The American Journal of Psychoanalysis, 2007, 67, (260274) 2007 Association for the Advancement of Psychoanalysis 0002-9548/07 $30.

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THE POWER OF THE SPOKEN WORD IN LIFE, PSYCHIATRY, AND PSYCHOANALYSISA CONTRIBUTION TO INTERPERSONAL PSYCHOANALYSIS

Zvi Lothane
Strictly speaking there are only two sciences: psychology, pure and applied, and natural science For sociology, too, dealing as it does with the behaviour of people in society, cannot be anything but applied psychology. (Freud, 1933). In the analytic treatment there is nothing else but an exchange of words between the analysand and the analyst. (Freud, 1933)

Starting with a 1890 essay by Freud, the author goes in search of an interpersonal psychology native to Freuds psychoanalytic method and to in psychoanalysis and the interpersonal method in psychiatry. This derives from the basic interpersonal nature of the human situation in the lives of individuals and social groups. Psychiatry, the healing of the soul, and psychotherapy, therapy of the soul, are examined from the perspective of the communication model, based on the essential interpersonal function of language and the spoken word: persons addressing speeches to themselves and to others in relations, between family members, others in society, and the professionals who serve them. The communicational model is also applied in examining psychiatric disorders and psychiatric diagnoses, as well as psychodynamic formulas, which leads to a reformulation of the psychoanalytic therapy as a process. A plea is entered to dene psychoanalysis as an interpersonal discipline, in analogy to Sullivans interpersonal psychiatry.

KEY WORDS: interpersonal; psychoanalysis; word; language; speech; interpersonal; suggestion.

DOI:10.1057/palgrave.ajp.3350029

The Gospel of St. John begins thus: In the beginning was the word (logos) and the word was with God and God was the word; and the word became esh and lived amongst us. For St. John the word meant Jesus the son of God. I mean the word as word, concretely, as language and speech,
Zvi Lothane, M.D., Clinical Professor of Psychiatry, Mount Sinai School of Medicine, New York. Member IPA, APsaA. Address correspondence to Zvi Lothane, 1435 Lexington Avenue, New York, NY 10128; e-mail: schreber@lothane.com Paper presented at the Clinical Sndor Ferenczi Conference, August 26, 2006, BadenBaden, Germany.

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as the difference of man from beast and the difference it makes, as the power of the spoken word in interpersonal relations. And so did Freud (1890a, b), in a forgotten paper on Psychische Behandlung (Seelenbehandlung [soul treatment]), translated in The Standard Edition as psychical (or mental) treatment, rather than psychological treatment, whose publication date of 1905 was changed in the index volume of the Standard Edition to 1890.1 Better yet: Freud should have said: therapy of the word, the essential component of any psychotherapy seen as a dialogue between the doctor and the patient. It is a remarkable essay, pregnant with a wealth of ideas. Last year we celebrated Freuds 150th birthday (Lothane, 2006a). As a medical student, Freud was so enthused by Aristotelian Brentanos lectures in philosophy that he wrote to his gymnasium friend Eduard Silberstein he had intended to have two doctorates, in philosophy and zoology. After rst considering law, he did enter science via zoology but would become a philosopher malgr lui, a moralist, as Philip Rieff (1959) called him, in spite of the detour through medicine, and the greatest psychologist since Aristotle. Without studying medicine Freud might have been another Montaigne; thanks to medicine he was confronted with human suffering and discovered a psychological method for healing suffering. The 1890 essay was written when Freud had already been practising psychotherapy, as taught to him by three mentors: in Vienna, Josef Breuer, who learned psychotherapy from the animistic, that is, psychological, Mesmerists and told Freud in 1883 about his therapy of Anna O.; at the Paris, Salptrire, J.-M. Charcot, who rehabilitated both hysteria and hypnosis; and in Nancy, Libeault and Bernheim, the rival school of hypnotism and suggestion. Suggestion remains the central method of inuencing people and remains the essential ingredient in all the varieties of verbal psychotherapy, including psychoanalysis. What do the words in the essays title mean? The German Behandlung is related to handeln, to handle, related to verhandeln, to negotiate, with a cognate meaning of to narrate. Treatment derives from treatise, tractatus, a dialogue. The ancient Greek therapein means to treat, to heal, to attend, to servethe therapist, or attendant, serves the sick person by soothing words and other means. And what is soul? For we do not observe souls, unless we are God, we only observe persons expressing their emotions, thoughts, and actions through speeches and gestures, in and out of therapy. Freud is crystal-clear in his denition:
Psyche is a Greek word which may be translated as soul [ = mind, in Stracheys translation]. Thus soul [i.e., psychical] treatment means mental treatment. The term might accordingly be supposed to signify treatment of the

