中国精神分析的现状及我们的原则
作者: 施琪嘉 / 7084次阅读 时间: 2010年6月18日
标签: GERLACH Gerlach
www.psychspace.com心理学空间网中国精神分析的现状及我们的原则心理学空间8v{ y/T(H8_ q$I
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Psychoanalysis in China -
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/~|xG:t0In International Psychoanalysis, volume 7 issue 2, Teresa Yuan from Argentina reports on her work in disseminating psychoanalytic knowledge in China. From my own experience I would like to underline her comments, and draw attention to the support so urgently needed at present by our Chinese colleagues who are interested in psychoanalysis.心理学空间8s-vi5jX T
在《国际精神分析杂志》第7卷2期(International Psychoanalysis, volume 7 issue 2),由阿根廷的特蕾莎.袁(Teresa Yuan)所报道的工作涉及到中国精神分析的情况。根据我自己的经历,我想对她的内容作进一步的补充,以示对那些目前正献身于精神分析的中国同行的支持。心理学空间 k:P I _9O'MD

Q,rw`%X@-g0My first impressions of China go back to 1983 and 1985, when I, together with E. Troje from Frankfurt, was invited by the Psychiatric Clinic in Canton to hold lectures and discussions on the psychoanalytic theory of neuroses, analytic psychotherapy and psychosomatic questions. Even then, only a few years after the end of the Cultural Revolution and before China’s sharp change of policy towards the market economy, I was astonished by the level of interest in psychoanalysis and the readiness to absorb and discuss psychoanalytic ideas. I did have the impression, however, that while an intellectual interest in psychoanalysis existed, there was little willingness or even possibility of applying its ideas therapeutically or including them in cultural reflections.心理学空间.Exp-n'q4?#F
我对中国的印象要追溯到1983年及1985年,当时,我与来自法兰克福的特洛依先生(Troyer)受广东省精神病院的邀请前去作学术讲演并开展了讨论,内容涉及到神经症的精神分析理论、动力性心理治疗及心身医学等问题。虽然文化大革命只不过结束数年,中国正处于市场经济改革的政治分娩期,我仍为学员们对精神分析表现出来的兴趣及如饥似渴地吸收所讨论的精神分析内容的现象印象深刻。然而,尽管知识分子们对精神分析深感兴趣,但将之运用于治疗或用其思路反思其文化的可能性或愿望几乎为零。心理学空间%vU#e.dS}S*sb
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Since 1997 I and four colleagues from the German Psychoanalytical Association (DPV) - M. Berger, M. Elzer, A. Haag and U. Stuhr - have been involved in a training project in which two groups of Chinese participants, each group comprising seventeen members, have been receiving further training in analytically-orientated psychotherapy continuously for three years. The trainees, psychiatrists and psychologists, are predominantly between 25 and 40 and as a rule work in psychiatric or psychotherapeutic clinics or at psychological advice centres. This project has developed from congresses held in the late 1980s and early 1990s when, at the request of leading Chinese psychiatrists, psychotherapists from Germany were invited to China to give lectures and seminars on current issues in psychoanalytical therapy, systemic family therapy and behavioural therapy.心理学空间#?9yK,\O
1997年我与四个德国精神分析协会(German Psychoanaly-tical Association, DPV)的同事:博格、埃尔策、哈克及斯图尔(- M. Berger, M. Elzer, A. Haag and U. Stuhr)参与了一项有两组中国学员参加的培训项目,每一小组有17名学员,将接受为期3年的动力性取向的连续培训。参加此项目的学员有研究生、精神科医生及有心理学背景的工作者,其年龄在25-40岁,来自全国不同的精神病院及心理咨询中心。这一项目的初衷始于80年代末、90年代初的一次心理会议,受到中国精神病学界德高望重者的邀请,德方的一些资深的心理治疗师来到中国就当前学术发展的情况作了有关精神分析性治疗、系统性家庭治疗和行为治疗的演讲及研讨。心理学空间[p'J zX,e)w?

