Hungarian school, active technique, relaxation technique and mutual analysis

1. Introduction

Version followed: Sándor Ferenczi's own technique papers 1919–1933 ("Technical difficulties in the analysis of a case of hysteria" 1919; "Further development of the active technique" 1921; "On forced fantasies" 1924; "Contra-indications to the active psycho-analytical technique" 1926; "The elasticity of psycho-analytic technique" 1928; "The principle of relaxation and neocatharsis" 1930; "Child-analysis in the analysis of adults" 1931; "Confusion of tongues" 1932/33), the Clinical Diary (1932, publ. 1985/1988) and Ferenczi & Rank, The Development of Psychoanalysis (1924). Papers were read in the Spanish Obras Completas translation (Selecciones Ferenczianas) and the German 1924 text; English titles are the standard ones. The guide treats three successive versions separately: (A) active technique (1919–1926, including the 1926 self-revision), (B) elasticity/relaxation and neocatharsis (1928–1931), (C) mutual analysis (1932, historical only). Where a later paper revises an earlier one, the later revision is followed and the change is named. There is no treatment manual and no originating training institute's protocol; Ferenczi himself called the 1930 paper provisional and gave no step-by-step protocol [source: Ferenczi 1930].

What it is. The "Budapest/Hungarian school" technique is psychoanalytic psychotherapy (couch, free association, transference analysis) to which Ferenczi added deliberate modifications of the analyst's behaviour when ordinary analysis stalls. Early on he raised tension (injunctions, prohibitions, forced fantasies, termination dates); later he lowered it (relaxation, warmth, flexibility, admitting errors) so that traumatic experience could be relived safely [source: Ferenczi 1921; 1926; 1930].

Core idea of change. Insight by reflection alone is weak; conviction comes from experiencing – repeating the infantile situation in the present with the analyst – and then turning that repetition into memory (Ferenczi & Rank: repetition instead of remembering, aiming at lasting memory) [source: Ferenczi & Rank 1924, pp. 7–8, 27–29]. Active technique produces this by frustrating discharge so that tension pushes repressed material up [source: Ferenczi 1921]. The relaxation version holds that trauma is relived productively only when the present relationship differs clearly from the original traumatising one – sincere, non-hypocritical, non-authoritarian – so that the patient can reproduce rather than merely repeat the trauma [source: Ferenczi 1930; 1931; 1932/33 via commentary].

2. Framework

Ferenczi described no numbered stages. The phase structure below is assembled from his papers [synthesis, built from cited elements].

Format (historical). Classical analysis: couch, high frequency, multi-year duration; Ferenczi warned patients that treatment could last years and refused to promise outcomes [source: Ferenczi 1928]. In the relaxation period sessions were sometimes lengthened until the emotional reaction subsided, sometimes two or more per day, and patients could sit up, walk about or face the analyst [source: Ferenczi 1930]. No typical session counts are given in any primary source [uncertain]. For present-day use, 2–4 sessions per week of psychoanalytic psychotherapy is the closest workable frame; extended or extra sessions only within an explicit, pre-agreed contract [synthesis].

Phase 1 – Opening: passive analysis, let the transference grow

Goal: teach the fundamental rule (free association), let spontaneous transference develop, gather material.
Therapist stance: reserved, receptive; no activity at the start – activity is contraindicated here [source: Ferenczi 1921; 1926].
Contracting: a realistic, somewhat sober picture of duration, cost and uncertainty; no promise of cure; fees discussed openly [source: Ferenczi 1928].
Move on when: a stable (preferably positive) transference exists and material is accumulating.

Phase 2 – Working phase: interpretation; activity only at stagnation (Version A)

Goal: analyse resistance and transference; when association stagnates despite exhausted passive means, use a targeted active measure to mobilise material, then return to passivity "as quickly as possible" [source: Ferenczi 1921].
Two sub-steps of an active episode: (a) injunction phase – do something avoided/unpleasant or let a latent impulse develop; (b) prohibition phase – renounce the gratification that has emerged; then interpret/reconstruct [source: Ferenczi 1921].
Criteria to use activity (1926 revision): passive technique exhausted; genetic roots already worked through; transference strong enough; a concrete, specific indication (not the patient's wish for activity); only the element of current experience is missing for conviction [source: Ferenczi 1926].
Criteria to stop: stagnation resolved → back to free association; resistance rising unmanageably or transference threatened → withdraw the measure [source: Ferenczi 1921; 1926].

Phase 2′ – Working phase in the relaxation version (Version B)

Goal: where analysis stalls on seemingly insoluble resistance (often in traumatised patients), alternate the frustration principle with a relaxation (indulgence) principle: freedom of movement and expression, warmth, flexibility, deeper relaxation of association [source: Ferenczi 1930].
Neocatharsis: late in a long analysis, short fragmentary reliving of trauma (bodily symptoms, trance-like states) signals that the work has reached the etiological reality; the analyst becomes the bridge to reality and works with the dissociated part [source: Ferenczi 1930; 1931].
Criteria to use: analysis has stalled; frustration is producing only more defence; the patient's suffering exceeds what the work requires ("economy of suffering") [source: Ferenczi 1930].
Criteria to limit: demands escalate, reconciliation is delayed, or the adult patient is "playing" the child to coerce – then limit the regression in mode and scope and analyse the frustration [source: Ferenczi 1931].

Phase 3 – Detachment and termination

Goal: loosen the libidinal tie to the analyst; translaboration (revising the whole analysis from a distance) and return to real life [source: Ferenczi & Rank 1924; Ferenczi 1928].
Active measures permitted here (1921/1924): forced fantasies, pushing overdue decisions, setting an end date [source: Ferenczi 1921; 1924].
1926 revision followed: the end date is not mandatory; use it only exceptionally, by agreement, revocable; do not predict duration [source: Ferenczi 1926]. By 1928 termination is ideally patient-led, ending when the analysis has exhausted itself [source: Ferenczi 1928].
End when: the patient can renounce the analyst as a love object without the analyst becoming a new superego [source: Ferenczi & Rank 1924; Ferenczi 1928].

Version C – Mutual analysis (1932): historical only

Not a phase to implement. Ferenczi let a patient (R.N., Elizabeth Severn) analyse him in alternating sessions; he concluded mutual analysis could "only be a last resort" [source: Clinical Diary 1932, quoted in Fortune]. See 4.C.

