我的关系性的自体心理学 简版
我的关系性的自体心理
My Relational Self Psychology
Judith Guss Teicholz
Massachusetts Institute Jar Psychoanalysis, Lexington’s Massachusetts, USA
翻译:老垓蕤

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.

摘要

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。

Introduction简介

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.

最近几年,对精神分析的影响来自于一些不可信的地方,其中有:生物学、物理,还有后现代哲学。尽管这些来源和变化对精神分析的影响还有许多尚需处理,但我想先提及一些。

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.

来自生物学的观点是把头脑当作一个非线性的动力系统,系统中任何一个小的变化都可能对整个系统产生深远的影响。生物系统理论进一步提出,人类的关系——包括了精神分析的关系——伴侣中每个人各自构成一个“系统”,但是两个系统一起构成了更大更复杂的系统,整体发挥着作用。同时,借助量子力学的知识,也使我们产生了新的认识:不可预知地不可测性、突现、不确定和宇宙“法则”的混乱,渗入到精神分析概念模型(conceptualizations)的观点(包括人类心智的发展的构想和人类关系的演变和成长的构想)。这些观点不能替代早前人类心智有关组织化和连贯性的观点,但是被保留为对其的辩证张力。

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.

以上观点与分析过程当前看法的密切关系是:承认观察或者测量,不可避免地改变了被观察或测量的事物。带着这样的观点,把分析师视为中立的观察者,置身于由病人带来的动荡之外的早期理想消失了。从这个角度,我们看到分析师的独特和不可消减的主体性,与病人的心灵在恒定的、同步的、相互影响的条件下的相互作用。然而这个对于分析关系的看法也很容易破坏我们之前对于分析师专业性和权威性的看法,它也同时为两伴侣组成分析的一对参与到共同构建某些完全不可预见和新的事物做好了丰富而有创造力的准备。

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.

后现代哲学对精神分析的影响同样是彻底的和不可预测的,特别是关于“自体”方面。自体现在被视为是没有内核并且永远在过程中,不断演化净化,持续着对他人和这个世界的作用。后现代理论基于即刻体验质疑了意义的可能性,除了个体可以创造或与他人交谈。这些观点乍一看是一样的激进,其结果是科胡特的描述(1971)——自体感由早期的个体关系构成并维持终生——非常适合20世纪晚期和21世纪早期精神分析的许多变化。在这个自体的持续构建过程中,意义由独特而富有情感自我描述所决定,为重要他人所认可或肯定。

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.

人类的发展是一个持续的进程,在一生中恰到好处地持续着。正是因为心灵成长的开放性,通过精神分析在生命周期的任何时候做出改变都是可能的。尽管所有的精神分析理论都没有认识到,早期的发展和后期的改变的直接联系,但对我来说最不可思议的是通过个体首次放下经验和行为的模式的路径和过程可以完全不同于那些在成人生活中经历了心理改变的人。成人的人格仍然是非常复杂和多层面的,一生中必须以某种方式接受挑战和打破平衡,以便建立新的适应和解决方案。同样,对于那些经受了早期创伤的个体,害怕于再次受伤,并因此减弱了对新体验的开放性,就是可被理解的。这些情况结合到一起,使得治疗难以完成。

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.

心理发展过程中当然还有多种途径,以及个人在心理上茁壮成长和发展的广泛而多样化的条件。途径和条件的多样化导致了互相矛盾的关于人们发展和变化的解释。变化过程可以在许多维度以及多个抽象级别观察到。此外,大多数发展和心理过程主要发生在意识之外,这意味着在早期发展或精神分析治疗中无法确定很多事情。由于这些原因,治疗因素仍然颠三倒四难以捉摸和模糊的,任何关于人们在精神分析中如何改变的理论必然是多面但不完整的。

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.

虽然某些早期的建立感觉、态度和行为模式现在可能妨碍了患者达到选择的生活目标,但这些相同的态度和行为可能是面对困难或痛苦的童年环境下最有创意的适应方式,也可能是针对于无法忍受的发展性挫折和打击,已经采取了自我保护目的的威慑措施。换句话说,现在需要改变的感觉、行为和“自我防御”的模式可能是患者在不太理想的发展条件下能够生存和胜出的唯一方式。

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?”

