PSYCHOANALYTIC INQUIRY

2018, VOL. 38, NO. 6, 416–434

https://doi.org/10.1080/07351690.2018.1480225

Free Association as the Foundation of the Psychoanalytic Method

and Psychoanalysis as a Historical Science
Henry Zvi Lothane, M.D.

ABSTRACT
Freud established psychoanalysis as a historical science and free association
as its basic method of healing and research, differentiating a theory of
method from theories of disorder. Psychoanalytic therapy was based on
the fundamental rule of free association as an indispensable instrument for
decoding and interpreting such phenomena as dreams, daydreams, hallu-
cinations, delusions, and enactments occurring in various normal and
pathological states, juxtaposing formulaic interpretations with free associa-
tions and process interventions. It was embraced by the first (Ferenczi,
Jung) and second generation (Reik, Isakower) followers of Freud, and by
contemporary analysts. The evolution of free association in Freud is sur-
veyed during four periods and themes: (a) the prepsychoanalytic, 1888–
1892; (b) 1893–1895, in the Studies on Hysteria; (c) 1900 in The Interpretation
of Dreams; and (d) 1912–1915 in the papers on technique. The purpose of
this article is to validate free association as a method for exploration of
unconscious processes, to ground the psychoanalytic method as historical,
and address the question is Freud’s working out of free association still
relevant today.

Associating, i.e., linking a thought or a feeling with another is an ongoing everyday psychological
activity expressed in words and images, in performing cognitive and existential tasks. It involves
both conscious and preconscious memory, imagination, and emotion. A present thought leads to
remembering past or anticipating future thoughts: Association is a synonym for thinking, tout court.
Association is also active in everyday dreams and reveries, sequences of thoughts and images not
purposively directed, which inspired Freud’s technique of free association, a paradigm shift that
defined “psycho-analysis [as] a method of research, an impartial instrument, like the infinitesimal
calculus, as it were” (Freud, 1927, p. 36). Free association emerged as a superordinate, deterministic
method of investigating unconscious processes and a procedure (Freud, 1903) for healing psycho-
logical pain and trauma, applicable to the continuum of interpersonal communications in sympto-
matic acts, neurotic, psychotic, and character disorders, and the psychoanalytic situation. It
transcends diagnoses and dynamic patterns in the quest of reconstructing the complete history of
a person’s life, its dramas and stories of love and work, and more. In evaluating free association as a
method, it is essential to keep in mind the differentiation between theories of technique and theories
of disorder.
Once a valued and widely discussed method, free associations has, in recent decades, met with
neglect and even denial, e.g., Hoffman (2006), who
challenges the traditional and still prevalent view of “free association,” arguing that it entails three forms of
denial (also formulated in terms of corresponding myths): 1) denial of the patient’s free agency; 2) denial of the
patient’s and the analyst’s interpersonal influence; and 3) denial of the patient’s share of responsibility for
coconstructing the analytic relationship. … Free association is still one of the sacred cows of the psychoanalytic
tradition. … Kris declares, “For me, the central point in psychoanalysis is the commitment to the free

CONTACT Henry Zvi Lothane, M.D. henry.lothane@mssm.edu Icahn School of Medicine at Mount Sinai, Department of
Psychiatry, 1435 Lexington Avenue, New York, NY 10128.
Copyright © Melvin Bornstein, Joseph Lichtenberg, Donald Silver
 FREE ASSOCIATION AS THE FOUNDATION OF THE PSYCHOANALYTIC METHOD 417

association method” (1996, p. 7). Bollas … closely following Freud, states, “Psychoanalysis can be said to be
taking place if two functions are linked—the analysand’s free associations and the psychoanalyst’s evenly
suspended attentiveness. I think of these functions as the Freudian pair” (2001, p. 93, original italics). [p. 43]

Such controversy about free association calls for clarification: reaffirming its centrality and
reinvigorating an interest in it by tracing its evolution in Freud and early, later and recent followers.
When psychoanalysis was born in 1893 (Breuer and Freud, 1895; Studies on Hysteria, henceforth
Studies), a question emerged that would reverberate down the decades: Should the fundamental
psychoanalytic task, interpretation, be practiced with formulas or with free associations, as captured
by Freud in 1933: “A few formulas have become generally familiar … [but] really important [is] the
impossibility of interpreting a dream unless one has the dreamer’s associations to it and … the
process of the dream-work” (1933a, p. 8), also applicable to interpreting daydreams and fantasies,
delusions and hallucinations, jokes and slips and other enactments, and last but not least, transfer-
ences and countertransferences.
Approaching association begins in ancient Greece where philosophy was born. In the Phaedo,
Plato explicated “the principle of association in which the lyre might remind me of its player, or a
picture of the person represented or his friend … based on likeness or unlikeness. … The activity of
the mind thus supplying the counterpart of any given experience is called Anamnesis, recollection”
(cited in Brett, 1912, pp. 77–78). In Memory and Reminiscence, Aristotle offered
the formula ‘All memory involves time’, reviving an activity through its connection with an existing activity [in]
the condition of Recollection, [based on] laws of “habits” or sequences of ideas. The art of recollection consists
in starting such a train of imagination, [as] a voluntary effort. The laws of this process are the laws of
association between psychic activities, the laws of similarity, dissimilarity, and contiguity, [i.e.] the movements
of change which we desire to initiate, thought of as analogous to physical [i.e. bodily] movements. The phrase
‘association of ideas’ conveys a different meaning. [Brett, p. 125; condensed, italics added]

The term association of ideas, first coined by the physician-philosopher John Locke, refers to his
epistemological theory of knowledge which gave birth to atomistic and mechanistic British associa-
tionism that included Hobbes, Hartley, and John Stuart Mill, whose latter’s phrase “chain of
associations” was quoted by Freud (1891b, p. 89). Association also plays a role in learning from
experience, e.g., associating fire with burns and blisters and developing a reflex of defense, or
acquiring habits and skills, in all of which association becomes automatic and unconscious (James,
1890, Chapter IV, “Habit”); Chapter IX is about “the stream of thought,” echoed in Freud’s “stream
of my memories” (Freud, 1899, p. 309), “stream of ideas” (Freud, 1900, p. 528), echoed in Freud
regarding the patient’s “stream of associations” (Freud, 1925a, p. 41).
Associating as an everyday psychological activity was described by Francis Galton (1883) in a
book Freud (1900) cited. In the section “Associations,” Galton wrote: “The furniture of a man’s mind
chiefly consists of his recollections and the bonds that unite them … the fruit of experience … a
large part [of which] consists of childish recollections …of early education” (p. 131), all experienced
as “mental imagery,” “visual memory,” “visual presentation” (p. 57), and “the visualizing faculty”
(p. 73). Freud quoted “his friend in Berlin” who in his letter “had shown his power of visualization: ‘I
am very much occupied with your dream-book. I see it lying finished before me and I see myself
turning over its pages’” (1900, p. 172; italics Freud’s), a rarity, because Freud destroyed all Fliess’
letters after their dramatic breakup.
Another source was unearthed by Zilboorg (1952): Galton’s 1879 description of free association in
“Psychometric experiments,” in Brain (journal cited by Freud, 1891b, p. 57):
Ideas present themselves by association either with some object newly perceived by the senses or with previous
ideas … associated ideas [that] are fixed and vivified by the attention, as happen to be germane to the topic on
which the mind is set … [they] arise of their own accord, and we cannot, except in indirect and imperfect ways,
compel them to come. … These associated ideas, though they are for the most part exceedingly fleeting and
obscure, and barely cross the threshold of our consciousness, may be seized, dragged into daylight and
recorded. … They gave me an interesting and unexpected view of the number of the operations of the mind,
and of the obscure depths in which they took place, of which I had been little conscious before. … They lay bare
418 H. Z. LOTHANE

the foundations of man’s thoughts with curious distinctness and exhibit his mental anatomy with more
vividness and truth than he would probably care to publish to the world. … Perhaps the strongest of the
impressions left by these experiments regards the multifariousness of the work done by the mind in a state of
half-unconsciousness, and the valid reason they afford for believing in the existence of still deeper strata of
mental operations, sunk wholly below the level of consciousness, which may account for such mental
phenomena as cannot otherwise be explained. [Zilboorg, 1952, pp. 492–493; italics added]

