译者:斑鸠
The technical rules which I am putting forward here have been arrived at from my own experience in the course of many years after unfortunate results had led me to abandon other methods. It will easily be seen that they (or at least many of them) may be summed up in a single precept. My hope is that observance of them will spare physicians practising analysis much unnecessary effort and guard them against some oversights. I must however make it clear that what I am asserting is that this technique is the only one suited to my individuality; I do not venture to deny that a physician quite differently constituted might find himself driven to adopt a different attitude to his patients and to the task before him.
我正要提出的这些技术规则,是在那些令人遗憾的结果促使我放弃了其他的方法之后,在许多年的过程中,从我自己的经验里总结得出的。这会很容易看到,它们(或者至少是它们中的许多)是用一个单一的规则总结出来的。我的希望是,对这些规则的遵守会节省开业从事精神分析的医生的许多精力,并且会防止他们的一些疏忽。然而,我必须澄清,我正在主张的东西是这个仅适合我个人的技术。我不敢否认说,一个(理论)构成十分不同医生可能会感觉自己受到驱使而对他的病人和他眼前的任务采取一种不同的态度。
(a) The first problem confronting an analyst who is treating more than one patient in the day will seem to him the hardest. It is the task of keeping in mind all the innumerable names, dates, detailed memories and pathological products which each patient communicates in the course of months and years of treatment, and of not confusing them with similar material produced by other patients under treatment simultaneously or previously. If one is required to analyse six, eight, or even more patients daily, the feat of memory involved in achieving this will provoke incredulity, astonishment or even commiseration in uninformed observers. Curiosity will in any case be felt about the technique which makes it possible to master such an abundance of material, and the expectation will be that some special expedients are required for the purpose.
这第一个问题,是在一天之中治疗超过一个病人的分析师面临的问题,对他来说似乎是最困难的问题。那是一个记住所有的数不清的名字、日期、详细的回忆和由疾病引起的产物之任务,而这些产物是每个病人在治疗的成年累月的过程中传达的;还是一个不把这些产物与其他病人在治疗下同时或先前产生的相似材料相混淆的任务。如果我们每天需要分析6个、8个或者更多的病人,那么,完成这个任务所需要的记忆之壮举会在无知的观察者中引起怀疑、惊讶甚至同情。无论如何,对于能够掌控如此多的材料的技术,(我们)都会感到好奇,并且会预想,为了这个目的会需要一些特殊的策略。
The technique, however, is a very simple one. As we shall see, it rejects the use of any specialexpedient (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 attention’ (as I have called it) in the face of all that one hears. In this way we spare ourselves a strain on our attention which could not in any case be kept up for several hours daily, and we avoid a danger which is inseparable from the exercise of deliberate attention.
然而,这是一个非常的简单的技术。如同我们会看到的,它拒绝使用任何特殊的策略(即使是谈话记录的策略)。这个技术仅仅在于:尤其不要把我们的注意力引向任何东西和在面对我们听到的所有的东西时保持相同的“均匀-悬浮注意力”(如同我已经称呼它的)。以这个方式,我们避免了我们的注意力上的紧张,我们的注意力无论如何不可能每天都保持几个小时,并且我们避免了一种危险,这种危险和故意的注意是分不开的。
For as soon as anyone deliberately concentrates his attention to a certain degree, he begins to select from the material before him; one point will be fixed in his mind with particular clearness and some other will be correspondingly disregarded, and in making this selection he will be following his expectations or inclinations. This, however, is precisely what must not be done. In making the selection, if he follows his expectations he is in danger of never finding anything but what he already knows; and if he follows his inclinations he will certainly falsify what he may perceive. It must not be forgotten that the things one hears are for the most part things whose meaning is only recognized later on.