所以这个问题就变成了,何种过程——或者何种关系——可以帮助一个人放弃看起来像是达到任何稳定和充分的运作——甚至到目前为止在生活中已经实现的任何好时期和乐趣的一种类似于本质上自我创造的关键点?什么允许了一个人跳跃到未知的心灵,只靠承诺治疗——在时间和金钱都很昂贵——将有助于发展出更有效的策略,通过它来生活和获得更多的需要和想要的生活?分析师一定要赢得病人的信任;这个过程的第一步通常是分析师非常注意聆听,试图了解他或她可能关心患者可能被用来“治愈”的所有事情。分析师应该期望患者也可以一直被倾听,而不是怀疑地问,“谁是那个我正在托付全部秘密的人?这样的聊天怎么会帮助我的在这里以外的生活呢?

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.

精神分析的目标是宽泛和包容的,不同的个体结束的方式也不一样。在最普遍的层面上,我们可能会说,当人们无法自己转换对自己和他人的痛苦或有问题的感觉,或改变痛苦或无效的感觉和行为模式时,人们就会寻求精神分析治疗。大多数现代精神分析理论理解的经验性和行为性的问题都涉及到某种形式的情感生活;无论是太多或太少的情感强度,同时难以将个体的情感生活引导到更令人满意和有效的生活选择。从这个观点来看,寻求心理治疗的个体很大程度上被令人不悦的感觉所压倒,需要帮助情绪的容纳和加工,或者他们无法连接情感体验,如果这些情感可以被认可、接受和整合,可能有助于让病人在生活中更加洞察并且表达自己是谁并且可以是谁。

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.

作为情感生活中不可或缺的一部分,我们还会发展出早期和长期的观念:关于我们个人的范围和可能性,我们的愿望和价值,以及基于早期关系中我们对他人的亲密关系中的期望而产生的信念。这些期望和信念大多在我们的形成期中逐步形成,虽然并不总是能意识到,但它们在我们的生活中发挥核心作用。

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.

许多病人常带有消极的体验来做精神分析,因为发生在他们的生活中的事件,完全超出了他们的控制,然而他们为此暗中责备自己。在这种情况下,充分阐述这些早期经历可能有助于他们的最终理解:作为婴儿或儿童,他们对于如何对待他们的方式或者实际上无法控制的事件无需负责。这样的事件可能包括兄弟姐妹的诞生;父母或兄弟姐妹的身体或精神疾病甚至死亡;父母吵架,分离或离婚;家庭经济情况受挫;兄弟姐妹、父母或其他成年人迁怒于孩子的任何虐待——情感或身体;或与家庭生活相交的社会经济或历史/政治事件和情况。这些早期的经历——和我们对他们的适应或防御——可以以某种方式阻止我们目前的生活。心理治疗或精神分析为我们探索和重组自己和对这个世界的看法提供了第二次机会。在与另一个受过促进式的方式进行倾听和回应的培训的人工作时,有助于病人在新的语境中再次体验他或她生活的问题,并以新的方式使这些问题变得有意义。这个过程旨在改变对自我和关系世界的概念和感觉,并且在需要这种变化的情况下,使行为变化成为可能。

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.

当患者最紧迫的问题与破坏性的过度感觉有关时,反复表达和分享这些感觉与另一个人(这个人的情绪回应传达真正的共鸣和理解)的新体验——同时也提供了同一种情绪更多的调节过的表述——可能适时地使患者能够内化或接收(作为他或她自己)这些处理情感体验的新方式。独自反复分享“太多”的感受这种行为,往往本身可以帮助调节体验。

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.

当患者最紧迫的问题更多地与患者的情感或相关生活中的贫乏感有关,或者以某种方式导致无法达到满意的关系或提高生活目标的行为相关时,逐渐被帮助的经验连接和表达了一个人更多的想法和感觉,在一个共情的回应的他人面前,这个他人致力于从病人自己的角度“得到它”,并以更加细致和细微的方式反映出来——可能最终使得整合以前回避的经验变得可能起来,然后可以带来生活选择,使患者更接近于一直希望甚至更接近于病人从来没有敢去希望的东西。

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
精神分析中的早期发展和后期变化

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.

