>> From the Library of Congress in Washington, DC.
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>> James Hutson: As you know, this is a symposium about Elizabeth Severn who was virtually unknown to me.  I'm not a specialist in science or psychoanalysis or any of those fields.  I did however read the interview she had with Kurt Eissler and immediately had great admiration for her as a self-made woman who really had a remarkable success, didn't she as an analyst.  But you don't want to hear me talk about this.  Dr. Rachman will give the principal paper.  He's supervising and training analyst and faculty member at the Institute of Post Graduate Psychoanalytical Society of New York City.  He's also on the faculty of the program in trauma and disaster studies in NYU, a post-doctoral program in NYU post-doctoral program in psychoanalysis and psychotherapy.  He's a member of the Board of the Sandor Ferenczi Study Center.  That's at the new school for social research in New York.  He's the author of ^IT Sandor Ferenczi, the Psychotherapist of Tenderness and Passion ^NO.  That was in 1997.  ^IT Psychotherapy of Difficult Cases ^NO, 2003 and ^IT The Evil Genius of Psychoanalysis, Elizabeth Severn ^NO.
We have Dr. Rachman, thank you.
>> Arnold Rachman: Thanks, Jim.
>> James Hutson: Yeah.
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[ Applause ]
^M00:02:01
>> Arnold Rachman: Do you need these?
>> James Hutson: Thanks.
>> Arnold Rachman: Okay.  First, a word of thanks.  Can you hear me?
>> Yes.
>> Arnold Rachman: Okay, good.  I wish to express my gratitude to several individuals at the Library of Congress.  First of all, Leonard Bruno for agreeing to accept the Elizabeth Severn papers and helping establish the Elizabeth Severn section of the Freud archives.  To Jim Hutson who just spoke, for continuing the establishment of the Severn section and being instrumental in planning and executing the Severn Symposium today.  Karen Stewart, for helping with the administration and coordination of today's symposium.
I'm also grateful to my wife, Nancy, for her help in preparing the talk today as well as the slide presentation.  And Susan Klett and Harriet Pappenheim, two of my cherished colleagues and friends from the Postgraduate Center for helping me with the publicity for today's talk.  And of course, I thank you all for attending.
Just one note of caution, I need to tell you that the photographs and slides from the Elizabeth Severn papers which I'm going to show are copyrighted.  There can be no duplicate images made from cellphones, cameras or any devices, in terms of this talk.  And I appreciate your cooperation in that.
Let me give you a short word about the Elizabeth Severn papers before I begin my presentation.  The Elizabeth Severn papers proceeded in several ways.  First, what happened was that her daughter, Margaret Severn, preserved them sensing that her mother's work hopefully someday would be discovered.  You know, Severn's, as Jim suggested, no one had heard.  Not many people have heard about her and that's because of a process that Esther Menaker and I described in 18 -- in 1989 [laughter] called "death by silence," a [inaudible].  It's a process which traditional analysis removes dissidence from consideration.  So they are no longer discussed.  In institutes, their papers are not published and no one talks about them.  So Elizabeth Severn -- Ferenczi, of course, was used in this way and so was Elizabeth Severn, even more so.  So that's why no one knows about them, Severn in particular.
So they were in her daughter's possession and then when Margaret died, she left them to Peter Lipskis, her personal friend and then Peter heard about my interest in Ferenczi from one of the people at the Postgraduate Center who -- Hannah [Inaudible], and Hannah was a senior analyst there and she realized that I was interested in Ferenczi, so she told Peter to call me and he said, "Would you be interested in purchasing the Severn papers?"  And I said, "Of course, I would."  And so I got them from him.  And when I got them, of course, I said, "Now what do I do with them?"  They were several boxes so I had the bright idea of contacting Nellie Thompson at the -- she's the archivist of the New York Psychoanalytic A.A. Brill Library, and she was very generous in allowing me to store them for several years.  And then, it was not possible to keep them there because they didn't have any budgetary allocations and so we discussed it and she said, "Call Len Bruno at the Library of Congress and see if he's interested."  I called them and he was.  And so they're going to be housed here when I finish getting them in shape to send here.  So I'm very grateful to the Library of Congress that there is now a home for these papers so scholars can begin to study her and hopefully the analytic community will become more knowledgeable about her.
So Karen, could you show the first three slides?  Can I move this without making any disaster?  Okay, so it's slides one, two and three.  Yeah.  The first, of course, is the godfather of psychoanalysis, and then there's his son, and then there's the Holy Ghost [laughter].
These are all photographs of Freud, Ferenczi, and Elizabeth Severn in 1925, just about the time that analysis between Ferenczi and Severn began.  So we have then like a trinity in this analytic drama with Freud, of course, being overseeing both in his words and his deeds what was going on between these two people.  So the -- could you go back to the Ferenczi picture just for a second?  This picture which you can't see the writing was given to Elizabeth Severn by Ferenczi with the following inscription, "To Dr. Elizabeth Severn, as a token of high consideration, December 1925."  So this was given by Ferenczi to Severn about four months after Severn began her analysis with Ferenczi sometime in the autumn of 1925 and the analysis continued on until February 1933.
Okay, now Freud for reasons that we have to study more fully, called Severn an "evil genius".
^M00:10:00
It's in a quote in the Jones biography in the last volume.  And I wanted to illustrate how Freud thought about Ferenczi and Severn by reading a letter that Freud wrote to Ernest Jones on May 22, 1933.  So this is -- no, it was after that period.  This is after Ferenczi's death.  Actually, it was written May 29th but Ferenczi died May 22nd.  So this is what he says, "Ferenczi takes a part of the old era with him.  Then when I stepped down, a new one will probably begin in which you will still be prominent," talking to Jones, "Faith, resignation, that is all.  To be sure, the loss was not a new one.  For years, Ferenczi has no longer been with us.  It is easier to comprehend the slow process of destruction to which he fell victim."
You see, this is the reference both Jones and Freud believed that Ferenczi deteriorated emotionally and psychologically during his later years.  "During the last two years, it expressed itself organically in pernicious anemia," which was true, which led to severe motor disturbances.  Liver therapy improved the conditions of blood but had no effect on the other symptoms.  In the last weeks, he could no longer walk or stand at all.  Simultaneously, a mental degeneration."
Now this is the controversial part where Freud and Jones both believed that he deteriorated mentally and there's no -- that was -- it's been disputed by Michael Balint, Ferenczi's student and heir apparent that to the last, Ferenczi was lucid and had not deteriorated mentally.
"Central to this was the conviction that I did not love him enough."  This is what Ferenczi wrote in the clinical diary.  "Did not want to acknowledge his work and also that I had not -- I had analyzed him badly.  His technical innovations were connected with this.  As he wanted to show me how lovingly one has to treat one's patients in order to help them."
So this is Freud's idea that Ferenczi was trying to show him this.  And these were induced regressions to his childhood -- in other words, Freud is saying, "Look, the reason he went so off kilt and did his relaxation therapy and his trauma analysis was that he was losing his mind.  Because he himself had a very serious problem because of his relationship with his mother that she didn't love him enough and therefore, he sought out patients who he could express this need to."  He would be, as Freud said, a better mother to his children than his mother was to him.
And then he says, "Among them," meaning these patients, "a suspect American woman to whom he often devoted four to five hours a day," this is Severn, "after she had left, he believed that she influenced him through vibrations across the ocean and said that she analyzed him and thereby saved him."
So I'm just quoting all this to give you a feel for how Freud had such a negative view of Severn and Ferenczi's work with her.  I believe that hopefully, I'll be able to show you today that Severn was an emotionally courageous individual who herself was a self-taught therapist who struggled all her life to overcome severe childhood trauma.
So we could go now to slides four, five and six.  Severn was Ferenczi's analysand and friend and colleague as the inscription on the photograph indicates and collaborator.  Clearly a very complicated relationship filled with many moments of disturbed clinical interaction.
There was a series of new material that I've had been able to research to develop an alternate view of Freud's assessment of Severn as an evil genius and a suspect patient.
Okay, so Severn, this is slide four, correct?  And this is -- it seems to be out of -- this is the autobiography that Margaret Severn, her daughter wrote.  I'm trying to put this together.  There's about a thousand pages missing.  In total, it's about over 2000 pages typewritten.  So I have about 1200 pages and I have to get the others.
And this is her version of what happened during her mother's existence including her therapy.  So we could -- I think you can go to the next one which just is some excerpts from the preface, okay.
And then, we -- let me just say this.  That Severn was a clinician before she was in analysis with Ferenczi.  And she developed apparently an interest in helping people through her work as a door-to-door encyclopedia salesperson, so a strange beginning.  But don't forget.  We're talking about, as I will show you, one of the slides is from 1908 so there was no formal training for psychotherapy or psychoanalysis in those days.  And you had to put it together.  There was no institutes.
So apparently, as she's selling these encyclopedias door to door in order to make a living, people started asking her for advice.  And why do think that happened?  I think because there was something about her personality that invited them to think of her as some form -- what would you say?  A healer or a person who will respond to them?  I think it indicated that she had some natural capacities for empathy, for assertiveness, likeability and characteristics like that.
So the next step was she started to work in a women's hair salon and several people, several women there seemed to want massages, you know.  And so she said, "Oh, I can do that."  And she started doing the massages and as she's doing the massages, she's talking to people.  And she was very successful.  People were coming to her and she decided now to open up her own practice.  And so she was doing what you would consider now therapeutic massages in a clinical practice.
>> She stopped the hairdressing.
>> Arnold Rachman: Well, she was never the hairdresser.  But she worked in a hair salon perhaps, I don't know exactly what but that's right.
>> Dr. Rachman?
>> Arnold Rachman: Sure.
>> Could you clarify [inaudible]?  Could you tell us when you understand Margaret Severn began writing her --
>> Arnold Rachman: Oh, I think -- I think it was in the 1980's, yeah, yeah.  Now, can I have slides seven, eight, nine and ten?  Just do them slowly.
So this is a slide of one of her -- oh, this is a slide of one of her books, her last book, 1933.
^M00:20:05
She was an author as well as a clinician.  This book has been out of print, I think, probably from the day it was published [laughter].  And it's completely unknown to most of the analytic community.  But it's very interesting.  I think it's a very interesting book.  Even though it did get negative reviews from Jeffrey Masson didn't like it.  He thought it was unscientific.  But what it is, is it's an analysand's version of the analysis.  It's her version of what happened between Ferenczi and her in the analysis.  So if you take Ferenczi's ^IT Clinical Diary ^NO and you -- which is his version of what happened between the two of them, and you put Severn's book, you have the book that they were supposed to write.  They planned to write a book on trauma.  But because of his death, they were not able to do that.  So you take ^IT Clinical Diary ^NO and you take this and you have a two-sided view of the analytic process in terms of the treatment of trauma.
