Among Freudian analysts today, there is fairly universal agreement about what constitutes analytic behavior and what doesn’t. The analyst as far as possible confines himself to listening to the patient and (sparingly) offering him his conjectures—which are called “interpretations”—about the unconscious meaning of his communications. He does not give advice, he does not talk about himself, he does not let himself be provoked or drawn into discussions of abstract subjects, he does not answer questions about his family or his political preferences, he does not show like or dislike of the patient, or approval or disapproval of his actions. His behavior toward the patient is as neutral, mild, colorless, self-effacing, uninterfering, and undemanding as he is able to make it, and as it is toward no one else in his life—with the paradoxical (and now absolutely predictable) result that the patient reacts with stronger, more vivid and intense personal feelings to this bland, shadowy figure than he does to the more clearly delineated and provocative figures in his life outside the analysis. On this paradox—on the patient’s quickness to overfill the emotional vacuum created by the analyst’s reticence—the analysis is poised, and it may as easily founder as take off. If the patient sees the analyst as a cold, callous person of limited intelligence and unbounded tactlessness, he may decide to quit the analysis. In fact, Freud originally felt that positive feelings toward the analyst at the start of treatment were a necessary precondition for it. Although this is no longer accepted (numerous patients have stuck out analyses with analysts they detested), analysts continue to search themselves for what may have been their own contribution to the debacle of discontinued, aborted, or failed treatment. Perhaps it wasn’t a patient’s negative-transference reactions so much as his obscure perception of the analyst’s unkindly, if not outright sadistic, disposition toward him that caused him to flee the analysis. For to the complication of transference must be added that of countertransference; i.e., the analyst’s inappropriate reactions to the patient, based on his own unconscious misassociation of him with significant figures in his own past. (In its original, limited meaning, countertransference referred to an obstruction to the analyst’s understanding of the patient, which the analyst had to strive to overcome. In recent years, countertransference has been expanded to embrace all the feelings of the analyst toward the patient, with special attention to those that are deliberately—if unconsciously—elicited by the patient and thus properly belong in his dossier rather than in the analyst’s.) And to that complication must be added the treacherous and unresolved (unresolvable?) question of analytic “reality.” For implicit in the idea of transference as distortion is the assumption of some true, or truer, state of things that is being obscured. If the patient’s “menacing illusion” (as Freud called it in “An Outline of Psychoanalysis”) of being in love with the analyst is just that—an illusion, which the analyst must “tear the patient out of,” showing him “again and again that what he takes to be new real life is a reflection of the past”—then how is one to regard the “reality” to which the patient is returned? What is the nature and who is to be the judge of the “real relationship” between patient and analyst? Freud never much interested himself in this question. His discovery of the illusory relationship was, after all, the news, and the actual relationship between doctor and patient was not. But as time went on it became increasingly evident that in psychoanalysis doctor and patient stand in a relationship markedly different from the relationship that exists between doctor and patient in medical practice, and analysts have been increasingly preoccupied with (and divided on) the subject of the “non-transference relationship.” The lengthening duration of analysis is a factor in this new interest: analysis as a kind of weird avant-garde experiment that you lend yourself to for a couple of months (as the early patients did) is quite a different proposition from the eight- or ten-year analyses that are nowadays commonplace. (When analysis changed from a symptom-curing therapy to a character-changing therapy, as the shift from id to ego psychology caused it to do, it naturally required more time.) A modus vivendi of some sort must be established between patient and analyst, tolerable to both, if this singular and unprecedented association is to last the course, to say nothing of whether it will benefit the patient. “With due respect for the necessary strictest handling and interpretation of the transference,” Anna Freud wrote in 1954, “I feel still that we should leave room somewhere for the realization that analyst and patient are also two real people, of equal adult status, in a real personal relationship to each other. I wonder whether our—at times complete—neglect of this side of the matter is not responsible for some of the hostile reactions which we get from our patients and which we are apt to ascribe to ‘true transference’ only.”