3. Guiding principles

Analysis first, activity as exception. Most patients need no active measure; activity is the "obstetric forceps" of analysis. → Default to free association and interpretation; reach for activity only at genuine stagnation [source: Ferenczi 1921].
Activity belongs to the patient. The analyst prescribes, the patient acts; the analyst stays an observer. → You never act on the patient; you propose a behaviour and analyse what it stirs [source: Ferenczi 1926].
Action serves memory, not abreaction. Unlike Breuer's catharsis, discharge is a means to reach memory and interpretation. → Every enactment must be followed by interpretation/reconstruction before the session ends [source: Ferenczi 1921; 1931].
Tension raises material (frustration principle). Blocking habitual discharge raises tension that disturbs deeper repressed regions. → Identify the patient's covert gratifications (habits, fidgeting, verbosity) as the leverage point [source: Ferenczi 1921].
Relaxation lowers defence (indulgence principle); both alternate. → Use frustration where the ego is strong and defending; use relaxation where the patient is retraumatised by deprivation [source: Ferenczi 1930].
Economy of suffering. Let the patient bear only the pain the work needs. → Ask: is this frustration therapeutic or merely repeating deprivation? [source: Ferenczi 1930].
Transference is the precondition of activity. Without a solid transference, a task becomes a pretext to break off. → Never use activity early or in a fragile alliance [source: Ferenczi 1921; 1926].
Elasticity. Yield to the patient's pull like an elastic band while keeping your own direction until a position is shown untenable. → Give way on form, not on the analytic aim [source: Ferenczi 1928].
Agreement, not command (1926). Seek the patient's intellectual consent; make every measure revocable; never a sine qua non. → Phrase tasks as proposals you can withdraw [source: Ferenczi 1926].
Tact = feeling-into, then cool judgement. Oscillate between empathy, self-observation and judgement; withdraw your own feeling before intervening. → Before each interpretation, check timing, dose and your own motive [source: Ferenczi 1928].
Interpret tentatively (salvo errore). → Offer interpretations as propositions open to correction; economise them; let the patient interpret [source: Ferenczi 1928].
Primacy of the present analytic situation. The whole situation outranks detail-translation; avoid "interpretation fanaticism" and complex-hunting. → Start from the patient's current surface and the here-and-now relationship [source: Ferenczi & Rank 1924, pp. 25–36].
Sincerity; no professional hypocrisy. Patients perceive the analyst's real feelings; feigned warmth or feigned severity both harm. → Do not perform a feeling you lack; acknowledge real ones when they are affecting the work [source: Ferenczi 1921; 1930; 1932/33 via commentary].
Admit mistakes. Admission increases trust and does not cost authority. → When the patient's criticism is plausibly right, say so before considering projection [source: Ferenczi 1928; 1931; 1932/33].
Don't retaliate; be a seesaw for hostility. → Absorb negative transference without defending yourself; positive feeling tends to follow [source: Ferenczi 1928].
Trauma is real and is relived, not only fantasised. → Take reports of abuse seriously; do not deny what the patient experienced – denial is itself traumatogenic [source: Ferenczi 1931; 1932/33].
Differentiate present from past. The frame must keep the analyst from becoming the traumatising adult again. → Avoid coldness, authority and forcing the trauma [source: Ferenczi 1932/33 via commentary].
Exo- not intro-suggestion. Encourage the patient's own productions; never impose your theory. → Questions over assertions, especially in regressed states [source: Ferenczi 1931].
Respect the adult in the patient. Relaxation must not become infantile licence; sexual and aggressive wishes cannot be gratified. → Indulge expression, not action [source: Ferenczi 1930; 1931].
Analyst's own analysis ("second fundamental rule"). → Countertransference sadism can masquerade as frustration and the analyst's own needs as tenderness; keep yourself in analysis/supervision [source: Ferenczi 1928; 1930].
No promises. Activity promises unpleasantness, not cure; never raise hopes you cannot meet. → Frame tasks as experiments, not remedies [source: Ferenczi 1921; 1928].

4. Complete intervention inventory

Organised by version. All therapist wording is illustrative unless quoted and cited. Elements Ferenczi described that cross today's ethical limits are listed under 4.C or flagged as historical only. They are not given as steps.

4.A Active technique (1919–1926; 1926 revision applied)

A1. Injunction ("Gebot"): carry out an avoided or latent action

Purpose / when: At stagnation in a well-established transference, when free association has dried up around a theme the patient avoids in action. Ask the patient to do something unpleasant they avoid, or to fully develop an impulse that shows only in traces, so that affect, and through it memory, becomes available [source: Ferenczi 1921]. Not at the start of treatment [source: Ferenczi 1921; 1926].
Steps: (1) Confirm the indications: passive means exhausted, genetic material already worked through, transference solid, and a specific concrete indication present [source: Ferenczi 1926]. (2) Name the pattern of avoidance you have observed. (3) Propose one specific, bounded behaviour, in session or between sessions, and get the patient's explicit consent. It is a proposal, not a condition of treatment [source: Ferenczi 1926]. (4) Say clearly that it will probably be unpleasant and is not a cure [source: Ferenczi 1921]. (5) Have the patient report associations, affects and memories that arise. (6) Interpret the reaction as repetition and reconstruct the infantile situation from dreams and associations if no memory comes [source: Ferenczi 1921]. (7) Move to A2 if the action becomes pleasurable, or drop the measure.
Ferenczi's examples: a musician with stage fright was asked to sing a childhood song and play the piano with full passion, then the excitement she discovered was forbidden; a woman was asked to write poems; a man prone to fainting was pressed to finish his sentences and fantasies [source: Ferenczi 1921].
Example language (illustrative): "Each time we approach your singing, the associations stop. I'd like to propose an experiment, and you're free to say no. Next session, would you sing the song you mentioned, as fully as you can, and then tell me everything that comes up? It may be uncomfortable. That's the point, not a sign it's failing."
Watch for / working signs: New memories, dreams or affect-laden associations, and transient symptom intensification (expected) [source: Ferenczi 1921]. Warning signs: compliance with no material (suggestion, not analysis), mounting resistance, or the task used as a pretext to quit [source: Ferenczi 1921; 1926]. If the patient feels you are a schoolmaster giving orders, the father-child dynamic is repeating. Interpret it, or withdraw the measure [source: Ferenczi 1926].