So now, could I have -- so this, yeah.  This is Elizabeth Severn in 1908.  This is when she -- I believe she began practice.  So did she look like evil here?  [Laughter] I don't see any pictures that I have that she looks evil.  But this is when she first started her practice and she started sending out notices to colleagues, patients and friends describing her clinical practice.
What's the next one, please?  Yeah, that's one of the cards that she sent out announcing that she had a clinical practice and she called herself a metaphysician at that time.  So you're going to see a progression of someone who's starts as a little funny but it's true.  She starts out as an encyclopedia salesman then she goes to sort of a massage therapist and now she gets interested in metaphysics and she starts a practice with that kind of frame of reference.
So what is the next slide, please?  Oh, she also started to give talks.  She gave talks to groups of people so she not only practiced but she does what many of us do today, you know, we give talks as well as practice.  So she was doing all this in a very early period without any training except her self-taught.
>> Maybe she was a doctor or something.
>> I was just to ask that.
>> Arnold Rachman: She doesn't have a doctorate.  She doesn't have a doctorate.  She called herself at times, doctor.
>> What is her center of operation?  Where is she [inaudible]?
>> Arnold Rachman: Oh, well it's in different places.
>> Oh, she moved around.
>> Arnold Rachman: Yeah, she moved around a lot.  She was in Texas --
>> Every new location, she acquires a new addition to her [inaudible]. 
>> Arnold Rachman: Well, I don't think it's that.  I think that she develops intellectually.  You see, as I will tell you as we go on, she starts getting interested in Mary Baker Eddy's Christian Science.  And then the French psychologist Coue and his applied psychology.  So she's studying and trying to integrate some of the things that are developing intellectually in the culture and integrating it.
Okay, so could you give me the next ones?
>> Question.
>> Arnold Rachman: Oh, I can't see the light, oh.
>> Yes.
>> Arnold Rachman: Hi, sweetie [laughter].
>> Where did the analysis take place between Severn and Ferenczi?
>> Arnold Rachman: Oh, it took place in Ferenczi's office in Budapest.
>> In [inaudible].
>> Arnold Rachman: Yeah, in Buda.  You know, it's divided into Pest on one side and the older side which was a kingdom of Buda is where Ferenczi had his office.  And that office and that apartment is now a historic landmark because the Ferenczi Society bought the apartment several years ago.  And I'm going to try to put together some of these papers and give them a copy of what's in the Library of Congress so the people in Europe and in Buda -- in Hungary will have something to refer to too. 
Okay, so she published three books, one of which I discussed.  Could you give me the next slide please?  Oh, this is one of the announcements.  Please go.  Oh, here's the -- is this one of her earlier books?  What does it say, please?  I'm having trouble.
>> [Inaudible], can you say this?
>> Arnold Rachman: What?
>> Psychotherapist, An Instructor in Applied Psychology.
>> Arnold Rachman: Oh, so this is -- you see how her designations are changing as she's -- she actually moves closer and closer to psychology and then eventually sees herself as a psychoanalyst because, you know, in those days, to become a psychoanalyst meant that you had an analysis, you know, and that's how Anna Freud became an analyst.  She didn't have any graduate training.  Of course, she was analyzed by -- who's going to argue with Freud that his daughter is not an analyst when she uses him as the reference [laughter].
Okay, next please.  Okay, here's Elizabeth Severn in 1916 at the Hotel Seymour, in New York City, I believe, where she practiced.
Next one.  Yeah, there's the Hotel Seymour in its heyday.  It's now completely changed.  It has a glass and metal façade.  Next please.
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>> That's Mark somebody.
>> Arnold Rachman: She had an inter -- actually she started to gain an international reputation, you know, as a therapist and as I mentioned before, she had people from reading her book; she became very popular in Europe and in London in particular.  And there were people, I think, this is the gentleman who wrote to her asking her if she knew anyone in London who could refer him to a therapist who practiced the way she did.
Next please.
>> Rachel somebody.
>> Arnold Rachman: Oh yeah.  Go next, please.  Is this --?
>> Karen Horney.
>> Arnold Rachman: Karen Horney, yeah.  This is a letter sent by Karen Horney, the founder of the Cultural School but not at the time.  After her analysis by -- sent to Severn, when she was playing -- when her daughter was going to live in London and Horney wrote to Severn hoping that she would befriend her daughter and told her daughter about Severn.  So it's interesting that you have someone of Horney's reputation and functioning, feeling that Severn was someone that her daughter should be connected to.
Now, we go into a more complicated area which is Severn, I talked to you just briefly now about Severn as a person and as an author and clinician.  But now, the really complicated stuff is Severn as an analysand of Ferenczi's.  So I believe that Severn was the analysand of last resort and she came to Budapest to enter into analysis with the analyst of last resort.  In other words, here we have a very disturbed but yet in some areas, highly functioning person who comes to see Sandor Ferenczi who's definitely was seen as the analyst of last resort.
^M00:30:05
So analysts of his time referred him their patients who they could not, who they were not successful with.  They went to Ferenczi.  Now what was, what could we say about Severn's psychological background?  Well, she was a severe trauma survivor.  According to Ferenczi as he outlined in her clinical diary, she had three stages of trauma.  The first trauma occurred very early, as he says it, at the age of one-and-a-half, a promise by her father to give her something good instead of which he drugged her and sexually abused her.  She, of course, suffers from total disillusionment and helplessness, a state of half-stupor as he called it, a wish not to be alive, a complete repression of her own inclinations and feelings.
The second wave of shock, he calls the trauma shock, at the age of five, renewed brutal attacks, genitals artificially dilated by her father, insisted suggestion to be compliant with men, stimulating intoxicants administered, suicidal impulses, the sensation of dying, she has. Helplessness and despair of any outside help, propel her towards death, he says.
The third stage, what he called the last great shock, was she personality split into three parts at the age of 11-and-a-half.  Now this is all coming as a result of Ferenczi and Severn working together and going into what they termed a trauma analysis.  So they tried to reconstruct all this material from the period in which Severn is trying to what I would consider therapeutically regress back to the original shocks.
As a result of her childhood traumas, Severn developed severe psychopathology as an adult.  She has debilitating headaches, severe depression, with suicidal ideation and periodic hospitalizations.  However, she was able to marry and have a child, Margaret.  And as I've tried to outline to you, through all this, she developed a career as a therapeutic healer.
Now, Severn had a history of seeking psychotherapy and psychoanalysis throughout her life.
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She sought help from many analysts and found the work unsuccessful.  But she never gave up hope.  In her own words, Severn summed up her experiences with psychoanalysis before seeing Ferenczi.  "Dr. Ashe," she said, "A very nice fellow.  His own analysis was incomplete and his analysis of me was limited.  He stopped it on his own because it was not progressing as it should."  She saw Otto Rank.  Actually, she saw Rank right before she came to Ferenczi and I believe it was Rank who referred Severn to Ferenczi.  Otto -- this is interesting.  And as Jim suggested, her observations and conclusion are very interesting.
So here's what she says about Otto Rank.  "Otto Rank, I found him completely wrapped up in this one idea of the birth trauma."  Now how many people in analysis have said that about Rank?  She just pinpointed it.  "He was uncapable of thinking of anything else."
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[ Laughter ] 
^M00:35:04
Okay.
>> Could you give the source of that?
>> Arnold Rachman: That's her.
>> From where though?
>> Arnold Rachman: It's from the -- from her interview with Kurt Eissler.
>> Which is now open to the public, right?
>> Any questions?
>> Arnold Rachman: I'm sorry.  I'm having trouble seeing because of the lights.
>> Sorry, I just wanted to ask in what language did Severn conducted the analysis of the different [inaudible]?
>> Arnold Rachman: I think English.  I would believe English.  And I think Ferenczi conducted his analysis with her in English.
>> Well, that's what I meant with [inaudible].
>> Arnold Rachman: Yeah, yes.  Okay, can we go, give me some slides?  That's one of her books, good.  Keep going.  Oh, is this the subjective trance?
>> Yes.
>> Arnold Rachman: Yes.  The subjective trance, this slide, I think it's hard for you to read so I'll just suggest to you what I think this is all about.  As early as 1916, Severn developed this notion of what she called a "subjective trance state."  And what she did was that she went back.  She closed her eyes, was in a reclining position and she tried to go back to the time at which her earlier problems ensued and kind of what we might call now as self-hypnosis or meditation.  But she did this on her own.
And so, she found it very helpful to her.  It gave her a certain amount of peace and quiet and it helped her get in touch what she called her inner self.  And I think this subjective trance notion is what Ferenczi and she used to help her develop this therapeutic regression that helped her go back to her original traumas and what Michael Balint later described as therapeutic regression.  So I think it goes from Severn developing the semi-subjective trance state to the therapeutic regression in the trauma analysis that she and Ferenczi developed and then Balint elaborates that in a more theoretical way in therapeutic regression.
So I think that's a remarkable contribution myself which is still being used, you know.
>> She read studies with this [inaudible] by then or --
>> Arnold Rachman: I have no -- right now, I couldn't answer that question.
>> It's published here.
>> Arnold Rachman: Yeah, I mean, I don't know.
>> She had access to this material.
>> Arnold Rachman: She had access --
>> I wonder if she had access with [inaudible] concept of the hypnotic state.
>> Arnold Rachman: Well, I don't know.  So far, I don't have any mention of that.  But it's possible.
>> Is this a published piece in one of her books or is this in -- 
>> Arnold Rachman: No, no.  This is hand typed, you know, remember when people used the typewriter?  And on onion skin paper, remember that?  From 1916.
>> I'll [inaudible] with that.

[ Laughter ]

>> Arnold Rachman: When everything was done by hand.  And this is part of the Elizabeth Severn papers but it can't be quoted from right now.  What's the next please?
So here we have -- this has been, I think in other -- it's been published in books.  I don't know if in -- Lewis, was this in your -- you and Adrian's book?
>> This picture?
>> Arnold Rachman: Yeah.
>> No.
>> Arnold Rachman: Oh, okay.  But this is a very controversial picture.  Could you imagine why?  Give me -- someone give me one sentence.
>> Two wives.

[ Laughter ]

>> Arnold Rachman: Two wives.  This is Ferenczi and his wife on a trip to Madrid with Elizabeth Severn in 1928.  So this is what people like Freud and Jones would use to suggest that there's something very wrong with Ferenczi.  What is he doing taking his analysand on vacation with him?
^M00:40:01
Go ahead.
>> Well, I'm wondering, what is this -- typical, you know --
>> Arnold Rachman: It wasn't --
>> The cultural content.
>> Arnold Rachman: Well, good -- good statement because there are other people who did this.
>> Yes, it was [inaudible].
>> Including Freud?
>> Arnold Rachman: Please.  Go ahead.
