Book Commentary: Psychoanalysis and Society’s Neglect of the Sexual Abuse of Children, Youth and Adults: Re-addressing Freud’s Original Theory of Sexual Abuse and Trauma.

Disclaimer: The views expressed in this review are solely those of the author.

In The Complete Letters of Sigmund Freud to Wilhelm Fliess, I resurrect the letter, omitted in the first edition (of the letters), where Freud recognizes that his colleague will now never accept him. He seemingly, and fleetingly had the courage, which he later lost, to defy medical colleagues. He described them as “asses”: “They can go to hell,” he wrote in a letter that Anna Freud omitted from her jointly edited early edition of the letters (she told me, many years later: “It makes my father sound so paranoid,” but he was not, he was prescient). Rachman seems not to have seen my edition and translation of these complete letters – but they only support his views. Freud later retreated from this position, insisting, instead, that children, especially women, fantasized or imagined their abuse to hide their own desires in childhood for the parent of the opposite sex: The Oedipus Complex.

This is an important book about an extremely important topic: Freud and the sexual abuse of children: Has psychoanalysis kept the world in the dark for years? And, is it true that there was one analyst who was ahead of his time? The answer to both questions is yes. Freud initially held that sexual abuse in childhood was the major source of what he called, “hysterical neurosis,” basically, human unhappiness. He took this position in a remarkable (and very courageous) lecture he delivered to his male medical colleagues in Vienna in 1896: “The Aetiology of Hysteria” (i.e., the origins of misery: sexual abuse in early childhood).

He gathered around him a group of disciples, foremost among them the Hungarian medical doctor, Sandor Ferenczi. But toward the end of Ferenczi’s too-short life, he came to understand that Freud was right the first time; abuse was real. He knew because, he explained to Freud, he saw male patients in analysis who confirmed that they abused children. He believed these confessions (why would he not?) and he also believed the women who told Ferenczi of their abuse. Freud would have none of it, insisting that Ferenczi was repeating his initial error, believing these accounts were real, whereas he later recognized that they were merely fantasies (the women were, as the terrible phrase had it, suffering from “hysterical mendacity” – their desire made them lie!).

Rachman, captured in a relaxed moment

Ferenczi did not back down: He wrote a paper called “The Confusion of Tongues Between Children and Adults”, that in my opinion is still today in 2023, one of the most profound essays on child abuse ever written (I provide a new translation of this fundamental text in my book The Assault on Truth). Freud tried to dissuade Ferenczi from giving the paper at the annual meeting (in 1932) in London of the International Psycho-Analytical Association where he was supposed to become the president (Freud assured him he would have this position, but behind his back, he made sure he did not get it – such was his sin in believing his women patients). Analysts, especially Ernest Jones, Freud’s biographer, and an analysand of Ferenczi saw to it that the German original was not published for 17 years thus depriving, as Rachman correctly points out, psychologists from reading the finest account of the origins of sexual abuse available then or even now. Ferenczi paid the ultimate price: He died a year later, estranged from Freud and all the major analysts at the time. I believe he died of a broken heart.

What I have just written is not the usual history. It is revisionist history. But it happens to be true. It is to Arnold Rachman’s great credit that he believes passionately in both the reality of child sexual abuse and the moral courage of Sandor Ferenczi whom, with good reason, he praises. He is also puzzled, as am I, why so many analysts fail to see this, while society in general knows it to be true. He is a psychoanalyst at odds with many of his colleagues.

There are some wonderful things in his book: He repeatedly points to the effect of Totschweigen (“silence to death” – that is, refuse to recognize something as true by remaining silent about it); he is very good on Ernest Jones, pointing out that he almost certainly was guilty of abusing at least two young disabled girls at an institution where he was the medical director (I wonder if Freud knew this when he heaped praise on Jones?); He notes that Jones accused Ferenczi of paranoia and even psychosis (because he believed his women patients) thereby preventing analysts paying any attention to Ferenczi’s ideas about abuse; He demands that traditional psychoanalysts should offer an apology to Ferenczi for their more than 50 years of silencing his ideas; he points out that two of Freud’s most famous patients, “Dora” and “The Wolfman” had both been subjected to sexual abuse as children (I pointed out that Freud asked one of his American pupils, Ruth Mack Brunswick to analyse the Wolf Man in later life, and she discovered that he had been anally raped – whether she ever told Freud remains unknown – I suspect she would have been terrified to do so – note that according to Rachman, colleagues warned him that my comment could not be trusted, but Rachman, being the good sleuth he is, found the unpublished paper in the Library of Congress, where Pankejeff tells he was anally raped by a family nursemaid); Rachman is responsible for many other minor and major discoveries. Historians will be delighted by the diligence of Rachman in tracking down obscure papers.

Rachman seems to believe that Ferenczi “found refuge in his Hungarian analytic community.”
I don’t think this is so: everyone at the time was under Freud’s intellectual thumb. Ferenczi was cast out precisely because he no longer believed the main tenet of psychoanalysis; i.e. what matters, from a psychological point of view, is not what happens in the real world, but in the inner world of fantasy. Nobody except perhaps his pupil, analysand, and later, herself an analyst, the American Elizabeth Severn, believed Ferenczi.