自体感最初的发展和不断增强凭借的是最早的照料关系的转化性品质(科胡特,1971)。这些相同的品质也恰好贯穿于精神分析的关系,但是在成年患者对此能力的使用方面比起最初的发展具有更多的障碍。当发展中的任何一点出现问题时,个人必须找到在其他心理功能领域向前发展的方法,即使有问题的情况和孩子最好的解决办法必须建立在发展中的人格结构。生活的颠簸和扭曲因此成为心理的颠簸和扭曲——其中一些将会在精神分析治疗关系中解除。为此,分析关系有时会变成再次体验儿童期的挑战或挫折,但在一个受保护的环境中,其目的是理解和掌握干扰今天患者生活的早期伤害、失望和解决方案。

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.

什么是通往这种自体感的途径?是强大和稳定的,足以产生独特的兴趣,识别和发展天赋,设定可实现的目标,追求雄心和理想,发展持续的关系,找到爱与工作的意义吗?所有这些途径均贯穿促进性人类环境——最初通过儿童与其父母之间的本质上促进成长的纽带,或者后来通过任何在患者和分析师之间建立的纽带——这些纽带被科胡特称为“自体客体”连结,因为其中的“客体”用于“自体”的成长。这种使用和成长是在关系条件正确的情况下自然发生的,并且是在意识之外的。

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.

在科胡特的理论中,“自体”与“关系”错综复杂地相互交织在一起,可以理解为父母与孩子之间的早期开始的第一次互动。自体和关系于是从出生起就参与不断的反馈循环,在自体和通过自体的发展,不考虑关系就不能考虑自体。

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.

科胡特认为,镜像、双生关系和理想化的适应阶段的共同作用,将童年期正常的自恋变成能够与他人共情的能力、关于个人自体和世界的幽默感以及接纳自己和他人局限和死亡。童年期的自恋里既有自体又有其他夸大的重要他人。他认为,在整个生命周期中,都需要这种促进关系,但是在成年期的强度要比童年期的强度要小,只要在原初发展阶段对这些需求做出了充分的反应。

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.

同样地,一名患者的双生关系需求在儿童期被剥夺——需要与重要他人相似感并归属于重要他人——可能会频频地提到她在分析师和自己之间所注意到的相似之处。此外,自体心理学家不是“解释”这种行为,而是真正地找到了一种方式来接受患者对相似性的看法,从而使患者需要的情绪感受迎来人类同伴的出现,伴随着这个同伴她可以感受到她有一些共同的东西和她的“归属”。最后,如果一个患者使分析师认为自己被理想化的评价,那么自体心理学家就试图接受患者的暂时的高估,即使感觉到错误。这种接受的目的是允许与分析师相关的理想化恢复经验,直到自发地解决自身问题,因为加强的自体感使患者不再需要理想化。这些相互作用绝不是治疗的重点,而是沉默的背景,精神分析对话的其他方面在治疗关系中发挥其重要作用。

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.

到目前为止,在谈到发展或自体客体需求时,我将重点放在三部分上——镜映、双生关系和理想化上,这些都被科胡特确定为对自体感的出现至关重要的经验。然而,大多数当代自体心理学家现在将关系中的自体客体或促进成长功能看作是一个开放性的类别,包括了有助于发展、合并或增强自体感的随便什么经验。(Stolorow,Brandchaft,&Atwood,1987)。理解为促进精神分析中的心理发展的互动类型被扩大了,不仅包括科胡特的三个自体客体功能,还包括自体描述(Trop&Stolorow,1992)以及患者和分析师之间的各种直接参与或积极协商,这取决于患者的时刻状态和心理需求。

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.

Lichtenberg(1989)也为自体心理学中也引用了其他动力,包括生理和情感调节、归属、自体肯定和探索,感官和(相适应阶段的)性经验和厌恶(对有害经验的面对或是逃避的反应)。在这些动力得到了人类环境的肯定,它们也可以融入更丰富和更充分运作的自体感中。

Freudian Drives and Defenses in Self Psychology
自体心理学中弗洛伊德式驱力和防御

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.

当科胡特(1971)首先提出了他的经验性自体的理论及其形成(或自体客体)关系时,他的意图是对弗洛伊德理论提出纠正,他认为过分强调不带有个人色彩的驱力和心理机制,既没有充分强调个人的全部经验也没有强调对心理发展深刻影响的独特关系(科胡特,1984)。在弗洛伊德理论中,其他的重要角色是:是孩子(或病人)驱力的客体、本能冲动或幻想。

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.