>> Freud and many of the analysts went on vacation with and their patients would travel with them, sometimes with families staying in the same resort area, staying in the same sanitarium.  Ferenczi took his patients to Groddeck's Sanitarium with him.  They were treated there together.  That was not uncommon.
>> And the analysis continued on vacation [laughter]?  What did they [inaudible]?
>> I have not; I haven't found anybody describing how it worked.  I'd be very interested in that material.  For example, if a patient came with their family, what the relations were between the family and the analyst's family?  I haven't seen any firsthand accounts of that.  But I do know that people would bring patients with them.  And actually when Severn went to Budapest to start her analysis with Ferenczi, several of her patients went with her to Budapest to continue treatment.
>> Arnold Rachman: Oh yes, that's right.  That's right.
>> Maybe there was a group rate [laughter].
>> Arnold Rachman: Well, a group what?
>> A group rate.
>> Arnold Rachman: No, but you have to -- I think what you're saying is very important.  The psych guide for psychoanalysis at that time was that it was undesirable to have any breaks from the analytic experience.  So it was five or six, you know, and it was the early version of what psychoanalysis should be.
You see, in that way, he was doing what other people were doing but since he was doing it and he was labeled not only a dissident but someone as Jones suggested in the -- his third volume of his biography of Freud, he was mad.  In other words, his madness was -- his therapy was a function of madness.
Okay, what's the next one please?  All right, this is some -- this is what Elizabeth Severn looked like about February, March, April, May -- several months after she was prematurely terminated by Ferenczi because in February of 1933, she was prematurely terminated because Ferenczi was having the advanced stages of pernicious anemia.  So he was having trouble standing.  He was confined.  Eventually, he was confined to bed and he had to be fed.  But clearly, this does not look like someone --  this looks like someone who's in trouble herself.
>> It looks like Ferenczi's wife.
>> Arnold Rachman: Oh really?  [Laughter] I don't think so.  If you remember some of the images that I presented before you saw, Elizabeth Severn in a very different way than this.  You know, someone who was not overweight, who had her face was in a very positive image.  But now, it looks like someone who's been through the wars.  That's what she looks like.
And the -- I think, there's a whole series of things that happened.  I think they did regress and she did unearth these childhood traumas but she couldn't finish because there was premature termination and -- as soon as I finish this sentence, please.  Because she was -- someone like this may have had to be in analysis for another five years, 10 years, who knows?  So she was in the midst of the crisis of retrieving her childhood traumas but had not worked them through.  So this is what I think you get from something like that, yes.
>> Do you have any data on her relationship with her mother?
>> Arnold Rachman: No, so far I haven't.  So far I haven't.  That's a good question, of course.  We know about her father.
>> I've been thinking about the [inaudible] files today and I think there was a picture of the father with four children and there's some reference to the mother having died.  I don't know.  I have to check the notes to see [inaudible].
>> Arnold Rachman: Yeah.  Yeah, okay.
>> I would agree with your understanding of the [inaudible].
>> Arnold Rachman: Yeah, yeah.  So what is the next one, please?  Okay, so you see, here's another interesting [inaudible].  Go back to -- Karen, go back to 33, oh now go to 33.  Now go to the next one.  So this is 1935.  Now this is more of what she generally was in terms -- she -- when the analysis was prematurely terminated, she went to live with her daughter, Margaret, in London.  Margaret Severn was an important modern dancer of the 20's and 30's.  And she went there to recover which apparently she did.  I think as this photograph suggests and she set up after about a year or so, she set up a clinical practice in London.  As I had mentioned previously, her book, books that she had published were successful and she had, as I indicated in the letter that I showed you, people were asking her does she know anyone in England or London for help because they found her early works so helpful.  So it was apparently, it was not difficult for her to do that.
Okay, now one of the things that is often used to indicate Ferenczi's inappropriate and controversial work with Elizabeth Severn is what he and she both called mutual analysis.  So what happened as far as I can tell and this is very complicated.  And it also has a very prejudicial history.  In other words, the analytic community had a very negative reaction to this.  So often, you do not get what actually happened but the criticism of why it happened and the fact that it should never have happened to begin with.  So in that kind of atmosphere, you cannot assess actually what really went on and how value or negative it really was.
So what happened was that Severn developed what one we would now call an intractable transfer, negative transference in the relationship which she had developed with the other people that I suggested, Ashe and Otto Rank.  And usually what happened is that the analysis was either she terminated it or the analyst terminated it.  So the same thing, it'll come as no surprise to you, happened with Ferenczi.
So here's what she said.  This takes a lot of guts to say to an analyst.  Just think of yourself today.  What if someone came in to your office and said to you, "You know something?  You have a very serious countertransference problem.  Do you know why?  Because you hate women and because you hate women, you can't analyze me."  So that was no -- that's the first part.  That's enough to say to yourself, "[Inaudible], what's going to -- "
^M00:49:15
[ Laughter ]
^M00:49:18
What's going to happen next?  So that's, if that wasn't bad enough, listen to what comes next.  "And I know how to fix it."
>> Aha!
>> Arnold Rachman: "You see, what needs to happen is that you need to let me help you analyze this problem."  What?  Now we're talking about 1930, '31, '32.
Now, do you think there was any analyst in that period who would say to themselves, "Wow, this is very interesting.  I don't like it.  I don't like it.  I'm not sure I want to do it but this is interesting.  I have to listen to it."
^M00:50:13
I don't think so but that's what Ferenczi did.  He said, "Look," I'm now interpolating what he did.  "Things are not going well.  This has happened before.  She's a very desperate person, you know.  She's got very serious problems.  Can I do something different than has occurred before to help this person?"
So after wrestling with this in his own head for a year, he finally conceded that maybe she had a meaningful thought and so they started what they both had termed mutual analysis.  They took turns analyzing each other.
Now, I'm going to say something very dramatic and in a paper that Bob -- is Bob here, Bob Prince?  Well, Bob Prince and I are writing.  It's called "The Three Analyses of Dr. Ferenczi".  I'm going to suggest, we both suggest that this analysis was the death warrant of the three analyses that he had.
The first one was with Freud.  The second was a peer analysis with Groddeck and the third analysis with Elizabeth Severn.  Now, why do I say this?  I say this because this is what he was able to come to.  He was able to retrieve his own childhood sexual trauma in this analysis.  Now that's a pretty darn good piece of work.  You know, between the two of them, they retrieved first a memory and then a fantasy and then an insight that he did have very negative feelings towards women that were connected to his mother but also to a sexual abusive experience with a nursemaid when he was a young boy.
So that's a pretty special kind and I -- the problem, as I said before in that sort of very negative photograph of Elizabeth Severn when in her premature period before or after her analysis was terminated, it wasn't finished.  That's not an easy thing to work on.  So it was difficult for her and it was difficult for Ferenczi.
>> But Ferenczi, is there any merit to the psychoanalyst agreeing to this process and sort of playing along with it as it were with the hope that [inaudible].  From what I understand, they had come to a point where there was no [inaudible].
>> Arnold Rachman: Right.
>> And if he said, "Well, I'll let her play doctor and maybe in that process, I will learn more about her issues."  You know, it will come out.  Did that get any [inaudible]?
>> Arnold Rachman: Well --
>> And I could see just on the surface of it would get her thinking about it.
>> Arnold Rachman: Okay, well let me just relate to what you said.  The notion of playing with this idea, in other words, going along with it, is not an authentic -- that would not be an authentic clinical interaction.
>> Well, I know it would be controversial.
>> Arnold Rachman: No, no, no.  I'm not talking about controversial.  I'm talking about its not authentic.  In other words, you don't play a game with this kind of work.  You have to do it because you believe that there is something meaningful in what the person is asking you to do and as you can see, from Ferenczi's response, he was completely into it.  I mean, he doesn't retrieve his own childhood trauma unless he's authentically involved in interacting with her.  So it's his expertise and her expertise coming together, I believe, in a very special event.
Many -- I mean, I don't know if Lewis is going to talk about this because he's written about mutual analysis.  But I don't know that anyone would recommend this.  Ferenczi himself had doubts about it and said it should only occur in the direst of circumstance.
>> Oh, absolutely.
>> Arnold Rachman: Yeah, but it has to be authentic.  Anyone else?  I can't -- I'm having trouble seeing but okay.  All right, so could you give me the next slide, please?
So here's Severn at '38.  That's three years after.  She still seems to be in decent shape, you know, very different from the 1933 picture when she first terminated.  She's practicing in London as you can see from the caption.  And by the way, her practicing seems to have been successful.  People came to see her.  She made a living, you know.  She gave lectures, as I said.  And so, she was able to do something that was helpful.
By this time, she sees herself as a psychoanalyst.  And if you, in the 1933 book that's out of print, she talks about analysis.
And by the way, Severn went to see Freud several times to consult with him during the analysis with Ferenczi.  Now, I don't know if she was interested in making sure that Ferenczi was doing a good job or that she wanted to have some contact with Freud as everyone in those days wanted to do.  But she felt that her contacts with Freud were not particularly helpful to her.  She would talk to him about what was going on.  He never criticized Ferenczi in his work.  He said that in essence that he was doing a fine job.  But that she thought that his ideas were not in the spirit of being a healer.  That he was more theoretically oriented and don't forget, she had the opportunity, if you think about it, to go see Freud.  Even though Otto Rank sent her to Ferenczi, she did want to go see someone who was seen as a healer, seen as a clinician who could work with difficult cases.  She knew she was a difficult case.  God knows.  So she did not see Freud as a helpful person to her yet she did believe in psychoanalysis.
Next slides, please.  Now here's the last slide, the last photograph, I think I have of Severn.  This is in 1950.  So she looks fine.  Yeah, she looks animated and not particularly depressed.  Now what did she say about her analysis with Ferenczi?  Now everyone is talking, everyone talked about what the analysis with Ferenczi was like but what did she think of it?  She thought that Ferenczi was a very good clinician that helped her.  He particularly helped her with her depression.  She no longer felt suicidal.  Don't forget from the early description of the traumas, from the earliest period of her life, she felt like she might do away with herself.  And so that did not happen.
So I would say, in her own words, that Severn was talking about now, you know, I'll just diverge for a minute.  Michael Balint said of the Ferenczi and Severn analysis, "This was a talented woman who made some recovery but could not be considered cured."
^M01:00:00
Now, that brings up a whole other topic, in my opinion.  What is being cured? Particularly in someone this disturbed, what would be, I think that if you look at the trajectory of her life after her analysis with Ferenczi, you could say she was in very good shape, and was able to function, and she was able to have relationships with friends and her daughter, they were very close, and were able to work. So what is Freud's dictum about a successful analysis?  What have we all been taught?  What is this -- the result of a successful analysis? 
