Contribution of Hungarian Psychoanalysts

The American Journal of Psychoanalysis, 2009, 69, (207–220)
© 2009 Association for the Advancement of Psychoanalysis 0002-9548/09
www.palgrave-journals.com/ajp/
CONTRIBUTION OF HUNGARIAN PSYCHOANALYSTS TO
PSYCHOANALYTIC PSYCHOSOMATICS
Judit M é sz á ros
How is psyche related to soma? What tricks does the mind play on the body — and vice-versa?
In psychoanalysis, few have probed these questions more deeply than analysts from the
Budapest school. Their work began in Hungary and was carried forward in other countries,
following their forced emigration. In this study, I touch upon common features of Ferenczi ’ s
and Groddeck ’ s thinking about psychosomatics. I explore the work of S á ndor Ferenczi, Lajos
L é vy and Mih á ly B á lint among others, and the attraction between avant garde Hungarian
intellectuals — mainly writers infl uenced by Ferenczi — and Georg Groddeck.
KEY WORDS: The Budapest School of psychoanalysis ; Ferenczi ; Groddeck ;
B á lint ; early object relations ; psychoanalytic psychosomatics .
DOI: 10.1057/ajp.2009.11
BUDAPEST
S á ndor Ferenczi, Lajos L é vy and Michael Balint
In Ferenczi ’ s work, body and mind form a unit; physical and psycho-
logical processes fl ow into one another ( Pfi tzner, 2005, pp. 30 – 31 ).
1 The
subject of Ferenczi ’ s interest in psychosomatics is himself — his own body,
“ my poor Konrad ” ( Ero˝ s, 2004 ) — as he describes it in the Freud-Ferenczi
correspondence, using the Swiss writer Spitteler ’ s term. Seeing the body
more generally as the stage on which the mind expresses itself, Ferenczi
views the body as a surface abounding in symbols whose hidden messages
can be decoded through psychoanalysis. At the same time, in Ferenczi ’ s
approach, the body makes it possible to demonstrate the depths of psychic
regression. This view refl ects Haeckel ’ s theory of onto — and philogenetics,
according to which the development of the individual repeats the phases
Judit M é sz á ros, is a Ph.D., Training and supervising analyst, Hungarian Psychoanalytical
Society. President, S á ndor Ferenczi Society, Hungary.
Address correspondence to Judit M é sz á ros , Szt. Istvan krt. 13, Budapest, 1055, Hungary
E-mail: [email protected]
An earlier version of this paper was presented at the clinical S á ndor Ferenczi Conference,
August 2 – 6, 2006, Baden-Baden, Germany
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M É SZ Á ROS
208
of earlier development. Ferenczi contends that this is a fl exible, two-way
process in terms of the functioning of the mind: in regression we see the
very reverse of individual development. Earlier phases of ego development
can be reconstructed. In fact, as he discussed in his bioanalysis, his famous
Thalassa (1924), intercourse enables us to return to the womb and even
beyond to the very beginning of life and to the primordial soup (Thalassa).
In addition to all this, the psychosomatic phenomena in Ferenczi ’ s approach
appear to be appropriate to revealing any intrapsychic confl ict, whether it is
a problem in adulthood or in very early mother — infant, or even prenatal,
object relations — the latter case representing nothing more than the emotional
disposition of the mother and the environment toward the pre-born child.
Let us examine two examples of the appearance of relational
disturbances.
According to Ferenczi, a frustrating relationship full of bitterness and
disappointment, but still marked by a strong bond — like his own relation-
ship with Freud — can manifest itself in physical destruction. As we know,
his study, (1933) Confusion of tongues between adults and child written
for the Wiesbaden conference represented, by today ’ s assessments, a para-
digm shift toward modern trauma theories, and widened the gaps between
Freud and Ferenczi.
In an October 2, 1932 entry in his Clinical Diary , Ferenczi states the
following about pernicious anaemia:
Regression in  —  Embryonic state during analysis (in organic disintegration)
Further regression to being dead. [ … ] In my case the blood-crisis arose when I
realized that not only can I not rely on the protection of a “ higher power ” but on
the contrary I shall be trampled under foot by this indifferent power as soon as I go
my own way and not his. [ … ] And now, just as I must build new red corpuscles, I
must (if I can) create a new basis for my personality, if I have to abandon as false
and untrustworthy the one I have had up to now? Is the choice here one between
dying and “ rearranging myself ” — and this at the age of fi fty-nine? [ … ] A certain
strength of my psychological makeup seems to persist, so that instead of falling ill
psychically I can only destroy — or be destroyed — in my organic depths (Ferenczi
(Ferenczi, 1933b, 212 – 213.
