A Therapeutic Alliance



Mary Montaut

Although the therapeutic relationship holds a central place in most theories
 of psychotherapy and there are many accounts of its workings from the point of
 view of the therapist, there are few published records of the client’s experience, and
 even fewer by clients who were not either in training at the time or subsequently 
took up the practice of psychotherapy themselves. There is, however, an account
 by one of Freud’s own patients, who attended him in Vienna in 1933 1934 just 
before he fled to England early in the War. She was an American poet called Hilda
 Doolittle, ‘H.D’., and she published the first account of her sessions with Freud 
under the title Writing on the Wall (1945-6) and then wrote a further account called
 Advent which she did not publish but which has been included under the title
 Tribute to Freud in a new edition by Carcanet [H.D., Tribute to Freud, new 
edition, Carcanet Press 1985, ISBN 0 85635 599 2] to which I shall refer 
throughout this piece.

At the time of H.D.’s analysis, Freud was seventy-seven years old. This was 
important to both of them, and early in Writing on the Wall, she says:

“The Professor was seventy-seven. His birthday in May was significant… I had 
nothing for the Professor. I said, I am sorry, I haven’t brought you anything 
because I couldn’t find what I wanted.’ I said, ‘Anyway, I wanted to give you
 something different.’ My remark might have seemed a shade careless, a shade
 arrogant. I do not know how the Professor translated it. He waved me to the 
couch, satisfied or unsatisfied with my apparently casual regard for his birthday.”

She goes on to tell of her quest throughout Vienna to find gardenias for him,
 following a chance remark he made months earlier. Wherever she goes in Vienna,
 she is told that the Professor likes orchids. Obstinately, she will not give him an 
orchid – which is what everyone else gives him, as witness the display of orchids 
on his desk that day. She goes on:

“It was sometime later that the Professor received my gardenias. It was not a 
birthday, it was not Vienna. I had been to see him in London, in new surroundings. 
He had arrived lately, an exile… But in imagination at least, in the mist of a late 
afternoon, I could still continue a quest, a search. There might be gardenias 
somewhere. I found them in a West End florist’s and scribbled on a card, To greet
 the return of the Gods.’  The gardenias reached the Professor. I have his letter.

‘Dear H.D.,


I got today some flowers. By chance or intention they are my favourite flowers, 
those I most admire. Some words ‘to greet the return of the Gods)’  (other people
 read: Goods). No name. I suspect you to be responsible for the gift. If I have 
guessed right don’t answer but accept my hearty thanks for so charming a gesture.
 In any case,


Affectionately yours,


Sigm. Freud'”

I have given this passage at length because it so clearly expresses the romantic -
 the lover-like, I would say – atmosphere of the relationship between them. And
 clearly it is H.D. who is going a-courting.

Yet, she records, early in the analysis Freud had found reason to say to her:

‘The trouble is – I am an old man – you do not think it worth your while to love
 me.
 And with considerable candour, she also records her reaction:

“The impact of his words was too dreadful – I simply felt nothing at all. I said 
nothing. What did he expect me to say?” Her angry feelings however are plain, 
and lead directly into a passage where she recalls her mother’s honeymoon and
 possible pregnancy with a first child  whom she lost (and H.D.’s own first child was 
stillborn), and then links back to the analysis:

“The Professor had said in the very beginning that I had come to Vienna hoping to 
find my mother. Mother? Mamma. But my mother was dead. I was dead; that is,
 the child in me that had called her mamma was dead. Anyhow, he was a terribly
 frightening old man, too old and too detached, too wise and too famous 
altogether…

“
It is Freud’s work in bringing children to life which H.D. appreciates – a kind of 
work which, as a poet, she regards mythologically. At several points in the account 
of the analysis, she expresses her gratitude for this work, and it seems to me that in
 a very lucid way she has made poetic sense of the real meaning of the word
 “transference.”

She comments, too, that “In our talks together he rarely used any of the now rather
 overworked technical terms, invented by himself and elaborated on by the…
somewhat formidable body of the International Psychoanalytical Association.
 When, on one occasion, I was endeavouring to explain a matter in which my mind
 tugged two ways, I said, ‘I suppose you would say it was a matter of ambivalence?’
And as he did not answer me, I said, ‘Or do you say am-bi-valence? I don’t know
 whether it is pronounced ambi-valence or am-bi-valence.” The Professor’s arm 
shot forward as it did on those occasions when he wished to stress a finding or 
focus my attention to some point in hand; he said in his curiously casual, ironical
 manner, ‘Do you know, I myself have always wondered. I often wish that I could
 find someone to explain these matters to me.'”

It is only very much later, towards the end of her second account of the sessions in
 Advent, that she mentions the fact that her father was known as The Professor, and 
her brother as The Little Professor; and she sometimes refers to Freud himself as 
’Papalie’. But the transference which she discusses with Freud is around her 
mother, and she expresses it with a subtlety which is illuminating:

“The Professor… said he wanted me to feel at home here. The house in some
 indescribable way depends on father-mother. At the point of integration or 
regeneration, there is no conflict over rival loyalties. The Professor’s surroundings 
and interests seem to derive from my mother rather than from my father, and yet to
 say the ‘transference’ is to Freud as mother does not altogether satisfy me. He had 
said, ‘And – I must tell you (you were frank with me and I will be frank with you), I do not like to be the mother in transference – it always surprises and shocks me a
 little. I feel so very masculine; I asked him if others had what he called this 
mother-transference on him. He said ironically and I thought a little wistfully, ‘O,
 very many.'”