A2. Prohibition ("Verbot"): renounce a covert or newly discovered gratification

Purpose / when: After A1, or when the patient is already spontaneously active. Habitual discharges (stereotyped movements, touching face or body, leg-pressing, sphincter play, urge to urinate around sessions, nervous habits, compulsive acts) drain tension that would otherwise push repressed material into association. Blocking them raises tension "against the pleasure principle" [source: Ferenczi 1921].
Steps: (1) Notice the small motor or behavioural habit and its timing in the session. (2) Optionally first invite the patient to let it develop fully, since it may be the seed of a latent tendency [source: Ferenczi 1921]. (3) Propose temporary suspension, for example during sessions or for a defined period, with consent. (4) Ask the patient to report the urge, the tension and the thoughts when they refrain. (5) Interpret what the habit was discharging. (6) Lift the prohibition once its material has been analysed [source: Ferenczi 1921; 1926]. The 1919 case paper is the origin: a patient's leg-crossing on the couch was treated as concealed masturbation and prohibited [uncertain: recalled from the standard account].
Example language (illustrative): "I notice that when we get near your father you press your hands together hard. For the next few sessions, could you leave your hands still and tell me what happens inside when you do?"
Watch for / working signs: Rising tension followed by emergence of fantasy or memory [source: Ferenczi 1921]. With obsessional patients, a demand felt to be inexorable leads to rumination and stalling, so keep it revocable [source: Ferenczi 1926]. Today, sexual-behaviour prohibitions outside the session (Ferenczi's handling of masturbation and coitus in impotence) are historical only. They intrude on autonomy beyond current practice standards [synthesis].

A3. Encouraging in-vivo exposure in phobia

Purpose / when: Anxiety-hysteria at a standstill. Ferenczi attributed the idea to a remark by Freud: the patient exposes themselves to the feared situation, the anxiety this provokes makes repressed material accessible [source: Ferenczi 1921]. By 1928 the patient should set the timing, and the analyst supports a patient who asks to try [source: Ferenczi 1928].
Steps: (1) Wait until the patient raises trying the feared situation, or explore their readiness. (2) Agree on the specific situation. (3) Ask them to note thoughts, images and bodily sensations at peak anxiety. (4) Analyse that material next session. Exposure here serves associative material. It is not a desensitisation protocol [source: Ferenczi 1921].
Example language (illustrative): "You've said you want to try crossing the square alone. Good. When the fear comes, catch whatever pictures or memories go with it. That's what we'll work with."
Watch for: Rapid symptomatic "flight into health" without working through. Ferenczi reported a phobic patient who left too early and was incompletely cured [source: Ferenczi 1921].

A4. Interrupting misuse of free association

Purpose / when: The patient uses the fundamental rule as resistance: verbosity, daydreams, changing the subject, inventing material. Interrupting is not a breach of the rule, because the analyst's duty is to expose resistance [source: Ferenczi 1921; 1924].
Steps: (1) Note the pattern of flight. (2) Interrupt and show that it avoids a painful task. (3) Bring the patient back to the avoided theme or impression [source: Ferenczi 1924]. (4) If the patient threatens to invent dreams, Ferenczi might invite them to do so and analyse the inventions [source: Ferenczi 1921].
Example language (illustrative): "Let me stop you. We've drifted three times today, and each time just after you mentioned the hospital. Let's go back there."
Watch for: Shame or feeling scolded. Interrupt with tact, not as a reprimand [source: Ferenczi 1928].

A5. Forced (provoked) fantasies

Purpose / when: Near the end of treatment (detachment period), with a patient who has poor fantasy life and no affect despite intense experience, and only for analysts experienced in non-active analysis [source: Ferenczi 1924].
Steps: (1) Identify the theme the material points to, typically aggressive or erotic transference fantasies, fantasies about childhood scenes, or masturbatory fantasies. (2) When the patient says they feel nothing, ask what they would feel or do in that situation. (3) If nothing comes, ask them to imagine it deliberately. (4) Answer the objection that the fantasy is "artificial": it need not be objectively true or spontaneous. (5) Keep up steady pressure through attempts to change the subject. (6) If still refused, outline what you yourself might have felt, then let the patient add the details, which count more than your scaffold. (7) Afterwards comes a prohibition phase: the patient learns to bear the fantasy and its affect without discharging it [source: Ferenczi 1924].
Example language (illustrative): "You say you feel nothing about my cancelling last week. Suppose you did feel something. What would you have wanted to say or do to me? Don't worry whether it's 'real'. Just let the picture form."
Watch for: Fantasies that only mirror your suggestion. If later material contradicts the induced fantasy, admit the error [source: Ferenczi 1924]. Conviction usually requires reliving the fantasy in later sessions [source: Ferenczi 1924]. Present-day limit: do not direct a patient to produce sexual fantasies about the therapist or a parent, or to masturbate. This appears in one of Ferenczi's cases and is historical only [synthesis]. Keep induced fantasies to aggression, rivalry and dependency in the transference, and to childhood scenes the patient has already raised [synthesis].

A6. Muscle tension and relaxation exercises

Purpose / when: Ferenczi first used muscular (including sphincter) tension to raise tension, then found that relaxation exercises sped up the release of psychic tension and of resistance to association. He meant them only as analytic aids, not yoga-like self-mastery [source: Ferenczi 1926]. In 1930 he asked a patient to give up a stiff posture [source: Ferenczi 1930 via Rachman].
Steps: (1) Point out the rigid posture or held tension. (2) Ask the patient to let it go or loosen it, or, in the earlier version, to hold it deliberately. (3) Ask for associations as the body changes. (4) Interpret. No specific relaxation exercise sequence is given in the sources [uncertain].
Example language (illustrative): "Your shoulders are up near your ears. Could you let them drop and just notice what comes to mind as they do?"
Watch for: Paresthesias, tremor or dizziness may come before trauma material [source: Ferenczi 1930]. Go slowly, see 4.B8.

A7. Permitting "forbidden" words

Purpose / when: Ferenczi found that allowing obscene words loosened tics, stammering and obsessional symptoms [source: Ferenczi 1926]. In the forced-fantasy paper, a woman who denied knowing obscene words was asked to produce sounds while thinking of the genitals [source: Ferenczi 1924].
Steps: (1) Notice euphemism or a speech block around sexual or aggressive content. (2) Explicitly permit the plain word. (3) Analyse the affect that follows. Ferenczi's genital-hygiene instruction in the same paper is historical only [source: Ferenczi 1926].
Example language (illustrative): "You keep saying 'that thing'. Here you can use the actual word. What happens when you say it?"
Watch for: Shame spikes. Permission, not demand.

