My Relational Self Psychology
Judith Guss Teicholz
Massachusetts Institute Jar Psychoanalysis, Lexington’s Massachusetts, USA

In this article,I suggest recent sources of influence on psychoanalysis and describe a contemporary relational self psychology that is my personal attempt at integration. Even with this integration, I struggle to find the right “therapeutic” balance between my essential but imperfect instrument for empathic listening, on the one hand, and the risks of authentic engagement, on the other. These dialectical tensions in me mirror those in the psychoanalytic community as a whole, poised between a scientifically based practice and a healing “art”--or between a complex but teachable methodology or discipline-- and an ordinary (yet extraordinary) human relationship in which spontaneity and even improvisation play a role. Complicating this balancing act, there is new evidence from neuroscientists, attachment theorists, and infant-caregiver researchers that, from birth onward, bidirectional influences on brain and psychic development create contingent and unpredictable outcomes in every intimately related dyad. Thus, the contemporary analyst must expect to be changed by the work and--while taking full responsibility for his or her own contribution--must recognize patient and analyst as co-creators of the psychoanalytic project. At the same time that we now recognize contingency, complexity, and chaos at the heart of human minds and relationships, we also acknowledge the central importance of a sense of continuity and coherence as the individual undertakes the pursuit of goals and relationships in life. What kind of relationship can facilitate these qualities in the sense of self? That is the question that this article undertakes to answer.


在这篇文章中,我会提出最近影响精神分析的来源,并描述当代的关系性自体心理学,这是我个人的整合尝试。即使有了这种整合,我也很难找到正确的“治疗”平衡——一方面是,我基本而又不完美共情性倾听的手段,而另一方面是真正参与的风险。对我来说,这些辩证的张力局势反映了整个精神分析共同体,介于科学的实践和治疗的“艺术”之间——或者在一个复杂而又可教导的方法论或纪律之间——以及一个普通(但非凡的)自发性甚至是即兴起作用的人类关系。使这个平衡更加复杂的行为有:来自神经学家的新证据,依恋理论家和婴儿照料的研究人员,从出生以来,对脑和心理发展的双向影响,在每个密切相关的二元组中产生偶然和不可预测的结果。因此,当代分析师必须期待工作的变化,并且——在为自己的贡献承担全部责任的同时——必须将患者和分析师认定为精神分析项目的共同创始人。同时,我们现在认识到人类心灵和关系的核心是偶然性、复杂性和混乱,我们也承认,作为个人承担追求生活中目标和关系的重要的连续感和统合感。什么样的关系可以促进自体感中的这些品质? 这就是本文试图回答的问题。


Influences on psychoanalysis in recent years have come from unlikely sources including biology, physics, and postmodern philosophy, among others. Although these sources and the changes they have effected in psychoanalysis are too many to address, I shall mention a few.


From biology has come a view of the mind as a nonlinear dynamic system in which small changes in any part of the system are likely to have far-reaching effects on the whole. Biological systems theory further suggests that in human relationships—including the psychoanalytic relationship—-each partner constitutes a “system" in its own right, but the two systems together form a larger and more complex system, functioning as a whole. Meanwhile from quantum mechanics have come new recognitions of randomness unpredictability, emergence, uncertainty and chaos in the “laws” of the universe, ideas that have seeped into our psychoanalytic conceptualizations of how the human mind develops and how human relationships evolve and grow. These ideas have not replaced earlier ideas concerning the organization and coherence of the human mind but are held in dialectical tension with them.


Especially germane to our current view of analytic process is the acknowledgment that observation or measurement irrevocably changes what is observed or measured. With all these ideas, the prior ideal of the analyst as a neutral observer, standing outside the turmoil brought by the patient, has fallen away. In its place, we see the analyst unique and irreducible subjectivity, interacting with the patient’s psyche under conditions of constant, simultaneous, mutual influence. While this view of the analytic relationship tends to undermine our earlier views of the analyst professional expertise and authority, it also sets the stage for a richer more creative process in which the two partners to the analytic dyad uniquely participate to co-construct something quite unforeseeable and new.


From postmodern philosophy the influences on psychoanalysis have been equally thoroughgoing and unexpected, especially in regard to the “self”. The self is now seen as without a core and forever in process, an evolving distillation of its ongoing interactions with others and the world. Postmodern theory questions the very possibility of meaning, other than what individuals can create or negotiate with others, on the basis of their immediate experience. As radical as all these ideas might seem at first glance, it turns out that Kohut’ss (1971) description—of a sense of self constructed originally through the individual relationships and sustained by them throughout life—fits well with many of the late 20th and early 21st century changes in psychoanalysis. In the ongoing construction of this self, the meaning that matters is the unique and affectively laden personal narrative that has been recognized or affirmed by important others.


