色情性移情 情欲性移情Erotized (or eroticized) transference
作者: 《病人与精神分析师》 / 1401次阅读 时间: 2020年7月21日
标签: 情欲化移情 色情性移情 移情
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Erotized (or eroticized) transference
色情性移情

erotic  色情性
erotic transference  色情性移情
erotized 色情化
erotized transference 色情化移情

In 1915 Freud described certain cases of 'transference love' in which the patient undergoing psychoanalytic treatment declared herself to be 'in love' with the analyst (1915a). While the 'ordinary' erotic transference may be a normal and manageable occurrence in the course of analysis, some patients may experience it to such a degree that they refuse to carry on the usual work of treatment, may reject interpretations relating the present feelings to the past, and seek no further enlightenment as to the meaning and cause of the symptoms of which they had previously complained. The analytic sessions are used for the expression of love, for gratification through the presence of the beloved, and these patients beseech the analyst for a return of their love. Although Freud did not necessarily regard such patients as suffering from unusually severe neurotic disturbances and did not see the emergence of this form of transference as an inevitable contraindication to psychoanalytic therapy, he suggested that sometimes a change to another analyst might be necessary. He spoke of such patients as possessing 'an elemental passionateness', as being 'children of nature'.

1915年弗洛伊德在他的一个病例中描述了“移情的爱”,一名女性病人在精神分析时向她的分析师表示“她爱上了分析师”(1915a)。虽然“一般性(ordinary)”色情性移情(erotic transference)为正常的、可控制的、与分析进程相协调的表现,可有的病人则因这种体验而拒绝完成一般性的治疗,他们可能会拒绝目前的感情与过去相关的解释,也不想继续弄清楚引起以前在他们一直抱怨症状的原因背后所具有的含义,分析性治疗便成为表达爱和满足即刻被人爱的场所,病人会恳求分析师对他们的爱作出回应。尽管弗洛伊德认为没有必要将这种病人视为罹患了不寻常的严重的神经症性障碍,也没有看出这种移情形式的出现是分析性治疗的绝对禁忌,他仍然提出对某些这样的病人存在着转诊必要的建议。他将这类病人描述为具有“不假修饰的热情(an elemental passionateness)” 和“率真的孩童特征”。

When the 'passionate* transference occurs to the extent that there is an intense demand for gratification, and productive analytic work ceases, then serious psychopathology is thought to be present. (The term 'sexualized' transference is sometimes used, but as it covers a much wider range of phenomena than the erotized transference, its use as a synonym for 'erotized' transference should be avoided—see Coen, 1981. The term 'erotic transference' should be reserved for positive transferences accompanied by sexual fantasies that are known by the patient to be unrealistic.) Alexander (1950) has drawn attention to the problem of the dependent patient, who both demands love and wishes to give it. Blitzsten (whose unpublished remarks are quoted by Rappaport, 1956, and Greenson, 1967) is regarded as the first to have linked a highly erotic transference attitude with serious pathology. Rappaport (1956), in an extensive discussion of the subject, comments that 'Blitzsten noted that in a transference situation the analyst is seen "as i f he were the parent, while in erotization of the transference "he is* the parent (a form of over-statement not uncommon in psychoanalytic writings; this statement probably reflects the analyst's feeling that he is treated very much like a parent might be, without the quality of "as i f existing to the same degree as with his other patients). The patient does not even acknowledge the "as if. ' The difficulties inherent in such a formulation are obvious, and we shall return to this point later.