[ Inaudible Response ]
To work and to play, so I would say if you use Freud's criteria, I think you could say it had a success. She wasn't cured, no one ever -- Ferenczi didn't think she was cured.  She didn't think she was cured, but there was some positive changes.  Was Elizabeth Severn evil or a genius? I find it very difficult to assume that she was evil. I don't see anything in the material that I've studied, or the things that have been written where Elizabeth Severn was evil.  I think Freud -- this is my assessment -- I think Freud saw her as evil, because she was taking Ferenczi away from him. You see, this all happened at a very interesting crisis moment. Freud was suffering from mouth cancer.  Ferenczi was suffering from pernicious anemia. Severn was suffering from her analysis [audience laughter], you know, and so I think Freud wanted Ferenczi to continue to be his dutiful colleague and not venture into these controversial methods, and not work on trauma analysis. Do analysis the way he was taught, and be a best friend to Ferenczi -- to Freud.  And it's true that Ferenczi was drifting away from Freud.  He knew that Freud could never approve of what he was doing with Severn. It was impossible, because it was so far afield from the prescription for psychoanalysis that Freud had laid down, you know by 1915, 1916, was very different. But it was Freud's -- Ferenczi's idea that this was what was necessary in order to treat severe trauma, so it's a completely different frame of reference.  It's an innovative frame of reference to treat trauma as it expresses itself in a severely disturbed person.  And it necessitated a new frame of reference, and a new theory, you know, of Ferenczi's Confusion of Tongues Theory.  Yes?
>> I always thought that the reference to her being evil had more to do with Freud's field for his expression, that she was a destructive influence on Ferenczi, and that she had entrapped him in some way, and that was what -- 
>> Arnold Rachman: I think that was part of it too.  I'm suggesting that's also -- 
>> No you're suggesting something underneath.  I'm suggesting his reason, the meanings of his words, but I think that's why he called her evil.
>> Arnold Rachman: No, no.  He called her evil because -- 
>> Because he felt that she was a destructive influence -- 
>> Arnold Rachman: Well she was taking -- 
>> -- was trapping him.
>> Arnold Rachman: Well she was -- that's another part of the evil -- 
>> That's a -- 
>> Arnold Rachman: -- connotation, that she was forcing by dint of her psychological powers to put Ferenczi in a completely different way of functioning that was destroying him.  I mean if you want to push it to a further, it was destroying him clinically. In other words, he was doing very inappropriate clinical things.  It was destroying him physically, because he had to spend so much time and energy on her therapy, and it was destroying him emotionally. In other words, he was becoming a victim of her seductive emotional powers.  Yes, I think that's true, I think he felt that.
>> Do we know anything about what the negative transference in that analysis was like, and how rigorously, she may have been disemboweling him and traumatizing him with a negative transfer?
>> Arnold Rachman: Wait a minute -- 
>> Do we know how intense that was, and it would seem to me like if we knew something about that part of the analysis, then we would have some idea about the evil thing.
>> Arnold Rachman: He -- I mean it was so intense, you know, that he was immobilized, if you will, and she wouldn't budge either.  So, she was making expressions emotionally and directly that he was, he hated her, he hated women, he'll never be able to fully analyze her until he comes to grips with his own internal subjective experience, which relates to her.
>> That would be relatively denying compared with threatening suicide and a whole bunch of other things.
>> Arnold Rachman: No, I don't think, not that I know that she created suicide. I mean but he may have been frightened that she would.  Don't forget he knew her history, and she had a very severe, you know, depressive mood, and she had a very active suicidal ideation, so that certainly can be in the back of his head you know.  Sure, that's a good point.  Does someone else -- 
>> Yeah, I wanted to mention that Freud uses the phrase evil genius earlier with respect to Alfred Poach, who was a German psychiatrist, who was one of the bitterest enemies of psychoanalysis.  And I think it probably derives from Dakar's evil genius basically, you know, so that it's a term like in Freud deserve for the thing that he despised the most. 
^M01:07:47
[ Laughter ]
^M01:07:53
>> Arnold Rachman: Was she a genius?  I don't think so. 
>> You don't think so.
>> Arnold Rachman: No.
>> Why don't you think so?
>> Arnold Rachman: Because -- 
>> I think she might have been one.
>> Arnold Rachman: Really well why don't you say what you think.  [Background speaking] No, no, no you go first [audience laughter]. Go ahead.
>> Because I think she may have had this, be this kind of person that has this kind of exquisite insight that many other people don't have.  That she could experience, you know it's entirely possible, I mean she was right about him.
>> Arnold Rachman: Yes that's absolutely correct.  That's absolutely correct. One of the things that Michael Balint suggested she had a very, you know he was an observer to the analysis, because Michael Ballot was Ferenczi's primary student at the time which this was occurring, and he wrote about it in his book, a 1968 book on, ^IT Therapeutic Regression Basic Fault ^NO.  He said she had an uncanny ability to discern, this is not quotes this is my interpretation, uncanny ability to discern the subjective state of the other.
>> That's one of the -- 
>> Arnold Rachman: So that's -- so in that sense I still wouldn't call that genius, but I would say that she had a very special sort of clinical capacity, I believe, for empathy. See?  I think she had very special capacity to empathize.  I think that's why when she went door-to-door as an encyclopedia sales person, I think people sensed, you know, when she talked to them that she had some special quality, you know, and that they opened up to her. Did I do something?
[ Inaudible Speaker ]

 And so I think in that sense she had a very special capacity for empathy. 
^M01:10:03
 I think she had a very special -- she could use her own pathology in the service of her own thinking, and feeling, and behaving.  Don't forget was a severely disturbed person, yet she had the capacity with this disturbance to continue to search out the meaning of her existence, to go back into her earliest period, and to try to make sense of it. She developed, you know, great insight into her own functioning. So in that sense I would say she had special qualities.
>> Question, within her framework, we're on framework -- 
>> Arnold Rachman: Right.
>> -- of what she recalls it, or develop, evolved - 
>> Arnold Rachman: Right.
>> As her sense of how to do -- to propagate, could she conceivably be regarded as successional in that type?  She was following her own, and always trying to -- 
>> Arnold Rachman: No, well it wasn't just her own, as I've suggested.  She was trying -- she was integrated -- like towards the end of her functioning, she integrated Ferenczi ideas.
>> Well, that -- to me that would indicate, you know, she is not -- her position isn't locked.  She's open to ideas -- 
>> Arnold Rachman: That's right, that's right, that's right. 
>> -- with which to grow that's sounding like a desire to be professional in spite of the fact -- 
>> Arnold Rachman: Yes -- 
>> -- that the established world thinks she's [inaudible].
>> Arnold Rachman: Well, some of the world thinks she's -- 
>> Well -- 
>> Arnold Rachman: You mean this -- the traditional analyst of the time may have had that -- but don't forget think what it takes to go from America to Budapest for analysis. I mean those days it wasn't -- 
>> In the 1930's yeah -- 
>> Arnold Rachman: Well no, in the20's [background speaking] you don't hearanyone doing that anymore [laughter], but in those days that was a -- anytime it was a big thing, and she had to completely, you know, overturn her life and go there. And she took the patients with her so she could, I guess not only be able to continue with them, but to have some form of living to pay for her analysis and her living situation.
>> Did she advocate mutual analysis in her own clinical world?
>> Arnold Rachman: I don't think so. I don't think so -- I think that's one of the things that people have to understand. It was a very special moment in the history of psychoanalysis, because it was a very difficult moment in history of psychoanalysis.  And I think she believed that that was the way the impasse could be broken, and as Harriett suggested, she was right.  How else could he retrieve his childhood trauma if it wasn't accurate that he had some feelings about women, and her in particular, that were interfering with the analysis.   It was actually accurate.  So, anything else?
>> Sounds like a high function borderline -- 
>> Arnold Rachman: That's what I would say, I would say, remember in the 1960's when we were first training Henry, they used to talk about an ambulatory schizophrenic?  To me it's between borderline and ambulatory schizophrenia.  Some -- 
>> To help you get through complainers so that if you went to Ferenczi you could reject that help that he needs to get, but when she helped others, and they were seeking her help, she didn't have to be [inaudible] to complain.
>> Arnold Rachman: Yeah.
>> And might be functioning borderline have that exclusive thing that Harriett was talking about.
>> Arnold Rachman: I would say that's a close to a diagnostic definition than I would accept, yes.
>> Could we get an image of the mother through the great powerful transference that she had, especially the devouring, and the hunger, I mean it's coming the Depression [inaudible] that we have problems stemming through [inaudible] and when she was trying to digress [inaudible].
>> Arnold Rachman: Well, I mean it's a good hypothesis.
>> This is a hypothesis -- 
>> Arnold Rachman: It's a good one, it's a good one.  We should be able to retrieve some idea of the mother's functioning through the transference that developed.
>> Might could have a feel for it -- 
>> Arnold Rachman: Oh, please -- 
>> You know about in the Clicking Review, in the paper that you donated, in order to the Cincinnati Inquirer, 1934 reported a lecture that she did on Psychoanalysis today, what she discloses that she analyzed her own daughter, Margaret -- 
>> Arnold Rachman: Yes she did.
>> What she's saying the patterns go all the way back to the weaning.  Okay so she talks about the difficulties of her daughter, and that coming back to weaning experience that they -- so that's a presumption considered to work with.
>> Arnold Rachman: Yes, she and other analysts of the time analyzed their siblings, I mean their children, including Sigmund.
>> Melanie -- 
>> Arnold Rachman: Melanie yes.
>> When she's, it seems like you learn about yourself and your own analysis which she might went about her patients and can you get insight into how she had to work with one.
>> Arnold Rachman: That's a good question actually, that's something that I have to work on. You know this -- what I have is letters of -- testimonial letters from patients about how much they appreciated the work that she did with them.  I may -- I haven't fully gone through the autobiography of Margaret Severn yet, and so I hope that there might be some material in there about her mother's functioning with patients.  That's a good thing to keep in mind.
>> I was just wondering about her -- 
^M01:16:50
[ Inaudible Speaker ]
^M01:17:01
>> Arnold Rachman: Well, I think she saw Ferenczi -- there was that kind of transference to Ferenczi, you know.
>> Was there any indication [inaudible]?
>> Arnold Rachman: And what?
>> Did she -- were there any murderous thoughts or feelings, if she wanted to get revenge of any -- 
>> Arnold Rachman: Not that I know of, right now.
>> I couldn't hear it in here -- 
>> Arnold Rachman: Not that I know of right now, but that's something to keep in mind too.
>> [Inaudible] clinical diary and he was clinically, a mess.
>> Arnold Rachman: Well, I wouldn't say that.
>> Well, it was -- 
>> Arnold Rachman: I wouldn't say that it was a mess. It was just very difficult.
>> Yeah.
>> Arnold Rachman: Well that's different than a mess, because it was conducted, you know, in a -- 
>> He spent hours, days with her, out all day -- 
>> Arnold Rachman: Yeah, that was one of the criticisms that had been alluded to -- 
>> Very depleted, and excited about doing it.