Perhaps people reading these extracts may be rather surprised themselves at the 
things which Freud expressed to H.D.? The fullness of his personal presence in 
these accounts completely shatters any idea that he found it necessary to be a 
’blank screen or wall’ to her and it is no coincidence that the main work of the 
sessions as she records them is to confront and seek to understand a vision she 
experienced of signs or symbols forming on a real blank wall in a cottage in Greece 
some years before. She feels confident in the work with Freud because he himself
 has in his room a number of Greek and other anitiquities (his famous collection)
 and they talk about them.

“Freud took me into the other room and showed me the things on his table. He
 selected a tiny Athene from near the end of the semicircle, he said, ‘This is my 
favorite.’… He opened the case against the wall and displayed his treasures, antique
 rings.”

Clearly, the the old man is trying to make her feel ‘at home’ and she quickly
 responds.

“I found I was not so shy…”

In short, in the most vivid way, Freud really does ‘share’ himself with her and 
makes it possible for her to reciprocate at a level which allows her to do the
 psychological work of reintegrating the wild, strange and frightening experiences 
of her breakdown.

Even from the first session, the old man seems to have the key to opening this
 relationship with her. She comes, full of a sense of privilege, or as she puts it: “it
 seems to me, in some curious way, that we were both ‘miraculously saved’ for
 some purpose.” In the waiting room just before her first session she identifies 
vividly with ‘the macabre, detailed, Dureresque symbolic drawing, a Buried Alive
 or some such school of thought …’ and yet when she actually walks into his room
 for the first time:

“Automatically, I walk through the door. It closes. Sigmund Freud does not speak.
 He is waiting for me to say something. I cannot speak. I look around the room. A 
lover of Greek art, I am automatically taking stock of the room’s contents.
 Pricelessly lovely objects are displayed here on the shelves to right, to left of me…
But no-one had told me that this room was lined with treasures. I was to greet the
 Old Man of the Sea, but no one had told me of the treasures he had salvaged from 
the sea-depth.

He is at home here. He is part and parcel of these treasures… He is the infinitely
 old symbol, weighing the soul, Psyche, in the Balance. Does the Soul, passing the 
portals of life, entering the House of Eternity, greet the Keeper of the Door? It 
seems so. I should have thought the Door-Keeper, at home beyond the threshold, 
might have greeted the shivering soul. Not so, the Professor. But waiting and 
finding that I would not or could not speak, he uttered. What he said – and I thought a little sadly – was, ‘You are the only person who has ever come into this room and
 looked at the things in the room before looking at me.'”

“
I feel that H.D.’s lucid and expressive prose leaves the reader plenty of room to 
appreciate that moment, when already the old man had found the key and the 
alliance was able to be formed.

I feel that I learned an immense amount about the nature of a therapeutic alliance 
from this book. It is full of moments which will be familiar to every therapist 
when H.D. doesn’t want to talk, when she is afraid that something in her may harm 
him, and most touching of all, when she comes to him through a Vienna which is
 deserted because of a Nazi rally, the maid and Freud himself amazed that she has 
come and also somehow wonderfully respectful of her courage in doing so, though 
it is the same courage that brings her to him every time. The closing-in of the War 
forms a tragic backdrop to the sessions – sometimes coming into the foreground, as
 when Nazi atrocities are in the papers,”I cannot talk about the thing that actually 
concerns me, I cannot talk to Sigmund Freud in Vienna 1933 about Jewish 
atrocities in Berlin.” Her own story emerges, of course, but it is the extraordinary
 perceptiveness with which she records the process of the relationship with Freud 
throughout the sessions which makes the book so rare. And she has no other axe
 to grind – no theory to advance, or point to make – but treats the entire account as
 if it were music, with movement flowing on from movement: as, for examp
le, here, where she describes Freud’s voice:

“The tone of his voice, the singing quality that so subtly permeated the texture of
 the spoken word, made that spoken word live in another dimension, or take 
another colour as if he had dipped the grey web of conventionally woven thought,
 and with it, conventionally spoken thought, into a vat of his own brewing – or held 
a strip of that thought, ripped from the monotonous faded and outworn texture of 
the language itself, into the bubbling cauldron of his own mind in order to draw it
 forth dyed blue or scarlet, a new colour to the old grey mesh, a scrap of thought,
 even a cast-off rag, that would become hereafter a pennant, a standard, a sign again,
 to indicate a direction or, fluttering aloft on a pole, to lead an army…” 
She seems to appreciate him as a poet himself.

The editor of this new edition has included Freud’s letters to H.D. at the end of the 
volume. This is a very wise inclusion, for it confirms the sense of the relationship 
throughout:


”Vienna, May 1936


Dear H.D.,

…I had imagined I had become insensitive to praise and blame. Reading your kind 
lines and getting aware of how I enjoyed them I first thought I had been mistaken 
about my firmness. Yet on second thoughts I concluded I was not. What you gave
 me, was not praise, was affection and I need not be ashamed of my satisfaction.
 Life at my age is not easy, but spring is beautiful and so is love.


Yours affectionately,


Freud.”

[All quotations are from Tribute to Freud by H.D., revised edition 1985, Carcanet Press.]