In a sign of the truly frank relationship between Groddeck and he,
Ferenczi not only noted this in his own clinical diary, but he shared it with
his friend in the last letter he wrote to Groddeck:
The underlying psychological reason for this decline was due, apart from sheer
exhaustion, to my disappointment in Freud, about which you also know. (Ferenczi to
Groddeck, 20 March 1933. Ferenczi-Groddeck correspondence , 2002, p. 105. )
It could also be said that Ferenczi saw the body as a second system of
signals , one which has its own language to relate to the inner confl icts that
take place unconsciously, like a sort of messenger whose functioning is
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PSYCHOSOMATICS CONTRIBUTION OF HUNGARIAN PSYCHOANALYSTS 209
determined by psychological processes. S á ndor M á rai, one of the greatest
writers of the 20th century and a friend of Ferenczi, had this to say on the
occasion of Ferenczi ’ s death:
Ferenczi ’ s death had a completely primal effect on me: I simply couldn ’ t believe
it. When I put down the receiver that brought the news of his death, after a mo-
ment of refl ection, I called my informant and asked if he had not made a mistake.
Later, I thought about it and realized that I was hurt and angry at the death of
Ferenczi. I had a childlike idea that he had discovered something, that it didn ’ t
apply to him, that he would die when he wanted to. As far as I knew, he hadn ’ t
wanted to and [ … ] he looked down on death and life ’ s primitive structure [the
body] [ … ] he ordered a member of his family, if she happened to fi nd him,
dying, not to believe it straight away, but to shake him violently [ … ] This is what
he thought of the body; it was like a faulty clock that sometimes stops and just
needs to be shaken to get it to start ticking again [ … ] This is also why I was hurt by
his death. Perhaps he simply wasn ’ t shaken properly ( M á rai, 2000, 47 – 48 ).
Another example draws our attention to the potentially grave psychoso-
matic consequences of a frustrating mother--child relationship. The ideas
that Ferenczi put forth in his 1929 study The Unwelcome Child and His
Death Instinct also appear in the later works of other analysts. Whether
linked to Ferenczi or independent of him, these ideas were developed
further and made complete. They also brought about a change of perspec-
tive not only in the theory of psychoanalysis and in therapeutic practice,
but more generally in clinical work, as well as in infant care and in modern
childbirth. In 1929, Ferenczi thought that the symptoms of many patients
could be interpreted as psychosomatic expressions of the death instinct.
On this, there was complete agreement between him and Groddeck, who
also saw early deaths as unconscious suicides. Thus, Ferenczi writes the
following about a defi cit in early emotional relationships:
I obtained a somewhat deeper insight into the genesis of unconscious self-destructive
trends during analysis of nervous circulatory and respiratory disturbances, especially
of bronchial asthma, but also of cases of complete loss of appetite [ … ] not explicable
anatomically [ … ] patients came into the world as unwelcome guests of the family ,
so to speak [ … ] In later life, relatively slight occasions were then suffi cient motiva-
tion for a desire to die, even if this was resisted by a strong effort of will. Moral and
philosophic pessimism, scepticism, and mistrust became conspicuous character traits
in these patients [ … ] I only wish to point to the probability that children who are re-
ceived in a harsh and unloving way die easily and willingly. Either they use one of the
many proffered organic possibilities for a quick exit, or if they escape this fate, they
retain a streak of pessimism and aversion to life ( Ferenczi, 1929, pp. 103 – 105 ).
An important part of treatment is that Ferenczi allows these patients to
be children again in the psychoanalytic process, and to enjoy early primary
love, or passive object love, and, in this case, complete acceptance by the
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M É SZ Á ROS
210
analyst. Love and attention, in Ferenczi ’ s view, are indispensable to staying
alive (Haynal, 2002). Without love, the growing child can actually die;
indeed, early love is “ equivalent to nutrition. ” Winnicott said almost the
same: “ A baby can be fed without love, but lovelessness or impersonal
management cannot succeed in producing a new autonomous human
child ” ( Winnicott, 1971, p. 127 ).
Ferenczi ’ s ideas on the serious psychological and psychosomatic damage
suffered by the unwelcome child, the infant that has been left on his own,
were strengthened and took a new developmental tack through the work
of people like Ren é Spitz. Ferenczi ’ s deductive conclusions were borne out
through Ren é Spitz ’ s own experiments and observations that it was really
true that a child can become seriously ill in an environment without love
and can actually die.
Spitz was also infl uenced by the early years of Hungarian psychoanalysis.