A8. Setting a termination date ("Termingebung")

Purpose / when: In 1924, with Rank, Ferenczi set a fixed end date once the transference neurosis was established, to force detachment [source: Ferenczi & Rank 1924, pp. 16–17; Ferenczi 1921; 1924]. 1926 revision followed: not universal; exceptional only, agreed with the patient, and revocable. Never predict the duration of treatment [source: Ferenczi 1926].
Steps: (1) Use it only when the patient is clearly prolonging analysis to avoid renouncing the analyst. (2) Discuss the date jointly. (3) Keep the option to revise it. (4) Analyse the reactions, which are often the final memories and gestures [source: Ferenczi 1921; 1926].
Example language (illustrative): "I think we've reached the point where continuing indefinitely protects you from saying goodbye. How would it be to set an ending in the spring? We can review it if something important opens up."
Watch for: Ferenczi's agoraphobic patient relapsed under a six-week deadline, and he had to admit the miscalculation [source: Ferenczi 1926].

A9. End-phase decisions and "sacrifices"

Purpose / when: In the end phase, push an overdue real-life decision so that the final material emerges [source: Ferenczi 1921].
Steps: Name the decision being postponed, connect the postponement to keeping the analysis going, and invite the patient to decide. Ferenczi's examples of requiring a special sacrifice, an act of charity or a monetary donation are historical only [source: Ferenczi 1921]. Financial or charitable demands are now a conflict of interest and exploitation risk [synthesis].
Example language (illustrative): "You've been 'about to' apply for the post for a year. I wonder if deciding would mean you no longer need to come here."

A10. Regulating the relationship's "optimal temperature"

Purpose / when: Ferenczi allowed limited, sincere use of praise and reproach, or coolness and benevolence, to bring the relationship to a workable warmth, then a return to analysing [source: Ferenczi 1921].
Steps: Assess whether the transference is too cool or too heated. Adjust your warmth slightly and sincerely. Never feign a feeling, and never raise hopes you can't meet [source: Ferenczi 1921; 1930].
Watch for: Analyst sadism disguised as "frustration" [source: Ferenczi 1930].

A11. Exaggerating character traits (character analysis)

Purpose / when: Narcissistic or "private psychosis" character traits resist interpretation and the transference has not reached "boiling point". Ferenczi assigned tasks that intensified the trait until it became absurd to the patient. He warned this risks breaking off the analysis [source: Ferenczi 1921].
Steps: No step sequence is given in the source. Present-day use, if any: with consent, invite the patient to carry the trait further in a small, specified way and examine the result together [synthesis; uncertain whether this matches Ferenczi's practice].
Watch for: Humiliation and dropout. Ferenczi himself called it a double-edged sword [source: Ferenczi 1921].

4.B Elasticity, relaxation and neocatharsis (1928–1933)

B1. Tactful, tentative interpretation ("salvo errore")

Purpose / when: At every interpretation. Tact means "feeling into" the patient, then judging coolly when there is enough material, how to phrase it, and when silence becomes useless torture [source: Ferenczi 1928].
Steps: (1) Let material build up. Don't interpret on a single association. (2) Step back from your own feeling about the patient. (3) Offer the interpretation as a proposition that may be wrong. (4) Watch the reaction, including subtle disbelief. (5) Do less interpreting over time and let the patient interpret [source: Ferenczi 1928; Ferenczi & Rank 1924 on "interpretation fanaticism"].
Example language (illustrative): "I may be wrong, so correct me: it seems that whenever you feel close to someone, you find a reason to be disappointed in them, and perhaps that's happening with me this week."
Working signs: The patient elaborates, corrects or extends the interpretation. Rote agreement suggests compliance.

B2. Admitting the analyst's mistakes

Purpose / when: When the patient's criticism or correction is plausibly right. Ferenczi found that admitting error built trust and did not cost authority. It separates the analyst from the denying adults of the patient's past [source: Ferenczi 1928; 1931; 1932/33 via commentary].
Steps: (1) Treat the criticism as possibly accurate before considering projection. (2) Check your own behaviour honestly. (3) Acknowledge the specific error simply. (4) Explore what it meant to the patient and what it echoes [synthesis of cited principle].
Example language (illustrative): "You're right. I did cut you off when you started talking about your brother, and I was impatient. That's mine. What was it like for you?"
Working signs: Relief, deeper disclosure, conviction about the reality of past experience. Watch that the admission doesn't turn into the patient caretaking you.

B3. Non-retaliation: being the "seesaw" for hostility

Purpose / when: Negative transference, insults, mockery, attacks on your appearance or competence. A defensive analyst prolongs resistance, while one who doesn't defend himself tires the patient's hostility, after which friendly feelings and childhood material tend to emerge [source: Ferenczi 1928]. Ferenczi held that allowing aggression toward the analyst leads to positive transference [source: Ferenczi 1930].
Steps: (1) Don't defend or counter-attack. (2) Name and invite the hostility. (3) Tolerate it, if necessary for weeks. (4) Ferenczi did let patients see he was displeased while holding himself back, aware that the "bad" role had a reason. Being honest that you're affected is compatible with not retaliating [source: Ferenczi 1931]. (5) Interpret it in relation to past educators when friendly feeling returns.
Example language (illustrative): "You're furious with me and you think I'm useless. Say all of it. I'm not going anywhere."
Watch for: Your own sadism or masochism. Tolerance is not submission to abuse or threats (see section 5).

B4. Relaxation principle: freedom of posture, movement and expression

Purpose / when: The analysis is stuck on seemingly insoluble resistance and frustration is only producing more defence [source: Ferenczi 1930]. Let the patient sit up, stand, walk, face the analyst, raise their voice, or stay lying down for long periods. The analyst stays an observer and benevolent counsellor [source: Ferenczi 1926; 1930].
Steps: (1) Note rigidity in posture, voice or association. (2) Explicitly permit freer expression. (3) Keep the limit that emotions are expressed, not acted out against the therapist or the frame. Psychotic patients must not be allowed acts that endanger themselves or the analyst [source: Ferenczi 1926]. (4) Analyse what the freedom brings up.
Example language (illustrative): "You don't have to lie still. If you need to sit up, move, or look at me, do. And if you want to shout, you can."
Working signs: More direct, childlike speech, small gestures and "passing symptoms" appear, and these can be analysed [source: Ferenczi 1931].

B5. Deepening free association (relaxed association)

Purpose / when: When free association is really a conscious selection of thoughts. Encourage deeper surrender to spontaneous impressions and feelings [source: Ferenczi 1931].
Steps: (1) Drop stereotyped prompts. Ferenczi's patients complained that his routine "What comes to mind about that?" made it impossible to take inner movements seriously [source: Ferenczi 1931]. (2) Invite the patient to let images, sensations and feelings come without editing. (3) Treat gestures and transient bodily symptoms as communications and analyse them [source: Ferenczi 1931].
Example language (illustrative): "Don't try to make sense for me. Just let whatever is there come, a picture, a feeling in your body, even a sound."
Watch for: Drift into trance-like states (see B8). Ferenczi admitted he was sometimes "hypnotic" without noticing it [source: Ferenczi 1931].