然而当“热情(passionate)”的移情发展到要求满足的愿望变得极为强烈,从而出现了分析性工作终止的现象时便可将其理解为严重的心理病理状态的表现。[有时也用“性欲化移情”移情(sexualized transference)的描述,但它的涵盖面远远广于色情化移情(erotized transference),故应避免将它作为情欲化移情的同义词而加以运用——见科因(Coen,S.J.,1981)。色情性移情的术语应视为正性移情的修正,病人同时伴随着性的幻想成分并知道这是不现实的]。亚历山大(1950)将注意力集中于存在着这样问题的依赖性病人的身上,一方面,他们要求获得爱,另一方面则希望放弃它。 (Blitzsten),其文献未公开发表,但1956年被拉普帕波特(Rappaport, E. A.)、1967年被格林森引用,被认为是首位将色情性移情与严重的病理状态联系起来的人。1956年拉普帕波特在该主题的广泛讨论中指出:“认为在移情的状态下分析师看起来‘好象’他扮演了父母的角色,而在情欲化移情的状态下,他‘就是’父母亲(为精神分析描写中不寻常的‘超状态类型’,可能反映了分析师在同等程度下非常喜欢作为父母的形象出现更甚于被病人视为父母的感情)。病人几乎没有认识到“好象”,固有形成这种状态的困难是显而易见的,我们将在后面回到此点来。

Rappaport states that patients who show such an intense erotic component in the transference 'insist unequivocally, from the very beginning, that they want the analyst to behave toward them as the parent [had done]'. The patients are not embarrassed or ashamed by such wishes. They express their anger openly when the analyst does not comply with their demands. Rappaport correlates such intensely sexual demanding reactions in analysis with the severity of the patient's pathology. 'Such an erotization of transference corresponding to a severe disturbance of the sense of reality is indicative of the severity of the illness. These patients are not neurotics, they are "borderline" cases or ambulatory schizophrenics.' He comments that 'though the analytic situation is especially liable to such distortion, these patients try to convert every significant person into a parent'.

拉普帕波特指出在移情时那些表现出有强烈色情性成分的病人从治疗伊始就“坚定地要求分析师要象父母曾做过的那样对待他们。”病人们并不因有此念头而感到尴尬和害羞,如果分析师没有满足他们的要求,他们会公开地表示出他们的不满。拉普帕波特将在分析中出现的这种强烈的与性欲要求有关的反应与病人病理的严重性联系起来。“与现实感觉严重障碍相关的这种移情的性爱形式代表了疾病的严重程度,这些病人并非是神经症病人,不是边缘性人格障碍就是可疑的精神分裂症病人。” 他指出“尽管分析情景对引起上述障碍负有特别的倾向性作用,这些病人仍试图将特别的对象视为父母”。

Rappaport, in expressing his agreement with Blitzsten that for such patients the analyst is the parent, nevertheless does not maintain that these patients are deluded or hallucinating to the degree that the analyst is believed to be the actual parent; there is definitely a special quality to their transferences. The transference is not hidden, and 'the patient screams out that he wants his fantasy to be reality'. The patient believes that in his analyst he can acquire a parent (presumably someone who will act and be like a real or wished-for parent in the patient's life). The view of the analyst qua analyst is lost.

拉普帕波特同意布利茨斯腾的看法,即对这些病人而言,分析师是父母,然而并不认为这些病人幻觉和妄想的影响达到了坚信分析师就是真实父母的程度,这种移情一定有着特别的涵义,移情并不是隐藏了起来,“病人哭喊着说他/她需要他/她的幻想变成现实。”病人坚信在她的分析中他可以获得一个父母(或者是在病人生活中真正待其如父母或符合其对父母想象的人),作为分析师其观点已经丧失。

It could be argued that such feelings and wishes are not transference at all. In 1951 Nunberg had put forward the view that the patient's attempts to transform the analyst into the parent do not constitute transference. He spoke of a patient whose 'particular fixation to her father created the wish to find his reincarnation in the person of the analyst, and, since her desire to transform the latter into a person identical with her father could not be fulfilled, the attempts to establish a working transference were futile'. If this patient had projected unconscious images of her past objects onto the person of the analyst, then, in Nunberg's view, we would be dealing with transference. However, 'She did not project the image of her father on to the analyst; she tried to change her analyst according to the image of her father*. Clearly Nunberg is referring to phenomena similar to those later described by Rappaport. Moreover, in chapter four we spoke of the 'concealed' repetition of earlier experiences and relationships in the transference, implying that the patient is not aware of the repetition of the past in the present. While this might argue against the use of the term 'transference' in regard to the phenomena described by Rappaport, it is equally possible for a patient to have an erotized transference of this sort without being aware that a repetition of the past is involved. Rappaport's main theme in his 1956 paper relates to the management of the patient who wishes to give sexual love to, and to receive it from, a therapist. The question of management is also considered by Menninger (1958) who regards erotized transference as a manifestation of resistance, characterized by demands for love and sexual gratification from the analyst, demands that are not felt by the patient to be alien or inappropriate (i.e. they are felt to be 'ego syntonic*).

