Self psychology’s primary goal is to strengthen the self through specific qualities of relationship that enable the patient to have a new experience in the treatment and also get in touch with and include more and more of his or her past and current experience in the patient’s sense of who he or she is or can be. The more of our experience we can include in our sense of self, the richer we feel and the more confidence we have that we will be able to face life’s inevitable challenges and setbacks. But what anyone can include in a sense of self is closely related to what is positively responded to by the individual’s human environment from birth onward. Additionally, effective parents both “dose” and name their children's experience in accordance with the child’s momentary state and current level of development (Emde, 1990). At times, analysts may need to do the same with their patients.
自体心理学的主要目标是通过特定的关系量来强化自体,这种关系使患者能够在治疗过程中获得新的体验,并与患者的认同感中(他或她是谁或者可以是谁)越来越多的过去和现在的经验联系起来。我们容纳在自体感的经验越多,我们感觉就越丰富,我们能够面对生活中不可避免的挑战和挫折的信心也就越大。但是,任何人都可以在自体感中容纳的是与个人的人类环境从生而来的密切联系的积极响应的东西。另外,起作用的父母也按照孩子的瞬间状态和当前的发展水平“量身定制”并命名了孩子的体验(Emde,1990)。有时,分析师也许需要对患者做同样的事情。
The analyst’s mirroring or responsiveness does more than reflect what the patient presents. When successful it adds something, however subtle, or enhances the patient’s understanding of his or her own experience. For instance, for a patient who was the second of seven closely spaced children—with a depressive and understandably exhausted mother— an abiding theme of treatment was her inability to feel she had a right to anything even to her own psychoanalysis. She worried about burdening me with her talk. One day she began her session as follows: “I feel like saying ‘this happened and this happened and this happened’, but what stops me is that I think of my mother” I responded, “You’re afraid I’ll react the way your mother did.” And then I continued, in a mock-exasperated voice, “I can barely survive just seeing that you seven kids get clean and clothed and fed. So don’t ask me to just sit here and listen to you!” The patient’s eyes filled with tears and she responded, “Yes, that’s exactly how she talked.” She later spoke of how comforting it had been to feel so known and understood by me in relation to her painful formative experiences. Ultimately she felt more confident that not everyone in her life would feel as put-upon by her everyday needs as had her fatigued and harassed mother (Teicholz, 199’s).
分析师的镜映或回应不仅仅是反应患者的表现。当它成功地增加了一些东西时,无论如何微妙,会提高患者对自身体验的理解。例如,一个患者,她是七个出生年龄间隔很短的兄弟姐妹中的第二个孩子——有一位抑郁且可想而知的疲惫的母亲——她治疗的永恒主题是,她无法感觉自己对一切东西的权利甚至是自己的精神分析。她担心与我的谈话会加重我的负担。有一天,她开始了会谈,如下:“我想说‘它发生了,发生了,发生了’,但是阻止我的是,我想到我的母亲”我回应说,“你害怕我会以你母亲的方式做出反应。”然后,我以一种模仿的声音继续说道:”只是看到你们七个孩子弄干净,穿上衣服和吃饱,就够我受的了。所以不要要我坐在这里听你的话!“病人的眼睛充满了泪水,她回答说:”是的,那就是她说的话。“她后来谈到我对于她痛苦的形成体验的了解,是多么令她安慰。最终,她更感确信,她的生活中的不是每个人都会受到日常需要的影响,像她的疲惫而厌烦的母亲(Teicholz,199年代)一样。
Just as we are strengthened by having a more inclusive sense of self, we are weakened to the extent that, for any reason, the experience we are able to include in our sense of self is highly selective. The less our experience has been contained, made sense of, and named by our early caregivers, the ''thinner” or more shallow is our sense of who we are and the more fragile and vulnerable we are likely to feel. Without the fullness of our own experience in our sense of who we are,we go through life “operating on one cylinder” or “without a full deck of cards.”
正如我们通过拥有更加包容的自体感而得到加强,那么我们减弱的程度,就是因为,我们包含在自体感中的经验是精挑细选的。我们容纳早期照料者理解和命名的经验越少,我们是谁和我们可能感到的脆弱性的感觉就更“单薄”或更肤浅。如果我们对自己是谁的感觉缺乏丰富经验,我们就会经历“无从下手”或是“没有底牌”的生活。
Traumatic experience, large or small,is the biggest contributor to the gaps in our sense of self, generating ''black holes” of the mind that admit no light or leading to psychic ''compart- mentalization” in which the traumatic experience and associated self-states are walled-off and lose their (associative) links to the rest of the personality. Although trauma is defined as any experience that the mind cannot assimilate,there are nevertheless degrees of trauma ranging from the more catastrophic—as, for example, repeated childhood experiences of severe pain and terror intentionally inflicted by those who are supposed to be protecting and nurturing the child—to the more subtle disruptions of a sense of “going on being” (Winnicott,1960b), such as might come from the daily experience of being raised by a parent who fails to respond or responds negatively or by a parent who chronically responds in ways that are slightly off, to the spontaneous gestures and initiatives of the child. Many children are regularly beat up or sexually abused by older siblings or have parents who repeatedly tell them they are stupid, ugly, or will never amount to anything. It is not only the gross trauma of such outright attacks on the self that derail development but also the everyday erosions that accumulate over time; these latter experiences, although less dramatic, can also lead to a somewhat compromised, distorted, or impoverished sense of self.