Even if Galton was the first, “it was left to Freud … to take the decisive step and assign human
intuition the dignity of a scientific working tool co-equal at least with the method of ‘imposing
measurement and number’” (Zilboorg, 1952, p. 495) and to elaborate free association over four
periods: (a) the pre-psychoanalytic publications, 1888-1892; (b) in the Studies, including the 1893
“Preliminary Communication” (pp. 5–17); (c) in the Interpretation of Dreams (Freud, 1900; hence-
forth Dreams); and (d) in papers on technique (1912–1915). In all these phases, recollection and
revival not only of conscious but also of unconscious past memories played a central dynamic role.
In 1888(a), before psychoanalysis, Freud delineated “along the physical symptoms of hysteria a
number of psychical disturbances, an analysis … scarcely begun … of changes in the passage and in
the association of ideas” due to “trauma” (p. 49) and “fright” (p. 51) and “conscious and unconscious
ideas” (p. 57). In 1888(b) “Preface” to Bernheim’s book, Freud noted “the link between hypnotic
phenomena with ordinary processes of waking and sleeping” (p. 75), that autosuggestion and direct
suggestion have “the same meaning as the reciprocal arousing of psychical states according to the
laws of association” (p. 83), that hypnosis was mainly employed “from the standpoint of suggestion”
(p. 85). Continuing in the 1891a “Hypnosis” Freud considered various “procedures at our choice if
we only keep the aim before us of arousing, by an association of thought (Gedankenassoziation), the
picture of falling asleep” (p. 111), which facilitates “a state of consciousness cut off from the ordinary
one” (p. 110). In the 1892–93 case, Freud underscored the dynamic role in “disposition to hysteria”
to “inhibited and suppressed ideas (Vorstellungen) … excluded from the chain of associations
(Assoziationskette) of the normal ego” (p. 126), phenomena which “had a meaning” (p. 127).
Laplanche and Pontalis (1973) have “Idea (or Presentation or Representation” (p. 200) as translation
for Vorstellung. In “Appendix C” (pp. 209–215), an excerpt from Freud 1891b (pp. 74–81), Freud
uses “presentation” and “image” (Bild) interchangeably (Freud, 1915).
In 1893, Freud showed that “considered psychologically, the [non-organic] paralysis of the arm
consists in the fact that the conception [here: image] of the arm cannot enter into association with
the other ideas (idées) constituting the ego (le moi) of which the subject’s body forms an important
part … [due to] the abolition of the associative accessibility of the conception of the arm. The arm
behaves as though it did not exist for the play of associations” (p. 170; italics Freud’s); “it will be
inaccessible to the free play of other associations … [for] the lost function is involved in a
subconscious association … in association with a large quota of affect … the arm is liberated as
soon as this quota of affect is wiped out … it is saturated … with the memory of the event, the
trauma, that produced the paralysis” (p. 171; Freud’s italics).
The Swiss neurologist/psychologist Edouard Claparède (1903), a future adherent of Freud,
reviewed association experiments of the 1880s and 1890s and linked those with “représentations”
(p. 181) and “évocation des images” (p. 185). He noted that “a psychic element develops an
alliance with an emotion … an affective soldering of all the psychic elements belonging to the
same object,” which is how “Breuer and Freud explained tics, contractures and other accidents of
hysterics” (p. 349). Claparède’s 1903 work would be cited as “subtle and ingenious” in a 1906
book on experiments in word associations edited by C. G. Jung (1906, p. 16) under the influence
of Wilhelm Wundt and Freud’s Studies and Dreams. There, cited by Jung (1906), Bleuler wrote:
“In our observations on the psyche we come upon the process of association again and again.
Everything else in these investigations is found to be subordinate to association” (p. 2); “associa-
tion is a fundamental phenomenon of psychical activity” (p. 3); “Thus in the activity of associa-
tions is mirrored the whole psychical essence of the past and the present, with all their experiences
and desires. It thus becomes an index which we have but to decipher in order to understand the
 FREE ASSOCIATION AS THE FOUNDATION OF THE PSYCHOANALYTIC METHOD 419

complete man” (p. 5; Bleuler’s italics). Bleuler criticized German psychiatry for ignoring “uncon-
scious mental functions” (p. 266) and their role in life and disorder. Jung held that the
emotionally charged “complex appearing in the associations of a psychogenic neurosis exhibits
the causa morbi [cause of disease]. … Associations give us experimentally an insight into the
psychological structure of the neurotic symptoms” (p. 321). Freud (1906) acknowledged that
Bleuler and Jung
assumed that the reaction to the stimulus-word [as a ‘complex’] could not be a chance one but must be
determined by an ideational content present in the mind of the reacting subject (p. 104). … We have to uncover
the hidden psychical material. … We ask [the patient] to give himself up to the thoughts that occur to him
spontaneously and to say without any critical reserve whatever comes into his head [for] these spontaneous
thoughts will not be arbitrarily chosen but will be determined by their relation to the secret—to his ‘complex’—
and may be regarded as derivatives of that complex. [p. 109]

Although subconscious was used by Pierre Janet (first to publish observations on hysterics in 1886,
Breuer treated Anna O. in 1880-82 and informed Freud in 1883), there was an essential methodo-
logical difference in their approaches to hysteria: Janet saw it as caused by a negative deficit, an
organic mental weakness and disintegration due to fixed subconscious ideas and resulting in
dissociation. Freud advanced a positive concept of conflict, as external conflict between people or
an internal conflict between desires, emotions and the opposing force of repression, so as to avoid
painful feelings. Thus, repression could cause unconscious forgetting of the traumatic event or its
conscious connections, resulting in inhibition of action and endless reminiscences. Janet worked
with suggestion and synthesis; Freud’s method was dynamic, deterministic and reductive, teaching
the patient to utilize his own associations to make the unconscious conscious: unlock the repressed
emotion-charged thoughts and ideated emotions, expressive of one’s character and life style. In his
case histories, Janet called his method psychological analysis. In 1896, named his method
psychoanalysis.
In his most eloquent paper composed in 1891–1892 (Lothane, 2014) but published in 1905, Freud
described the interpersonal nature of psychotherapy and the therapist’s
words [as] the essential tool of mental treatment. … Words are the most important media by which one man
seeks to bring his influence 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.
[1905a, pp. 283–292; cited in Lothane, 2007]

Freud also emphasized the person’s “‘expression of emotions’” via “facial muscles, the vocal apparatus
and the movement of his limbs” (p. 286), the role of love and faith, of the “power of suggestion” and
“the dream situation” (p. 301), all manifestations of emotional reality (Lothane, 2015).
In 1893, Breuer and Freud launched psychoanalysis (1895, pp. 3–17) as they “[investigated] …
forms of hysteria … and their precipitating cause or event which provoked the first occurrence” (p. 3;
italics added), redefining hysteria as a traumatic neurosis: a dual disorder consisting of the historic
traumatic event and the reaction to it, the “distressing affects such as those of fright, anxiety, shame
or physical pain” (p. 6). In a normal person who “has experienced a psychical trauma, the memory of
such a trauma … enters the great complex of associations … and is subjected to rectification by
other ideas … by putting the facts right, by considering his own worth, … [bringing] about the
disappearance of the accompanying affect through the process of association … [with] effacement of
impressions and ideas no longer affectively operative” (p. 9). Because “the patient wished to forget,
and therefore intentionally repressed from his conscious thought and inhibited and suppressed
distressing things of this kind” (p. 10) “as a motive for defense—that is for repressing ideas from
consciousness” (p. xxix), the result was that
[1] the memories which have become the determinants of [traumatic] hysterical phenomena (p. 9)—of the
event which provoked the first occurrence … or [2] the causal connections [between] the precipitating event
and the pathological phenomenon (p. 3), [are not inaccessible by] simple interrogation (p. 3) [because]
420 H. Z. LOTHANE

completely absent from the patients’ memory … [and] not until they have been questioned under hypnosis can
these memories emerge with the undiminished vividness of a recent event … re-lived with hallucinatory clarity.
[p. 9; second italics original, others added]