B6. The question-and-answer "game" with the regressed (child) part

Purpose / when: The patient spontaneously regresses: speaks or gestures as a child, or addresses you as a figure from childhood [source: Ferenczi 1931].
Steps: (1) Don't break the state with a transference interpretation. Answer in the same tone with a simple question. In Ferenczi's example a patient called him "grandfather", and he replied in the same confiding tone by asking why the patient thought so [source: Ferenczi 1931]. (2) Keep questions simple, at a child's level. Complex or scientific questions break the game [source: Ferenczi 1931]. (3) Use questions rather than assertions, to encourage the patient's own production (exo-suggestion), not to impose your theory (intro-suggestion) [source: Ferenczi 1931]. (4) Let the patient draw, recite verses or tell small stories, and use these as starting points [source: Ferenczi 1931]. (5) Afterwards, in adult mode, analyse the material fully and make it conscious before the session ends [source: Ferenczi 1931].
Example language (illustrative): "What's happening now? Who's there with you? … And what did the little one want to say?"
Watch for: Your questions disturbing the spontaneity of the fantasy. Severn pointed this out, and Ferenczi narrowed his role to simple encouraging questions [source: Ferenczi 1931]. If the adult drops the play and acts as an adult, the game has been falsified, and the regression should be limited in mode and scope [source: Ferenczi 1931].

B7. Working with dissociated parts and autosymbolic material

Purpose / when: After abandonment or hurt, the patient may split: one part parents the other, or a body part (hand, head, eyes, genitals) stands for the whole person. Dreams such as the "wise baby" show this [source: Ferenczi 1931; 1930].
Steps: (1) Interpret images both historically (what happened) and autosymbolically (how the psyche represents its own split). (2) Address the split-off part with simple questions and encouragement. (3) Link it to the trauma when the patient can tolerate it [source: Ferenczi 1931].
Example language (illustrative): "In the dream the baby gives advice and rushes to save the wounded child. Could the baby be a part of you that had to grow up far too early?"
Watch for: Overwhelm. Pace (see B8 and section 5).

B8. Containing neocatharsis (trauma reliving in session)

Purpose / when: Late in a long analysis, relaxation can lead to brief, fragmentary reliving of trauma: paresthesias, tremor, violent movements, dizziness, altered consciousness, sometimes trance-like states. Ferenczi took this as evidence that the work had reached the real cause. In these states the analyst is the patient's bridge to reality [source: Ferenczi 1930]. Ferenczi's example was a man who relived a childhood hydrocele operation under chloroform [source: Ferenczi 1930].
Steps (usable today): (1) Stay calm and present. Speak softly and tactfully [source: Ferenczi 1931]. (2) Keep contact through the voice and keep the patient oriented to the present relationship. (3) Ask simple questions of the reliving part: what is happening, who is there [source: Ferenczi 1930; 1931]. (4) Don't push for more. Forcing the trauma recreates the original injury [source: Ferenczi 1932/33 via commentary]. (5) Before the session ends, re-orient the patient, analyse the material and make it conscious. Ferenczi didn't end until conflicts had been resolved in reconciliation [source: Ferenczi 1931]. Present-day addition: pre-agree grounding steps and a session-end safety check, and be able to slow or stop the reliving [synthesis].
Historical only: Ferenczi calmed crises by pressing the hand and, if needed, a friendly caress on the head [source: Ferenczi 1931]. He shook patients in twilight states to restore contact [source: Ferenczi 1921; 1931]. Unsolicited touch and shaking are outside current ethics codes for psychotherapists. Any touch needs prior explicit consent and must be non-erotic, minimal, documented and supervised, and many codes and insurers advise against it altogether [synthesis].
Example language (illustrative): "I'm here. You're in my room, it's Thursday, and you're safe now. Tell me what you see." Afterwards: "Let's sit up together and look at what just happened."
Working signs: Reliving followed by conviction about past events, and a felt difference between then and now. Warning signs: repeated flooding without integration, dissociation that persists after the session.

B9. Validating the reality of trauma

Purpose / when: When the patient reports abuse or neglect. The most traumatogenic adult responses are denying that anything happened, or neglect or ridicule [source: Ferenczi 1931; 1932/33 via commentary].
Steps: (1) Take the account seriously. (2) Don't treat it as fantasy by default. (3) Note how the patient may identify with the aggressor and take on the aggressor's guilt [source: Ferenczi 1932/33 via commentary]. (4) Separate your stance clearly from the adults who denied it.
Example language (illustrative): "What you describe was done to you. The guilt you carry for it belongs to the adult who did it."
Watch for: Suggesting memories. Keep to exo-suggestion (B6), with questions, not assertions [source: Ferenczi 1931].

B10. Sincerity about countertransference (non-hypocrisy)

Purpose / when: Patients sense the analyst's moods, sympathies and antipathies. Hidden irritation behind friendliness repeats the hypocrisy of traumatising adults [source: Ferenczi 1930; 1932/33 via commentary].
Steps (usable today): (1) Work out your own reaction first, in supervision or your own analysis. (2) When the patient accurately perceives a feeling of yours that is affecting the work, confirm it briefly and own it. (3) Don't burden the patient with your personal material (contrast 4.C) [synthesis based on Ferenczi's later limits].
Example language (illustrative): "You picked up that I was tired and distant today. You're right, and it was about me, not you."
Watch for: The patient becoming your confidant. Ferenczi himself counted burdening a child with adult suffering as traumatic [source: Ferenczi 1932/33 via commentary].

B11. Limiting regression and indulgence

Purpose / when: Extended indulgence ("pampering") leads patients to demand more, delay reconciliation, or threaten in order to force a fusion with the analyst [source: Ferenczi 1931]. Relaxation must not become infantile licence. Sexual and aggressive wishes are not gratified, and the adult part is respected [source: Ferenczi 1930].
Steps: (1) Name the escalation. (2) Set the limit kindly and firmly. (3) Treat the resulting frustration as material, with patience and tact [source: Ferenczi 1931]. (4) Return to the agreed frame.
Example language (illustrative): "I can see how much you want me to stay longer. I'm going to end on time. I know that will hurt, and that hurt is something we need to understand together."

B12. Realistic contracting, fees and no promises

Purpose / when: At the start of treatment, and whenever the patient asks "Will it help?". Ferenczi gave a sober picture of duration, cost and effort, never a simple "yes", and discussed fees openly as a place where resistance shows [source: Ferenczi 1928].
Example language (illustrative): "I can't promise a cure. I can promise we'll work seriously. Many people come to know themselves better and live differently, but it can take a long time, and you'll judge from your own experience."