Human development is an ongoing process, optimally continuing throughout a lifetime. It is because of this open endedness of psychic growth that change is possible through psychoanalysis at any time during the life cycle. Although a direct link between early development and later change is not recognized in all psychoanalytic theories, it is inconceivable to me that the pathways and processes through which individuals first lay down patterns of experience and behavior could be entirely different from those through which individuals undergo psychological change in adult life. Still the adult personality is infinitely complex and multilayered, and the adaptations and solutions of a lifetime must somehow be challenged and destabilized in order to make room for the new. Also, for individuals who have suffered early trauma, there is an understandable fear of retraumatization and, therefore, a diminished openness to new experience. In combination, these conditions can make therapeutic change difficult to achieve.


There are of course multiple pathways along which psychic development proceeds as well as a broad and variegated range of conditions under which individuals can psychologically thrive and grow. This multiplicity of pathways and conditions contributes to competing explanations of how individuals develop and change. Change processes can be viewed along many dimensions as well as at several levels of abstraction. Additionally, the fact that most developmental and psychic processes take place largely out-of-awareness means that it is impossible to pinpoint much that goes on in early development or in psychoanalytic treatment. For all these reasons, curative factors remain elusive and ambiguous, and any theory of how people change in psychoanalysis is necessarily multifaceted yet incomplete.


By their training, analysts are well versed in developmental theories and have some sense of the range of “expectable” human experience when beginning to work with any patient. At the same time, the absolute singularity of every individual requires that analysts also be prepared to respond creatively to what is unique in each patient’s experience and life trajectory. In addition to the inevitable limitations of general theory as a guide to individual treatments, it is also true that in lived experience every psychological problem and all attempted solutions for that problem are ineluctably interwoven with the individual’s most enduring strengths and adaptive strategies. Patients may, therefore, understandably feel that to rid themselves of their problems and of their less-successful solutions is also to tamper with their most sustaining qualities of self and their most familiar and favored patterns of behavior.

通过培训,分析师精通了发展性理论,并在与病患工作的开始,某种意义的“预期”人类的体验。 同时,每个人的绝对独特性也要求分析师准备好创造性地去回应每位患者独特的经验和生活轨迹。除了一般理论作为个人治疗指南的不可避免的局限之外,同样真实的是,在生活经验中的每个心理问题和所有对这个问题的尝试解决方案,与个人最持久的优势和适应性策略不可避免地交织在一起。因此,患者可以理解的是,摆脱自己的那些问题和不太成功的解决方案,同样损害了自己最持久的自我品质和他们最熟悉和最受欢迎的行为模式。

While certain earlier established feelings, attitudes, and patterns of behavior may now be getting in the way of the patient attaining chosen life goals,these same attitudes and behaviors may have been the most creative adaptations possible in the face of difficult or painful childhood circumstances or may have been valiant measures undertaken for self-preservative purposes against what would otherwise have been experienced as unbearable developmental setbacks or blows. In other words, the patterns of feeling, behavior,and “self-defense” that are now in need of change may be the very ones that enabled the patient to survive and prevail in the face of less-than- optimal developmental conditions.


So the question becomes what processes—or what kinds of relationship—can help an individual give up what might feel like an essential self-invented key to whatever stability and adequate functioning—or even to whatever good times and fun—have thus far been achieved in life? What allows a person to take a leap into the psychic unknown on just the promise that the treatment—costly in both time and money— will help to develop more effective strategies by which to live and get more of what is needed and wanted in life? The analyst must certainly earn the patient’s trust; and the first step in this process is usually for the analyst to listen very attentively, trying to learn everything he or she can about the patient that might be harnessed toward “cure.” The analyst should expect that the patient will be listening attentively as well, no doubt asking, “Who is this person to whom I am entrusting my lifers secrets? And how is this talking ever going to help with my life outside of here?”


