoanalysis held by Ferenczi and Winnicott stresses the need for humility on the part of the analyst and the indispensability of emotional repeating as well as intellectual remembering to analytic treatment. In “Freud’s Influence on Medicine” Ferenczi coins the term “utraquistic” to pay tribute to Freud’s combination of science and humanism in the discovery of psychoanalysis (1933b, 147–48). ¹ But since utraquism is originally an ecclesiastical term, used of the moderate fifteenth-century followers of Jan Hus who defended the right of the laity to take communion in both kinds, I think it appropriate to label Ferenczi’s own approach utraquistic in its insistence that the analyst must heal the patient with the wine of sympathy as well as with the bread of insight. As he writes in the Diary: “Analysis on its own is intellectual anatomical dissection. . . . Kindness alone would not help much either, but only both together” (1985, 207).

Although Ferenczi employs the notion of the analyst’s murder of the patient in a metaphorical sense, this does not make it any less real. Sexual or other forms of abuse in childhood can lead to spiritual death, transcending anything that might be classified as castration anxiety, which makes the analytic process ultimately a quest for rebirth. A compelling illustration of this claim is provided by Harry Guntrip’s analyses with W. R. D. Fairbairn and Winnicott, about which I have written elsewhere (1991, 115–48). Like Guntrip, Ferenczi must have experienced a soul murder in childhood, as his Diary confirms: “The continuous protests (from the deepest unconscious) that I do not have any real empathy or compassion for the patient, that I am emotionally dead, was in many respects analytically proven, and could be traced back to deep infantile traumata” (1985, 85). He proceeds to acknowledge how his “infantile aggressiveness and a refusal of love toward my mother became displaced onto the patients. But, as with my mother, I managed with tremendous effort to develop a compulsive, purely intellectual superkindness” (86). Thus, in a complex dialectic, Ferenczi recreated the failures of nurturing to which he had been subjected at the hands of his mother in his own insincerity toward his patients, a symbolic murder that duplicated what they too had suffered in infancy. Analysis for Ferenczi, therefore...