Another great merit of Rachman is that he found Severn’s papers and donated them to the Freud Archives in the Library of Congress. Understandably he wants her role in the discovery of child abuse recognized at last – but one point I found obscure: Rachman writes: “Elizabeth Severn, Ferenczi’s most controversial analysand, who finished her training as an analyst with Ferenczi, was in a relationship with him for 8 years, from 1925 to 1933.” I believe he means that they were associated for that time, not that they had any kind of sexual relationship (which is normally how the phrase “in a relationship” is used). I think it may well be that she is the person who convinced Ferenczi of the reality of childhood sexual abuse, in which case she certainly deserves all the credit that Rachman affords her, if not more.

Rachman does a fine job of explaining how her story fascinated and resonated with Ferenczi her analyst. She was from the United States but spent 8 years in Budapest seeing Ferenczi. (Freud, on the other hand, called her an evil witch, though he met her only very briefly). Rachman has written a very useful book about her and her traumas: Her father sexually abused her, then tried to poison her, and eventually threw her out of the house. It is unlikely that any analyst in 1925 would have believed her. No, let me change that wording: It is certain that no analyst in 1925 would have believed her. Except for Ferenczi. He began what he called “trauma analysis” with her, the first time this term was used. I believe something along these lines, which emphasizes listening, empathy, and respect, is essential to the treatment of dissociative identity disorder (DID), and is practiced by a group of psychiatrists, psychoanalysts, and other therapists worldwide (members of the International Society for the Study of Trauma and Dissociation and other trauma societies), including here in Australia by my colleague Professor Warwick Middleton and others. Severn may have been the first person to tell her analyst to “just shut up and listen.” He did so and became what Rachman calls, with good reason, “an empathic presence.” (Another find by Rachman is an interview that Kurt Eissler did with Severn in New York, which was placed under restrictions in the Freud Archives, but which Rachman managed to lift – which is a great service to historians.)

Where we differ is that Rachman believes that the Oedipal Complex and the reality of child sexual abuse (as recognized by Ferenczi) are not contradictory and a clinician can use both. (He is, after all, a clinician, and I am not). I don’t see how: Either a woman has imagined abuse (highly unlikely) or it is real. If it is real there is no room for the Oedipus Complex or basically any of Freud’s views about childhood sexuality, female sexuality, or male sexuality. Anna Freud herself told me that my belief that Freud was right the first time when he believed his women patients, would mean that there would be no psychoanalysis. “So be it,” I thought, even though I was about to open my own practice at the time. (Other analysts soon realized the contradiction and took away my membership in all analytic societies thereby making the choice easier for me to find another profession). The real world, she told me, was less important than the internal world of fantasy. At least for the analyst. I believe that this is the main reason why people are turning away from psychoanalysis today: Analysis still underplays trauma despite the rest of the world finally recognizing how common it is, with sexual abuse right up there as one of the most common reasons for anyone seeking psychological help.

Reviewer and Author Masson

It is highly unusual for a psychoanalyst to see the central problem of the history of psychoanalysis as lying in the reality of child sexual abuse. When Freud first entertained this idea (1896) he had to pay dearly for this highly unorthodox belief. He caved. Similarly, when Ferenczi came to the same conclusion in 1932, he did not back down, but he paid with his life. Freud had perhaps only one close friend in his life: Wilhelm Fliess (they fell out). Fliess’ son Robert became a prominent analyst in New York, but toward the end of his life, he too, just like Ferenczi began to doubt Freud’s volte face: “Abuse was real,” he said, and “I should know,” he added, as “my father” (Wilhelm Fliess himself!) “abused me.” He was denounced by his colleagues in New York, and moved away, only to die in obscurity. When Anna Freud gave me the unpublished Freud Fliess letters (all 163 of them), and I saw that the history of child abuse was far more complex than we had been taught, I too was shunned, even by my closest friends in the analytic community (my very best friend at the time went on to become the President of the International Psychoanalytical Association in London but would not talk to me until a year ago, now that he is 92 with little time left).

Now it is Arnold Rachman’s turn to be shunned by his colleagues (though not all of them). The reason is that while society has at last recognized just how prevalent the sexual abuse of children is, this has been in spite of the attempt of the entire field of psychiatry, psychoanalysis, and psychology for over a hundred years to keep people in the dark about this reality: The “me-too” movement; many feminist thinkers, the scandals in the Catholic Church and elsewhere, the denials of Roman Polanski, Woody Allen, and many others, (all of which are covered by Rachman in his book) have made a huge difference. Totschweigne is finally dead!
Rachman is, like Ferenczi, something of a hero!

A short coda: I don’t understand why that which Rachman can see is invisible to just about all psychoanalysts. Rachman is not alone: almost everyone apart from analysts sees clearly. I believe the problem may lie in turning a perfectly good thinker, and an even better writer (Sigmund Freud) into a cult figure who can never be wrong. We can all be wrong! I agree with Rachman that Ferenczi was wonderful but he too, like everyone else, had his faults: allowing his analysand, Clara Thompson, to kiss him during sessions was a mistake. But about the essentials he was right. Why did he see it and nobody else for half a century? That is a good question, but there is no obvious answer. But you will learn a great deal of information that is relevant to this question by reading this wonderful book by Arnold Rachman. I hope you will.