Goals of Psychoanalysis 精神分析的目标

The goals of psychoanalysis are broad and encompassing, playing out differently from one individual to the next. At the most generic level, we might say that people seek psychoanalytic treatment when they have been unable on their own to transform painful or problematic feelings about self and others or to change painful or ineffective patterns of feeling and behavior. Most contemporary psychoanalytic theories understand experiential and behavioral problems to involve emotional life in some way; either too much or too little intensity of feeling, with concomitant difficulty in using one’s emotional life as a guide to making more satisfying and effective life choices. From this viewpoint, individuals seeking psychotherapy are in large part either overwhelmed by undesirable feelings and need help with emotional containment and processing or they have lost touch with aspects of their emotional experience, which— if recognized, accepted, and integrated—could contribute to living a life more fully informed by and expressive of who the individual feels he or she is and can be.


As an integral part of our emotional lives, we also develop early and long-standing ideas about our individual limits and possibilities, our desirability and worth, as well as convictions based on early relational experience about what to expect in our intimate connections with others. These expectations and convictions evolve during our most formative years and, although not always in awareness, they play a central role in how we live our lives.


Many patients come to psychoanalysis with a generally negative experience of themselves because of events that occurred in their lives that were totally beyond their control but for which they nevertheless implicitly blame themselves. In such cases, the fullest elaboration of these early experiences may contribute to the their ultimate understanding that as an infant or child they were not responsible for how they were treated or for events that were in fact beyond their control. Such events might include a sibling’s birth; a parent’s or sibling’s physical or mental illness or even death; the parents‘s fighting, separation or divorce; the family’s financial setbacks; any kind of abuse—emotional or physical—visited on the child by a sibling, parent, or other adult; or socioeconomic or historical/political events and conditions as they intersect with family life. These early experiences—and our adaptations to or defenses against them—can somehow trip us up in our current lives. Psychotherapy or psychoanalysis offers a second chance to explore and reorganize these views of ourselves and the world. Working with another person who is trained to listen and respond in facilitative ways, the patient is helped to relive problematic aspects of his or her life in a new context and to make sense and meaning of them in new ways. The process is intended to change both concept and feeling about self and the relational world—and to make changes in behavior possible, where such change is desired.


When a patient’s most pressing problems have to do with disruptive excesses of feeling, the new experience of repeatedly expressing and sharing these very feelings with another whose emotional responses convey genuine resonance and understanding—but also provide a more modulated rendering of the same emotions—may in time enable the patient to internalize or to take over (as his or her own) these new ways of processing emotional experience. The very act of repeatedly sharing what feels “too much” when alone can often, by itself, facilitate modulation of the experience.


When the patient’s most pressing problems are related more to a sense of impoverishment in the patient’s emotional or relational life or to actions that somehow do not lead to the achievement of satisfying relationships or life-enhancing goals, the experience of gradually being helped to articulate and express more of one’s thoughts and feelings in the presence of an empathically responsive other—someone committed to “getting it” from the patient’s own viewpoint and reflecting it back in increasingly detailed and nuanced ways—may ultimately make possible the integration of previously warded-off experience, which can then be brought to bear on life choices that bring the patient closer to what has always been hoped for—or closer to what the patient had never even dared to hope.


But psychoanalysis is not only about the content of what the patient tells the analyst nor necessarily about the patient's life history (which nevertheless remains important because the repeated linking of past and current experience does enhance self-understanding and integration); it is also about lived experience in the relationship between patient and analyst and how this new experience fosters not only self- and mutual understanding but also the transformation of life beyond the therapeutic relationship. While the analyst uniquely responds to the specificity of who each patient is, the analyst is also at every juncture listening and responding in keeping with his or her own distinctive subjectivity and personhood; in this way, experiences of both similarity and difference are built into the process.

但是,精神分析不仅仅是病人告诉分析师的内容,也不一定关于患者的生活史(尽管仍然是重要的,因为重复联系着过去和现在的经验的确增强了自我理解和整合); 还有关于患者与分析师之间关系的生活经验,以及这种新体验如何不仅促进了自我和相互理解,而且促进了超越治疗关系的生活转型。分析师独特地回应了每个患者的特异性,分析师也在每一个特定时刻聆听和响应,以符合他或她自己独特的主体性和人格; 通过这种方式,经验既是相似的又是不同的构建到这个过程中。

Early Development and Later Change in Psychoanalysts

The sense of self originally develops and is continually enhanced through transformative qualities of the earliest caretaking relationships (Kohut, 1971). These same qualities optimally prevail in the psychoanalytic relationship as well, but there is more that gets in the way of an adult patient’s capacity to make use of them than in original development. When things go wrong at any point in development, the individual must find a way to move forward in other areas of psychological functioning, even if the problematic situation and the child’ s best solutions for it have to be built right into the fabric of the developing personality. The bumps and twists of life thereby become the bumps and twists of the psyche—some of which will have to be later disentangled in a psychoanalytic treatment relationship. To this end, the analytic relationship sometimes becomes a reliving of the challenges or setbacks of childhood but in a protected environment whose very purpose is to attain understanding and mastery over the earlier hurts, disappointments, and solutions that are interfering with the patient’s life today.