The defense had its cost: It “denied the normal wearing-away by means of abreaction and reproduc-
tion in states of uninhibited association” (p. 11; original italics).
Because repression resulted in “the emergence of abnormal states of consciousness (which we shall
bring together under the name of hypnoid)” (Breuer and Freud, 1893, p. 12; their italics), questioning
the patient under hypnosis, a similar altered state of consciousness, enabled recovering repressed
memories and reliving them with “the accompanying affect … described in detail and put into words”
(p. 6, their italics), by abreaction, “an adequate reaction … a completely ’cathartic’ effect” (p. 8; their
italics): “the roots of hypnoid hysteria and defense hysteria [came] together” (p. 286). Catharsis,
purging and purification of affects, came from Aristotle’s theory of drama.
At first Freud pressed Lucy R.’s forehead, suggesting: “[When] I relax my pressure you will see
something in front of you or something will come into your head. Catch hold of it. It will be what we
are looking for” (p. 110). Omitted in translation was the second something, the word Einfall, which
means an unbidden, sudden, and spontaneous thought or feeling. Lucy R. first refused to tell her
Einfall and then admitted “I knew it the first time,” because she “had not yet learned to relax [her]
critical faculty” (p. 111). Similarly, in treating Elisabeth von R., “different scenes relating to a given
theme emerged … as though she were reading in a long concertina picture book (Bilderbuch) whose
pages were pulled (vorübergezogen) before her eyes” (p. 153; retranslation). Increasingly, the pressure
technique and hypnosis were being replaced by free association, enabling the patient to

see before him a recollection in the form of a picture (Bild) or will have it in his thoughts in the form of an
unbidden idea (Einfall) occurring to him; and I pledge him to communicate this picture or this idea to me,
whatever it may be. He is not to keep it to himself. … There is to be no criticism, no reticence, either for
emotional reasons or because it is judged unimportant. Only in this way can we find what we are in the search
of, but in this manner we shall find it infallibly. I then … [ask] “What did you see?” or “What occurred to you?”
(1895, p. 270). The advantage of this procedure lies in the fact that I dissociate the patient’s attention from his
conscious searching and reflecting (Nachdenken). … The pathogenic idea which has ostensibly been forgotten is
always lying ready “close at hand” and can be reached by associations that are easily accessible. It is merely a
question of getting some obstacle out of the way, … people can learn with different degrees of ease to free
themselves from their intentional thinking and to adopt an attitude of completely objective observation towards
the psychical processes taking place in them. [p. 271]

In her images suffused with emotions, Elisabeth von R. expressed her “unconscious feelings, … her
love for her brother-in-law [that] originally must have been in communication with the main stream
of thought” (Breuer and Freud, 1895, p. 167).
Moreover, it struck Freud “as strange that [his] case histories should read like short stories”
(Breuer and Freud, 1895, p. 160). However, these stories also contained lots of dialogues and scenes,
both narrated and enacted, the stuff of dramatic situations in real and fictional dramas. Anna
O. described her “daydreaming … as her ‘private theatre’” (p. 22). Reacting to Breuer’s temporary
leave, she experienced “hallucinatory absences [in French] … filled with terrifying images of skulls
and skeletons. As she lived through these things and dramatized [tragierte, from obsolete tragieren =
enact, perform on stage] them partially in speech, the people around her could understand most of
the content of her hallucinations” (Breuer and Freud, 1936, p. 18, italics added). Or else she
dramatized her “disgust” and “anger” at her “English lady-companion” who let her “little dog
[drink] out of a glass” in a pantomime of “someone suffering from hydrophobia” (Freud, 1910a,
p. 13). Similarly, Dora (1905b) “acted out [agierte] recollections and phantasies instead of reprodu-
cing them in treatment” (p. 119), i.e., not in words but in dramatized enactments and transferences;
but such enactments are a mode of unconscious remembering waiting to be revealed by free
association.
 FREE ASSOCIATION AS THE FOUNDATION OF THE PSYCHOANALYTIC METHOD 421

A male patient,

an employee who became a hysteric as a result of being ill treated by his superior, suffered from attacks in
which he collapsed and fell into a frenzy of rage without uttering a word. … Under hypnosis …the patient
revealed … that he was reliving [durchlebt] the scene in which his employer had abused him … a scene to
which the actual onset of the illness was related: the scene in the law-court when he failed to obtain satisfaction
for his maltreatment. [p. 14]

The man’s traumatic scenes were dramatic. Like catharsis and drama, the Greek word scene is a stage
for performing dramas and also a real-life place where anything is acted or done.
In everyday life and in literature, (a) story is an account of incidents and of facts pertinent to a
situation in question, (b) narrative is a story told or written, and (c) drama is a situation or series of
events involving a conflict of forces, a state having a dramatic effect or quality. Literary drama, from
Greek dran, to do, to act, pertains to dramaturgy, the art of composing and staging dramas. Real life
dramas belong to dramatology, a way of conceptualizing human interaction in life and in therapy.
Life’s dramas deal with character, conflict, and crisis, in which dramatization in act and dramatiza-
tion in fantasy go hand in hand (Lothane, 2009). Furthermore, dramatic communications are
enacted and observed in the here-and-now, whereas past, i.e., remembered interactions are described
in a story in evocative literal words and graphic metaphors, similes and symbols, with their
associated emotions. A story is either listened to or read: When read, images and emotions described
in words by the author evoke images and emotions in the reader. Similarly, when stories are listened
to, the tone of voice and expressive emotions of face, body, and limbs of the teller evoke images and
emotions in the listener, as also happens in a session during psychoanalysis or psychotherapy. Thus
dramatology and narratology complete each other. Stories serve one more purpose: They reflect a
person’s character, style, and identity; goals and values; socio-political ideas and ideologies—a
composite self-portrait narrated and enacted with others in dramatic situations and scenes.
The adjective hysterike in Hippocratic writings was reified as a noun in the 19th century, creating
a conundrum solved by Breuer and Freud. Charcot looked at hysterical bodies showing bizarre
neurological signs hysteria, which turned out to be historia and histrionics, dramatizations of her
story or his story. Breuer and Freud (1895) listened to and dialogued with their patients and together
with them coconstructed psychoanalysis therapy. Freud described it as follows:

The procedure is laborious and time-consuming … [requiring patients] capable of arousing human sympathy
(p. 265). Their personal relation to [the doctor] will force itself … unduly into the foreground. … It seems
indeed that an influence of this kind on the part of the doctor is a sine qua non solution of the problem
(p. 266). … By explaining things to him, by giving him information about the marvelous word of psychical
processes into which we ourselves only gained insight by such analyses, we make him himself into a
collaborator … and push back his resistance, resting as it does on an affective basis … [not] in formulas.
One works … as an elucidator … as a teacher, …as a father confessor … by a continuance of his sympathy
(p. 282). … The patient. … transferring onto the physician the distressing ideas which arise from the content of
the analysis … is a frequent, and indeed in some analyses a regular, occurrence. [p. 302; italics added]

Here Freud is unmistakably interpersonal (Lothane, 1997), committed to and engaged with his
patients.
Whereas the emotional aspect of catharsis was never abandoned, Freud recalled in 1925 having
“devoted himself to the further perfection of the instrument left over to him by his elder collabora-
tor … [and] changed the cathartic method into psychoanalysis … substituting for it the method of
‘free association’ … of ideas that occurred … spontaneously (involuntarily) and that would prove in
fact to be unfree … to be determined by the unconscious material” (1925b, p. 195).
In 1900, Freud introduced dream psychology and, in Chapter II, “The Method of Interpreting
Dreams,” operationalizing the “technique of the procedure” (p. 100) “according to the dreamer’s free
associations” (p. 353). The state of free association replaced the “widening of consciousness” (1903,
pp. 249–250) previously accomplished by induced hypnosis.
422 H. Z. LOTHANE

This involves some psychological preparation of the patient … to increase the attention he pays to his own
psychical perceptions through the elimination of the criticism by which he habitually sifts his emerging
thoughts … noticing and reporting whatever comes into his head, not … suppressing an idea because it strikes
him as irrelevant or because it seems to him meaningless. … The man who is reflecting (Nachdenken) … is also
exercising his critical faculty … [while] innumerable ideas will come into [the self-observer’s] consciousness …
in a psychical state … (that is, of mobile attention) which bears some analogy to the state before falling asleep
and no doubt also to hypnosis … [as] involuntary (ungewollte) ideas emerge they change into visual and
acoustic images … used for analysis of dreams and pathological ideas. … In this way the ‘involuntary’ ideas are
transformed into ‘voluntary’ ones. [pp. 101–102, italics Freud’s]

Involuntary is an ambiguous translation of ungewollt, meaning unwilled, unwanted, or “undesired”