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pathological phenomena of mental life. This, however, is not its meaning. Psychical treatment denotes, rather, treatment taking its start in the mind, treatment (whether of mental of physical disorders) by measures which operate in the rst instance and immediately upon the human mind. Foremost among such measures is the use of words; and words are the essential tool of mental treatment. A layman will no doubt nd it hard to understand how pathological disorders of body and mind can be eliminated by mere words. He will feel that he is being asked to believe in magic. And he will not be so wrong, for the words which we use in our everyday speech are nothing but watered-down magic, . [due] to their former magical power (Freud, (1905[1890], p. 283). Words are are the most important media by which one man seeks to bring his inuence to bear on another; words are a good method of producing mental changes in the person to whom they are addressed. So that there is no longer anything puzzling in the assertion that the magic of words can remove the symptoms of illness, and especially such as are themselves founded in mental states. (p. 292)

In these luminous passages, Freud dened the soul of psychotherapy and the principles of psychosomatic therapy. Both therapies are based on the use of words. However you call it, psychotherapy or word therapy, word magic and word power derives its efcacy from the power of suggestion, that is, inuence of one person upon another by means of the spoken word. Speech implies speech acts exchanged between individuals in interpersonal relationships. The most important interpersonal action and emotion is love, feeling love and expressing it, among others, in words. In the course of evolution, word magic became combined with love magic to give us the magic of love and language, as wrote the great American semiotic philosopher Charles Peirce (1893). The learning about love, sex, and language starts at birth. As a sexual liberator, Freud at rst focused on sex at the expense of love writ large, love as the basic interpersonal and social relationship (Lothane, 1982, 1986a, 1987ac, 1997a, b, 1998a, 1999, 2003a). His monadic sexual or libido theory of the neuroses was epitomized in the 1905 Three Essays on the Theory of Sexuality and peaked in the Schreber analysis (1911), the harbinger of ego psychology, which is natively dyadic but continued to be theorized about in a monadic manner. This created a constant conict in Freuds theorizing: theories of neurosis were monadic whereas the method and theory of treatment was interpersonal or dyadic from the word go (Lothane, 1997a). However, on closer inspection, even sexuality is by its nature interpersonal and thus Freuds theory of sexuality, his most monadic formulation, reveals its hidden interpersonal face (Lothane, 2002).

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Freuds rst explicit interest in sociology, that is, the interpersonal, surfaces in the 1913 Totem and Taboo and then comes to fuller fruition in his 1921 Group Psychology and Analysis of the Ego, where a new realization emerges: the contrast between social and narcissistic levels of being, Freud now sees that in the individual mental life someone else is invariably involved, as model, an object, as a helper or an opponent; and so from the very rst individual psychology is at the same time social psychology as well (Freud, 1921, p. 69). Possibly echoing Nietzsches saying, that the Thou is older than the I, Freud reasons as follows: the psychology of groups is the oldest human psychology; what we have isolated as individual psychology, by neglecting all traces of the group, has only since come into prominence out of the old group psychology (Freud, 1921, p. 23). Finally, Strictly speaking there are only two sciences: psychology, pure and applied, and natural science For sociology, too, dealing as it does with the behaviour of people in society, cannot be anything but applied psychology (Freud, 1933). Developmentally speaking, there comes a time in our infancy when we learn to speak from and with our mothers and from then on we are surrounded by words our entire life: we think, dream, and speak with words, but of course, not in words only. Later we see printed words. I have no idea what the preverbal infant thinks with or how he thinks; Melanie Klein and others claim they do. Animals also have souls and feel love and communicate love in sound and gesture. We humans, in addition to articulating in words, express love, anger, and hate in the symbolic arts of dance, music, and lyrical poetry, or the language of the emotions. Emotional language and representational language are older than discursive language (Langer, 1942); the latter, a further evolution, is suited for expressing intellectual ideas. Philosophy, theology, law, and politics are all a matter of words. The sciences of matter are also mediated by words: it is all rhetoric; science is also literature, it tells stories as well. To be effective, therapy should match the disorder it is intended to cure. Word therapy, the magic of suggestive inuence, is effective because emotional disorders are, among others, caused by traumas of communication (Lothane, 1983, 1986b, 1986c, 1987a, 2004a), due to good or bad suggestions. Words can hurt and heal. Words are used for begging love and bestowing love, for pleading and persuading, commanding and cajoling, and caressing and crushing. Words can be (s)words: they can cut and kill like knives. Emotions are expressed in words: they are spoken or written content and form; for example, Paul Schrebers delusions or Salman Rushdies Satanic Verses. For his ery words (Flammenworte) Paul Schreber was labeled paranoid and jailed 9 years in an asylum; for his words in the Satanic Verses Salman Rushdie was placed under a fatwah