A successful analysis is expected to increase the patient’s capacities in such realms of life as finding ways to express one’s unique individuality and talents; finding and enjoying meaningful work; finding others with whom to create and sustain satisfying relationships; and perhaps becoming part of, as well as contributing in some way to, a chosen community. According to self psychology, any of these achievements requires a relatively cohesive, continuous, and valued sense of self that is experienced as the center of experience and initiative (Kohut, 1971). The self is forever evolving and in process; it is infinitely complex and multifaceted; and under certain conditions it remains forever vulnerable to fragmentation. But, in order to live, function, and thrive in the world, every individual needs to fed some degree of continuity and coherence in the sense of self.

一个成功的分析可以预期增加患者在以下生活领域的能力:寻找方式来表达个体的独特性和天赋; 找到有意义的工作并享受于其中; 找到与之建立和维持令人满意的关系的他人; 并可能成为所选团体的一部分,并以某种方式在某方面做出贡献。根据自体心理学,上述这些成就都需要具有相对统整的、持续和有价值的自体感,这种自体感被经验为个体体验和自发性的中心(科胡特,1971)。 自体永远在演化和进行中; 它是极其复杂和多层面的; 在某些情况下,它仍然永远易于崩解。但是,为了在世界上生活,发挥作用,和茁壮成长,每个人都需要在自体感上给予一定程度的连续性和统整性。

What are the pathways to such a sense of self that is robust and stable enough to generate unique interests, to identify and develop talents, to set achievable goals, to pursue ambitions and ideals, to develop sustaining relationships, to find meaning in both love and work? All such pathways run through the facilitative human environment—initially through the essentially growth-promoting bonds between children and their parents or later through whatever bond can be forged between patient and analyst. These bonds are called “selfobject” ties by Kohut because in them the “object” is used for the growth of the “self.” Such usage and growth take place spontaneously and out of awareness when relational conditions are right.


In KohutJs theory the “self” is so intricately intertwined with “relationship” that it is understood to have its earliest beginnings in the first interactions between parent and child. Self and relationship then participate in a ceaseless feedback loop from birth onward, and there can be no consideration of the self without consideration of the relationships within and through which the self develops.


Kohut(19’s9,1966,1971,1977,1982,1984) was also specific about what kinds of relationships initially facilitate psychic growth. In the first year of life he believed that children need to be permitted a fantasy of merger with their parenting figures, whom they experience as omnipotent, This idea is similar to Winnicott’s (1960a) British Object Relations concept of the “good enough” mother who meets her baby’s basic needs so well that the baby can entertain the fantasy of being self-sufficient. Both Kohut and Winnicott believed that in the first year of life the child must be allowed fantasies of omnipotence to provide soothing or containment in the face of what would otherwise be overwhelming anxieties caused by the infant’s real dependence on others for survival.

科胡特(19’s9,1966,1971,1977,1982,1984)也具体说明了什么样的关系最初促进了心理发展。 他相信,在生命的第一年,孩子们需要被允许与他们的父母形象合并的幻想,他们被孩子体验为无所不能的,这个想法类似于英国客体关系学派温尼科特(1960a)“足够好”的母亲的概念,她很好地满足了宝宝的基本需要,使宝宝能够享受自给自足的幻想。科胡特和温尼科特都认为,在生命的第一年,孩子必须被允许全能幻想,提供出舒缓或遏制,以面对在婴儿为生存对他人的真实依赖所造成的压倒性焦虑

Beyond the first year, Kohut (1971, 1977,1984) identified three more psychological functions that must be adequately provided by the human environment in order for development optimally to proceed. These include the need for emotional resonance and for recognition or affirmation of one’s spontaneous gestures, perceptions, and feelings (the mirroring function); the need for a sense of similarity to and belonging with others (the twinship function); and the need to admire, look up to, or idealize others (the idealizing function). All of these “functions” are two-person processes that occur in a relational context, and, under “good enough” conditions, all of these processes become two-way exchanges.