(Brill 1938, p. 193; Balter, Lothane, and Spencer, 1980, p. 478, footnote), reflecting both the
spontaneous nature of associations, “ideas that seem to emerge ‘of their own free will’,” and that
such “‘unwilled’ thoughts are liable to release a most violent resistance, which seeks to prevent their
emergence” (p. 102), an oscillating between disclosure and defense.
Although dreaming and associating are innate capabilities, free association is a skill that needs to
be taught. Ogden (2007) also suggested a method of preparation of the patient for free association.
Like traumatic events in reminiscences, the dream’s instigators are “distressing residues of the
previous day” (Ogden, 2007, p. 557), “anxiety arisen from in the day’s residue” (p. 274), from painful
interactions with others, including one’s therapist—these are the dream’s latent thoughts. Due to
“the censorship of endopsychic defense” (p. 308), the unconscious process called dream work
distorts, encodes, and thus transforms the day’s latent thoughts into the puzzling manifest dream
content. Analysis-work via free association reverses the dream work and brings the dreamer back the
memories of the day’s conflict-provoking events, arduous work for both analysand and analyst, a
“zigzag journey” (p. 574).
Eventually, Freud integrated memory dynamics and dream dynamics: “One of the facts arrived at in
the Studies was that infantile scenes (whether they were memories or phantasies), were seen like
hallucinations … with the quality of sensory vividness” (1900, p. 546); “my explanation of hallucina-
tions in hysteria and paranoia and of visions in mentally normal subjects, that they are in fact
regressions—that is thoughts transformed into images—but that the only thoughts that undergo this
transformation are those which are intimately linked with memories that have been suppressed or have
remained unconscious” (p. 544). Freud’s ‘regressions’ were inspired by John Hughlings Jackson (1884):
Evolution is a passage from the lowest, well organised centres up to the highest. … The progress is from
centres …well organized at birth to …centres continually organizing through life … from the most simple to
the most complex … from the most automatic to the most voluntary. … The [reverse] negative process [is]
dissolution. … The symptomatology of nervous disease is a double condition: there is a negative and there is a
positive element in every case. … The disease only produces the negative mental symptoms answering to
dissolution and … all the elaborate positive mental symptoms (illusions, hallucinations, delusions, and extra-
vagant conduct) are the outcome of the activity of nervous elements untouched by the pathological process
(p. 46) … [in] insanity, … delirium in acute non-cerebral disease (p. 50) … Sleep is a normal dissolution; the
dreams are analogous to our positive element. [p. 25]

Jackson wrote dissolution, not regression; Freud cited Jackson’s “functionelle Rückbildung (Dis-
involution) of the highly organized [speech] apparatus” (1891b, p. 89), a functional, not organic
Rückbildung or involution which in biology or medicine means degeneration or shrinking of organs.
Jackson’s negative process foreshadows Freud’s suspension of the higher critical faculties. In Die
Traumdeutung Freud switched to regression: “We have not traced [the dream work] to any known
psychological laws but … characterized [it] with the word ‘regressive’ [regredierent]” (1942, p. 547),
i.e., going back to antecedent memories, as shown in two clinical examples.
Although “leaving on one side all the arguments so familiar to psychiatrists on the nature of
hallucinations” (1900, p. 50), who de rigueur confused perception and imagination (Lothane, 1982),
Freud himself occasionally conflated visual images with sense perception: “we may speak of dreams
as having a hallucinatory revival of the perceptual images” (pp. 542–543; italics Freud’s), instead of
revival of memory images. This mistaken formulation contradicted his method: There are no
 FREE ASSOCIATION AS THE FOUNDATION OF THE PSYCHOANALYTIC METHOD 423

“perceptual images” when the person is asleep with eyes shut, only perception-like and sensation-like
images, as in daydreaming. For “dreams think essentially in images; dreams construct a situation out
of these images; they represent an event which is actually happening … they ‘dramatize’ an idea …
but we appear not to think but to experience … that is we attach complete belief in the hallucina-
tions” (pp. 49–50; Freud’s italics). Freud elaborated in Chapter VI(D): In dreams thoughts are
expressed as “pictorial and concrete, [as] capable of being represented (darstellungsfähig)”
(pp. 339-340) due “considerations of representability (Darstellbarkeit) … in visual images” (p. 344;
italics Freud’s), combining both terms in 1925: the dream is “translated into visual images or
dramatized” (p. 45; Freud’s italics). In 1901, Freud added, “Condensation, together the transforma-
tion of thoughts into situations (‘dramatization’) is the most peculiar characteristic of the dream-
work” (Freud, 1901, p. 653); “unconscious thinking … provides the dream-work with the material
for condensation, displacements, and dramatization” (p. 685). The polysemous words darstellen,
représenter, and represent mean to display dramatically, to mimic, impersonate in scenes of life or on
stage and on “the scene of action of dreams” (p. 536, original italics).
In sleep, delirium, intoxication, in “the agreement between the methods of the joke-work and
those of the dream-work” (Freud, 1905b, p. 89), and even in “delusion-work (Wahnbildungsarbeit)
[for] paranoia [is based] on the far more familiar mental phenomenon—the dream” (Freud, 1911, p.
38); in all these, thinking and emoting are transformed into visual and verbal images of varying
vividness. As shown above, dramatization in act and in fantasy proceed together in ordinary life,
disorder, and the analytic situation (Lothane, 2009).
Freud’s approach to images was adopted by Varendonck (1921), for whose book Freud (1921)
wrote an introduction: “a significant novelty, … freely wandering or phantastic thinking” (p. 272),
”the mode of activity to which one abandons oneself during the state of distraction into which we
readily pass before sleep or upon incomplete awakening … [including] Bleuler’s [1912] autistic
thinking” (p. 271). Heavily indebted to Freud, Bleuler (1912)—in stark contrast to his psychiatric
book of 1911—gave a comprehensive survey of “dream pictures” (p. 409) and “memory-pictures”
(p. 436) in children and “in dementia praecox and in the dream, … mythology … in the daydreams
of hysterics and normals and in poetry” (p. 435). Describing associations in daydreams and citing
Freud’s (1900) Dreams, Varendonck (1921) emphasized imagery, its “visualizing power” (p. 459) and
“thinking in pictures” (p. 461), suggesting to him “the analogy of a cinematographic film” (p. 463).
Freud also addressed the “role of affects in dreams” (1900, pp. 460–487): “an intense expres-
sion of affect appears in connection with the subject matter. … Analysis shows us that the
ideational material has undergone displacements and substitutions, whereas the affects have
remained unaltered” (p. 460; Freud’s italics), which he reaffirmed in 1910a: “The Zurich school
(Bleuler, Jung, etc.) [described] a group of interdependent ideational elements cathected with
affect as a ‘complex’ …[discoverable] provided the patient puts a sufficient number of free
associations at our disposal” (p. 31; original italics). In dreams, emotions are either a constituent
of a complex or may separate from ideas due to the dream work. Bleuler (1912) stressed “the
affective tendencies” of autistic thinking (p. 404) and Varendonck (1921) that “word and idea …
are always emotionally emphasized” (p. 457; his italics; reprinted and commented in Rapaport,
1951). Lothane (2015) proposed the concept of emotional reality as completing psychic reality.
Studying dreams enabled “solving the more difficult problems of the psychology of the neuroses”
(Freud, 1900, p. 104): Freud then realized that “My own approach to the subject of dreams was
determined by my previous work on the psychology of the neuroses, […] the contrary direction
[was] using dreams as a means of approach to the psychology of the neuroses” (p. 588). Freud
quoted Maeder that “dreams contain attempts at solving conflicts…as practices for waking actions…
[that] persist in the state of sleep as ‘the day’s residues’…which may be revealed to us by the analysis
of dreams and other phenomena” (p. 579). Thus, like a dream, every symptomatic, neurotic, or
psychotic act, thought, and emotion, has a two-tiered structure, a remembered manifest content and
a latent content decodable by free association. Moreover, “the technique which I describe … imposes
the task of interpretation upon the dreamer himself. It is not concerned with what occurs to the
424 H. Z. LOTHANE