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and a death sentence. Disorders are caused by words and are healed by words. Moreover, in psychiatry and psychoanalysis disorders are diagnosed according to the words used by patients to describe their inner experiences of feeling and thought that are later labeled dreams, hallucinatory visions and voices, and imageless delusions. However, it is the form of the patients speech, the crazy words, more so than the crazy acts, that are viewed as the manifestation of the disorder and diagnosed accordingly; and such diagnoses are a matter of invention. That therapy of the word is based on the magic of word inuence and suggestion was clear to Freud even before he met Jewish-born Hippolyte Bernheim, for he dened: Suggeriren, wie man die Einredungen whrend der Hypnose nennt = to suggest, as we call talking a person into something during hypnosis (Freud, 1888, p. 727) (citation supplied by Gerhard Fichtner). Einredungen is derived from the root reden, to speak, which in German gives rise to unterreden, to converse, and berreden and zureden, to persuade, to talk into. The antonym of einreden is ausreden, to talk oneself or someone or someone else, out of something, by oneself or through a helper or therapist. The latter has an advantage, for:
it is not the same to know a thing in ones own mind and to hear it from someone outside. The doctor plays the part of this effective outsider; he makes use of the inuence which one human being exercises over another the doctor, in his educative work, makes use of one of the components of love. In this work of after-education, he is probably doing no more than repeat the process which meade education of any kind possible in the rst instance. Side by side with the exigencies of life, love is the greatest educator; and it is by the love of those nearest him that the incomplete human being is induced to respect the decress of necessity and to spare himself the punishment that follows any infringement of them. (Freud, 1916, p. 312; emphasis added)

Love healing through word magic is the essence of that analytic aftereducation (Nacherziehung) that corrects past errors of love and completes what needed yet to be learned. Freud knew that already by 1890 that treatment requires a modicum of purely human liking aroused in [the patient] by the doctor (1905 [1890], p. 291), for the relation of the patient to the therapist employing hypnotic suggestion is like a child towards his beloved parents, and that an attitude similar to subjection on the part of one person toward another has only one parallel, though ac complete onenamely in certain love-relationships where there is extreme devotion. A combination of exclusive attachment and credulous obedience is in general among the characteristics of love (p. 296). He wrote of the necessary faith in the doctor (p. 291), capable of coloring the affects, concentration of the will, distracting the attention, expectation (p. 292), and the need to gain

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the patients condence and, to some degree, his affection (p. 293)he was thoroughly interpersonal but did not have the word interpersonal at his disposal. The same insights were repeated in the chapter on psychotherapy in the Studies on Hysteria (1895):
the procedure is laborious and time consuming. I cannot imagine bringing myself to delve into the psychical mechanism of a hysteria in anyone who struck me as low-minded and repellent; With others, who have decided to put themselves in his hands and place their condence in him it is almost inevitable that their personal relation to him will force itself, for a time at least, unduly into the foreground. It seems indeed, as though an inuence of this kind on the part of the doctor is a sine qua non [indispensable] to the solution of the problem. (pp. 265266)

It was all interpersonal: the doctors work was a labor of love. Word magic and love magic are intimately related: all emotional disorders are love disorders, due to want of love, excess of love, or distortions of love. Thus: anxiety is due to the fear of loss of love; depression is due to loss of love; paranoia is due to jealousy and envy over love; and sadism and masochism are perversions, or distortions, of love. These emotions are experienced by the sufferer in the form of thoughts, fantasies, daydreams, and dreams and then enacted with or told to another person. The therapy of the word, as communications and actions of love, is a cure for the problems with love. Freud stated this in 1926 in The Problem of Lay Analysis. But in matters of love, as I showed, student Ferenczi surpassed the master (Lothane, 1998a). The premise that love and language are processes of communication leads to the following methodological theses to be upheld during the treatment of any disorder by word therapy, thus:

There are no diagnoses, only individual life histories. There are no universal dynamics, only speeches in the here-and-now,
expressing actual personal contents and intents, dreams and desires, colored by the personal memories, or history. There are no formulas for interpreting: there are only conscious and unconscious processes in the form of words, metaphors, images, fantasies, communicated from speaker to listener, in life as in therapy. In therapy, such processes are experienced and studied in the frame of mind and activity, which Freud dened and described as free-oating attention and free association, a process ruled by psychic determinism. Diagnoses, dynamic formulas, and formulaic interpretations are abstractions and generalizations, or universals, that is, ctions created by

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psychiatrists and psychoanalysts. They are often reications of metaphors or patients: for example, the split souls of Schreber become a technical term: splitting. In his Clinical Diary Ferenczi called them delusions, I call them counter-fantasies. As I argued in a panel discussion in New Orleans (Lothane, 2004b), the heart of the psychoanalytic method is process interventions, that is, communications, not formulaic interpretations and labels. The latter are a critical and scientic reection on the experience. Freud stated explicitly in his interpersonal 1912 papers on technique:
One of the claims of psycho-analysis to distinction is, no doubt, that in its execution research and treatment coincide; nevertheless, after a certain point, the technique required for the one opposes that required for the other. It is not a good thing to work on a case scientically while treatment is still proceedingto piece together a structure as scientic interest would demand; the most successful cases are those in which one proceeds, as it were, without any purpose in view, allows oneself to be taken by surprise by any new turn in them and always meets them with an open mind, free from any presuppositions. (p. 114)

Let me emphasize once more: a major obstacle to the interpersonal process conception stems from the continual confusion and conation of the psychoanalytic method and the various theories of disorder, the problem of one and the many. The method or the technique of therapy is conversation, or, as Anna O., the cofounder of psychoanalysis, charmingly called it, the talking cure, when cure meant treatment. The process of talk has been applied to a plethora of disorders and theories of disorders. The various schools of psychiatry and psychoanalysis are sects ghting not over the value of words in therapy but over whose theory of disorder is the right one. Freud did not use the locution therapy of the word nor did he ever say or write interpersonal: like the proverbial M. Jourdain who did not know he spoke prose when he asked for his slippers, Freud did not know he was a Sullivanian; but, as I have shown, he was interpersonal from the beginning (Lothane, 1997a): speaking, suggesting, catharsis, and the psychoanalytic method are all interpersonal, and, as foreshadowed by Freud in 1890, psychosomatic medicine. It was the great Harry Stack Sullivan who recreated psychiatry as an interpersonal process, his Copernican revolution. It comes to this: what we, under the sway of the medical model of disorder, euphemistically call symptoms, are but metaphorical symptoms, and are actually conducts, that are communicated by one person to another with deeds or words. Such communications are both intrapersonal, or intrapsychic, to oneself; and interpersonal, to another person, that is, dyadic. Diseases, as monadic phenomena, show concrete symptoms and signs of corporeal events occurring in the organism as an enclosed system. Actions are inter-actions,

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interpersonal events, not monadic but dyadic (Lothane, 1982). The word became esh, or embodied, is mediated through the bodily organs, the tongue and the ear, and speaker and hearer. At the same time, the uttered word, expressing the widest ranges of thought, emotion, and meaning, or a symbol, is an air wave, a atus vocis, and has no more corporeality than a musical sound, whether produced by vocal cords or an instrument. Like a ripple in the water, it does not leave a trace. And yet its consequences for human actions and for human happiness are incalculable. Thinking, Plato said was the soul talking to itself. But where is the soul? Is it in the brain, the heart, the stomach, or the diaphragm, or phrenhence schizopheniaas some ancients thought? The theory of localization of the mind, if we count from the Alexandrian Erasistratos, must be at least 24 centuries old. Some think we have nally localized the soul in Freuds expurgated 1895 Project and, thanks to technology, in MRIs and fMRIs of the brain. However, localizing the mind or soul in the brain is beset by the same problems now as then (Lothane, 1998b). Hlas: we have looked in the wrong places, the mind is not in anywhere, it is inter, or between, it is between two (or more) persons communicating and interacting via word and expressive gesture of face and body. There is no brain and no soul, except in learned theories: in life, there are only persons engaged in speaking with each other. Such speeches are addressed to oneself, or to an other, someone in the esh, that is, in the presence, or to someone in efgie, that is, in absence, in the imagination, that is, in ones dreams or day dreams. Speeches may be soliloquies or colloquies, monologues or dialogs. But even in the monologue, there is always someone else that is thought of or silently addressed. Freud joked that in the analysts room there are at least six persons present: the two interlocutors and the analysands parents. What about the analysts parents? Brothers and sisters, friends and lovers? At issue is not the seat of the mind but the seat of psychopathology: is it in the person or is it between two or more people? According to Sullivan, to observe another person is to enter into a temporary relationship of participating in the process of listening and speaking: it is using imagination, sympathy and, long before Kohut, empathy, in the process of communication of emotions and meanings. It is unlike the observation of objects, a participant observation. Therefore, the locution object relations is a sad misnomer (Lothane, 2003b). Objects have no relations, only persons do. Martin Buber differentiated Iit relations, to objects, from Ithou relations, with people. Participant means mutual and reciprocal, involving give and take. To listen means to think the thoughts and feel the emotions of the speaker, to recreate those within oneself and thus come into contact with the inner world of the other. Traditional descriptive psychiatric phenomenology, even when eschewing the brain as a description or

