THE HISTORY OF
PSYC HOT H E RAPY
ALTHOUGH the history of psychoanalysis has been characterized by a trend toward increasing length of treatment, there have been occasional counter efforts. Those of Ferenczi stand out; for a time he advocated "active therapy" as an effort to shorten the length of therapy. In a paper written in 1920, he presented the theoretical rationale for his approach, citing Freud's observation (1919) that in the treatment of phobic and obsessional anxiety it was often necessary to suggest firmly that the patient confront a phobic situation as a necessary adjunct to the analysis of the unconscious reasons for symptom formation, and to encourage such efforts once they were made. Ferenczi (cited in Marmor 1979) believed that the ideal of a neutral and unobtrusive analyst was unattainable, because each time the analyst interpreted patient material, the flow of the patient's "free" associations was interrupted to some degree, stimulating a new train of thought that otherwise would not have occurred in that exact form or at that exact moment. In this sense, Ferenczi argued that all therapeutic techniques were suggestive to some degree ; his explicitly active technique differed only in degree and timing.
Despite this rationale, it was clear that Ferenczi advocated a controversial shift toward directive therapy. He prohibited such tension-reducing