4.C Mutual analysis and physical-affection elements (historical description only; not for use)

C1. Mutual analysis (1932)

What Ferenczi did: R.N. (Elizabeth Severn) insisted that his hidden hostility toward her was blocking her analysis. After resisting for about a year, from January 1932 he let her analyse him in alternating sessions. He acknowledged hating her despite his displayed friendliness [source: Clinical Diary 1932, p. 99, via Fortune].
Why: He wanted to remove the analyst's hidden resistance and hypocrisy, which he thought the patient perceived and which blocked her conviction about her traumas. He recorded real progress toward that conviction [source: Clinical Diary 1932, pp. 26, 99–101, via Fortune].
His own reservations: He described putting himself into the hands of a not undangerous patient. He wrote that mutual analysis "could only be a last resort" and that analysis by a stranger would be better [source: Clinical Diary 1932, pp. 100, xxii, via Fortune]. He more or less abandoned it during 1932, though he found that one-sided analysis with that patient then felt flat [source: Clinical Diary pp. 213 via Fortune; Gay 1989]. Further concerns usually reported, such as confidentiality toward his other patients, whose material he might reveal, are [uncertain].
Current ethical boundary: Reversing roles, or using the patient as your therapist, breaches the fiduciary asymmetry and dual-relationship rules of all major professional codes (e.g. APA, BACP, UKCP). What can be carried forward is B2 and B10: limited, purposeful acknowledgement of your own contribution, with your own analysis or supervision done elsewhere [synthesis].

Harm account: Ferenczi's mutual analysis

What was actually done: Elizabeth Severn (R.N.) came to Ferenczi in 1924 aged 44 as an "analyst of last resort" after earlier treatments, including one with Otto Rank, had failed [source: Fortune 1993]. By 1928 he was seeing her twice a day for a total of four to five hours, at weekends and, "if necessary, at night". Because she was often too ill to leave bed, he analysed her in her hotel rooms. He continued sessions on holidays abroad, and in September 1928 she went with him and his wife to Spain [source: Fortune 1993]. In 1929–30 she began demanding to analyse him, arguing that his hidden hate was blocking her treatment. He resisted for about a year and then agreed [source: Fortune 1993]. In practice, the two took turns in the roles of analyst and analysand, in double or alternating sessions [source: Grosskurth 1988]. The analyst could take the couch and the patient the analyst's chair. Some mutual-analysis patients had two sessions, one for themselves and one for the therapist, and Ferenczi did not pay for the sessions he received [source: Kahn, citing Clinical Diary]. He told Severn that he had hated her despite his displayed friendliness, and he disclosed his own failings and past [source: Clinical Diary p. 99 via Fortune; Grosskurth 1988]. The diary shows he also tried mutuality, in whole or in part, with other patients in the same close-knit group of mostly American analysands [source: Kahn; Berman 2015]. In June 1930, when she was collapsing, he offered to waive his fee so she could stay in Budapest. By late 1932 she had no money and was distraught [source: Fortune 1993].
How it caused harm:
- Role reversal and burden. The patient's own treatment became a vehicle for the analyst's needs. Ferenczi recorded that some patients reacted to his exposed vulnerabilities with more "anxiety, helplessness [and] contemptuousness" [source: Clinical Diary p. 213 via Kahn]. Clara Thompson, also his patient, felt it "went too far and burdened the patient" [source: Shapiro 1993].
- No way back. Once mutuality had been tried, he found that "one-sided analysis then is no longer possible – not productive" [source: Clinical Diary p. 213 via Fortune]. He could not simply restore the frame.
- Confidentiality and contagion. The diary itself raises the problem of what an analysed analyst might reveal about others. It also warns that the arrangement could degenerate into "gangsterism" [source: Clinical Diary p. 74 via Kahn]. His analysands knew one another and passed on what happened in sessions, and divided loyalties may have left some feeling betrayed or abandoned [source: Berman 2015].
- Dependency and collapse at ending. After years of near-unlimited sessions, money ran out. The ending was unplanned and was forced by Ferenczi's illness. When Severn left in February 1933, her daughter described her as in "critical mental and physical collapse" and wrote Ferenczi a "terrible letter" of protest [source: Fortune 1993]. She recovered in London within months and resumed practice [source: Fortune 1993].
- Analyst depletion. Ferenczi wrote that his patients were "literally trying to overwhelm me" (1929). Fortune judges his receptivity to Severn "probably clinically unwise, even naive" and a contributor to his final exhaustion [source: Fortune 1993].
- Ferenczi's own verdict. He limited the method on 16 February 1932: it was admissible only to the extent that the patient's needs require it or the patient can bear it [source: Clinical Diary via Grosskurth 1988]. He later called it "a last resort" and said analysis by a stranger would be better (see above).
- Documented injury beyond these accounts, such as lasting harm to other patients, is [uncertain].
Recognising it today [synthesis]:
- The therapist asks the client for advice, comfort, interpretation of the therapist's dreams or "honest feedback about me" beyond the work.
- Sessions drift into the therapist's own trauma or crises, and the client listens.
- Rebrandings include "co-counselling with my client", "reciprocal" or "peer" sessions, "we heal each other", and "radical mutuality" or "full transparency" used as a rationale.
- Red flags in a colleague or service: a "special" client seen far beyond the frame (very long or extra sessions, evenings or weekends, home or hotel visits, shared holidays); fees waived open-endedly; the therapist believing only they can help a "last-resort" client; secrecy from supervisors; the client knowing about the therapist's other clients.
- How legitimate techniques differ: relational acknowledgement of an enactment or a brief, purposeful self-disclosure (B2, B10) stays client-centred, time-limited and reflected on in supervision. The roles never swap, and the therapist's own work happens elsewhere.
What to do instead / helping those harmed [synthesis]:
- Instead: when a client accurately perceives your feelings, confirm briefly and take the rest to supervision or personal therapy. If the treatment is stuck, consult or refer rather than invent a new frame alone. Plan endings, including what happens if you fall ill.
- Assessing a client who went through role reversal: ask openly about previous therapy. Expect parentified caretaking of you, guilt or loyalty towards the former therapist, idealisation alternating with contempt, and difficulty asking for help. Keep the new frame especially clear and predictable.
- Ethics: role reversal or dual relationships with a client breach the multiple-relationship and exploitation standards of major codes (e.g. APA 3.05/3.08; BACP). If a colleague is doing this, consult, and follow your professional body's and jurisdiction's reporting rules. Support, but do not pressure, a client who wants to complain.