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explanation of behavior, observes the person as object and claims to have achieved objectivity. However, in viewing the person from the outside, doing the interview in the manner of a neurological examination, it forgoes the opportunity to knowing and understanding the person from inside, from his intimate interiority, or the entire realm of the persons psychological reality. External observation of bodies or behaviors, whether normal or abnormal, healthy or disordered, is synchronic or cross-sectional, as in anatomy, physiology, and pathology, and forensic psychiatry. Such observation results in medical and psychiatric classication and nomenclature. In the clinical sciences, we then organize the data into symptoms, syndromes, and systems. Sullivans interpersonal approach was continued in the United States by the now forgotten Jurgen Ruesch (1961). The thrust of Rueschs approach was that the varieties of disorder in contents and form converge upon a nal common pathway of words and speeches exchanged between interlocutors in life and in therapy. Published the same year as Thomas Szaszs The Myth of Mental Illness, Ruesch argued that communication is the overarching principle in health and disease.2 For Sullivan and for Ruesch, the interpersonal was true science, not the descriptive and diagnostic categories of psychiatry; what Freud dubbed the ostensible exactness of which modern psychiatry affords the most striking example (Freud, 1912, p. 114). The time has come to promote the concept of interpersonal psychoanalysis. In the interpersonal approach we focus on the person as an individual, in-dividual, which means: not further divided into parts, not further anatomically dissected; a whole person indivisible, acting, experiencing, and functioning as a whole person, not the parts of the person, seen synchronically but a person viewed diachronically, longitudinally, and historically. This whole is only divided for the sake of conceptual analysis, whether of physical or psychical: analysis means taking something apart, breaking down into components, parts, elements, particles, and to see they are tted together. But dealing or understanding the person is a different matter. The whole person moves as a whole, with his emotions, thoughts, acts, and expressions. The whole person is an individual with a history. Participant observation studies that individual history, or biography, accomplishing the paradox of history as the science of the particular. This is the most essential contribution of Freud to synchronically descriptive, crosssectional, and an historical psychiatry, la Emil Kraepelin or Karl Jaspers. Freud would have agreed that there is no hysteria, there is only historia, or, as he said, echoing Nietzsche, the genealogy of symptoms. America was discovered but the USA were invented, now reinvented by Bush and his followers, using lies and mass suggestion of crowds (Lothane, 2006b). Were psychiatry and psychoanalysis discovered or invented?