创伤经验,无论是大还是小,最大的贡献是造成了自体感的缺口,产生心灵的“黑洞”,它不允许光明或导致心理上的“精神分化”,隔离了创伤经验和相关联的自体状态,并失去与其他人格(相关)的联系。虽然创伤被定义为心灵无法吸收的经验,但是创伤的程度是不一样的,从更大灾难——例如,由那些应该保护和照顾孩子的人造成的严重的痛苦和恐惧童年期重复经验——到更加微妙的“持续存在”感的破坏(温尼科特,1960b),比如可能来自父母提出的无法回应或消极回应,或长期以来的父母以偏离的方式对孩子自发的姿态和主动性做出日常的回应。许多孩子经常被哥哥和姐姐殴打或性虐待,或有父母反复说他们是多愚蠢多丑陋,或者说他们会一事无成。不仅是这类阻碍自体发展事件的完全爆发,而且日积月累的日常侵蚀,都会造成严重的创伤,后一种经历虽然不那么戏剧化,但也可能导致一些有些妥协、扭曲或消耗了自体感。
I believe that the process of articulating one’s life experience, both current and historical (the process of bringing all the parts of oneself together in one place), in the presence of an affirming and active listener or resonant witness is growth promoting in itself, exactly because over time it does seem to accrue to a sense of continuity, cohesion, and value about who one is. This experience in psychoanalysis is especially powerful because most patients feel the recognition to be coming from an idealized other—no matter how complex, qualified, or “ironic” the adult patient’s experience of the analyst’s authority might be (Hoffman, 1996).
我相信,在一个肯定和积极的倾听者或共同见证者面前,将当前和历史(将自己的所有部分结合在一起的过程)表达出来的过程本身就是促进性成长,正是因为随着时间的推移,它似乎会产生一种连续感,内聚力和价值观。精神分析的这种体验特别强大,因为大多数患者感觉到来自理想化他人的认可——无论成人患者对分析师权威的体验可能是多复杂、有限或“讽刺”(Hoffman,1996)。
Thus far, I have described the analyst’s participation as if the analyst is easily able to achieve the goals of listening, accepting, and understanding what the patient presents. This is not, of course, what happens at every moment of every treatment. Beyond the analyst's extensive training and experience—and beyond the patient’s commitment to the process—the match or fit between patient and analyst can be an important factor in its success; not every patient can work with every analyst and vice versa. New research also suggests that, from the moment of birth, bidirectional influence begins between parent and child. We now recognize that the analyst's influence on the patient also goes beyond the intended impact and that the analyst is affected in unrecognized ways by each patient as well. These factors complicate the goals with which analyst and patient begin any treatment.
到目前为止,我所描述分析师的参与,就好像分析师很容易实现倾听、接受和理解患者所呈现的目的。当然这并不是每次治疗的每一时刻都会发生的事情。除了分析师的丰富的训练和经验外——在患者对该过程的承诺之外——患者和分析师之间的匹配度或适合度可以成为分析成功的重要因素; 不是每个患者都可以和每个分析师一起工作,反之亦然。新的研究也表明,从出生的时刻起,父母和孩子间的双向影响就开始了。我们现在认识到,分析师对患者的影响也超出了预期的影响,分析师也受到每个病人的未被承认的影响。这些因素使分析师和患者开始治疗的目标复杂化。
Self psychologists tend to use this new knowledge of bidirectionality as a spur toward more vigilant self-monitoring and more constant exploration of the ways that the intersection of subjective experience between patient and analyst might in some way unwittingly hurt the patient or stymie the analytic progress. In spite of recognizing bidirectionality of influence, in other words, the self psychologist's emphasis remains on facilitating an elucidation of how the patient is being affected by the analyst in unintended or hurtful ways.
自体心理学家倾向于利用这种双向性的新知识来激励更加警惕的自我监测,并且更多地不断探索患者和分析师之间的主观感受可能以某种方式不经意地伤害患者或阻碍分析的进展。尽管认识到双向性的影响,换句话说,自体心理学家的重点仍然在于促成一个说明:即分析师是如何以无意或有伤害的方式影响到患者的。