>> Arnold Rachman: I just want before my time runs out -- well could we hold it because I want to finish something.  I'd like to suggest that the -- Elizabeth Severn made a very significant contribution to psychoanalysis in that in her work that she did with Ferenczi. I think -- and Ferenczi has suggested this himself, that there was the introduction of clinical empathy in his 1928 paper.  He suggests that his notion of empathy owes some work to Elizabeth Severn.  The introduction of non-interpretive measures into the analytic encounter were definitely all played out, some of them successful, some of them unsuccessful, but nevertheless the notion that interpretation alone is not the road to analyzing severe trauma, that you have to be willing to do other meaningful things. The establishment of trauma analysis, in other words, the analysis that Elizabeth Severn and Ferenczi developed during the course of this eight-year analysis is something that can be seen as the beginning of the analysis of trauma.  Counter transference analysis, I think we owe this both to Ferenczi and Severn, because if you think about it his --  the mutual analysis experience is basically Ferenczi working on his counter transference as Severn suggested that he do. 
^M01:20:06 
So for now that's as much as I'm going to say and I thank you for your attention.
^M01:20:15
[ Applause ]
^M01:20:19
>> James Hutson: We have two very distinguished commentators. Lewis Aron the Director of the Post Doctorial Program in Psychoanalysis at NYU, he's the author with Adrian Harris, ^IT The Legacy of Sandor Ferenczi ^NO," I'm told it Ferenczi.  We have Hungarians here and I've checked this with them. The Legacy of Sandor, not true?
>> Arnold Rachman: I asked George Hedash, who's President of Sandor --
>> James Hutson: Yeah. You said [inaudible]?
>> Arnold Rachman:  -- Ferenczi and Edith [inaudible], and she didn't say -- 
>> James Hutson: All right I guess the --
>> Arnold Rachman: Ferenczi!
>> James Hutson: -- the doctors disagree, maybe huh?  The doctors disagree. ^IT The Legacy of Sandor Ferenczi A Meeting of The Minds ^NO," and with Karen Starr, ^IT a Psychotherapy for People Towards A Progressive Psychoanalysis ^NO. We also have Dr. Joseph Lichtenberg, Editor and Chief of Psychoanalytical Inquiry and the author of ^IT Psychoanalysis and Motivation ^NO," and also ^IT Craft and Spirit ^NO, and ^IT Sensuality and Sexuality across the Divide of Shame ^NO."  Gentlemen?
>> Lewis Aron: Hi, welcome and I'm really glad to be here. I want to thank the Library of Congress and I especially want to thank Arnie Rachman for inviting me, and for putting this together and donating the papers.  It's I think a very significant historical occasion.  These are really historically important documents and I'll try and comment on them a little bit. The question of how to pronounce Sandor Ferenczi, or Ferenczi, seems to me it's a matter of whether you speak Hungarian with a Yiddish accent or not [audience laughter].
^E01:22:18
^B01:22:26
 I think I want to start by saying that I think the biggest temptation and the biggest problem when talking about Ferenczi and Freud, is the tendency to create polar oppositions, binaries where one of them is idealized, and the other is villainized. So that Freud becomes either the villain, and Ferenczi is the hero of the future, or Freud is seen as really the mature stable one, and Ferenczi is seen as a wild character who's acting out and the good and the bad keep flipping. And I think that they represent two versions of psychoanalysis, two different ethos, two different ideas about what people are, what the mind is, what treatment is about, what the ideal of health is, or how we view pathology.  They have very different perspectives, and the temptation is always to think that one was right, and the other got it wrong, or that one somehow had more maturity and the other immature. And this was the nature of their relationship, except that Ferenczi accepted, through most of his life, that Freud was the more mature one, that Freud was the one that got it right, and that his own tendencies were immature. And by immature in those days what that meant was that because Freud stressed independence, autonomy, individuality, and Ferenczi stressed communion and relationality, and thinking with others, that his way of thinking was more in those days considered feminine and Freud's more focused on independence and autonomy was marked as masculine. And so, Ferenczi realized that he was -- his vision was by those standards a more feminine vision. And therefore, he accepted that it was really his homosexual dynamics that led to that, so that he was both immature, feminine, and therefore homosexual.  In contrast, he agreed with Freud that that's what it was and saw Freud as the contrary, the more masculine, autonomous, independent, heterosexual, straight, and himself as essentially on the margins.  And so when Freud would make those interpretations to him, which Freud did throughout not only the years of the actual analysis of Ferenczi, Ferenczi was in analysis with Freud in three periods. Really, we're talking about a total of six to seven weeks spread out over three periods of analysis interrupted by World War One.  During those years of the analysis Freud would make that kind of interpretation to Ferenczi.  Here's an example I think brings it to light, in the way they actually worked, and they way they worked on their writing, and the way they worked on their papers, Freud liked to work alone. He liked to work independently. He liked to think in his own mind about what he was creating, what he was doing.  And then when he had it down, he would share it in a letter with a friend or a colleague and think it out with them for their feedback, when he was done more or less.  Ferenczi didn't like to work that way. Ferenczi liked to go for walks with a friend and think out with his friend what his ideas were, and he would come to his conclusions in dialogue. But Freud viewed that as a less mature way to think, because it was dependent.  It had to do with his need for others. In contrast to Freud's vision where thinking alone was more autonomous and masculine.  So Freud would interpret to Ferenczi that his way of doing it was reflected on conscious homosexuality, femininity, childishness. You hear the binaries, what is adult is masculine, is healthy, is mature.  What is feminine is immature, and associated with homosexuality in a man.  They played those binaries out with each other and sometimes in the legacy of Freud and Ferenczi, those binary's get played out once again, but often with reversals.  So, instead of Freud being the champion of autonomy, Ferenczi becomes the champion idealized for relationality and for getting it all right, and then Freud is then put down as being too self-centered, too independent, and just rejected as then being misogynistic and homophobic.  So these things get reversed back and forth.  Let me move from that to say a little bit about Elizabeth Severn. I think that Severn's -- I think Severn made enormous contributions, and I think that Ferenczi made enormous contributions and that they really did do it together and mutually influenced each other. It seems clear to me that it's neither -- it's not as if Ferenczi had all of this worked out and he taught it to Elizabeth Severn, nor is it the case I think that Severn had this all worked out as she sometimes claimed in America before she even met Ferenczi, and then went to Budapest and basically taught it to him.  There are lines in her book where it seems like she's making that case. I don't think either is true. I think these are two people that really had a very deep, extensive encounter over many years and mutually influenced each other's ideas. As much as we saw the one picture that looked so bad of her in 1933, I think it's important to remember a few things. First of all, that's one picture, you know, it's not as if they had digital photography and we have a whole bunch to select from.  There's one photo.  She looks pretty good in all the others we saw.  Who knows why she looked bad right then? I would be reluctant to come to too many conclusions on the basis of one photo. Second of all, it's not just that she had an incomplete analysis, whatever that is.  It's also that somebody that she loved was dying. So she was -- she may have very well been very thrown, not just by ending an analysis, but by the death of somebody that she was very attached to, depended on, loved, and had a very rich experience with. So, I'm not sure that we should make too much of that picture, especially because her book, and I'm indebted to Peter Raniski [phonetic] who's here, who's working with me on publishing the book that she wrote in 1933.  We're trying to get permission, trying to actually get it written.  We've gotten approval to go ahead and we are going to go ahead and publish it.  And Peter's writing an introduction to it and we're doing a lot of work on it.  This is a book that she wrote, it was published in 1933.  It was published, that means I don't know if within weeks, months or at most a year of her analyst Ferenczi's death. She wrote this book presumably either while he's dying at the very end, or shortly after he died. 
^M01:30:12
The book -- now to comment on the book is very challenging.  When the book came out, the analytic community totally said it was trash, and the reviews that were published of it, said that it's just garbage.  When you actually read the book, it is certainly, whatever we argue about how brilliant or not brilliant it is, it's certainly very well organized, coherent, well written, there are rich examples of her clinical work, this is a sophisticated thinker who has a point of view, and she wrote this supposedly when she's at her worst phase.  So I have doubts about really what she was like in that period.  It seems to me there's actually good evidence that she was as thrown as it's been described that she was.  Now in terms of the books approaching contributions, there are many things in this book that foreshadow or anticipate many of the things we are all thinking about and working about today.  And these come not just from her, but certainly come from her and Ferenczi together.  For example, the notion of enactment, the idea that patient and analyst re-enact -- actually act out together reciprocally, key things from their life.  And those enactments are a way of remembering, a way of learning about yourself.  That it's not just from words, from free associations that we learn, but we actually learn from enacting with our therapist, what our core issues are.  That idea is spelled out in some detail, it's also related to trauma, and even in today's world, people working on trauma are saying that you can't process memory and trauma as you do other things.  And therefore instead of remembering verbally in words, you tend to remember it procedurally by doing.  That's exactly what she was writing about and Ferenczi was writing about, in the early 1930s, anticipating work both in trauma, psychiatry and in contemporary psychoanalysis.  In addition, they were relating the ideas of trauma, to the notion of dissociation, they were expanding Freud's ideas of defenses beyond repression.  Although unlike some people today, they maintained an interest in repression as well.  They didn't get rid of repression and replaced it with dissociation, they added the notion of dissociation and went further.  Beyond dissociation, they talked about the fragmentation of the psyche, and how the fragmenting reflected essentially -- she spells this out beautifully, it's really Freud's drive theory.  It's libido and aggression, it's the integration versus the disintegrative forces of the mind.  The parts of us that bring things together versus those that split things up.  And so she anticipates this idea that when love does not conquer hate, when love does not conquer aggression, we're split apart and fragmented.  These ideas, all picked up by later thinkers.  Now, let me say something a little bit more cautious about their work.  Their work, both Ferenczi's and Severn's, in my view, and remember this is from the early 1930s, they did not yet have anywhere near as much information as we do today about both trauma and memory.  But in my view, there's too quick a tendency on both of their parts, to believe what comes to their mind as reality.  So that when they have a memory of trauma, and let me remind you that they're experimenting with altered states of consciousness.  They're using hypnosis, they're using deep relaxation techniques.  Ferenczi's work on relaxation techniques and what he calls the active method, are clearly influenced by Severn.  They're experimenting with going into altered states of consciousness, trying to regress what Bailin later calls therapeutic regression.  And it's under those circumstances of deep regression and altered states that they have memories that come to them, hard to distinguish fantasies and memories, and they I think, jump too quickly to the conclusion that those are real memories.  I think we have to at least exercise some caution about that, and that's another example then, of how the binary, the polarity between Freud and Ferenczi gets played out.  Where Freud becomes the one that stands for caution about that, but it's all fantasy, and Ferenczi becomes the spokesperson for, "No, it's really trauma, it's reality."  And so we get a split between reality and fantasy that goes along with Freud and Ferenczi.  In my view, that's a big problem to bifurcate it that way and we need to keep thinking dialectically about both and how they interact.  For example, one of the things that Severn remembers is, she remembers that she was involved in a murder with her father in childhood.  In which she was forced to swallow the testicles of a black man who was murdered, now I don't know -- I can't pinpoint, did she remember that before she came to Ferenczi, or was that something that she remembered in an altered state, and was there any question of whether it was really or fantasy and how do you know?  And how you do you figure out?  I'm not arguing it was not real, I don't know that.  I'm just saying that in reading this, I think it's -- it behooves us to remain cautious, and not just jump to conclusions about trauma or fantasy, or let ourselves be pulled into that kind of binary.  It is interesting to me that there are several things even in 1933, you know, I really -- I read this book, I have now had the chance to read it twice carefully, and it impresses me that she gives much more credit to Freud than she does to Ferenczi.  She mentions Freud's name much more, she's very clear that it's Freud that --
[ Inaudible Speaker ] 
Tell me if that works?  Yeah, she's very clear that Freud is the one that gets the credit for this revolutionary discovery of the unconscious, she's very explicit about that.  She credits Ferenczi, but with a certain kind of -- a couple of times that she was the one that influenced him and taught him.  And so it's -- and it's hard to know, I mean I believe she probably did, but that doesn't mean he didn't also teach her, and there's not as much credit given to him in that way.  Her - there's certain things she accepts from Freud, which I think ae particularly interesting.  Because people accuse Ferenczi or having rejecting them, or moved beyond them, and it seems to me that she's probably stating more accurately what Ferenczi believed at the end.  For example, she does not reject infantile sexuality, you know, one of the things that people say is while Ferenczi went toward trauma, and he began to believe that it was all trauma, and that therefore he rejected infantile sexuality.  She goes out of her way and is very explicit about the importance of infantile sexuality, of childhood sexuality, how hard it was for her to come to believe in it, and how she now realizes that she's never had a case where it wasn't important to reflect on childhood sexuality.  She focuses on the importance of conflict, it's a very important psychoanalytic idea, that a person is conflicted and not just because it's their instincts in conflict with their super-ego or the conscience, or society, a person is inherently conflicted.  She says that very clearly at the beginning, now later in the book, she does emphasize certainly trauma over internal conflict, but both are there.  And she's using both sets of ideas, so it's very rich.  Where she disagrees with Freud, and Dr. Rachman talked about this, I completely agree with him.  One of the most important things that she disagrees with Freud about, is the lack of emotional related connection to the patient.  She makes it very clear that this not just a research activity, and that if your main interest is research, and I think she's thinking that Freud, because that's what was [inaudible] criticism was, that you're not going to be able to heal somebody when the predominant interest is research.  And she makes the argument that you can't just be this objective neutral and mechanical doctor.  That you really need to be there in a caring, empathic, concerned, identified with the patient way, and that you can't be so afraid that because you're a researcher and you want to be objective, you might be too afraid to actually influence the patient. And she makes it very clear that you can't be so afraid of influencing the patient, you're there to influence the patient, and you should use yourself to influence the patient in a good way.