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Psychiatric diagnoses and nomenclature, based on external observation, unlike medical diagnoses, are in the main not discoveries but inventions. It takes one person to have pneumonia, it takes two to have paranoia: one persons prejudice may become another persons paranoia. The meaning of the symptom is in the interaction (Lothane, 1997a). What follows is an excursus about the history of psychiatry. The American Diagnostic Statistical Manuals, and the quasi-Linnean taxonomy of Emil Kraepelin upon which it is based, are not unlike the Malleus malecarum (the Witches Hammer) of 1486, the invention of the various forms of witchcraft and their cures. Philippe Pinel, the French internist who ushered in the psychiatric millennium with his 1801 Trait medicophilosophique sur lalination mentale, originally called trait de la manie, rst set forth a unitary concept of madness, contrary to the anatomo-clinical science of his day. Pinel was concerned with the human condition, with the patients emotions and the passions, such as fear and anger, and hatred and sorrow; with the persons educational history; with conict between instincts and intelligence, and sex and religious dogma. It was his immediate heir Esquirol and such mid-century followers as Baillarger and Falret, who split the unitary theme into the mutliple forms of maladies mentales: the varieties of disorder and degeneration. Sydenhams concept of the species morbosa, the disease species, akin to vegetable or animal species, had been the inspiration for Kraepelin and the typing and classication of psychiatric disorders. In the rst half of the 19th century, Germany Zeller still conceived an Einheitpsychose, a unitary psychosis, as did Griesinger, until the latter changed course by claiming that all mental diseases are brain diseases. Thereafter, French and German nosographers in the second half of the 19th century, oblivious of Occams razor, multiplied diseases entities. One could wonder about these, as Freud did in connection with Schreber, if there is more truth in the delusions of patients or more delusion in the psychiatrists ctions (Lothane, 1992). From the ethical perspective it can be asked: do these diagnoses serve the patient or the professional? Methinks, the latter, not the former: the need to be authoritative and authoritarian, to think of himself as scientic, and, last but not least, to be paid for his diagnoses or reimbursed by insurance companies. Once more we encounter the problem of the one and the many. Similar questions can be asked of psychodynamic formulas. Psychoanalytic interpretation is unlike any other: it is not applying ready-made formulas like the oedipus complex or penis envy and such like to the ow of the analysands associations. Such formulaic interpretations is analysis applied from the outside, not from the inside, it is making authoritarian pronouncements. It was Freuds Copernican revolution that the meaning of a memory, of a dream is in the dreamer, in his associations, that the dream should not

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be interpreted clef, according to the Egyptian decoding method (Chiffrier-Methode), or with the help of ready-made symbols, but only by means of the dreamers personal, free, that is, spontaneous, but yet determined, associations to the dream scenes, images, thoughts, and emotions. The memory and the dream emerged from the unconscious depths in the form of a personal metaphor. Nobody interpreted the dreams of the rst analyst: he did it himself, he found the solutions to his puzzling manifest content of his dreams in his associations that led him to the discovery of the latent content, the dream thoughts, of memories and dreams. The meaning of dreams was in himself. Since then it became true for all of us: the true interpretation of a dream is the achievement of the dreamer, not in the analyst, who acts as facilitator, or, in Socrates simile, performs a maieutic, or midwifely, function. But who has the interpretive authority? Do not we rely on the analysand to give us conrmatory material rather than remaining ensnared in the grandiose delusion of the all-knowing analyst? Under Breuers mentorship, Freud was rst concerned to understand the meaning of symptoms as caused by traumatic memories. The hypnotic technique worked in two ways: (1) it was an interpersonal relationship, the rapport in the case of hypnosis nd[ing] a parallel in the ways in which some people sleepfor instance, a mother who is nursing her baby (Freud, 1905[1890], p. 295); (2) to open the conscious mind to unconscious, or repressed, memories: As a rule it is necessary to hypnotize the patient and to arouse his memories under hypnosis of the time at which the symptom made its rst appearance (Breuer and Freud, in Freud, 1895, p. 3). The hypnotists couch became the ancestor of the psychoanalysts couch: the psychoanalytic method was nally elaborated in 1900, on pages 101104 of The Interpretation of Dreams. It was in studying dreams that Freud nally realized that full meaning of the dynamic unconscious, that puzzling symptomatic acts such as forgetting, slips, absurd dreams, and mysterious symptomsstrange fantasies and behaviorsare a series and have the same two-layered structure: a conscious manifest layer and an unconscious latent layer and both remain in constant interaction with each other, accessible via the simultaneous process of undoing of repression and free association. But if memories and dreams are forever ones own, what then can the analysts dreams and memories contribute to the work of analysis and therapy? This takes us to another level of interpersonal. The method of free association is not an activity of an analysand observed from the outside, it is also an interpersonal activity, it is reciprocal free association (Lothane, 2006c). Communication between people, both verbal and nonverbal, can be either conscious or unconscious. There are four possible modes of