Anna Freud’s plain speaking occurred at an analytic symposium where she discussed a paper called “The Widening Scope of Indications for Psychoanalysis,” by the New York analyst Leo Stone, with whose humanistic view of the analytic relationship she heartily concurred. A few years later, in 1961, Stone was to elaborate this view in his classic study “The Psychoanalytic Situation.” At the symposium, he was content to simply express his fear that analysts’ overzealous playing of their roles as silent, ungratifying, unknowable beings might subvert the very process it was intended to set in motion. Early in the paper, Stone reveals the sort of person (and analyst) he is as he looks with a kind of sorrowing wonder at the flourishing psychoanalytic scene of New York in the nineteen-fifties (today wistfully referred to as “the heyday of psychoanalysis”), when “scarcely any human problem admits of solution other than psychoanalysis.” Stone goes on to ruefully note that “by the same token, there is an almost magical expectation of help from the method, which does it grave injustice. Hopeless or grave reality situations, lack of talent or ability (usually regarded as ‘inhibition’), lack of an adequate philosophy of life, and almost any chronic physical illness may be brought to psychoanalysis for cure.” What Stone finds most disquieting about this overestimation is its implicit “loss of sense of proportion about the human condition, a forgetting or denial of the fact that few human beings are without some troubles, and that many must be met, if at all, by ‘old-fashioned’ methods: courage, or wisdom, or struggle, for instance; also that few people avoid altogether and forever some physical ailments, not to speak of the fact that all die of illness in the end.” Stone goes so far as to offer the startling suggestion that “if a man is otherwise healthy, happy, and efficient, and his rare attacks of headache can be avoided by not eating lobster, for example, it would seem better that he avoid eating lobster than that he be analyzed.”

In “The Psychoanalytic Situation,” Stone argues for the necessity of “framing” the stormy primitive drama of transference and countertransference in a placid relationship of two adults: one a doctor of manifest good will and reliability, the other a patient of comparable maturity and responsibility—insofar as he comes to the sessions, pays the bills, and takes the analyst’s unconventional behavior as a “technical instrumentality” rather than as a personal attack. Within the transference, of course, the patient may (and almost invariably does) wallow in his sense of injury and deprivation, rejection and outrage. But a part of him should always “know” that these feelings are not to be altogether trusted. This capacity of the patient for detachment and self-observation Stone characterizes as “a benign split of the ego” (into observing and experiencing parts), which he considers essential for the working of the analytic process. His concern is that the analyst’s unrelentingly analytic behavior may subvert the process by shaking the faith of the patient’s observing ego in the analyst’s benignity and tipping the balance in favor of the experiencing ego’s delusion of malevolence. “Whereas purely technical or intellectual errors can, in most instances, be corrected, a failure in a critical juncture to show the reasonable human response which any person inevitably expects from another on whom he deeply depends can invalidate years of patient and largely skillful work,” he writes. In wry protest against the overliteral and trivializing application of Freud’s “mirror principle,” Stone remarks, “I doubt that the evolution of the transference neurosis is often seriously disturbed by the patient’s knowing whether one takes one’s vacation in Vermont or Maine, or indeed (let me be really bold!) that one knows something more about sailing than about golf,” and he adds, “I think that it is not seldom disturbed by a persistent or repetitive arbitrary refusal to answer such questions, after sufficient speculative fantasy, if there is no more specific or adequate reason than a general principle that the patient must not know anything about one, or that the analyst does not answer questions.” (Kohut puts the matter very succinctly in a footnote in his book “The Analysis of the Self” when he says, “To remain silent when one is asked a question is not neutral but rude.”) Stone mordantly notes, “The enthusiastic and engaging assertion of an older colleague many years ago that his patient would have developed the same vivid transference love toward him ‘if he had been a brass monkey’ is, alas (or perhaps fortunately!), just not true. For all patients, to the degree that they are removed from the psychotic, have an important investment in their real and objective perceptions; and the interplay between these and the transference requires a certain minimal, if variable, resemblance.”