除了第一年,科胡特(1971,1977,1984)确定了人类环境必须充分提供的三个心理功能,以便恰到好处地进行发展。这其中包括需要情感共鸣,以及承认或肯定个人的自发姿态、感知和感觉(镜像功能); 需要与他人相似感并归属他人(双生关系功能); 并且需要欣赏,尊重或理想化别人(理想化功能)。所有这些“功能”是在关系环境中发生的两人过程,在“足够好”的条件下,所有这些过程都成为双向交流。

Kohut believed that stage-appropriate experiences of mirroring, twinship, and idealization work together to transform normal narcissism of childhood, in which both self and significant others are aggrandized, into a capacity for empathy with others, a sense of humor about one's self and the world, and an acceptance of one’s own and others’ limitations and mortality. In his view, the need for such facilitating relationships continues throughout the life cycle— albeit with less intensity in adulthood than in early childhood, provided that the needs have been adequately responded to during the primary developmental years.


But while the quality and intensity of need does change with development, our basic need for recognition or affirmation applies to the full panoply of human experience at every stage of life. For instance,the infant’s curiosity and love of novelty or her basic physiological needs; the toddler’s joy of exploration or his rage at being abandoned; the “oedipal” child’s passion for one or both parents or feelings of rivalry with other family members; the school child’s proud feelings of accomplishment or her new separation anxieties; the adolescent’s bid for greater autonomy or his sexual awakening and search for love outside the family are all experiences that must be affirmed by caregivers so that the child becomes able to include them in his or her evolving sense of who he or she is and able to use more of this unique subjective experience in making life choices large and small.

但在需求的质量和强度确实随着发展而变化的同时,我们对于承认或肯定的基本需求也适用于整个人类经验的每一个生命阶段。例如,婴儿的好奇心和对新奇事物的热爱或她的基本生理需要;蹒跚学步的小孩对于探索的欢乐或是被丢弃时的愤怒;对父母一方或双方“俄狄浦斯式”的激情或与其他家庭成员的竞争感; 学童骄傲的成就感或是新的分离焦虑; 青少年要求更大的自主权或他的性欲觉醒和寻求家庭以外的爱是一种必须得到照顾者肯定的经验,使得孩子能够将他们包含在他或她的发展的感觉中,在这种他或她是谁的感觉中,能够使用更多的这种独特的主观经验,使生活选择可大可小。

Kohut thought of these basic psychological needs—for mirroring, twinship,and idealizing—as functions not yet developed in the infant and young child. The “good enough” parent transiently provides these functions through positively charged caregiving interactions in which the child is protected, nurtured, guided, and engaged in creative play. In time, the child takes over to a greater degree the psychological functioning related to the developmental (or selfobject) needs—becoming gradually less dependent on the actual presence of significant others for containing anxieties; for maintaining an inclusive, well-delineated, and valued sense of self; and for sustaining the values and ideals that guide how the child lives.

科胡特认为这些基本的心理需要——镜像,双生关系和理想化——作为尚未在婴幼儿中发展起来的功能。“足够好”的父母通过积极充满感情的照顾与互动瞬间提供这些功能,孩子被保护、培养、引导和参与创造性的游戏。最后,孩子更大程度地接受了与发展性(或自体客体)需求相关的心理功能——逐渐减少了对实际存在的重要的他人的依赖,重要他人的功能对孩子来说是为了克制焦虑; 维护一个包容性、描述为好的和有价值的自体感; 并维持指导孩子如何生活的价值观和理想。

In psychoanalytic treatment the analyst does not set out actively to meet the patient’s selfobject needs but nevertheless is emotionally available to the patient in a way that does not interfere with spontaneously occurring and nonconscious processes through which the patient makes use of the analyst’s everyday psychic functioning in relation to these needs. For instance, a patient whose mirroring (affirmation) needs were routinely deprived in childhood might seem to be using his therapy sessions simply to recount his positive experiences at home and at work. Rather than asking the patient why he is not using the treatment to work on his problems, the self psychologist might initially do little but to affirm whatever self-presentation the patient has chosen, through the process of trying to listen and respond from within the patient's viewpoint.