C2. Physical affection and unlimited availability

What is documented: In December 1931 Freud wrote objecting to reports that Ferenczi kissed patients and let them kiss him, insisting that patients be denied erotic gratification [source: Gay 1989]. Ferenczi's 1931 paper describes holding a patient's hand and a friendly caress on the head during crises, and a patient putting an arm around his neck while speaking as a child [source: Ferenczi 1931]. The 1930 paper prescribes no touch. The only contact it describes is a patient embracing him after a reliving [source: Ferenczi 1930]. With Severn he gave sessions on demand, at night and at weekends, and sometimes took her on holiday [source: Balint 1968, via Rachman].
Why (as he explained it): to provide the tenderness the traumatised child was denied, so that reliving could happen in a different relationship [source: Ferenczi 1930; 1931].
Current ethical boundary: Kissing or any erotic or quasi-parental physical intimacy is prohibited. Open-ended availability, holidays together and night sessions are boundary violations. Fee waivers and extra sessions are acceptable only as transparent, time-limited, documented frame decisions [synthesis].

Harm account: physical affection / kissing in the relaxation technique (Ferenczi–Thompson "kissing" episode)

What was actually done: Under the relaxation principle, Ferenczi met regressed patients with tenderness: holding hands, a caress on the head, letting a patient put an arm around his neck while speaking as a child [source: Ferenczi 1931]. He also adopted a deliberately passive, non-forbidding stance. Clara Thompson ("Dm." in the diary) was in analysis with him in the summers of 1928 and 1929 and intensively from 1931 until his death [source: Shapiro 1993]. The diary identifies Dm. as a woman who had been "grossly abused sexually by her father" [source: Clinical Diary p. 3 via Shapiro 1993; identification per Dupont and Brennan 2015]. She "tested the boundaries repeatedly", moving from distancing to sexualised affection, humiliating disclosure and triangulation with his other patients [source: Shapiro 1993]. She kissed him, he did not stop her, and he analysed it rather than forbidding it. According to Grosskurth, the diary says he "would sit impassively" while she tried to taunt him with kisses [source: Grosskurth 1988]. She then told a colleague that she could "kiss papa Ferenczi whenever I want". The remark reached Freud [source: Shapiro 1993; Grosskurth 1988]. On 13 December 1931 Freud wrote to Ferenczi objecting that he kissed patients and let them kiss him, and insisting that patients be denied erotic gratification [source: Gay 1989]. Freud warned that others would go further than a kiss, so that analytic technique would slide into a "petting party", and he mocked a "technique of motherly affection" [uncertain: wording recalled from the published correspondence/Jones].
How it caused harm:
- Re-enactment of the original abuse. With a patient abused by her father, a passive "father" who allows kisses repeats the trauma's structure: an adult who does not hold the line and lets erotic contact happen under the label of care. This is the "confusion of tongues" between tenderness and passion that Ferenczi himself described in 1932/33 [synthesis].
- Responsibility shifted to the patient. Treating the kiss as the patient's material to analyse puts the job of keeping the boundary on her [synthesis].
- Spread beyond the dyad. The episode became gossip among Ferenczi's interconnected analysands and his colleagues. That exposed the patient and fed the conflict with Freud [source: Shapiro 1993; Berman 2015]. When Dupont's edition of the diary identified Dm., this troubled later commentators because confidentiality had been promised [source: Shapiro 1993].
- Long shadow. Thompson later criticised Ferenczi's regressive indulgence ("Ferenczi would make therapy too fantastic") [source: Shapiro 1993]. Shapiro argues she then swung the other way, minimising abuse: she wrote that "even rape is not easy without some cooperation from the woman" (1950). Shapiro also reports she did not favour reporting a therapist who had sex with a patient [source: Shapiro 1993]. One boundary failure can thus shape how a later clinician handles others' abuse [synthesis].
- No sexual intercourse between Ferenczi and patients is documented in the sources. Freud's fear was escalation along a slope [source: Gay 1989; Grosskurth 1988].
Recognising it today [synthesis]:
- Rebrandings include "reparenting", "holding" or "corrective" touch, "attachment-based" cuddling or hugging protocols, "the client initiated it, I just didn't reject her", and "it's healing because it's non-sexual for me".
- Red flags: hugs at every session that lengthen over time; kissing on cheek or lips; touch not discussed beforehand, not recorded and not supervised; touch with clients who have a history of sexual abuse or with a strong erotic transference; the client telling others about special physical closeness; the therapist feeling flattered or defensive when asked about it; affection coupled with extra time or contact.
- How legitimate approaches differ: in body-oriented or trauma therapies, any touch is brief, non-erotic, explained in advance with explicit, revocable consent, aimed at a clear clinical purpose, documented and supervised. It is never a substitute parental or romantic relationship and never at the client's or therapist's whim.
What to do instead / helping those harmed [synthesis]:
- Instead: offer tenderness through attunement, voice, pacing and words (B4, B8, B11). When a client reaches for physical closeness, decline kindly and explore the wish. If the client acts out sexually, set the limit clearly, without shaming, and seek consultation.
- Assessing a client who experienced therapist kissing or touch: expect confusion, self-blame, secrecy, idealisation of the former therapist, and re-triggered abuse memories. Validate without pressure, and do not tell the client what it "was". Let them name it. Be alert to mistrust of you and to tests of your boundaries.
- Ethics: sexual or erotic contact with clients is prohibited by all major codes (e.g. APA 10.05). Some jurisdictions impose specific duties when a client discloses sexual contact with a previous therapist. Check your local law and professional body, consult, and document.