8h%G!U)K#S8D k0The Chinese trainees come together for a week twice annually in different Chinese cities (Kunming, Beijing, Shanghai, Wuhan, Chengdu) for training with the German lecturers. Two days of instruction by Chinese lecturers are followed by five working days with the German teachers in the form of courses. Here we place special importance on the supervision of initial meetings or therapy sessions. On the basis of the difficulties of comprehension encountered there we select certain theoretical aspects and discuss them more intensively. Between the different teaching blocks the participants are asked to read specialist literature (classical psychoanalytical texts in English or in Chinese translation, and papers by the lecturers on specific topics), and to write reports on their therapeutic work following set guidelines. These are then commented on in writing.心理学空间y!E7~?0^ A)pG
中方学员每年两次在不同的城市(昆明、北京、上海、武汉、成都)作为期一周的集中,(学习内容)主要以德文文献为主,头两天由中方教员授课,在接下来的5天里由德方教员授课。我们将重点放在对初始访谈的强调及对治疗过程的督导上。基于在理解上存在着的困难,我们选择了一定的理论内容,然后重点就其展开讨论。在两次集中的中间期,学员必须阅读指定的文献(经典的精神分析文章-英文或中文译本,以及教员就特殊题目所作的讲演稿),他们还须就其在治疗大纲的指导下所作的心理治疗工作写书面报告,并获得书面的评语。心理学空间 Z\!g$s:a4?1`1O'X:A

&zP%\.`'f |^1jd-T nw0Our work as mediators in China is integrated within the institutional context of the "German-Chinese Academy of Psychotherapy", which receives funding from the Deutscher Akademischer Austauschdienst (DAAD), from the German Ministry of Education and Science and from various foundations.
u'b7c#^1`RZP0作为该项工作在中国的传播者,我们隶属于“德-中心理治疗学院”( "German- Chinese Academy of Psychotherapy"),得到了德意志对外学术交流基金会(Deutscher Akademischer Austauschdienst ,DAAD)、德国教育科学部及不同基金会的资助。心理学空间'DC"`/be||n
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Unlike the situation in the 1980s, the Chinese psychiatrists and psychologists now relate to me as colleagues who have to deal with patients with diverse neurotic disorders and psychosomatic symptoms in their daily work. Today every Chinese university has a psychotherapeutic advice centre for students, and almost every general hospital has a psychotherapy department, in which the staff up to now have had to derive their knowledge and skills largely from the literature available to them. As far as the field of psychoanalysis is concerned, the practical work often resembles "wild psychoanalysis", since it has not yet been possible to acquire a deeper understanding of the therapeutic processes of transference and countertransference and their difficulties, or to encounter them first-hand through psychoanalytic self-discovery.心理学空间D Q Y3nLf8i7f N
与80年代不同的是,现在,中国的精神科医生、心理学背景的工作者能够就他们所接触到的不同的神经症障碍及心身症状的病人与我进行同事般的交流了。如今,在中国的每一个大学里都为学生设立了心理治疗机构,几乎所有的综合性医院均设有心理治疗的科室,在这些科室中工作人员的知识和技巧来源于他们对所能获得的文献的阅读,就精神分析领域而言,他们的工作实际上仍属于“非正规性精神分析”,究其原因,他们尚无法对工作中的移情反移情作出深入的理解,也缺乏精神分析性的自我体验。
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&^0B&KDF YW/@o0At the present time, when there is a continuing upheaval in social conditions in China, when old certainties are being lost, new dangers and fears are emerging and previously unknown temptations and idealisations are making their appearance, our Chinese colleagues are under enormous pressure to find answers to the effects of these changes on individuals. Independently of state and Party directives, many individuals are seeking an opportunity to enter a dialogue with another person about themselves, relationship conflicts, inner conflicts and neurotic solutions. The facilities offered by universities and clinics, as described above, as well as telephone advice lines (e.g. the "Women’s Hotline" run by independent groups) and the opening of the first private psychotherapy practices, are possible responses to these social changes.
$f i^ Q9a&zF aQh0目前,中国的社会情况仍在继续发生着改变,打破陈规,产生了新的危险与恐惧,许多以往不了解的禁忌与理想开始显示出其本性。就是在这种巨大的压力之下,我们的中国同事寻找着个人能解答这些变化导致结果的途径。除外不同省市及团体之间的差别,许多人在寻求相互间能讨论自己、讨论关系冲突与神经症性解决方式的锲机,如前所述,由不同的医疗单位提供的机构及一些电话热线(如个别团体创建的妇女热线)以及开始出现的私人性心理治疗诊所均因这些社会改变应运而生。
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We ourselves are representatives of the second generation after the collapse of National Socialism, and come from a climate in which the question of coming to terms with its consequences for both perpetrators and victims has become a very topical issue for the public in general and for psychoanalysis in particular. We therefore looked forward particularly to the discussion with Chinese colleagues on their experiences during and after the Cultural Revolution. We were surprised to find that in case presentations the political past played hardly any part. In the four seminars conducted so far not a single case has been presented in which traumatisation by acts of terror, humiliation, forcible relocation or re-education were even mentioned. We were all the more surprised, therefore, that in the individual self-discovery sessions we offer, a protected situation with a stranger, experiences in the Cultural Revolution have a very prominent place (an analysis of this can be found in: A. Gerlach, A. Haag, "Trennungstraumata in der chinesischen Kulturrevolution", in A. Schlösser, K. Höhfeld, Trennungen, Giessen 1999).心理学空间b3e2f2ku.By~vb
反观自身,我们属于国家社会主义(纳粹)后的第二代出生者,我们出生的年代正值社会广泛对入侵者与牺牲品的概念展开大讨论的时期,此不仅为广泛的公众性话题,更是精神分析的讨论主题。我们当然特别关注我们的中国同事如何看待文化大革命中及之后阶段的体验。十分令人惊讶的是,那些过去的政治深深地渗透于每个病案的角落中,就所知的四组讨论来看,不约而同地涉及到受恐惧、敌对、胁迫和再改造后遗留下来的创伤性体验。自我体验的内容更使人触目惊心,在受到隐秘保护的前提下,文革的内容仍是一个重点(参考葛拉赫、哈克医生的文章《中国文化大革命所致‘分离性创伤’》, A. Gerlach, A. Haag, "Trennungstraumata in der chinesischen Kulturrevolution", in A. Schlösser, K. Höhfeld, Trennungen, Giessen 1999).心理学空间n4PR f l(](B|![_R