值得商榷的是有些感情和愿望根本就不是移情,1951年农贝格(Nunberg, H.)进一步讨论了病人试图将分析师视为父母并非为移情的观点,他指出“对父亲有着固着情结的女性病人存在着在分析师个人身上找到其父亲形象的愿望,由于将其父亲对某个特殊的人为赋型而进行转换的愿望得不到满足,建立工作性移情的尝试就显得不那么重要了。” 如果这个病人将过去客体的投射性潜意识形象放在分析师的个人身上,那么,按照农贝格的观点,我们可能涉及的是移情。然而“她没有将父亲的形象投射到分析师身上,她只是想按父亲的形象改变分析师。” 显然,农贝格所描述的现象与以后拉普帕波特描述的相似。而且,在第四章中我们曾提到过在移情中“隐藏”着的早期经历和关系的重复,即病人并不能意识到她是对过去的经历在现在加以重复,而这可能与拉普帕波特所描述的移情想象相矛盾,病人有性爱化类型的移情,而没有意识到这是过去相关经历的重复的可能性极大。在1956年的文章中拉普帕波特的主要观点涉及到如何处理那些想表达性爱和从分析师那儿获得性爱的病人。在谈到对其处理的问题时门宁格(1958)认为色情化移情(erotized transference)为阻抗的一种形式,以从分析师那儿获得爱和性的满足的要求为特点,在形成联盟或发生不合作时这些要求又并不为病人所察觉(即他们认为其“自我是和谐的”)。

Technical considerations are also the central concern of a paper by Saul (1962). He connects the erotized transference, more specifically than Rappaport does, with real frustration in relationships in early life, suggesting that the hostility and anger engendered by such frustration may also be repeated in relation to the therapist. In addition, the extreme love is seen as, in part, a means of protecting the doctor from hostile feelings. The hostility and destructiveness in such patients has also been noted by others (e.g. Greenson, 1967; Nunberg, 1951). Greenson relates the erotized transference to other areas of disturbance, and comments, 'Patients who suffer from what is called an "eroticized" transference are prone to very destructive acting out. .. . All these patients have transference resistances that stem from underlying impulses of hatred. They seek only to discharge these feelings and oppose the analytic work.' In speaking of his own experience of such cases he says that 'they came to the hours eagerly, but not for insight, only to eiyoy the physical proximity. My interventions seemed irrelevant to them.' An essentially similar point is made by Swartz (1967) when he speaks of the patient's expectation that the analyst will in fact reciprocate the patient's feelings. Patients with an erotized transference are on the whole not suitable for classical psychoanalytic treatment as they cannot tolerate the demands of classical psychoanalysis (Greenson, 1967; see also Wexler, 1960) and cannot maintain an adequate treatment alliance.

索尔(Saul, L. J.,1962)将技术问题作为其中心考虑所在。他比拉普帕波特更为甚之地将色情化移情与早期生活中的关系发生过真实的破坏联系起来,他假设这种破坏导致的敌意和愤怒也会在指向治疗师的关系中重复,故强烈的爱有部分这样的含义,即保护医生幸免于遭受这种敌意。其他研究者也注意到了这些病人的敌意和破坏性(如格林森,1967;农贝格, 1951)。格林森将色情化移情与障碍的其他方面相联系,他指出“那些被认为是罹患了‘情欲化移情’的病人实则有破坏性见诸行动的倾向……所有这些病人有着基于仇恨冲动的移情阻抗,他们仅为着释放这些感情并因此而阻遏治疗师的工作。”在谈到他自己处理这些病人时的经验时,格林森说“这些病人急切地赴约,但不是为着内省,而是乐衷于躯体性的接近,我的干预与他们丝毫不相关。” 斯沃茨(Swartz, J.,1967)的主要观点也与此类似,他认为病人的期望为分析师会回馈病人的感情,有着色情化移情的病人根本就不能确定继续经典的精神分析治疗,因为他们不能接受经典精神分析的要求(格林森,1967;也参照韦克斯勒,1960),从而形成一个适当的治疗联盟。