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communication: (1) from conscious to conscious; (2) from conscious to unconscious; (3) from unconscious to conscious; and (4) from unconscious to unconscious, and they can combine in various proportions. In view of the above, the interpretation is in the process, in the interaction, which Freud described as the rules of therapy as follows.
They are all intended to create for the doctor a counterpart to the fundamental rule of psycho-analysis which is laid down for the patient. Just as the patient must relate everything that his self-observation can detect, and keep back all the logical and affective objections that seek to induce him to make a selection from among them, so the doctor must put himself in a position to make use of everything he is told for the purposes of interpretation and of recognizing the concealed unconscious material without substituting a censorship of his own for the selection that the patient has forgone. To put it in a formula: he must turn his own unconscious like a receptive organ toward the transmitting unconscious of the patient. He must adjust himself as a telephone receiver [English in the original] is adjusted to the transmitting microphone. Just as the receiver converts back into sound-waves the electric oscillations in the telephone line which were set up by sound waves, sothe doctors unconscious is able, from the derivatives of the unconscious which are communicated to him, to reconstruct that unconscious, which has determined the patients free association. (Freud, 1912, pp. 115116)

Here Freud operationalizes the psychoanalytic method by using the metaphor of the instrument. Interestingly, the unmusical Freud, the type visual par excellence, uses an acoustic simile, compared to the overwhelmingly visual images. My teacher Otto Isakower elaborated this further with his idea of the analyzing instrument (Balter, Lothane, and Spencer, 1980). Before that Theodor Reik has used another metaphor: that of listening with the third ear (Lothane, 1980, 1981). My own operational approach was to dispense with metaphors and to call this reciprocal communication between analysand and analyst reciprocal free association (Lothane, 1984, 1994, 2006c). At the beginning of his psychoanalytic odyssey Freud confessed:
I have not always been a psychotherapist. Like other neuropathologists, I was trained to apply local diagnoses and electro-prognosis, and it still strikes me myself as strange that the case histories I write should read like short stories and that, as one might say, they lack the serious stamp of science. I must console myself with the reection that the nature of the subject is evidently responsible for this, rather than any preference of my own. The fact is that local diagnosis and electrical reactions lead nowhere in the study of hysteria, whereas a detailed description of the mental processes such as we are accustomed to nd in the works of imaginative writers enables me, with the use of a few psychological formulas, to obtain an intimate connection between the story of the patients suffering and the symptoms of his illness. (Freud, 1895, pp. 160161)

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Close to the end of his journey, Freud (1937) returned to his search of a picture of the patients forgotten years that shall be alike trustworthy and in all essential respects complete. The analyst has neither experienced nor repressed any of the material under consideration; His task is to make out what has been forgotten from the traces it has left behind, or, more correctly, to construct it. His constructions constitute the link between the two portions of the work of analysis, between his own part and the part of the patient. Both of them have an undisputed right to reconstruct by means of supplementing and combining the surviving remains. (Freud, 1937, pp. 258259) Science has its stories, too, being a special kind of literature. Freuds science is based on the historical method of reconstructing an individual biography or life story. As a method, psychoanalysis is a historical science of the particular, of the individual. Freud was not only a scientist and a moralist, he was himself a great creative writer, and his creativity has been a wellspring for the dynamic therapies of the word. Psychoanalysis must begin and remain interpersonal, or it is not psychoanalysis.

NOTES 1. The 1890 essay, printed in Volume 7 of the Standard Edition, is preceded by two other relevant texts. In the rst, Freuds psycho-analytic procedure (pp. 249254), published in 1904, Freud denes the essentials of the technique of the psychoanalytic method (p. 252). In the second, On psychotherapy (pp. 257268), delivered in a lecture of 1904 before the Wiener Medizinisches Doktorenkollegium and published a year later. Strachey opines that the latter essay may be a sequel to the 1890 essay, which makes sense to me, for in the latter essay Freud writes of Psychotherapie rather than of the already antiquated Seelenbehandlung and calls it by its new name, analytic psychotherapy ( = analytische Psychotherapie, p. 263); in days to come, Freud hopes, with suitable changes in the method, one might be able to initiate a psychotherapy of the psychoses (p. 264). 2. In the summary chapter of the book Ruesch state that his theory of human communication .. has three aims: To contribute towards a unied theory of human behavior. To conceive of psychopathology and social psychology as disturbed communication. To view human communication as a therapeutic tool. By eliminating the dichotomy between normal and abnormal behavior, deviant communication is viewed as a special case of ordinary communicationthat is distorted through erroneous timing, deviation in intensity, or inappropriacy of messages. The various method of psychiatric therapy in turn can be viewed as a efforts at improving either the organ systems of the functions of communication of man (Ruesch, 1961, p. 451).

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