^M01:40:05
A fascinating thing, a one footnote that I'll mention because I found it just really important, she discusses Jung's notion of the perspective function.  And Jung contrasted with Freud, Jung was emphasizing that it's not just a mechanical that we are influenced by our past and we become who we are through our fate, because we are influenced by the past.  But the perspective function is something about looking toward the future.  It's teleological, it's about something that we're moving towards.  She goes with Jung on the perspective function, but unlike what -- at least how Jung was presented some times, she doesn't reject Freud's explanation and go to the other side.  She holds both in this footnote, she says that we need both.  And understanding of the past and what led us here, as well as this perspective idea of what's coming in the future.  So I found that to be padded all simplistic, I found it to be actually a very prescient sort of integration and balanced, for somebody who's being described as a severe borderline.  She's taking actually quite sophisticated positions that are moderate and integrative and holding a lot together.  Let's see, I think I'm going to end by making one more point.  I want to put this in some historical perspective, and then say something clinical.  The historical perspective is that we owe a great deal to patients, and in particular to a group of women patients who taught their doctors a great deal, and of course the credit went to the doctors, at least on the surface.  And I'm thinking in the course of Anna O with Breuer, and by the way, it was asked whether she knew Breuer's work.  She cites Breuer and she cites Freud, and she cites a number of their books and uses them quite well.  She seems to me to be quite familiar with the main works of Carthisis and Breuer's work and Freud's work.  With Breuer and Anna O, what Freud learned from Dora, not always to her benefit, but what learned from her about transference and how to use transference and how to think about transference.  And certainly this becomes another example of Ferenczi and Severn and how much influences the analyst, and when it gets published, it's published under the doctor's name.  And because of confidentiality, often the patient isn't given any credit.  I have to say in fairness to Ferenczi, several places, he credits her by name.  He names her with her permission, and gives the patient credit in publications.  That's quite unusual historically.  And I want to end with something that Dr. Rachman said also when he was talking about how if you put this together with the clinical diary, you have this bookings of two perspectives. And I want to make the case that I think one of the biggest mistakes in the history of psychoanalysis, is that we have for a variety I think of rationalizations, rationales, for not getting the patient's input in the publications.  And I think it's one of the ways we have lost out.  The example that I'll use that comes right to my mind, I've used it before, is think of the difference if Freud had gone to Dora and said to her, five years after the treatment, "Look, I know we had a troubling ending, but I'm actually writing your case up, and I'm going to be publishing it."  Rather than doing it without her permission, without her consent.  "I'd like your permission to do that, but that I'd also like your input. I'd like to know how my case reads to you, is it the way you remember it. Do you have a different point of view about it?  And I will publish it with my point of view and add yours."  If we had that kind of input from patients or anything like it, I think psychoanalysis would have progressed in a very different way.  It's a huge rich source of material that we've deprived ourselves for a whole lot of reasons, and the discovery of this book -- the rediscovery of this book and of her on the self, a lot about the self.  About empathy, about the development of the self, the coherence of the self, the fragmentation of the self, themes that are absolutely current today.  A lot of it is there because we have the patient's point of view, because in this case the patient happened to somebody that was making their living writing books and doing therapy, so a very interesting person, a very powerful interesting, strong, and complicated woman, an amazing pair between the patient and the analyst.  And I again want to end by thanking Dr. Rachman for making this donation to the library, for setting this up, for his scholarship over many, many years, and for giving us a chance to discuss this and look at it again today. Thank you very much.
^M01:45:26
[ Applause ]
^M01:45:30
>> Joseph Lichtenberg: It's kind of fun to come second, because then I know where we agree and otherwise.  I got my Ferenczi through my mentor Lewis Hill, and I got to observe Lewis Hill with working with the hospitalized patients that we treated together at Sheppard Pratt.  And what was utterly amazing was the things that Lewis Hill would come up with, and I realized after -- long after, that what he would come up with, was placing himself in the state of mind of the other, and recognizing things that nobody else was recognizing.  So empathy was without the name, very much alive in the heritage that I got straight away in my training from Lewis.  I hear four stories in Dr. Rachman's paper, all in one paper, it's pretty complicated.  He is describing a famous event in the history of the psychoanalytic movement, he is describing a depiction of a famous analyst struggling with a difficult, talent, troubled patient, as well as his own conflicts pointedly triggered by her.  Third, a depiction of a patient struggling with her severe illness, and as well, the limitations of a gifted skilled analyst to help her.  And four, the contributions that emerge, that make important help for contemporary clinical work.  I'll comment about each of those.  First, this is as Lew said, one of a group of treatment stories, so when you place it in history, and Lou noted that clearly, most of them have female patients, but I'll throw in little Hans, the Wolfman and the Ratman.  So it's not all one sided on the patient's side, but it's pretty well heavily loaded on the male side of the analyst.  And -- but this story is a very, very important story, it's been left out, the others are all famous, every student in analysis in an institute, can tell you about all the others, not this one, so this contribution that fills a gap.  On the Ferenczi side, it's about counter-transference, it's about things that we didn't appreciate. [inaudible] helped us, others, people have  struggled with this all along.  How much do you take in, how much does an analyst take in, in attribution, a positive attribution?  A negative attribution?  How much does the analyst work with what I call, "Wear it."  That is, see how it fits, deal with it, acknowledge it, recognize it, recognize the reaction to it, and work with it.  This is so critical, in one sense it's so damn obvious, and in another sense it's so problematic in the doing of it, that we don't really want to make it obvious.  So it's -- this is all about that.  What Ferenczi was, was open and honest and able to absorb the narcissistic injury of recognizing that there was more than a grain of truth to the negative attribution.  That takes a lot of courage.