In 1973 Blum provided a comprehensive review of the status of the concept of erotized transference. He emphasized the need to distinguish it from erotic transference, a distinction which we fully endorse. Erotized transference is described by Blum as

1973年布卢姆对色情化移情状态的概念作了一个令人信服的总结,他强调了需将色情性移情( erotic transference)与性欲性移情(erotized transference)相鉴别的必要性,按照布卢姆对情欲化移情的描述:

an intense, vivid, irrational, erotic preoccupation with the analyst, characterized by overt, seemingly ego syntonic demands for love and sexual fulfilment from the analyst. The erotic demands may not seem unreasonable or unjustified to the patient. The frequent flooding with erotic fantasy may continue into daily life or be displaced onto situations outside analysis, or onto fantasies [about what will happen] after analysis. . . . The intensity and tenacity of erotized transference, the resistance to interpretation, and the continuing attempts to seduce the analyst into a joint acting out, as well as the frequent acting out of such a transference with a substitute for the analyst, confirm the complicated infantile reactions of these patients. These are not ordinary reactions of transference love, and these patients can resemble intractable love addicts. Their erotized transference is passionate, insistent, and urgent. . . . The conscious fear is not of regression or retribution, but of disappointment and the bitter anguish of unreciprocated love. Through projection and denial they can assume their analyst indeed loves them.

强烈的、活生生的、不合理的、以与分析师发生情欲关系的先占观念的特点为看上去似乎是自我和谐的、对从分析师那儿获得爱和满足性的要求。情欲要求对病人而言似乎不是没有原因的和不公正的,经常带有情欲幻想的泛滥贯穿于日常生活中,或为分析以外的情景所替代、或在分析之后继续(为即将获得幸福)幻想下去……。色情化移情的强度和坚韧、对于解释的阻抗、继续使分析师陷入有关的见诸行动的企图以及经常以分析师为替代者以此移情而见诸行动证实了这些病人复杂的婴儿性反应。这不是移情之爱的一般反应,这些病人象是患上了难以自拔的“爱”的癖好,他们的色情化移情是那样的热情、执着和急切……,意识中的恐惧不是退行和代偿性的,而是由于爱不能再现而导致的失望和苦涩的愤怒。通过投射和否认机制他们可以设想分析师实际上是爱他们的。

In agreement with a number of other authors (e.g. Lester, 1985; Swartz, 1967; Wrye & Welles, 1989), Blum stresses the role of pregenital factors and very early experiences in the genesis of erotized transference. He refers to

与其他作者一致(如莱斯特,1985;斯沃茨,1967; 赖和韦尔斯,1989),布卢姆强调了与色情化移情生发有关的发育前期因素和极早期经历的作用。他列举到:

sexual seduction in childhood, especially during the oedipal phase; instinctual overstimulation with deprivation of parental, phase-appropriate protection and support; intense masturbatory conflict; family toleration of incestuous or homosexual behaviour in the bedroom, bathroom etc.; revival and repetition of precocious and incestuous sexual activity in adolescence,

儿童时期特别是发生于俄底浦斯期的性诱惑、父母与发育期相适应的旨在保护和支持的严令禁止对本能所产生的过度刺激、对发生卧室内或浴室中的乱伦或同性恋行为的家庭性容忍等、青少年早熟及乱伦性行为的再现和重复。

and goes on to say that

他继续指出:

these patients have often participated in seductive childhood games, e.g. 'playing doctor', group teasing and play in the parents' or grandparents' bed, etc. Analysis may be treated as a pleasurable and perilous 'game' of seduction. Narcissistic injury and fragility [are] associated with parental insensitivity and lack of empathy. The erotization frequently masked the trauma of repeated seduction and overstimulation with consequent distrust and sadomasochism.