在精神分析治疗中,分析师没有开始积极地满足患者的自体客体需求,而是情绪性地作用于患者,不受自发事件和无意识过程的干扰,借此患者利用分析师的日常心理功能关联于自体客体需求。 例如,一个患者的镜映(肯定)需要的患者在童年时常被剥夺,似乎仅仅在使用他的治疗会谈来叙述他在家里和工作中的积极经验。而不是问患者为什么不使用治疗来解决他的问题,自体心理学家最初除了肯定其他做得很少,肯定所有病人选择的自我表现,通过这个过程尝试倾听和回应患者内部的观点

By the same token, a patient whose twinship needs were deprived in childhood—needs for a sense of similarity to and belonging with significant others—might frequently mention similarities that she sees between her analyst and herself. Again, rather than “interpreting” this behavior, the self psychologist finds a way genuinely to accept the patient’s perception of the similarities, thereby allowing the patient the needed experience of feeling welcomed into the presence of a fellow human being with whom she can feel she has something in common and with whom she “belongs.” And finally, if a patient makes what the analyst feels are idealizing comments about the analyst, the self psychologist tries to accept the patient’s transient overvaluing even if it feels mistaken. The goal in this acceptance is to allow a restorative experience of idealization in relation to the analyst until it spontaneously resolves itself because a strengthened sense of self renders the idealization no longer needed on the patient’s part. These interactions are in no way the focus of the treatment but rather the silent background against which other aspects of the psychoanalytic dialogue play out in the treatment relationship that is its all-important context.


Thus far,in speaking of developmental or seifobject needs, I have focused on the three—mirroring, twinship, and idealization— that were identified by Kohut as experiences essential to the emergence of a sense of self. However, most contemporary self psychologists now see the selfobject or growth-promoting function of relationships as an open-ended category that includes any and all experiences that contribute to the development, consolidation, or enhancement. of a sense of self (Stolorow, Brandchaft, & Atwood, 1987). This broadens the kinds of interactions that are understood to facilitate psychic development in psychoanalysis to include not only Kohut’s three selfobject functions but also self-delineation (Trop & Stolorow, 1992) as well as various kinds of direct engagement or active negotiation between patient and analyst, depending on the patient’s moment-to- moment states and psychological needs.


Additional motivations are recognized in self psychology today as well, introduced by Lichtenberg (1989), to include physiological and affective regulation, affiliation, self- assertion and exploration, sensual and (phase-appropriate) sexual experience, and aversion (the fight-or-flight response to noxious experience). To the extent that these motivations are affirmed by the human environment, they can also be integrated into a richer and more fully functioning sense of self.


Freudian Drives and Defenses in Self Psychology

When Kohut (1971) first presented his theory of the experiential self and its formative (or selfobject) relationships, he meant to be offering a corrective to Freudian theory, which he felt had placed too much emphasis on the impersonal drives and mechanisms of the mind and not enough emphasis on either the whole experiencing individual or the unique relationships that profoundly influence the developing psyche (Kohut, 1984). In Freudian theory the primary role of the Other was as the object of the child’s (or patient’s) drives, instinctual impulses, or fantasies.


Freud saw sex and aggression as the two primary instincts or motivators in human life and as the cornerstone of psychic development. Kohut agreed with Freud that sexuality was an essential and vital experience but he did not see it as one of two central motivations for all human behavior. Similarly, Kohut saw self-assertion as part of a universal healthy thrust toward survival and need fulfillment but he saw destructive aggression as only secondary—as a self-protective reaction to threats against the self.

弗洛伊德认为性和攻击是人类生活中的两个主要本能或动力,也是心理发展的基石。 科胡特同意弗洛伊德的观点,认为性是一种至关重要的经验,但他并不认为它是所有人类行为的两个主要动力之一。同样,科胡特也认为自体肯定是保持生存普遍健康的推力,是需要实现的部分,但他认为破坏性的攻击是次要的——仅仅作为威胁自我的自我保护的反应。

At first, Kohut (19’s9, 1966, 1971) used the Freudian language of drives and structures in his writings. But his theory increasingly emphasized the phenomenological and experiential correlates of these concepts and pointed to the effects of the “real” relationships of childhood on the developing individual. Another distinction between Freudian theory and self psychology had to do with psychic defenses, understood in Freudian theory as patterns of experience or behavior whose unconscious purpose is to avoid aspects of internal reality. In Freudian treatment, defenses are, therefore, interpreted in terms of the instinctual or drive content against which they have been erected. But Kohut tended to think more in terms of the adaptive or “self-preservative” functions of these same “defensive” attitudes or behaviors. With this “forward edge” (Tolpin, 2003) in mind, self psychologists try to convey the understanding to their patients that certain of their now-troubling attitudes or behaviors once served life-saving purposes and will likely be difficult to change. When the analyst repeatedly gets on the side of the patient’s feelings and behavior in this way and (re)constructs with the patient the original circumstances in which the defensive patterns once served adaptive ends, the patient may eventually feel supported enough to explore the drawbacks of these same behaviors or attitudes in the patient’s current life and to work toward taking initiatives to change them. At the same time, the treatment is working to strengthen the patients sense of self so that earlier defensive patterns may no longer be needed in the same way—no longer called up with such force or frequency.