起初,Kohut(19’s9年,1966年,1971年)在他的著作中使用了弗洛伊德驱动和结构的概念。但他的理论越来越强调这些概念的现象学和经验性的因素,并指出了童年期的“真实”关系对发展中个体的影响。弗洛伊德理论和自体心理学之间的另一个区别与心理防御有关,在弗洛伊德理论中的心理防御被理解为无意识目的是为了避免内部现实方面的经验或行为模式。因此,在弗洛伊德治疗中,防御被用来理解本能或驱力所建立的内容。但是科胡特则倾向于认为这些相同“防御”态度或行为的更多的是在适应性或“自我保存”方面的功能。考虑到这种“前沿”(Tolpin,2003),自体心理学家试图向患者传达这样的理解:一些他们现在令人不安的态度或行为曾经用于挽救生命的目的,并且可能难以改变。当分析师以这种方式重复地接受患者的感觉和行为,并且与患者一起(重新)构建曾用于适应性防御性模式的原始环境,患者可能最终感觉到足够支持以探索这些同样的行为或态度在现在的生活中的缺点,并采取行动来改变它们。同时,治疗正在努力加强患者的自体感,以便较早的防御模式不再以同一种方式被需要——不再需要这种力量或频率。

Mutual Empathy, Selfobject Exchange, and Intersubjectivity
互相共情,自体客体交换与主体间性

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).

科胡特(1984)另外警告了他的分析师同事,反移情情感可能从出自他们的自恋,而他认为他们以为在患者身上观察到的精神病理学实际上可能是产生于分析师自己的行为或态度。在分析关系中有两个主体的这种认识——以意想不到、不可预测和不明确的方式彼此相互影响——永远改变了分析早期的科学客观性的理想。科胡特(1984)以量子力学的观点隐喻性的联系到了分析关系与经验,他写到:观察者与观察物不可分割。这些和其他评论将他置于精神分析中现代与后现代理论之间的交叉道路上(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.

今天的分析师关注的是参与度的多寡,参与度可能有助于改变个人对自己和他人以及他们生活方式的感受(Teicholz,2006)。分析师期待,患者和分析师必须共同努力,找出他们是如何以有意和无意的方式相互影响的。作为意想不到的影响的部分,不同的患者将引起分析师独特的心理体验和能力的不同方面。因此,每一个初来找我治疗的人,我预计在某种程度上,我会以原始和未经审判的方式运用我的技能,有时必须延展自己,减少熟悉的部分,努力满足这个特定的病人。

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.

作为相互影响的概念,主体间性意味着无论分析师为分析情境带来什么理论,都会被不同地表达为根据患者的需要、欲望和可供使用。例如,我曾经和一个患者一起工作,不管我一贯恪守的共情立场,几个月的时间后她对我说:“无论我告诉你什么,你都要从我的角度来看它!”在那一刻,她很生气,拒绝了我的理解和情感共鸣。她继续告诉我,与我的做法形成鲜明对比的是,她的母亲和父亲对她变得非常冷酷,只从自己的观点来看事情。她已经从他们那里学会了,除了自己以外,绝对不会相信任何人,而且不想改变她以前的关系,这让她觉得可以避免再次受伤。我退开了,但这次爆发后不久,病人要求增加她的会谈的频率。她尝试开始依靠我——这是成人生活里第一次依靠一个外人。这种方式最终在分析之外的关系中得到回报。

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.

另一位病人,当她强烈需要称赞她的时候,经历了她的母亲的虚弱和不足。在我明白这位病人正在寻找我的力量和肯定之前,我踌躇地提供了自己的观点,出于尊重我们不同的经历。但是,病人看到我的踌躇看作是一种虚弱的迹象,类似于她在母亲身上所感受到的,使她害怕和愤怒的东西。她也遭受到父亲的身体虐待,她生活在一个长期的脆弱状态,绝望地把我体验为一个善良而稳固的存在,她绝对可以依靠的人。但是她无法平衡心理上的羞辱,她鄙视自己对我的需要。在这种情况下,我的“镜眏”反应和“共情共鸣”被她强烈地拒绝,因为她不想回想自己满是羞耻起伏。当她后来开始感觉到我们一起工作保持了她的完整,她的治疗变得更加配合,和她生活中的其他关系一样。

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?