5. Handling problems

Stagnation / stuck client (source-based). First, check yourself. Ferenczi treated a failing analysis as a problem with his technique, not proof that the patient was incurable [source: Ferenczi 1931]. Then try the options in order: (1) a tactful interpretation of the resistance in the here-and-now situation (B1); (2) interrupt any flight into verbosity (A4); (3) if the ego is defending strongly and the transference is solid, propose one revocable active measure (A1/A2); (4) if frustration is only producing more defence, shift toward relaxation (B4, B5) [source: Ferenczi 1921; 1926; 1930]. Return to passivity once the stagnation lifts [source: Ferenczi 1921].
Resistance intensified by activity (source-based). This is expected. Activity inevitably increases resistance [source: Ferenczi 1926]. If the transference holds, analyse the resistance as repetition. If it threatens the transference, withdraw or soften the measure openly. Example (illustrative): "I pushed this harder than was useful. Let's drop the task and look at what it stirred up."
Non-adherence to an agreed task (source-based + synthesis). Don't enforce it. The task was a proposal, not a condition, and enforcing it turns you into the strict father or schoolmaster [source: Ferenczi 1926]. Treat not doing it as material: what made it impossible, and what does refusing protect? With obsessional patients, release them from the task explicitly to stop the rumination [source: Ferenczi 1926].
Patient demands activity or "more" (source-based). A wish for activity is only a "pious intention" until a concrete indication appears [source: Ferenczi 1926]. Explore the wish rather than meeting it.
Negative transference, insults, attacks (source-based). Don't defend yourself. Tolerate it and invite it. Expect it may last weeks [source: Ferenczi 1928]. Limit (synthesis): threats, intimidation or violence end the session, and safety measures apply. Psychotic patients are not permitted dangerous acts [source: Ferenczi 1926].
Ruptures caused by the therapist (source-based). Acknowledge the specific error plainly before considering projection (B2). Ferenczi credits this with restoring trust and separating the analyst from the traumatising adult [source: Ferenczi 1928; 1932/33 via commentary]. Ferenczi had to admit miscalculations (a failed six-week deadline, mistimed provocations) to keep patients [source: Ferenczi 1926].
Overwhelm / flooding during reliving (partly source-based). Ferenczi used a soft voice and tactful words, and kept medication available but never used it [source: Ferenczi 1931]. Don't force the trauma [source: Ferenczi 1932/33 via commentary]. Present-day protocol [synthesis]: slow the pace, orient to the present (name the date and place, have the patient sit up, open their eyes, feel their feet), shift from reliving to talking about it, keep a session-end stabilisation slot, and assess risk afterwards. Ferenczi's practice of extending sessions until reconciliation is replaced by: plan a contingency (a brief check-in call, a crisis plan) in advance rather than open-ended sessions [synthesis].
Persistent dissociation or trance after sessions [synthesis]. Reduce relaxation and regression work. Strengthen grounding and adult-level reflection. Consider a trauma-specialist consultation. Ferenczi noted his own unintended "hypnotic" influence [source: Ferenczi 1931]. Check whether your questioning is inducing trance.
Escalating regressive demands (extra time, contact, touch) (source-based + synthesis). Ferenczi found that indulgence led to rising demands and threats [source: Ferenczi 1931]. Set the limit kindly, analyse the frustration, and keep the adult part addressed (B11). Requests for physical comfort: decline, and explore what is being asked for [synthesis, per current ethics].
Suggestion contamination: compliant fantasies or "memories" (source-based). Signs include material that mirrors your proposals, or no conviction without reliving [source: Ferenczi 1924]. Use questions not assertions (exo-suggestion) [source: Ferenczi 1931]. Admit an induced fantasy was wrong when later material contradicts it [source: Ferenczi 1924].
Too-fast "flight into health" (source-based). Ferenczi's phobic patient left cured but incompletely, without the renunciation phase [source: Ferenczi 1921]. Name the pattern and offer to continue, without coercion [synthesis].
Termination deadline backfires (source-based). Revise it openly. Never hold to a date that has become a pressure on you [source: Ferenczi 1926].
Patient perceives your hidden feelings (source-based + synthesis). Confirm what is accurate briefly (B10). Take the rest to supervision or your own therapy. Never turn it into role reversal (4.C) [source: Clinical Diary via Fortune; synthesis].
Your own sadism or need for love driving technique (source-based). Frustration can mask sadism and tenderness can serve the analyst's own libidinal needs [source: Ferenczi 1930]. Remedy: your own thorough analysis and continuing supervision [source: Ferenczi 1928; 1930].
Fee and money tensions (source-based). Raise them openly as a site of resistance [source: Ferenczi 1928]. Ferenczi's occasional fee waivers: today, only with documented reasoning, consistent with your policy [synthesis].
Patients unsuited to active technique (source-based + synthesis). Avoid activity at the start of treatment, with beginners as therapists, and where the transference is weak [source: Ferenczi 1921; 1926]. My additions [synthesis]: also avoid it in acute suicidality, active psychosis without containment, severe dissociative disorders early in stabilisation, and with clients for whom therapist directives replicate coercive abuse. Prefer B-version stances there.
Not addressed in the sources [synthesis]: cultural or linguistic mismatch in "childlike" game language (adapt the register, ask permission to use simple language); telehealth (no posture freedom or regression work without a safety plan and a known location); documentation (record every active measure, its consent and its withdrawal, and any frame deviation); informed consent (explain upfront that you may propose experiments the client can refuse).

Sources

Sources:

Books cited (further reading, not drawn on in full):

Ferenczi, S. (1919) "Technical difficulties in the analysis of a case of hysteria". In Further Contributions to the Theory and Technique of Psycho-Analysis (1926). [Primary text not drawn on; only referenced.]
Ferenczi, S. (1932/1988) The Clinical Diary of Sándor Ferenczi, ed. J. Dupont. Harvard University Press. [Quoted via Fortune and Gay.]
Ferenczi, S. & Rank, O. (1924/1925) The Development of Psychoanalysis. Nervous and Mental Disease Publishing.
Ferenczi, S. (1933/1949) "Confusion of tongues between adults and the child". International Journal of Psycho-Analysis 30. [Read via commentary.]
Balint, M. (1968) The Basic Fault. Tavistock. [Cited via Rachman.]

Sources for the harm accounts (C1, C2):

Shapiro, S. A. (1993) "Clara Thompson: Ferenczi's Messenger with Half a Message", in Aron & Harris (eds) The Legacy of Sándor Ferenczi, Analytic Press, pp. 159–173 – alsf-chile.org PDF (secondary; quotes Clinical Diary p. 3)
Kahn, S. R. (n.d.) "Ferenczi's Mutual Analysis: A Case Where the Messenger Was Killed and His Treasure Buried" – alsf-chile.org PDF (secondary; quotes Clinical Diary pp. 35, 74, 135, 213)
Fortune, C. (1993) "The Case of RN: Sándor Ferenczi's Radical Experiment in Psychoanalysis" – alsf-chile.org PDF, re-opened for session frequency, money, holidays and Severn's state in 1933 (secondary)
Grosskurth, P. (1988) "The Lovable Analyst" – review of the Clinical Diary, New York Review of Books, 8 Dec 1988 (secondary)
Berman, E. (2015) "On 'Polygamous Analysis'", American Journal of Psychoanalysis 75(1), 29–36 – abstract only
Brennan, B. W. (2015) "Decoding Ferenczi's Clinical Diary: Biographical Notes", American Journal of Psychoanalysis 75(1), 5–18 – abstract only (identifies Dm. as Clara Thompson)
Gay, P. (1989) "Kissing Cure", London Review of Books 11(16) – re-opened (secondary)

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