Mutual Empathy, Selfobject Exchange, and Intersubjectivity

Today’s self psychologists maintain Kohut’s emphasis on self-in-relationship but have taken an explicit turn toward intersubjectivity (Stolorow et al., 1987), understood as mutuality of influence (Beebe & Lachmann, 1988). Because Kohut (1984) had already suggested that the goal of psychoanalytic treatment is mutual selfobject exchange or to open up mutual channels of empathy between patient and analyst, I think of his theory as having been implicitly intersubjective from the start. He constructed a clinical theory focused on the subjectivity of the patient but simultaneously recognized the analyst’s subjectivity and its impact on the analyst’s choice of theory, the analyst’s emotional “presence,” and the effect of these on the patient.

今天的自体心理学家保持了科胡特对于关系中的自体的强调,但已经明确地转向主体间性(Stolorow等人,1987),主体间性被理解为相互影响(Beebe&Lachmann,1988)。 因为科胡特(1984)已经提出,精神分析治疗的目标是相互自我交换,或者在患者和分析者之间开辟相互共情的渠道,所以我认为他的理论从一开始就是隐含了主体间性。他构建了一个聚焦于患者主观性的临床理论,同时也认识到分析师的主观性及其对分析师理论选择的碰撞,分析师情绪“在场”及其对患者的影响。

Kohut (1984) additionally warned his fellow analysts about countertransference feelings that might emanate from their own narcissism, and he suggested that the psychopathology they thought they were observing in their patients might actually have been created by the analyst’s own behavior or attitudes in the treatment. This recognition that there are two subjects in the analytic relationship—mutually influencing one another in unintended,unpredictable, and unidentified ways—changed forever the earlier analytic ideal of scientific objectivity, Metaphorically linking the analytic relationship to experiments in quantum mechanics, Kohut (1984) wrote of the indivisibility between observer and observed. These and other comments positioned him at the cross- roads between modern and postmodern theory in psychoanalysis (Teicholz, 1998,1999,2007).


Today’s analysts focus on the qualities of engagement that might contribute to change in how individuals feel about themselves and others and in how they live their lives (Teicholz, 2006). Analysts expect that patient and analyst will have to work together to figure out how they are influencing each other in both intended and unintended ways. As part of the unintended influence, different aspects of the analyst’s unique psychological experiences and capacities will be evoked with different patients. Thus with every new person who comes to me for treatment, I anticipate that to some degree I will be exercising my skills in an original and untried manner and will sometimes have to stretch myself to bring forth less familiar parts of myself in an effort to meet this particular patient.


The concept of intersubjectivity as mutual influence means that whatever theory the analyst brings to the analytic situation will be expressed differently depending on what the patient needs,wants,and can make use of. For example, in spite of my usual commitment to an empathic stance, I once worked with a patient who, a few months into her treatment, yelled at me: “No matter what I tell you, you’re going to see it from my side!" At that moment she was angry and was rejecting my understanding and emotional resonance. She went on to tell me that in marked contrast to my approach, both her mother and father had turned a cold heart toward her and had seen everything only from their own viewpoints. She had learned with them never to trust anyone but herself and did not want to alter her previous approach to relationships, which she felt had saved her from retraumatization. I backed off,but soon after this outburst the patient requested an increase in the frequency of her sessions. And she tentatively began to count on me—someone outside herself for the first time in her adult life. This eventually paid off in her relationships outside the analysis.


Another patient had experienced her mother as weak and inadequate at a time when she intensely needed to admire her. Before I understood that this patient was looking to me for my strength and certainty, I had been proffering my viewpoint tentatively, out of respect for our differing experiences. But the patient saw my tentativeness as a sign of weakness similar to what she had perceived in her mother, which frightened and enraged her. Having also suffered physical abuse at the hands of her father, she lived in a chronic state of fragility, desperate to experience me as a benign but immovable presence on whom she could absolutely rely. But she was humiliated by the shakiness of her psychic equilibrium, and she despised her own need of me. Under these circumstances, my “mirroring” responses and “empathic resonance” were violently rejected by her as she wanted no reflection of her own shame-ridden turmoil. When she later began to feel more intact as a result of our ongoing work together, her treatment became more of a collaborative effort, as did the other relationships in her life.