因为,任何人一旦故意地把他的注意力集中到某个程度,他就会从他眼前的材料开始挑选;一个点将会特别清晰地固定在他的脑海中,并且,一些其他的点会被相应地忽视,在做这个选择时他将会跟随他的预期或者爱好。然而,这恰恰是不允许做的。在这个选择时,如果他跟随他的预期,那么,他就处在除了发现他已经知道的东西而决不会发现任何东西的危险之中;而如果他跟随他的爱好,那么,他将必定会歪曲他可能感知到的东西。必须不能忘记,我们所听见东西多半是只有后来才能识别它们的含意的东西。
It will be seen that the rule of giving equal notice to everything is the necessary counterpart to the demand made on the patient that he should communicate everything that occurs to him without criticism or selection. If the doctor behaves otherwise, he is throwing away most of the advantage which results from the patient’s obeying the ‘fundamental rule of psycho- analysis’. The rule for the doctor may be expressed: ‘He should withhold all conscious influences from his capacity to attend, and give himself over completely to his "unconscious memory".’ Or, to put it purely in terms of technique: ‘He should simply listen, and not bother about whether he is keeping anything in mind.’ What is achieved in this manner will be sufficient for all requirements during the treatment.
将会看到,对一切事物给予相等的注意力这条规则必须对应于对病人做的要求,即他应该没有批评没有挑选地传达一切他想到事物。如果医生表现得不是这样,那么,他就是在扔掉大部分的优势,这个优势缘于病人遵守“精神分析的基本规则”。对医生的规则可以表达为:“他应该抑制来所有的来自他的注意能力的意识的影响,而使自己完全屈服于“他的无意识记忆”,或者,单纯以技巧的措辞来说:“他应该仅仅是倾听,并且不要烦恼于他是否在记什么东西。”用这个方式所达到的东西将足以满足治疗中的所有要求。
Those elements of the material which already form a connected context will be at the doctor’s conscious disposal; the rest, as yet unconnected and in chaotic disorder, seems at first to be submerged, but rises readily into recollection as soon as the patient brings up something new to which it can be related and by which it can be continued. The undeserved compliment of having ‘a remarkably good memory’ which the patient pays one when one reproduces some detail after a year and a day can then be accepted with a smile, whereas a conscious determination to recollect the point would probably have resulted in failure.
已经形成了一个连贯的脉络的材料的那些部分将会任凭医生的意识处理;那些剩下的部分,当时还是不连贯的、秩序混乱的部分,似乎开始时是潜在水下的(潜在意识之下的),但是,一旦病人谈到某个与之相关的东西,那些混乱的部分就容易浮现在(医生的)回忆中,并且,通过谈到的那个东西,那些混乱的东西就能够继续(浮现)。当整整一年过后我们复述一些细节时,那时病人给予我们的拥有一个“非常好的记忆”这个不应得的称赞,会被(我们)用一个微笑来接受,然而,对于回忆这个要点,一个有意识的决定,将很可能导致(回忆)失败。
Mistakes in this process of remembering occur only at times and places at which one is disturbed by some personal consideration (see below) - that is, when one has fallen seriously below the standard of an ideal analyst. Confusion with material brought up by other patients occurs very rarely. Where there is a dispute with the patient as to whether or how he has said some particular thing, the doctor is usually in the right.
1 A patient will often assert that he has already told the doctor something on a previous occasion, while the doctor can assure him with a quiet feeling of superiority that it has come up now for the first time. It then turns out that the patient had previously had the intention of saying it, but had been prevented from performing his intention by a resistance which was still present. His recollection of his intention is indistinguishable to him from a recollection of its performance.
这种回忆过程中的失误只是有时会出现,并且只出现在我们被一些个人的顾虑打扰地方(看下面)--也就是说,当我们降到一个一个完美的分析家的标准以下时。混淆由其他病人提供的材料是很少发生的。与病人之间存在关于“他是否或怎样说过某个特殊的东西”的一个争论时,医生经常都是对的。
1一个病人会经常宣称,他在以前的一个场合已经告诉了医生某个事情,然而医生可以以一种优越的和缓的感情向病人担保,它现在是第一次出现。然后,结果证明,病人以前曾打算说这个事情,但是一个仍然存在的阻抗阻止了他实施他的意图。对他来说,他对他的意图的回忆与对这个意图的实施的回忆是不能辨别的。
(b) I cannot advise the taking of full notes, the keeping of a shorthand record, etc., during analytic sessions. Apart from the unfavourable impression which this makes on some patients, the same considerations as have been advanced with regard to attention apply here too. A detrimental selection from the material will necessarily be made as one writes the notes or shorthand, and part of one’s own mental activity is tied up in this way, which would be better employed in interpreting what one has heard. No objection can be raised to making exceptions to this rule in the case of dates, the text of dreams, or particular noteworthy events which can easily be detached from their context and are suitable for independent use as instances. But I am not in the habit of doing this either. As regards instances, I write them down from memory in the evening after work is over; as regards texts of dreams to which I attach importance, I get the patient to repeat them to me after he has related them so that I can fix them in my mind.