这些病人多半有参与儿童时期与性诱惑有关游戏的体验,如“扮演医生”、群嬉、在父母或“爷爷奶奶”的床上玩耍等。分析可能被当作一种有趣而“危险”的诱惑性游戏。自恋的伤害性和脆弱性与父母的迟钝及缺乏感情共鸣有关。情欲常常隐含着因不信任和受虐所导致的重复性诱惑和过分刺激的创伤

A return to the seduction theory of neurosogenesis is not advocated by Blum, who nevertheless emphasizes the pathogenic role of seduction and trauma in the production of erotized transference. He also stresses the fact that narcissistic needs are prominent in these patients. These are demonstrated in fantasies of being the 'favourite' and very special. Such narcissistic needs 'may be disguised through erotized ingratiation in the service of maintenance of a fragile self-esteem'. Blum concludes that:

布鲁姆并不提倡回归神经症生发(neurosogenesis)的诱惑理论,相反,他从未强调过诱惑和创伤在产生色情性移情时的作用。他强调了这样的事实,即自恋的需要对这些病人来说尤为重要,这可以在那些作为“逗人喜欢的”和非常特别情形下的幻想中得以证明,这些自恋性需要“可能会通过旨在对维护脆弱自尊的色情化逢迎而得以掩饰。布卢姆总结到:

erotized transference has multiple determinants and a variable course. It resembles a vehemently exaggerated, distorted form of expectable erotic transference. Erotic transference is a relatively universal, though variably intense and recurrent phase of analysis. There is a continuum from feelings of affection to strong sexual attraction, from ubiquitous unconscious sexual transference wishes to conscious, ego syntonic, erotic transference preoccupation. It is this insistent, conscious, erotic, transference demand that is erotized transference 'proper'.

色情性化移情(erotized transference)有着多层的要求和不同的过程。它相当于对所期望的色情性移情极端夸大和扭曲的形式。色情性移情尽管在分析的不同阶段会有不同的强度和反复,但相对普遍,感情和情感发展为强烈的性的诱惑、普遍存在的潜意识中性移情之欲望转向意识层面的、自我和谐的色情性移情的迫切需要持续存在,它正是持久的、被意识到的、色情性而符合移情需要的“特别”的色情化移情。

Erotized transferences of the sort discussed above have for the most part been reported in regard to female patients with male analysts. Lester (1985) remarks that, with the possible exception of Bibring-Lehner (1936), there is no literature on male patients developing an erotized transference towards a female analyst. She suggests that 'the expression of strong erotic urges to the female analyst by the male patient is somewhat inhibited by the fantasy of the overwhelming pre-oedipal mother. In contrast, such erotic feelings are fully expressed by the female patient' (see also Person, 1985; Wrye & Welles, 1989). While this is true in many cases, it is certainly not true in all.

上面讨论的色情化移情类型多在一些就诊于男性分析师的女性病人身上发现。莱斯特(1985)指出,可能除了比布林-莱讷(Bibring-Lehner,G.,1936)外,目前还没有男性患者发展出对女性分析师的色情化移情。她假设“男性病人对女性分析师强烈情欲需要的表达可能会受到来自于对前娥底浦斯其母亲幻想的阻遏。相反,女性病人则完完全全地表达她们的情欲(见珀森,1985;赖和韦尔斯,1989)。这种情形虽见于多数病例,但绝非见于所有情形。

Although many authors stress those elements that reflect the repetition of the past in the erotized transference, in our view the defensive aspects, especially the function of defending against the emergence of depressive affect, are extremely important.

尽管许多作者强调了色情化移情反映了过去的重复性成分,我们认为,防御观点,特别抵御压抑情感产生的防御功能是极为重要的。

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