interpreter in connection with a particular element of the dream but what occurs to the dreamer”
(p. 98, italics Freud’s). With this emphasis on the dreamer, Freud transformed the traditional
methods of interpretation: Free association is neither a hermeneutic nor “the popular decoding
method which translates any given piece of a dream’s content by a fixed key” (p. 105), i.e., by
“symbols with a permanently fixed meaning” (p. 225), like “some ‘Egyptian’ dream-book” (1925a,
p. 16). Nevertheless, Freud reintroduced symbols for an additional reason.
Symbols are either related to constant and conventional meanings of words, whether literal or
metaphorical, concrete or abstract, or to personal “dream-thoughts … not clothed in prosaic
language … but represented symbolically by means of similes and metaphors, in images resem-
bling those of poetic speech” (Freud, 1901, p. 659). In 1895, Breuer and Freud widened symboliza-
tion to include feelings and emotions: “a painful emotion arising during a meal but suppressed at
that time and then producing nausea and vomiting … a feeling of moral disgust consists in a
‘symbolic relation’” (pp. 4–5). This “somatic expression of an emotionally-colored idea by symbo-
lization … belongs to [Darwin’s 1872] “The Expression of the Emotions [in Man and Animals], …
[and] the expression of them in words … [is] a pictorial transference (bildliche Übertragung) of
[what] once was meant literally” (1895, pp. 180–181). Now in German in general and in Freud in
particular the word Übertragung, in addition to translation, also means: (a) transference proper, a
projection onto the analyst, first described in the Studies (Breuer and Freud, 1895); (b) a
translocation or shift, e.g., in wish-fulfillment “censorship transfers psychical intensity from what
is important but objectionable on to what is indifferent,” in the dream “intensities can be …
transferred from one idea to another” (p. 543), such transferring is a synonym for displacement;
and (c) metaphor, e.g., “a dream never tells us whether its elements are to be interpreted literally
or in a metaphorical (übertragenen) sense” (p. 341). Clearly, all three kinds of displacement are
connected with a person’s thoughts, emotions, and interactions, and dramatic enactments.
In revised editions of Dreams (Freud, 1900), Section (E) “Representation (Darstellung) by
Symbols,” Freud noted that (1) “as a rule, the technique of… free associations leaves us in the
lurch when we come to the symbolic elements in the dream-content” (p. 353); however, (2) “how
impossible it becomes to arrive at the interpretation of a dream if one excludes dream-symbolism,
and how irresistibly one is driven to accept it in many cases” (p. 359). Subsequently he confirmed “a
constant relation…between a dream-element and its translation… as a ‘symbolic’ one, and the
dream-element itself as a ‘symbol’ of the unconscious dream-thought…Since symbols are stable
translations…of ancient [and] popular…dream-symbols…interpretation based on knowledge of
symbols is not a technique that can replace or compete with the associative one. It forms a
supplement to the latter…” (1916–1917, pp. 150–151). When the patient’s free association is inactive,
the analyst gives it a boost by translating the symbol; when active, the patient is encourage to use the
free association method to decode the latent content of any poetic formation: dreams, images,
metaphors and other figures of speech, and symbols (Silberer, 1912, pp. 209–210).
The only time Freud used the word method in a paper’s title was in 1904, where he discussed free
associations. In 1914 Freud juxtaposed method with

barren theoretical controversy of…notions such as of an ego-libido, an energy of the ego-instincts…For these ideas
are not the foundation of science upon which everything rests; that foundation is observation alone…and they can
be replaced and discarded without damaging it. The same is happening in our day in the science of physics. [p. 77]

He repeated this to Einstein: “our theories are a kind of mythology… But does not every science in
the end come to a kind of mythology like this? Cannot the same be said to-day of your own
Physics?”(Freud, 1933b, p. 211).
In 1923, remarking “on the theory and practice of dream interpretation,” Freud evoked “the
original classical method” alone, a pragmatic, not a theoretical notion: interpreting a dream “falls
into…the phase in which it is translated and the phase in which it is judged or has its value assessed”
(pp. 111–112), for “it is possible…that corroborative dreams are really the result of [the analyst’s]
suggestion, [i.e.] ‘obliging’ dreams,” a problem soluble “in the further course of the analysis”
 FREE ASSOCIATION AS THE FOUNDATION OF THE PSYCHOANALYTIC METHOD 425

(pp. 115–116). In the companion text (1925b) Freud reiterated that interpreting a dream “without
reference to the dreamer’s associations would…remain a piece of unscientific virtuosity of very
doubtful value” (p. 128); that the “translation of the dream into the language of waking life (that is,
an interpretation)” (p. 127) cannot be “an isolated activity; it remains part of the work of analysis”
(p. 128). Sometimes a forgotten “portion of a dream may suddenly occur to [the patient]…or a new
association…after many months or years of analytic labor” (p. 129); so “it is not always easy to
decide whether [an interpretation] is a ‘complete’ one…[of its] many meanings” (p. 130).
Whereas in Studies (Breuer and Freud, 1900) Freud displayed intense emotional interactions with
his free-associating patients, in Dreams (Freud, 1900) he was mainly a solitary associator to his own
dreams; he returned to participant associating in his papers on technique.
In 1912 Freud operationalized free association as an interaction between analysand and analyst,
i.e., as a dyadic, interpersonal, intersubjective process:
The technique … is a very simple one. … It rejects the use of any special expedient (even that of taking notes).
It consists simply in not directing one’s notice to anything in particular and in maintaining the same ‘evenly-
suspended [gleich-schwebende] attention’ (as I have called it) in the face of all that one hears … and we avoid a
danger … of deliberate attention … of [selecting] from the material before him, … following his expectations
and inclinations [thus] in the danger of never finding anything but what he already knows … the rule of giving
equal notice to everything is a necessary counterpart to the demand made on the patient that he should
communicate everything that occurs to him without criticism or selection. [pp. 111–112]

The aforementioned mobile attention is here described as evenly-suspended, evenly-hovering, free-

floating, and “evenly-distributed” (Freud, 1924, p. 324): “one proceeds, as it were, without any
purpose in view, allows oneself to be taken by surprise by any new turn … and always meets [those]
with an open mind, free from any presuppositions. The correct behavior lies in swinging over
(schwingen) according to need from one mental attitude to another, in avoiding speculation” (Freud,
1912, p. 114; 1924, p. 326). Ferenczi (1928) added a synonym for schwingen:
The analyst … has to let the patient’s free association play upon him; simultaneously he lets his own fantasy get
to work with the association material … in unending oscillation (immerwährendes Oszilieren) between
empathy, self-observation and making judgments; … after the accumulation of evidence one is entitled to
make an interpretation. Above all, one must be sparing with interpretations [and] do no unnecessary talking. …
When the patient’s resistance has been analytically resolved … [he] does the work of interpretation practically
unaided. [p. 96]

Hoffer (2006) compared the approaches to free association in Freud and Ferenczi.
Despite Freud’s disclaimer that “this technique is the only one suited to [his] individuality” (1912,
p. 111) it has been embraced by generations of analysts as a recommendation
to create for the doctor a counterpart to the “fundamental rule of psycho-analysis” laid down for the
patient … to relate everything that his self-observation can detect and keep back all the logical and affective
objections … for the purpose of interpretation and of recognizing the concealed unconscious material
without substituting a censorship of his own for the selection that he patient has forgone. … He must
turn his own unconscious towards the transmitting unconscious of the patient … [to be] able from the
derivatives of the unconscious which are communicated to him, to reconstruct that unconscious which has
determined the patient’s free associations. But if the doctor is in a position to use his unconscious in this way
as an instrument in the analysis, he must himself fulfill one psychological condition to a high degree. He may
not tolerate any resistances in himself … [to] what has been perceived by his unconscious. [1912,
pp. 115–116]

Freud (1913) described his own matching free associating: “While I am listening to the patient, I,
too, give myself over the current of my unconscious thoughts” (p. 134). Warning “against any
mechanization of the technique” (p. 123), he enjoined the patient to
Say whatever goes through your mind. Act as though … you were a traveler sitting next to a window of a
railway carriage and describing to someone inside the carriage the changing view which you see outside. Finally,
never forget that you have promised to be absolutely honest, and never leave out anything out because, for
some reason or other, it is unpleasant to tell it. [1913, p. 135]
426 H. Z. LOTHANE