我将这些短暂的“负面”反应描述为我更加平常的共情式倾听的立场,用来解释我总是觉得不同病人以及同一病人的不同阶段需要一个灵活的方法。但是,除了病人隐含或明确地对分析师有要求外,能够对别人的经验维持一种共情的立场也存在着人的局限性。即使分析师突然意识到,情感协调和共情是达成共识的最有效途径,那么我们如何才能处理通常妨碍两个人共情关系的建立和连续性的障碍?

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.

处理移情概念的一个方法不是将其视为一个终点,而是作为一种两个人的过程,其中持续的对话被用来努力达成越来越相似的共识——或是达成互相接受无法解决的差异。即使用了这样的对话方式——无论两个人之间的目标是如何相似——由于每个人的独特性,协调和理解的也可能会反复崩溃。那么变得更为重要的——要么是在早期发展中或是在精神分析关系中——是这些可被修复的“破裂”的关系。

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.

在自体心理学中,分析师的共情失败主要被理解为共同创造,强调破裂中分析师的部分。当沟通失败时,分析师为自己的贡献找出并承担责任,希望能再次开始对话。分析师对“首先”承担责任的意愿往往可以促进患者的自我探索和理解。

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.

由于每个个体和二元组合的特殊性(Bacal&Herzog,2003),寻找可以阐明任何临床指导方针或“原则”的案例材料是一个挑战。但作为一个例子,我会提及一名母亲在分娩中死亡的患者,之后,他被年轻鳏居的父亲独自一人抚养。他的父亲患有未经治疗的双相(躁郁症)疾病,并对患者带有长期的敌意,经常让他独自一哭就是几小时。由于这些和其他早期被遗弃的经历,每次我会谈的时间表稍有变化时,患者就要自杀,在我看来,我的每一个假期对他来说都是一种残忍的自我放纵。

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:

经过几年的精神分析,病人变得终于能够更好处理这些中断而没有自杀,在我通知他自己即将去休假之后,他在这次会谈中讲述了一个梦。用他的话说:

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.

我在晴朗的阳光下驾驶着自己的卡车。卡车突然失控,我最终停在了道路上,完全转向了错误的方向。我意识到我一定是碰到了一片黑色的冰,而我只能完全震惊地坐在那里。

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:

在以前的会谈中,病人曾经对我的假期计划中表示愤慨,并且哀叹说,他永远不会变得更好,因为每当他开始重要的工作时,我都会动身去往另一段旅途,让他束手无策。所以在他告诉我这个梦的第二天早晨,我对他说:

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.

在你的梦中,我是那片黑冰。你认为你在阳光灿烂的日子里终于获得了坚实的基础。但是随着我的假期计划,我再次变得不稳定(英文中有滑的意思)和危险,把你带偏了轨道。我非常抱歉,我的来临和离开对你来说都是如此痛苦,这让你联想起你的父亲最不可靠和可怕的方面。

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.

我的话没有改变我即将被抛弃的事实,但这些话确实让我的病人冷静下来,多少让我认识到并承担起我在他的情感痛苦中的角色。

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.

关系的破裂和修复周期对于任何自体感的增长和强壮都是至关重要的。没有哪个生命没有艰难困苦,但重复轻微的伤害和失望的体验,然后在紧密的纽带背景下修复,有助于加强心灵的“结构”。这并不是说自体心理学以任何方式提倡分析师在治疗过程中故意伤害或令病人失望。相反,这个理论只是认识到,在任何关系中都不可避免地会有这样的痛苦和失望,无论两个人如何努力去理解和相互接受。自体心理学提倡的是,治疗中发生了这种破裂,分析师就很难确定什么受到了伤害,特别是他或她自己在破坏中的作用。分析师明确理解并接受患者的受伤和指责的感觉,如果相关,将治疗中的伤害和失望经验与患者童年中的类似经历联系起来。www.psychspace.com

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Judith Guss Teicholz 作者:Judith Guss Teicholz / 960次阅读
时间:2017年6月30日
来源: 老垓蕤 翻译
标签: 自体心理学 老垓蕤
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