He saw Freud for a few months in 1911 for his personal analysis, earned
a medical degree in Budapest, and attended Ferenczi ’ s lectures, but left
Hungary in the fi rst wave of emigration in 1919. The teachings of Freud,
Ferenczi, Balint and Klein appealed to him, and he carried on his special
interest in the early relationship between mother and child. In the 1930s,
when an ever more intensely fascist Europe forced him to escape as well,
he fi nally emigrated from Paris, and then settled in America. He quickly
came to understand the pragmatic way of thinking in America and the
demand for applicability. He thus observed infants placed in various insti-
tutions using the methods of experimental psychology with new techniques,
tests and other tools. He described hospitalism as a depressive symptom
in the abandoned child in the early few years. The studies Spitz conducted,
and his 1943 fi lm, Grief: A Peril in Infancy , prompted the consensus that
early contact and the early emotional and physical relationship between
mother and child should become a developmental imperative. The results
of his research changed the theoretical background and practice of hospital
care for infants. It is well worth noting that experimental psychology demon-
strated trends in line with psychoanalytic ideas in those years.
Harry Harlow ’ s research on primates placed the life-affi rming power of
maternal care that keeps us alive in a more general context. His experi-
ments were powerful proof of the fact that the possibility of clinging to the
mother, or the lack thereof, is a crucial issue. Later, other experiments with
animals bore this out on a much wider scale. Harlow ’ s greatest contribution
was his demonstration of the power of “ mother love, ”
1 that is, the necessity
of normal development (cuddling in general and especially if they were
frightened), and the devastation that ensues when an infant is untouched,
unloved and neglected.
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PSYCHOSOMATICS CONTRIBUTION OF HUNGARIAN PSYCHOANALYSTS 211
Both Ren é Spitz and John Bowlby had shown — before Harlow ’ s demon-
strations — how infants raised in orphanages became ill and failed to thrive
if they were fed, but never cuddled when they were isolated or abandoned.
On the topic of clinging, it would be a mistake to omit the name of the
man who discovered the infant refl ex that was named after him (the Moro
refl ex). In 1918, Ernst Moro described this refl ex so characteristic of infants.
2
Ferenczi also discovered Moro ’ s research. Ferenczi wrote that he had come
across the
interesting work of a pediatrician from Heidelberg on the fi rst trimenon, or on the
characteristic features of the fi rst three months of an infant ’ s life. [ … ] According
to Moro, if we slap a baby ’ s pillow with both hands, then a unique refl ex motion
takes place [ … ] the child brings both arms together symmetrically [ … ] at the same
time the legs demonstrate a similar motor behaviour ( Ferenczi, 1918, p. 225 ).
Ferenczi incorporated this into his study on the traumatic neuroses he
had observed in the First World War. According to Ferenczi, “ Moro is
referring to a tiny sort of fright (or traumatic neurosis). ” (ibid.) Ferenczi notes
that this reminds Moro of the cuddling refl ex in baby animals, and in baby
monkeys in particular, with which they “ cling to their mothers. ” (Ibid.) It
looks, therefore, as if this “ clinging phenomenon ” or refl ex was being
offered by Moro for the benefi t of scientifi c thinking. Imre Hermann (1933),
also of the Budapest school, defi nes the infant ’ s early clinging movements
as a component of instinct, and thus speaks of a clinging instinct in the
mother infant relationship. Hermann assumed a tendency toward a clinging
instinct behind the Moro refl ex. Perhaps these examples are suitable to
demonstrate the cycle in the complexity of somatic and psychological
components that is capable of bringing about changes in the successive
layering of physical and psychological needs in the organic depths — in a
harmony that represents satisfaction in optimal cases, but in a disharmony
of pathological reactions in opposite cases.
One more phenomenon can be added to the list of Ferenczi ’ s ideas on
psychosomatics: pathoneuroses. This is the expression Ferenczi uses to
describe psychological disturbances that develop in the soil of organic
abnormalities. He sees these as regressions that have come about as a result
of physical illnesses, injuries or mutilations — in fact, as narcissistic regres-
sions that are accompanied by a withdrawal of the libido from the outside
world and a seizing by the libido of the sick body part ( Ferenczi, 1917 ).
Psychoanalytic psychosomatics basically developed in Hungary through
the work of Ferenczi, Lajos L é vy and Michael Balint, but all of the physicians
of the Budapest school were of a similar mind, evidence of which include
the publications from the 1920s and 1930s. See, for example, G é za R é v é sz ’ s
study Organic diseases that serve to manage the libido ( R é v é sz, 1993 ).
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