4u UR2}rMk@0Many participants in our further training course first became interested in psychoanalysis through reading a work by Freud. I have in front of me a list of 31 translations of works by Freud from English into Chinese, including The Interpretation of Dreams, The Psychopathology of Everyday Life, Beyond the Pleasure Principle, Group Psychology and the Analysis of the Ego, Mourning and Melancholy, Problems of Lay Analysis, etc. Anna Freud’s The Ego and the Mechanisms of Defence has just been published in Chinese, and publications of contemporary psychoanalytical literature are to follow. It is my assessment that the current activities, both our working group and that of Teresa Yuan, will be able to continue to foster the existing interest in psychoanalysis in China. A working group has recently been formed in Peking in which colleagues meet regularly to discuss their psychotherapeutic work together from a psychoanalytic point of view. Two participants in the training project, from Shanghai and Wuhan, are currently spending a period of one year here, in Germany and Austria respectively, partly to carry out a piece of personal analysis and partly to find out about the analytically-orientated work with patients conducted here. In the coming years there will undoubtedly be increased demand for psychoanalytic self-discovery, supervision and theoretical training from Chinese psychotherapists. In this way the seed for autonomous development has been sown, so that China - to answer a question posed by Teresa Yuan - is certain to have a decisive influence on the fate of psychoanalysis in the next millennium.心理学空间 nm%{ Zdu1\0P H
在进一步的培训中,许多学员开始通过阅读弗洛依德的著作对精神分析产生了兴趣,就我所知,已经有31种弗洛依德的英文著作被译成了中文,包括《释梦》、《日常生活的心理病理学》、《超越现实原则》、《集体治疗与自我体验》、《忧伤与压抑》、《撒谎问题的分析》、安娜.弗洛依德的《自我及其防御机制》,一些最近发表的精神分析文献也在继续被译成中文发表。目前,在中国,依我个人的推测,德国小组与特蕾莎.袁的工作将继续促进人们对精神分析的兴趣。最近,在北京已经诞生了一个工作小组,一些同行定期聚会,从精神分析的角度出发来讨论心理治疗工作中所遇到的问题。已经有两位同事(分别来自于上海的肖泽萍和武汉的施琪嘉,译者注)目前正在德国及奥地利接受一年的培训,在部分时间里他们将开始其自我体验工作,其余时间则作以分析为取向的病人治疗的工作。今后,在中国对中国心理治疗师的自我体验、督导及理论培训的需求将会进一步增加。这种自我发展的模式已经初见萌,在此回应特蕾莎.袁女士的问题:在下个新千年里,精神分析必将在中国形成具体的影响。
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中国的心理咨询及心理治疗现状-- 施琪嘉 桑志芹 李哓晴 周娟 王海峰»

 施琪嘉

施琪嘉 教授
医学博士,中国首批国家注册心理督导师。华中科技大学附属同济医学院武汉市心理医院常务副院长,武汉市心理卫生研究所所长。华中科技大学附属同济医学院心理卫生研究中心副主任;中国精神分析学组华中地区组长,中国心理卫生协会心理咨询与心理治疗专业委员会副主任委员;曾获得德国对外学术交流基金(DAAD)留学德国法兰克福大学及获得国家教委对外学术交流基金留学奥地利茵斯布鲁克(INNSBRUCK)大学。



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