^M01:50:00
A major theme in the restoration and other major contribution of Dr. Rachman is the restoration of Severn's reputation, her good name.  As a persevering, creative, independent, and interdependent contributor to psychoanalysis, dyadically with Ferenczi and on her own.  Now I have  a slightly different mindset about this business of, she was so sick, how could she write?  She wrote so well because she'd be so -- I mean back and forth.  My way of thinking is, that there is a motivational system of exploratory system in which we look at the world, we work with the world, we use our creative minds, and that this is a system which operates even when you take a troubled child, and sit them down.  And as they can get their emotions under control, they pick up a toy and they start to play, and they're adamant, they're out of the other state.  So we're talking about different mind states, and there is a mind state of being able to function at whatever high level a person has, and have a migraine two hours later.  This is not, yes, no, this is about how we look at motivational systems as they operate throughout every day, moving from one mind state, one set of intentions and goals to another.  So I look at this in a different way as not to make this the argument, "Oh look, you couldn't be so sick."  It's not about that, it's about a different thing.  Okay, now to the contributions.  I agree with Arnold on the contribution to empathy, I think it's totally there.  The contribution to trust, and the ups and downs of trust, the significance of the ups and downs of trust, mutual trust.  That you have to be dyadically intensely invested and this was her argument against Freud, she didn't feel it from him.  And that -- and she's right on that. I don't know if she's right about Freud, but she was right that it has to be there.  But there's another whole set of issues which have to do with what I would call nonspecific implicit factors.  This is -- touches on the limitations of interpretations as such, compounded with the problem of not knowing how to deal with enactments.  That's what they didn't know was happening, they didn't know how to understand it, and they didn't know how to deal with it.  They enacted their enactment, in a serial fashion.  I'll get back to that if I have time.  Another thing I agree with -- is what didn't get said is said to have an [inaudible] function, which I take to mean an appreciation that there is within the individual, a capacity for resilience and preservation of a authentic sense.  A true self in [inaudible] terms, an authenticity, and that then every effort is made by the psyche to preserve that, and that I think is something that came -- was there, not emphasized but I think it's a very important contribution.  Okay, I partly agree about the trauma methodology being critical and important.  Where I want to make my little disagreement is, I think we did not -- we tended to see trauma in what I would call acute episodic trauma, overwhelming of the capacity of the mind to deal with the situation.  Much, much more trauma is stress trauma, is relational -- continuing relational troubles in the family, in the person, and that that methodology is similar but not the same.  And so I want to make a pitch for separating those two phenomenon.  Okay, now where do I disagree?  Well, I disagree by using a false measure.  I'm using contemporary idea to talk about something that they didn't have, the contemporary idea came from another guy who was isolated, Bowlby.  Who was pushed aside, published eventually in the psychoanalytic study of the child, and Anna, Freud, [inaudible], and I forget somebody else, wrote "It can't be, it can't be, it can't be."  Because [inaudible].  So therefore out goes attachment theory, except it didn't go out, and it's here.  Now what I'd like to say about the nature of certain kinds of attachment disorders which I see as critical is this, that building from the human infants altruism, natural altruism, inborn altruistic potential, and responsive just to the needs of others, children and adults would secure attachment, enhance their inherent care-giving skills.  That this a norm and care giving is as Bowlby says, a separate motivational system, and I truly believe that to be so.  But those with insecure attachments, especially disorganized attachment, often develop forms of relatedness, via compulsive care giving strategies.  One strategy is built around solicitors over-bright controlling care giving.  I envision her as having this mode of dealing, I envision her selling the encyclopedia as selling her self care giving skills through her wonderful capacity.  And I see this as  a compensatory, compulsive way to try and make a connection based on inherent, insecure attachment and probably disorganized given the degree of the symptomatology.  Another form is a domineering punitive strategy, in which the care receiver controls and punishes the care giver through embarrassment and having -- and harsh, harsh criticism.  I see her as enacting that with Ferenczi, I see that as the centerpiece of their enactment.  And I believe the sexual stories, and here I'm right with Lew, they took it because that was the currency of the day, and you use metaphorically whatever is the currency of your day to explain things.  If you're in the Middle Ages you use God, exorcism, devils.  If you're in the Freudian early -- Freudian era, you use sex and sex trauma, and early sexual trauma.  That's the currency that you use to express troubleness.  If you're in the inner circle, I suggest that what we're dealing with is not -- is certainly trauma, but not that trauma.  I think that's a metaphoric statement about unhappiness of a very severe nature, and what I tend to believe is that if we looked at it from the standpoint of the stress trauma of long continuous attachment problem,. I think we would see things unfolding differently.  But basically what they did with each other was care about it and work real hard.  And that's the intrinsic factor that I think is so easy to underplay because we don't want to see -- we want to see that we have much more specific modalities. 
^M02:00:02
I also think that the ending of a treatment when the analyst dies is not good.  Having had that experience myself, I know.  My first analyst died totally unexpectedly a week after I had seen her.  But I was close to the ending, and it was one traumatic ending and so I'm in full sympathy with what a shock that can be.  Anyhow, I also think that Freud had a problem in that Freud needed to have an answer and it made it hard for him to be more open-minded.  He was afraid of censure, he was afraid of being told that he was a fake, the whole thing was a fake, and so I think he was much more inclined to be defensive at times when it would have been better to have been more open-minded.  It's easy to say, not easy for somebody to do.  I think this is a wonderful contribution.  I think there's so much more that can be said, but I believe that what Arnold is doing is pulling together multiple features and facts to make a story that is an analytic story to give us a piece of our own history that we otherwise wouldn't have, and I thank him very much for it. 
^M02:01:49
[ Applause ] 
^M02:01:56
>> Questions for any of the panelists? 
>> How [inaudible] --
>> To whom is this directed?
[ Inaudible Speaker ] 
To whom are you directing the question -- okay.  
>> Could you tie in [inaudible] chronic stress, [inaudible] stress [inaudible] and what it does to the human brain, [inaudible]?  
>> Joseph Lichtenberg: I'm not -- that's not my expertise.  What I -- what I -- what -- what -- the way it comes out is [inaudible].  The way it comes out is that the openness to learn and expand is lessened the flexibility.  There's concretization and the way concretization plays out is that when you have a pattern that has a negative quality to it, with negative affect very strongly in it, you're expectation is that -- is so high that that will repeat.  And so low that something better is going to happen, although both always exist, but one person is going to be much more on the shit, shit, shit that's my world.  And any expectation outside is very hard to come by.  And another person is going to have much more capacity to say, hey, I'm looking around, there's somebody over there who I think is going to be a little different.  I'm going to gravitate toward that person.  So that's where I see it playing out. 
>> Okay.  
>> Arnold Rachman: Zeke, you're talking about the structural changes in the brain due to trauma?
>> [Inaudible] gravitation --
>> Arnold Rachman: Due to trauma?
[ Inaudible Speaker ] 
That you can demonstrate on the basis of MRI's that there are structural changes --
>> Absolutely. 
>> Arnold Rachman: Yeah, that's what you're talking --
>> [Inaudible] the brain is affected. 
>> Arnold Rachman: Well --
>> [Inaudible] chronic stress [inaudible] hands of [inaudible]. 
>> Arnold Rachman: You know, we'd have -- we don't have -- we don't have anything to give an MRI to, right?  Elizabeth Severn is long gone. 
>> Yeah, she's gone. 
>> Arnold Rachman: Yeah. 
[ Inaudible Speaker ]
But the interesting thing that I was responding to is that, let's say, given the description of severe trauma that Ferenczi and she described, that she was able to function so well, given what probably were severe [inaudible] changes in her brain.  
>> That she could trust, even.  
>> Arnold Rachman: Yeah, but that she --
[ Inaudible Speaker ] 
-- that she must have had some serious deficits, but still was able, as -- as Joe was talking about, to -- there's something about human functioning, you know, that we don't emphasize, and that is the positive functioning of human beings under severe stress, under severe trauma, and that there are certain people who maintain the capacity --
[ Inaudible Speaker ] 
Yeah, we don't talk enough about that.  
>> Okay.  
>> Yes, I wanted to ask Dr. Lichtenberg if he could talk a little bit more about [inaudible].  Because to talk a little bit more about what he thinks was being enacted, and what you might think might have happened if Ferenczi knew it [inaudible] enacted. 
>> Joseph Lichtenberg: What is the question [laughter].  
>> Arnold Rachman: Remember, you brought it up. 
^M02:05:55
[ Laughter ] 
^M02:05:58
[ Inaudible Speaker ] 
^M02:05:59
[ Laughter ] 
^M02:06:02
[ Silence ] 
^M02:06:05
>> Joseph Lichtenberg: What was being enacted was, I need help and I've got you interested in giving me help.  I've used all my brights, all my charms, and my ills to get you interested in me.  Now that you're interested in me, I have to tell you, it ain't enough; something more is needed.  And I have to tell you that by telling you over and over again you're failing, you're failing, you're failing, you're failing, you're failing, you're failing, and I've got to get you -- I've got to get you to recognize that.  Now, one way I can get you to recognize that is that I can tell you that you got a problem.  Now, anybody who hears that over and over and over and over and over again is going to have a reaction to it.  And the reaction to it is going to be, God, shut-up already, lady [laughter].  I've had enough of this.  Oh, see, see, you're reacting.  You're angry.  You're -- you don't like women.  Oh, oh, oh, what doesn't get stopped -- I mean, we don't know what was said, so we can't -- we weren't there. 
>> We've been there. 
>> Joseph Lichtenberg: [Laughter] Indeed.  But, what wasn't -- if you know that and you see this pattern, and you know about enactments and how they take place, you say, wait, I hear you right now telling me that I failed.  Let's go back to what we were saying to each other just a little while ago.  What -- what -- where did you sense my not being with you?  What did you sense?  In my tone?  In my -- in something -- in your silence?  Oh, okay, did you feel I was withdrawing?  Yeah, I could see you moving -- I saw you reaching in the chair.  Oh, okay, then let's look at that.  I think you're right.  I think at that moment I had this particular kind of response.  So you play this -- you play it then, but when you don't know about such things, they just mount and mount and mount and mount out of desperation.  And so the patient gets whatever it is she feels that she's getting into the analyst, and boy it can be done the other way, too.  I mean -- so, it's not a one-sided feature.  But when the patient doesn't feel is getting in there, she is going to redouble her efforts and redouble her efforts.  So the enactment starts to get -- to pile up and pyramid, and at that point, you don't know -- you're so into it that you say, oh, God, I'll come to your house tonight [laughter], which is what he did.  
>> Another way of looking at that -- another way of looking at that, [inaudible] enactment is that she was always [inaudible].  Everything else would come secondary. 
>> Joseph Lichtenberg: You're absolutely right.  
>> [Inaudible] secondary.  Even [inaudible] they're all secondary, but that's [inaudible] the analysis, I would venture to say nothing [inaudible]. 
>> Joseph Lichtenberg: Okay.  I hear Ferenczi as intuitively sensing that she is saying, I cannot get anywhere in this life if I feel depowered, if I feel like I'm being the patient.  I'm the therapist, I've been a therapist all along.  I'm a big shot, and now I'm a patient, and a miserable one, and so on. 
^M02:10:13
I'm depowered and it's making it worse.  It's adding to my helplessness.  So, hey, how about I be the therapist?  I see that as both a good thing and an enactment. 
>> Arnold Rachman: Yeah.  I would agree with that.
^M02:10:32
[ Inaudible Speaker ] 
^M02:10:37
>> Joseph Lichtenberg: Yeah. 
>> [Inaudible] used again. 
>> Joseph Lichtenberg: Yeah, I'm going to be the one who has control, who has the power, and we totally underemphasize in psychoanalytic theory the significance of power.  The significance of having a feeling of, I have some power to make this thing work, change, do.  
[ Inaudible Speaker ] 
Yeah.
^M02:11:08
[ Inaudible Speaker ] 
^M02:12:37
>> Lewis Aron: Yeah, there's a lot in what you're saying that I think is worth addressing.  Let me see if I can put it into the context of what we've been discussing.  You know, I think a lot of the speculation about the dynamics and what went on and how would we diagnose her today and what are the dynamics that were going on in the treatment, they're all interesting.  And I think there's merit in all of the ideas I've just heard.  But my concern is that it is so easy when anybody presents clinical material of any kind to jump to conclusions about it and especially to pathologize it and to use the clinical information that we have as a way of then dismissing what's come out of it.  And I'm very concerned that we do not do that.  There's, you know, there's no clinical presentation today that I can go to from any school of analysts at all where there wouldn't be a group of other analysts who would show how it was all an enactment of some other problem from their point of view.  I've seen -- you know, [inaudible] presents what they think is a successful case, presented along Freudian lines, and these are published cases.  I could show you details about it.  Then somebody from another school says they've enacted compliance where the patient is complying with this theoretical expectations and that's why it looks like a success to him.  So we can look at any clinical case presented by anybody and then re-explain it as an enactment that really wasn't they thought it was.  And I think what's important to me when I read Freud and Ferenczi or any of these pioneers, what's important to me is not whether they had the right answers.  What's important is, what were the questions that they opened up.  So I'm not concerned whether they handled the enactment right or not.  I don't think we have the answers today about the right way to handle enactment.  I think that's still something we're arguing about.  What's important to me is they put it on the agenda.  They asked the questions and framed it.  They certainly recognized they were enacting.  They talk about it as a dramatization of their inner worlds, a dramatization bringing to life things.  Now, they may have not handled it the way any of us today would handle it, but most -- you know, there's no agreement, there's no consensus today about how to handle it.  So I think it's always better when we're reading historical material not to look at whether they had the right answers -- whether Freud's answers were right, but what were the questions they were raising.  