I describe these transient “negative” reactions to my more usual empathic listening stance to explain the need I have always felt for a flexible approach from one patient to the next as well as from one period of time to another with the same patient. But beyond what the patient implicitly or explicitly asks of the analyst, there are also human limitations in the ability to sustain an empathic stance in relation to another’s experience. Even if ail analysts were suddenly to agree that emotional attunement and empathy are the most effective pathways to shared understanding, how would we then try to deal with the obstacles that often interfere with the establishment and continuity of empathic connection between two individuals?


One way to approach the concept of empathy is to see it not as an end point but as a two-person process in which ongoing dialogue is used in an effort to reach closer and closer approximations of attunement and shared understanding—or to reach mutual acceptance of differences that cannot be resolved. Even with such a dialogic approach—and no matter how similar the goals are between two individuals—repeated breakdowns in attunement and understanding are to be expected because of the uniqueness of every individual. What becomes important then—in either early development or the psychoanalytic relationship—is that these “ruptures” of connection be repaired.


In self psychology the analyst’s failure of empathy is understood primarily as co-created, with the emphasis on the analyst's part in the rupture. When communication breaks down, the analyst seeks out and takes responsibility for his or her own contribution,hoping to get the conversation started again. The analysts willingness to “go first” in taking responsibility can often facilitate the patient’s self-exploration and understanding.


Because of the specificity (Bacal & Herzog, 2003) of every individual and dyad it is a challenge to find case material that might illustrate any clinical guidelines or “principles.” But as one example I might mention a patient whose mother had died in childbirth, following which he had been raised alone by his young widowed father. His father had suffered from untreated bipolar (manic-depressive) illness and had treated the patient with chronic hostility, frequently leaving him crying and alone as a small child for hours at a time. Because of these and other early experiences of abandonment, the patient became suicidal every time I introduced the slightest schedule change, and every vacation of mine felt to him like a murderous self-indulgence on my part.


After a few years of psychoanalysis, when the patient had become finally more able to handle these disruptions without feeling suicidal, he reported a dream in a session right after I had informed him of an upcoming vacation. In his words:


I was driving my truck on a bright sunny day. My truck suddenly skidded out of control and I ended up off the road: turned completely around in the wrong direction. I realized I must have hit a stretch of black ice but I just sat there totally stunned.


In his previous session the patient had expressed anger at my vacation plans and had lamented that he would never get better because every time he started working on something important, I would go off on another trip and leave him stranded. So when he told me this dream the next morning, I said to him:


In your dream, I am the black ice. You think you have finally gotten yourself on solid ground on a bright sunny day. But with my vacation plans, I become slippery and dangerous again, throwing you off course. I am very sorry that my comings and goings are so painful for you and that they are so reminiscent of your father, in his most unreliable and frightening aspects.


My words did not change the fact of my upcoming abandonment,but they did calm my patient, somewhat, to have me recognize and take responsibility for my role in his emotional distress.


Cycles of rupture and repair in relationships are essential to the growth and hardiness of any sense of self. No life is without its slings and arrows, but the repeated experience of minor hurts and disappointments that are then repaired in the context of an intimate bond serve to strengthen the “fabric” of the psyche. This is not to say that self psychology in any way advocates that the analyst deliberately hurt or disappoint the patient during the course of a treatment. Rather, the theory simply recognizes that such hurts and disappointments are inevitable in any relationship, no matter how hard two individuals may try to understand and accept each other. What self psychology does advocate is that once such ruptures occur in a treatment, the analyst works hard to identify what has been hurtful, especially his or her own role in the disruption. The analyst explicitly understands and accepts the patient’s feelings of hurt and recrimination and, if relevant, links the experience of hurt and disappointment in the treatment to similar experiences in the patient’s childhood.


TAG: 自体心理学 老垓蕤
«从自恋到自我心理学,再到自体心理学 自体心理学
延伸阅读· · · · · ·
Judith Guss Teicholz 作者:Judith Guss Teicholz / 650次阅读
来源: 老垓蕤 翻译
标签: 自体心理学 老垓蕤
路径 > 心理咨询 > 精神分析 > 自体心理学