This interpersonal technique is described in literal and metaphorical words. The speaker metaphori-
cally sees his inner landscape as he visualizes a stream of memory and imagination images and his
words evoke images in the mind of the listener. The analytic listener also visualizes the images
evoked in him by the analysand’s words, not unlike a reader of a novel visualizes in his thoughts the
scenes described by the novelist. The narrator relives past historical scenes in the here-and-now, the
analytic listener relives them vicariously.
Defining the ethics of free association, Freud enjoins the patient to be candid: “The candor on
the patient’s part in reporting his thoughts was the precondition for the whole analytic treat-
ment” (Freud, 1925a, p. 40) ensuring the veracity of the speaker’s describing present feelings or
telling a true life story; however, “words, since they are the nodal points of numerous ideas, may
be regarded as predestined to ambiguity; and the neuroses … no less than dreams, make
unashamed use of the advantages thus offered by words for purposes of condensation and
disguise” (1900, pp. 340–341). Breuer and Freud (1895) had discussed “nodal points at which
two or more threads meet and thereafter proceed as one … [such that] a symptom is determined
in several ways, is ‘overdetermined’” (p. 290).
Freud (1910b) was clearly aware that associations could also be derailed by the analyst’s counter-
transference, remediable either by “self-analysis” (pp. 144–145) or, as required by the “Zurich school
of analysis … everyone … shall undergo an analysis by someone with expert knowledge” (1912,
p. 116). However, given “the plasticity of all mental processes and the wealth of determining factors,
“a course of action as a rule justified may at times prove ineffective, whilst one that is usually
mistaken may once in a while lead to a desired end” (1913, p. 123). As summed up by Laplanche and
Pontalis (1973):
the fundamental rule makes the free association method the basic principle of psycho-analytic treatment … it is
more than a technique of investigation—it structures the whole analytic relationship; it is … fundamental
despite the fact that it is not the only component of a situation where other factors play decisive parts such as
the ethical, practical, and historical aspects of the analysand’s life and the interpersonal analytic relationship.
[pp. 178–179]

Freud’s ideas about the analysand/analyst team were continued by Reik (1937): “The patient
experiences … surprise was within his ego … the most vital knowledge obtained by the analyst of
the unconscious repressed is, for him, too, a surprise” (p. 59). Reik explained: “The analyst must use
the same technique as the patient, must apply the same mechanism of condensation, displacement,
and omission, because by no other means has he any prospect of understanding the secret meaning
of unconscious processes. The analyst must therefore be capable of using the same methods, adopted
in the joke to attain pleasure, in order to grasp the unconscious intention of, say, some element in a
dream, or a special symptom” (p. 67; cited in Lothane, 2006).
In 1957, Freud’s instrument was revived by Otto Isakower (1899–1972) in presentations to the
faculty of the New York Psychoanalytic Institute, as the analyzing instrument. First cited by
Eidelberg (1968) as “a conception derived from Freud’s (1900) description of the analyst’s frame
of mind while listening” (p. 32), it was fully described by Isakower’s followers Balter et al. (1980). In
1992, the minutes of Isakower’s lectures were published by Wyman and Rittenberg.
Isakower (n.d.) cited the 1900 Freud passage and Bertram Lewin’s (1954) confirming “the
essential identity of dream and neurosis” (p. 500) “[and the] technique [of] putting the patient
into a sleep-like state that encouraged the dreamlike productions of the talking cure” (pp. 500–501;
cited in Wyman and Rittenberg, 1992, p. 205). “The analyzing instrument is the same when it works
in the analysand and the analyst” (Wyman and Rittenberg, p. 189):
The analyst’s frame of mind when analyzing: while listening, he suspends conscious intellection (reflective
thinking) and permits his own unconscious to arrive at a preconscious level. There, influenced by stimuli
arriving from the outside—the patient’s productions—compromise formations arise between what the patient is
communicating and the contents of the alert and receptive “analyzing instrument” of the psychoanalyst, the
ultimate result being potentially “verbalizable statements.” [Isakower, n.d.; cited in Lothane, 1984a, p. 179]
 FREE ASSOCIATION AS THE FOUNDATION OF THE PSYCHOANALYTIC METHOD 427

As Freud in 1912 and 1913, Isakower recommended that

The analyst conveys to the analysand the desirability of letting images emerge, the analysand is encouraged to
acknowledge and to behold visual contents in his consciousness, and to put these into words, in addition to the
contents which are already verbalized. When this happens, the patient’s attention is simultaneously directed to
that detail, and his own, the patient’s analyzing instrument is being activated. [Isakower, n.d., his italics; cited in
Lothane, 1984a, p. 179]

In supervision the student is asked: “What was going on in your mind” (specifically referring to this
or that detail); “What were your reactions and actions?” (Wyman and Rittenberg, 1992, p. 189);
“Does this help you to understand what is going on in the patient?” (p. 190). Accordingly, Isakower
(n.d.) discouraged “’typing’ of situations, as well as quickly pressing the manifestations of the patient
into patterns of a ‘complex’ or labeling them as partial instinctual trends” (p. 189):
The question might be raised … whether in urging free association in our patients we thereby are suggesting
the abolition of ego functions. We are in fact increasing the ego’s sphere of influence by encouraging extension
of its perimeter to include a greater number of charged memory units. … After Freud the problem of
[analyzing] has been dealt with … mainly in terms of the vicissitudes of “transference.” The concepts of
[transference and] countertransference do not cover and comprise what is to be elaborated as the analyzing
instrument, … denoting a specific psychological entity, an invariable element in the analytic procedure.
[Isakower, n.d.; cited in Lothane, 1984a, p. 183]

Isakower (n.d.) also recommended to keep the instrument functioning optimally: to “cleanse” it of
the variable “problems presented by the [analyst’s] personality coloration, those complexes of his
own which would be apt to interfere with his grasp of what the patient tells him … what has been
aptly described by Stekel as a ‘blind spot’ in his analytic perception” (cited in Wyman and Rittenbeg,
1992, p. 185), to be dealt with in a personal analysis. As an example, Isakower cited a case presented
to him by Morton Reiser, then a candidate, who had conveyed to the patient his association of the
Mona Lisa smile, evoking further memories and insights in the patient (Wyman and Rittenberg,
1992).
Although not cited, Isakower’s ideas were present in papers by McLaughlin (1975, on the sleepy
analyst) and Gardner (1983, on associations after the session). Isakower was endorsed by Grossman
(1992) and Jacobs (1992). Free association was emphasized by Balter et al. (1980) in “the elucidation
of the fantasy-memory constellations of the analysand” (p. 502), citing Arlow (1969) on free
associations. Litowitz (2007) discussed Arlow (1969) on fantasy (p. 202) and dreamer’s associations.
Free association was compared to other methods of psychoanalytic observation by Spencer and
Balter (1990, 1992). Lothane renamed Reik’s listening with the third ear (Reik, 1949) and Isakower’s
analyzing instrument, both similes, as reciprocal free association (1984a, 1994, 2006, 2010a). The
analyzing instrument was not cited by either Kris (1982) or Bollas (1992, 2009, 2015), although in
1992 Bollas, describing “The Psychoanalyst’s Use of Free Association” (pp. 117–120), is about
conveying the analyst’s images to the analysand. Helm (2000) utilized reciprocal free association
in the listening process.
Morton Reiser (1997) emphasized Isakower’s “anamnestic perspective in working with the
dream … for him of paramount importance in analytic work. He had a dictum: If in working
with a dream you did not learn something new, by which he meant relevant new historical
information, your work with that dream had not been successful” (pp. 892–893). Thus the “work
with dreams provides unique opportunities for achieving this goal. The method of free association,
by following the primary process mode of thought, gives access to neurotogenic mnemic content,
previously unconscious, and to related defensive activities … [and] repressed memories and early life
experiences” (p. 898). Reiser also stressed “the affective organization of memory” (p. 893), the
resonance between strong affects, nodal memory networks, and nodal images. Reiser (1999) com-
pleted his account of the analyzing instrument by integrating it with the interactive model and
empathy.
428 H. Z. LOTHANE

Here is my clinical vignette:

As I was listening to the stream of associations of my patient, in the fifteenth year of analysis, I became
somewhat drowsy and suddenly I saw in my mind’s eye a light-skinned black woman’s face, which I
conveyed to the patient. She appreciated my image and recalled this event: As a teenager she brought home
an African American female student. Her father became enraged and demanded she drop that friendship
on pain of forfeiting his financial help in the future. She disobeyed and years later the father refused to pay
her college tuition; she never got a degree, which is currently frustrating her efforts to get job commensu-
rate with her skills. Although blaming the father was not new, recalling the event with vivid emotion
enabled her to put the bitter memory of this trauma to rest. A single powerful image may illuminate a
whole chapter of a life, or even a life entire.