我不能建议在分析的会面中写下完整的记录,保留一个速写记录等。除了给一些病人留下不适宜的印象,关于注意力在这里的运用,同样的顾虑也被提出了。我们写下笔记或速写记录将必然成为对材料的一个有损害的挑选,并且用这个方法时我们自己部分的精神活动被占用了,而这部分的精神活动可以更好地用于解释我们所听到的东西。在日期、梦的原貌的情况中,或者在特别显著的事件的情况中,这些事件在它们的脉络中很容易被分离出并适合作为例子独立使用,没有一个异议能够被举出来排除这个规则。但是我也不习惯于这么做。至于一些例子、一些我认为有重要价值的梦的原貌,我在晚上工作结束后把它们从记忆中写下来,并且在病人提到它们后,我让他向我重复它们,以便我能够在心中牢记它们。
(c) Taking notes during the session with the patient might be justified by an intention of publishing a scientific study of the case. On general grounds this can scarcely be denied. Nevertheless it must be borne in mind that exact reports of analytic case histories are of less value than might be expected. Strictly speaking, they only possess the ostensible exactness of which ‘modern’ psychiatry affords us some striking examples. They are, as a rule, fatiguing to the reader and yet do not succeed in being a substitute for his actual presence at an analysis. Experience invariably shows that if readers are willing to believe an analyst they will have confidence in any slight revision to which he has submitted his material; if, on the other hand, they are unwilling to take analysis and the analyst seriously, they will pay no attention to accurate verbatim records of the treatment either. This is not the way, it seems, to remedy the lack of convincing evidence to be found in psycho-analytic reports.
根据出版这个案例的科学研究的目的,在与病人的会面中做记录可能是正当的。以一般的根据,这很少被拒绝。必须牢记,对分析案例的历史的精确报告所拥有的价值比可能预期的要少。严格地说,这些案例只拥有表面的精确性,是“现代的”精神病学提供给我们的表面上精确的典型例子。通常,对于读者来说,这些案例让人劳累的,并且还没有成功地成为分析中他真实的存在的替代品。经验总是表明,如果读者愿意相信一个分析师,那么,他将会信任任何对他所递交的材料的轻微修改;另一方面,如果读者不重视分析和分析师,他们也不会去注意精确的、一字不差的心理治疗记录。似乎,这不是补救在分析报告中发现的缺乏令人信服的证据的方法。
(d)One of the claims of psycho-analysis to distinction is, no doubt, that in its execution research and treatment coincide; nevertheless, after a certain point, the technique required for the one opposes that required for the other. It is not a good thing to work on a case scientifically while treatment is still proceeding - to piece together its structure, to try to foretell its further progress, and to get a picture from time to time of the current state of affairs, as scientific interest would demand. Cases which are devoted from the first to scientific purposes and are treated accordingly suffer in their outcome; while the most successful cases are those in which one proceeds, as it were, without any purpose in view, allows oneself to be taken by surprise by any new turn in them, and always meets them with an open mind, free from any presuppositions.
毫无疑问,精神分析特有的其中一个主张是,在它的践行中研究和治疗是一致的。
当治疗仍旧在进行时,在学术上致力于这个案例不是一件好的事情—如同科学兴趣所要求的,把案例的结构拼合起来、试图预言它进一步的发展和不时地获取当前的状况的一个图景。从一开始就被奉献给科学的目的并被相应地治疗的个案,在它们的结果中受到损害;而最成功的案例是那些,在其中,我们似乎没带任何在考虑的目的而进行治疗,我们允许自己惊讶于任何新的变化,并总是以开放的思想面对他们,免除任何预想。