^M02:15:05
And so, my argument would be it is clear to me in reading this that they were raising the questions that we're still struggling with today. I certainly think your idea about -- you know, I think the loss of Ferenczi for her was clearly something that would have thrown her and that there would have been mourning and you're totally right that she does conceptualize and she spells this out. It is what later Franz Alexander, who also learned from Ferenczi, called a corrective emotional experience. That was what she was arguing for and so was Ferenczi. That in some respect, the therapist does reparent, the therapist does enact the role of the good parent, that that's one aspect of the treatment; it's not everything. But she highlights it and there's no doubt that she experienced Ferenczi that way, along with other ways, and that the mourning would have involved that.
>> Joseph Lichtenberg: I have a question for Arnold.
>> Arnold Rachman: Sure.	
>> Joseph Lichtenberg: I got the impression from what you were saying that Freud tended to believe that the anemia was like a psychosomatic illness, that her stressing him was making that illness worse, and that that was part of her evil destructiveness, not recognizing that that is an illness, body illness, not a psychosomatic illness, and it had nothing to do with her, that the man was dying of an unfortunate illness. Is that --
>> Arnold Rachman: Yes. Well, in the letter that I read, you know, from him to Joan --
>> I think you should get up more.
>> Arnold Rachman: Oh, yeah.
>> Lewis Aron: Got to use the mic.
>> Arnold Rachman: Okay.
>> And maybe repeat what you're saying because we can't hear.
>> Arnold Rachman: Joe Lichtenberg just said that Freud implied that the evilness of Severn was that she was either contributing or causing his -- Ferenczi's pernicious anemia. And I think in the letter -- that's why I thought that letter was so meaningful. He -- Freud crosses by the pernicious anemia as if it weren't a significant issue, you know, that --
[ Inaudible Speaker ]
Yeah. And it was that -- almost that she caused him to break down and that her evilness, as you're suggesting, Joe, caused him to have pernicious anemia. And it's not a psychosomatic disorder. It's a dysfunction, you know, a biological dysfunction.
So I think that that's absolutely -- I believe that's right.
>> Joseph Lichtenberg: Okay.
>> Lewis Aron: Can I say something else?
>> Arnold Rachman: Yeah. Sure.
>> Lewis Aron: I'm sorry.
>> Arnold Rachman: No. That's fine.
>> Lewis Aron: Joe, I want to address that, too. Because this -- there are some ironies here. Because Ferenczi himself thought it was psychosomatic. He thought all illness -- he was influenced tremendously by Groddeck who -- Groddeck was really the founder of psychosomatic medicine, before Franz Alexander, who had gotten it from Ferenczi. And Groddeck believed that all illness had a psychosomatic component at least. Ferenczi was very deeply influenced by that.
But the irony here is that while Freud is blaming Elizabeth Severn, Ferenczi is blaming Freud. Ferenczi is saying that it's a result of his interactions, of losing the love of Freud and the support of Freud that he could barely go on without Freud's support.
And then, Severn, in her book following Ferenczi's death, does treat pernicious anemia and all -- she really talks about all medical illness as having a psychological dimension and even gives examples of healing patients who had been told that they were terminally ill and incurable and that she was able to cure it.
So the -- whether we dismiss it as megalomania or whether we say that there's a certain insight into that sometimes doctors tell you you're going to die and you don't [laughter].
>> James Hutson: Over here. Yes?
>> I wanted to comment on --
>> Joseph Lichtenberg: We can't hear.
>> Oh.
>> James Hutson: You got to stand up.
>> I wanted to comment on the issue of power. Everyone is focusing on the content of what Elizabeth Severn said and the influence on Tubin [assumed spelling], on Ferenczi. But I think the dynamic of someone you consider powerful, being able to say maybe you are more correct than I am in and of itself has a healing power.
^M02:20:08
And I think that's something about the nurturing parents or the good psychoanalyst or good therapist who can say, oh. Maybe you are more correct in your perception than I am and that, in itself, shifts things so that power, if you're getting it from someone you consider powerfully is the way of validating your own power. And I'd like to hear more about that rather than the content of what she is saying.
>> Joseph Lichtenberg: Can I?
>> James Hutson:  Yeah.
>> Sorry about this.
>> Joseph Lichtenberg: Okay.
>> It's your business.
>> [Inaudible] again.
>> Joseph Lichtenberg: When you look at infant studies and you say what is it -- what are the moments when the infant feels most, shall I say, powerful, it's when the initiative on the part of the infant is recognized and the goal and the infant is helped to achieve the goal of the initiative.
And so, when a patient says I think it would be better if I whatever and that initiative is recognized, dealt with, appreciated, and some goal that then becomes possibly a joint goal is actualized.
That gives power to both. So the -- this little observation that comes out of just every -- looking at baby stuff is one of the most powerful observations when you think of it on the tiniest scale or a much broader scale.
Because what we essentially are -- we are either a little tiny doer doings, which means having initiatives and responses, starting something and taking something in. And that little formula is essentially the core of the sense of self as a cohesive unit that has influence on the world.
And so, indeed, this -- when we say power, we can break it down to very small little units and those units appear in the -- at every analytic hour.
>> Arnold Rachman: Can I say -- do you want to come down?
>> Joseph Lichtenberg: Yes. Thank you.
>> Arnold Rachman: We have a traffic problem. I just want to relate to Dr. Kuden's [assumed spelling] remark that what happened between Ferenczi and Severn, when she suggested that she knew what was wrong and actually he didn't and then he didn't get involved in a power struggle with her and he didn't consider it a resistance.
Don't forget, in those days, and maybe even now, that's a very resistant remark. You don't tell an analyst that you know what's wrong and he doesn't. And not only is that true, but you know how to analyze it and he doesn't.
So I think it's a remarkable event that they didn't get involved in a power struggle and that he found a new way to deal with it and that is -- I mean, there's several concepts involved. Empathy is definitely one of them, but also, he affirmed her. In other words, he was able to demonstrate by his functioning that she was right. And then, she felt better as a person.
So the power struggle wasn't, well, I'm the analyst and you're a patient and don't tell me that you know what I don't know or that you can do better than I can do.
See, letting go of that is a remarkable thing, you know? We're still trying to work that out, you know, to be, you know, democratic instead of authoritarian, to have a two-person psychology and a two-person experience. We're both people who contribute to the analysis and both people are willing to analyze their contribution. It's not a one-person experience.
And just to go back to what Lew [assumed spelling] said about Dora, see, I have a whole thing about Dora. Freud could have discovered empathy in the case of Dora, now, we're talking about 1904, if he would have listened to what she was trying to tell him. He is -- he was so determined to apply the Oedipal complex to that case that he only responded to those aspects where he thought it was an Oedipal.
But I believe that it was completely different, that -- it was a trauma case, too, a sexual trauma case, that was completely avoided and that Dora needed to be understood and responded to. And Freud knew it because in the last paragraph of the case, he said, "Would it be different if I gave her the kind of understanding that she needed? I cannot say."
So he knew that there was something else to respond to, but he was so determined to prove the Oedipal complex that he let it go.
>> We've got a couple more questions.
>> I have one in rise of your remark, Doctor. Of the grounds for successful analysis being based on dialog, that is one way. I thought it was worth -- an instance where the doctor -- you have the curious patient who's starting out. Next person -- what would you do [inaudible] kind of understand that, you know, the discussion, that question of whether it's late in the day, way past naptime, and suddenly the doctor says I'm not here to teach you psychoanalysis. Now, would you answer my question? Would you say that would be the beginning [inaudible]?
>> Arnold Rachman: Would I?
>> Yes.
>> Arnold Rachman: Absolutely not [laughter].
>> That happened to me and --
>> Arnold Rachman: Oh, I'm very sorry that it did.
>> I suffered.
>> Arnold Rachman: I think that's the beginnings of a, you know, iatrogenic neurosis caused by the analyst.
>> And why would you stay with him?
>> He used to draw [inaudible].
>> Arnold Rachman: Oh, my God.
>> You stayed with him?
>> Arnold Rachman: Wow.
>> Not long.
>> Arnold Rachman: Well, I'm sorry you had that experience. You don't deserve it.
>> How do you know?
>> Arnold Rachman: No one deserves it. No one deserves it.
>> One more question, please. Yeah?
>> Peter Ridinski I'm reminded of the statement that there are two kinds of people in the world, those who divide things into two and those who don't
^M02:28:23
[ Laughter ]
^M02:28:31
And, you know, I'm just thinking that the historical importance of this relationship between Ferenczi and Severn, I think it could be converted to Freud's self-analysis. And you have the one person experience and the two-person experience. And I think there's a way to make the case that we need both. But there's also a case to be made that there's a choice. And for me, Freud could not admit he was wrong, fundamentally. He could not have gone with Burns and did it. And this was the tragedy of Burns' relationship with Freud.
So I do think in certain ways, we do have a need to choose between the two of them at the same time that we try to hold them together.
>> Arnold Rachman: I just want to say one --
>> Yeah. One -- let -- yes. Let's Dr. Rachman have just --
>> Arnold Rachman: A last word. Yeah. I just want to say to Peter Ridinski [assumed spelling] that Ferenczi was not interested in a dichotomy. He actually said in writing that he -- for example, the introduction of clinical empathy. He wanted that to stand side-by-side with interpretation. Not to choose empathy over interpretation or -- but side-by-side. And I think the -- and Freud seemed to accept it, you know, at that time.
^M02:29:59
But as he went further and further towards the treatment, I believe, of trauma cases and away from what Freud considered to be the more natural way to function, he himself, as you're suggesting, couldn't change and move -- so he had to be the father. He couldn't move towards the son. You know, children teach us, you know. We all know that.  But if you just want to be the father and be the one to teach and you're not willing to have the child teach you, it's a very limited system, in my opinion.
>> Well done.
>> Thank you.
^M02:30:45
[ Applause ] 
^M02:30:49
Thanks, everybody. It was a great session. Yeah?
>> Arnold Rachman. Thank you.
>> Thank you, professor.
>> This has been a presentation of the Library of Congress. Visit us at loc.gov.
^E02:31:02