And here is a recent session:

The patient begins the sessions saying she is anxious because of her approaching birthday and getting older; the
patient recalls that every time her previous therapist went on vacation she would “immediately feel I was going
inside a trunk, to stay there until he came back. I felt I could no longer live my life and would have to stay in the
trunk, dead, until he came back. It had to do with my fear of separation from someone I depended on that
started when I was eight and my mother was away for two weeks giving birth to my sister, leaving me with my
aunt and uncle. Does the trunk symbolize the safety of my mother’s womb? Do I suddenly feel so scared I want
to go back there?”
As I listened, I saw an image of Dracula entering to lie down in his coffin and told it to the patient. The patient
started crying softly and said: “When I heard your say Dracula I suddenly feel calmer, more relaxed, relieved as
though a burden is off my shoulders; I am at peace. You caught me off guard by looking into my soul. I felt the
“trunk” was Pandora’s Box: Once I opened it, all sorts of bad things would fly out. I better keep the lid on.” In
the next session she added this: “My paternal Grandma R. was born in Romania as Dracula. She was a warm,
heavyset cuddly woman who pressed me to her with affection whenever we met. She had large breasts and was
affectionate, positive and loving to me all the time!”

Brown (2011) in chapter 2, “The analyzing instrument: unconscious communication and classical
psychoanalysis,” cited Balter et al. (1980) and Lothane (1994, 2006) and creatively correlated free
association with intersubjectivity. He also noted Hoffman’s 2006 “myth of free association” (p. 10)
without commenting. In the “Foreword” James S. Grotstein (“a Kleinian/Bionian,” Brown, 2011, p. 15),
wrote: “My own understanding of the analytic field involves the contributions of Bion (1961) on groups,
McDougall (1985), Lothane (2009) and myself (Grotstein, 1979, 2009) on the concept that the analytic
session constitutes a theatrical play” (2009, p. xv). Lothane (2009) was also cited by Bromberg (2012).
Recently Atlas and Aron (2018) discussed and referenced Lothane (2009, 2010b, 2011b).
In 1916-1917, Freud reaffirmed free association and the fundamental rule, but erred in stipulating
that “sufferers from narcissistic neuroses,” his synonym for psychoses, “have no capacity for
transference … cannot be influenced” (p. 447) and thus untreatable. Freud’s early Viennese
followers, Federn and Nunberg, pioneered new approaches to treating psychotic which progressed
vigorously in the United States of America (Lothane, 2011a). A recent contributor to this field was
André Green (2000) identified
a particular quality of associative behaviour observed in some borderline patients, and its role in maintaining a
central defensive position, clearly discernible in a complex use of the analyst, and a particular functioning of the
mind that the author terms phobic. By constructing an analytic space in which free association and psycho-
analytic listening are possible, the analyst can voice and link previously catastrophic ideas, quite unknown to
the patient’s consciousness, to help the patient to create meaning and obtain relief from previously dominant
but unknown terrors. This implies a new formulation of the free association method. A negativistic’ manifesta-
tions of the [treatment] … the situation in which the meaning emerging from free association in the
transference relationship becomes subject to jamming and quasi-systematic asphyxiation. [p. 429]

Citing Bion on psychotic patients, Green (2000) elaborated:

This conception, which I propose to call the associative radiation, traces, by means of the manifest discourse
resulting from free association, lines of force running through it that constitute the veins of the discourse. This
makes it possible to follow, to resonate, to retroact, to gather in advance the richness of meaning circulating
along the pathways, the plan of which is based on the co-ordinates of the unconscious, marked by the hyper-
 FREE ASSOCIATION AS THE FOUNDATION OF THE PSYCHOANALYTIC METHOD 429

cathexes and counter-cathexes accompanying them. Moments during which there is a suspension of association
are of interest in that they point to the knots of resistance. [p. 444]

Knots is a synonym for nodal points: Green’s method is based on Freud’s method of free association
and resistance and is adapted to treating borderline and psychotic patients, an influence on
European and American analysts. Among his followers are Levine (2012) and Reed (2009), who
omitted citing Green (2000).
Like Ogden (2007), Levine (2012) described how to prepare a patient incapable of representing to
free associate in images and words:
In the presence of represented unconscious, latent content, the analytic process moves via free association
and interpretation from conscious and preconscious surface to unconscious depth. In the analysis of
unrepresented and weakly represented mental states, the elements of mind—conscious, preconscious and
unconscious—must first be created by a work that begins in the analyst’s psyche and is then offered and
inscribed in the psyche of the patient as part of an interactive, intersubjective relationship and process. That
is, the analyst may be required to provide some expressive, catalytic action in order to help precipitate or
strengthen the patient’s representational capacities. When this occurs, we may wonder to whom the
representation belongs. The analyst? The patient? Some combination of the two? The answer that I
would propose is simultaneously ‘both’ and ‘either,’ depending upon the perspective from which we observe
the process. [p. 625]

Freud (1937) showed “the link between the two portions of the work of analysis, between his own part
and that of the patient” (p. 259) and Levine how they coconstruct their work via empathy and
reciprocal communications. Similarly, Reed (2009) noted that “because the analyst cannot depend
entirely on free association to lead him or her to curative inferences about repressed, unconscious
fantasies, the patient must be helped to connect to the analyst in such a way as to be able to detour
through the analyst to arrive at the unconscious, unverbalized part of him- or herself” (p. 7). Both
Levine and Reed, like Green before, accepted free association and modified its application, as did
Botella and Bottella (2013, p. 105), who endorsed Freud (1900, p. 102), and noted that “recollection
represents a crossroads with multiple possibilities for association and the creation of chains of ideas,
crossing-points and referred to free associating by patient and analyst” (p. 105). However, they claimed
to have introduced a new term, figurabilité, borrowed from the French translation of
“Representability” by Laplanche and Pontalis (1973, p. 389). Nevertheless, as stated by Levine, Reed,
and Scarfone (2013) in the “Introduction: “To complicate matters even further, César and Sara Bottella
(chapter 5), who are two of the major contributors to the literature on this subject, have chosen to
translate [Freud’s] Darstellung by the word figurabilité (figurability in English), while Laurence Kahn
(chapter 6), another major contributor, opts for the word, presentation” (p. 8). Actually, Freud’s word
for presentation was the aforementioned Darstellbarkeit (1900). But there is another complication:
Figurability, an awkward archaism in English, carries a double meaning. According to Michael
Parsons’ introduction to Botella and Botellas’ 2005 book, (a) figurability is “the capacity to symbolise
depends on forming internal representations”(p. xvii) but the patient shows something “irrerepresen-
table [that] cannot be psychically apprehended” (p. xviii), an inability akin to Peter Sifneos’ alexithy-
mia, the lack of words for emotions, or Freud’s (1891b) Alexie and Asymbolie; but he needs “the
analyst’s free-floating attention … to detect traces of representations that the patient has needed to
remove from consciousness … to put them back into words” (p. xvii), the analyst’s free association,
“the analyst’s ‘work of figurability’… the achievement of allowing his or her own mind to undergo the
retrogressive movement, when that is needed in order to accompany the patient’s mind” (p. xviii), a
welcome complication, in keeping with Isakower’s analyzing instrument. It is a case of old wine in new
bottles.
Moreover, citing Freud, Kahn (in Levine et al., 2013) is also interested in another meaning: “The
symptom’s psychic act … [that] signifies the presentation [Darstellung]—the realization [Relisierung]
—of a fantasy … a sexual situation’ [Dora case] … Freud … is then confronted with the great scene
described by Charcot, a ‘tableau vivant’ returning him to the theatricality of the presentation”
(p. 130). Also relevant is Marilia Aisentein’s remark “about “[Darstellen figurer]. … I have chosen
430 H. Z. LOTHANE

here to speak of psychodramatic representation [mise-en-scène] and figurability, put forward by

César and Sara Bottella … simply less abstract than the term representability” (p. 177), and, like
Kahn’s, suggestive of dramatology. In any case, rather than challenging free association, the cited
authors were looking for ways of utilizing association in treating children, severe narcissistic,
borderline and psychosomatic disorders, thus widening the scope of psychoanalysis.
A similar approach was advocated by Bollas in 2015:

In the second half of the twentieth century, it was practically a given in psychiatry that one never asked about
the free associations of a schizophrenic or manic-depressive patient. It was argued that such approaches would
only deepen their illness by sending them into the chaotic realms of the primary process. Instead, one should
keep them firmly rooted in reality, shoring up defenses, and deliberately not taking up any unconscious
meaning resident in what they might be saying. The manic-depressive’s thought processes were dismissed as
“loose associations” that lacked any coherent thought. The schizoprhenic’s associations were seen as mean-
ingless “word salads” with no inherent logic. … My experience taught me to think very differently [citations
omitted]. I believed in listening to free associations and unconscious communications of the schizophrenic
person. [p. 50]

Thomä and Kächele (1996, Chapter 7 “Rules”) provided an excellent historical overview of
free association and recommendations how to teach the patient to free associate in a non-
authoritarian way. They emphasize, however, the danger when the free associating patient
“sinks into an apparent monologue, moving from verbalizing to hypnagogic states … [and] …
regressive states”(p. 294) thus it is no surprise that in Section 7.3 they criticize free-floating
attention based on Donald Spence’s 1982 attack on free association, rebutted by Lothane
(1984b); consider “the analyst’s unconscious as a receiving organ” as “Freud’s metaphor”
rather than method; distrust “the ‘analyzing instrument’ as free-floating attention, made
known by Balter et al. (1980) and technicalized by Isakower” (p. 299) citing Spence (1984).
But the analyzing instrument has nothing to do with technology. Instead, they offer their own
hermeneutically and cognitively oriented “context of understanding the communications of the
patient” (p. 299).
Free association is Freud’s historical method. Having realized that “dreams of my patients lead
up …always [to] the case history that underlies the neurosis” (1900, p. 104), that a dream is “to be
interpreted historically (as a recollection)” (p. 341; italics added), Freud’s life history comes alive in
his “self-analysis” (p. 105) of the Irma’s injection dream, asking the reader “to plunge along with
[him] into the minutest details of [his] life” (p. 106). The manifest content showed dramatizations of
a stream of places and persons, scenes and speeches, whose “detailed analysis” led back to the
latent day residue, a rich narrative of motives and meanings, of “revenge” and “wrath,” “concerns
about [his] own and other peoples’ health [and] professional conscientiousness,” and his “disagree-
able memories, … the extensive group of thoughts that underlay the dream” (p. 120), even “though I
have not reported everything that occurred to me” (p. 118). Freud’s dictum that every dream is “the
fulfillment of a wish” (p. 119) is incomplete: Every wish is a reaction to the dramatic/traumatic
event(s), thoughts and feelings of the day residue that instigated the dream. Thus an analyzed dream
becomes a historical record.
Freud recommended “not to work on a case scientifically while treatment is still proceeding”
(1912, p. 114): Diagnoses and dynamic formulas should not be an aforethought but an afterthought,
after the session, as did Isakower (Wyman and Rittenberg, 1992). The short-term historical and
interpretive yield of one session—a dream, an enactment, an association—is a microcosm that
reflects the macrocosm of the long-term search for the history of a lifetime. Starting from the initial
fragments, a person’s biography unfolds in countless free-associative and cognitive communications
“between the two portions of the work of analysis, between [the analyst’s] own part and that of the
patient” (Freud, 1937, p. 259), hopefully yielding “a picture of the patient’s forgotten years that shall
be alike trustworthy and in all essential respects complete” (p. 258).
Freud’s historical method can be profitably compared with Collingwood’s (1946) idea of history
as a science no less important than natural science.
 FREE ASSOCIATION AS THE FOUNDATION OF THE PSYCHOANALYTIC METHOD 431

The historian investigating any event in the past, makes a distinction between … the outside of an event …
which can be described in terms of bodies and their movements … [and] the inside of an event … that can
be described in terms of a thought. … [The] main task is to think himself into the action, to discern the
thought of its agent. … The history of thought, and therefore of history, is the re-enactment of past
thought in the historian’s own mind. … It is in the same way that we discover the thought of a friend who
writes us a letter, or a stranger who crosses the street. … In this sense all knowledge of mind is historical.
The only way in which I can know my own mind is by performing some mental act or other and then
considering what I have performed. [pp. 213–219]

Is historical science misnomer or oxymoron? Not for Collingwood: “Thucydides is the father of
psychological history. … It is not history at all, but natural science of a special kind. It does not
narrate facts for the sake of narrating facts. Its chief purpose is to affirm laws, psychological laws. A
psychological law is not an event nor yet a complex of events: it is an unchanging rule that governs
the relations between events; … what chiefly interests Thucydides” (pp. 29–30). “With Darwin’s
[Origin of Species] the scientific point of view [and] the historical … both now agreed in conceiving
their subject-matter as progressive. Evolution could now be used as a generic term covering both
historical progress and natural progress” (p. 129). “History is [for] Bradley [of a] ‘particular
[individual] … this individual is a concrete particular and a concrete universal” (pp. 140–141).
Whereas both points of view are historical, there is nevertheless the difference between “the
diagnosis of [a] disease as typhoid not so much an individual judgment as the subsumption of a
certain fact under a general formula, namely the definition of typhoid. … The business of the historian
is to explore the individual … the formulation of laws and the description of individuals are not two
mutually exclusive forms of thought” (Collingwood, 1946, pp. 166–167). Not only is history a science
of the particular but, as Carrel (1935) showed, “Physicians have to face both concrete reality and
scientific abstractions. Their mind must simultaneously grasp the phenomena and their symbols,
search into organs and consciousness, and enter, with each individual, a different world. They are
asked to realize the impossible feat of building up a science of the particular” (p. 249).
Collingwood (1946) juxtaposed “two alternatives … conceiving [1] what mind is and [2] what
mind does”, the latter dealing with “particular actions, history,” the former—with “mental science”
that sees mankind as “a machine” (p. 221); and, I add, foreshadowing current neuroscience
conceiving mind as brain, i.e., an organ. But machines and organs function; a person acts. Hence,
a mental science of machines and organs
tends systematically to dementalize mind and to convert it into nature…to transcend the sphere of history as
baseless…Types of behavior do, no doubts, recur…[but] In order that behavior-patterns may be constant, there
must be an existence of a social order which recurrently produces situations of a certain kind. But social orders
are historical facts, and subject to inevitable changes, fast or slow. [p. 223]

“As in the exact sciences,” Collingwood (1946) argued, so “in history the normal process of
thought is inferential, that is to say, it begins by asserting this or that and goes on to ask what it
proves. … In history conclusions are about events, each having a place and a date of its own. …
History, then, is a science, but a science of a special kind…to study events accessible to our
observation from something else which is accessible to our observation, and which the historian
calls ‘evidence’ for the events in which he is interested” (pp. 250–252). Finally, Collingwood
contrasted his individualistic approach to what he called “scissors-and-paste history as “no science,
because there was nothing autonomous, nothing creative about it … merely a transshipment of
ready-made information from one mind to another,” as if presciently describing the easy cut-and-
paste computer technology of today: “Let us put together all the facts that are known to historians
today, look for patterns in them, and then extrapolate these patterns into a theory of universal
history” (pp. 264–265), instead of having “the autonomy which is everywhere essential to scientific
thought; where by autonomy I mean the condition of being one’s own authority, making statements
or taking action on one’s own initiative and not because those statements or actions are authorized
or prescribed by someone else” (pp. 274–275). Regarding the role of history in applied psycho-
analysis, see Lothane, 2018.
432 H. Z. LOTHANE

An autonomous analyst and an autonomous analysand are a team working together to heal
the analysand’s suffering by re-examining the history of his or her life with free association and
other historical methods. A single session, as any dramatic event, has a beginning, middle, and
an end. A subsequent narrative of the event can be as multifarious as Pirandello’s 1921 play Six
Characters in Search of an Author or Kurosawa’s 1950 film Rashomon. And there is no end to
telling stories about the lives of ordinary and famous people alike or to revising them. An
analysis also has a beginning, middle, and an end, but there may be surprising aftermaths to
follow. Analysis may be terminable or interminable, but there is no end to writing books
(Ecclesiastes) and there is no end to history and interpretations of history.

Acknowledgment
This article is dedicated to the members of the “Work Group Free Association”—Martin Bölle, Axel Hoffer, Jonathan
House, Galina Hristeva and Joseph Reppen—of the International Psychoanalytic Association chaired by Henry
Lothane in 2012 and presented at the Congress in Prague in 2013.

Notes on contributor
Dr. Lothane is Clinical Professor of Psychiatry, Icahn School of Medicine at Mount Sinai, New York.

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