The term "abstinence/rule of abstinence" designates a number of technical recommendations that Freud stated regarding the general framework of the psychoanalytic treatment. As is the case with the fundamental rule, these recommendations have two symmetrical sides, that of the patient and that of the analyst.
The problems posed when acting out takes the place of remembering led Freud to recommend, "One best protects the patient from injuries brought about through carrying out one of his impulses by making him promise not to take any important decisions affecting his life during the time of his treatment—for instance not to choose any profession or definitive love-object—but to postpone all such plans until after his recovery. At the same time one willingly leaves untouched as much of the patient's personal freedom as is compatible with these restrictions, nor does one hinder him from carrying out unimportant intentions, even if they are foolish" (Freud 1914g, p. 153). This advice to abstain from all important decisions was, for a long time, stated at the beginning of each treatment, even while reflections on the place and function of "acts" in the course of a treatment, both within and outside the analytic situation, continued to stimulate much theoretical and practical debate.
Freud described the need for the analyst to observe abstinence in his article "Observations on Transference-Love": "I have already let it be understood that analytic technique requires of the physician that he should deny to the patient who is craving for love the satisfaction she demands. The treatment must be carried out in abstinence. By this I do not mean physical abstinence alone, nor yet the deprivation of everything that the patient desires, for perhaps no sick person could tolerate this. Instead, I shall state it as a fundamental principle that the patient's need and longing should be allowed to persist in her, in order that they may serve as forces impelling her to do work and to make changes" (Freud 1915a, pp. 164-165).
Thus it is after years of psychoanalytic practice that the notion of abstinence appeared as such in Freud's work. The theory of unconscious desire and of the transference had to be elaborated and their application to the progression of the treatment put to the test in order for their technical consequences to be recognized. The transferential demands and the counter-transferential responses that Freud's followers made him become aware of, such as the case of Jung and Sabina Spielrein, as well as what he then learned about the practice of "wild analysis," quickly persuaded him to enunciate a recommendation. His followers subsequently and little by little transformed the recommendation into a "principle," and then a "rule," which became quite rigid.
It is clear that, from the beginning, it was never a matter of moral prescription, but a technical one that accorded with the metapsychological demands, particularly the economic ones, involved in the psychoanalytic situation. In the twenties, when Freud and then Sándor Ferenczi experimented with the "active technique," frustration (Versagung) resulting from interdictions or injunctions that, it was hoped, would turn the patient away from modes of satisfaction judged to be pathological. In 1918, Freud wrote, "By abstinence, however, is not to be understood doing without any and every satisfaction—that would of course not be practicable; nor do we mean what it popularly connotes, refraining from sexual intercourse; it means something else which has far more to do with the dynamics of falling ill and recovering. You will remember that it was a frustration that made the patient ill, and that his symptoms serve him as substitutive satisfactions. [. . .] Cruel though it may sound, we must see to it that the patient's suffering, to a degree that is in some way or other effective, does not come to an end prematurely." (Freud 1919a , pp. 162-163) And Ferenczi continued, "[. . .] the 'active therapy', hitherto regarded as a single entity, breaks up into the systematic issuing and carrying out of injunctions and of prohibitions, Freud's 'attitude of abstinence' being constantly maintained" (Ferenczi, pp. 193-194). It is in this sense, then, that Rudolph Lowenstein—and also Anna Freud—explained that while some analysts think it necessary to prohibit their patients from performing this or that perverse sexual practice, it would not be wise to recommend the same to homosexual patients (Lowenstein).
It was chiefly in the United States that a slippage took place that turned the recommendation of abstinence into an increasingly restrictive "rule." Karl Menninger and Phillip Holzman (1973) even considered it the "second fundamental rule" of psychoanalysis. But the risk of insinuating a moral judgment left a lingering ambiguity, and proponents of relaxing the rule argued that some analysts used it to prohibit their patients from having sexual relations or extramarital affairs.
Over the years, the notion of abstinence came to be invoked less and less, and it has even been proposed that analysts speak instead of a "rule of the reality principle." Above all, it has been replaced by "neutrality," a concept not explicitly mentioned by Freud (Mijolla), and even a "benevolent neutrality" (Stone, 1961) or a "compassionate neutrality" (Greenson; Weigert 1970). In the evolution of these attitudes, the mark of Sándor Ferenczi's important influence on matters of practice is obvious, since the prescriptions of abstinence pushed to the extreme were those of the "active technique" and since the frequent tendency of "benevolent neutrality" to drift towards more and more established "benevolence" of the maternal type characterized the last years of his practice.
As an appropriate alternative Freud suggested the ‘rule of abstinence’, which consists in the analyst’s refusal to gratify the patient’s needs and demands so that all substitute satisfactions are avoided and a productive level of suffering is maintained. Freud refused to model the analytic treatment on a mental hospital’s policy to look after patients and to make them feel as comfortable as possible inside. He also emphasized that whatever educational effect psychoanalysis may entail, analysts should ensure that their patients do not come to resemble them, but are encouraged in the liberation and realization of their own being.