本论坛已有过极热烈的关于“移情, 反移情,共情”的讨论,对于专业心理咨询治疗人员来说,如果这些不是心理咨询治疗中最重要的概念,起码也是最基本的概念。对于非专业人员来说,如果只能选择心理咨询中的一个概念学会了带到日常生活中,我的推荐将是:“共情”。当然要想学会共情,就或多或少迂回地到了移情反移情那里。
几个帖子的讨论,主要还是集中与概念理论上的。当然这样的讨论还应该继续下去。但我觉得有必要结合具体的例子来领会它了。
以下就是一个例子:看人文主义心理治疗学派开创者卡尔罗杰斯如何在心理咨询中共情的。
对有经验的咨询师来说,不难看出这是一个相当不容易应付的个案。因为来访者大多时间都不说话。明显的抑郁症候,且有自杀倾向。他一直大多时间沉默,看起来象是抗拒帮助,且不时说:“你帮不了我,我想死”。
这种情形,很容易让咨询师焦急起来,“对方简直是“滴水不尽”,怎么办呢?需要教育他生命价值吗?纠正其错误认知吗?棒喝吗?让他想起家人需要他吗(他估计没有什么令他留念的家人)?
我们且来看罗杰斯是如何处理这个案子的吧!
THE CASE OF JIM BROWN(1962)
吉姆•布朗的案例(1962)
TUESDAY
Carl Rogers(C.R):I see there are some cigarettes here in the drawer,Hmm? Yeah, it is hot out.(Silence of 25 seconds)
C.R: Do you look kind of angry this morning, or is that my imagination? (Jim shakes his head slightly.) Not angry, huh? (Silence of 1 minute, 26 seconds)
C.R: Feel like letting me in on whatever is going on? (Silence of 12 minutes, 52 seconds)
C.R: (softly) I kind of feel like saying that if it would be of any help at all I’d like to come in. On the other hand, if it’s something you’d rather-if you just feel more like being within yourself, feeling whatever you’re feeling within yourself, why that’s OK too- I guess another thing I’m saying, really, in saying that is, “I do care. I’m not just sitting here like a stick.”(Silence of 1 minute, 11 seconds)
C.R: And I guess your silence is saying to me that either you don’t want to or can’t come out right now and that’s OK. So I won’t pester you but I just want you to know, I’m here. (Silence of 17 minutes, 41seconds)
C.R:I see I’m going to have to stop in a few minutes. 1(Silence of 20 seconds)
星期二
卡尔•罗杰斯(C..R):我看见抽屉里有一些香烟,嗯?是的,有一支正在冒烟。(25秒沉默)
C.R:今天早上你看来有些几分生气,或者那只是我的想象?(吉姆轻轻地摇了摇头)不生气,啊?(1分钟26秒沉默)
C.R:想让我进到你的心里去吗?不管里面有什么(12分52秒沉默)
C.R:(温柔地)我有点想说只要有任何一点帮助,我都愿意进去。另一方面,如果你愿意的-如果你只是感觉你更愿意一个人独处,感受着你心中感受到的任何东西,那也好-我想我要说的另一件事,真的,要说的是,“我确实在意你。我可不只是像木头一样呆坐在这里。”(1分11秒沉默)
C.R:我猜想你的沉默是要告诉我,你现在不想或不能走出来,那当然是可以的,我不会再打搅你,不过我只是想让你知道,我在这里。(17分41秒沉默)
C.R:我想,几分钟内我不得不停止了1(20秒沉默)
C.R: It’s hard for me to know how you’ve been feeling, but it looks as though part of the time maybe you’d rather I didn’t know how you were feeling. Anyway it looks as though part of the time it just feels very good to let down and-relax the tension. But as I say I don’t really know-how you feel. It’s just the way it looks to me. Have things been pretty bad lately? (Silence of 45 seconds)
C.R: Maybe this morning you just wish I’d shut up-and maybe I should, but I just keep feeling I’d like to-I don’t know, be in touch with you in some way. (Silence of 2 minutes, 21 seconds) (Jim yawns.)
C.R: Sounds discouraged or tired. (silence of 41 seconds)
Jim: No. Just lousy.
C.R: Everything’s lousy, huh? You feel lousy? (Silence of 39 seconds)
C.R: Want to come in Friday at 12 at the usual time?
Jim: (Yawns and mutters something unintelligible.) (Silence of 48 seconds)
C.R: Just kind of feel sunk way down deep in these lousy, lousy feelings, hmm? -Is that something like it?
Jim: No.
C.R: No? (Silence of 20 seconds)
Jim: No. I just ain’t no good to nobody, never was, and never will be.
C.R: Feeling that now, hmm? That you’re just no good to yourself, no good to anybody. Never will be any good to anybody. Just that you’re completely worthless, huh? Those really are lousy feelings. Just feel that you’re no good at all, hmm?
C.R:对我来说,是很难知道你现在的感受是怎样的,但看起来好像有一段时间你宁可我不知道你的感受是怎样的。看起来,无论如何,好像在一段时间里就这样放下紧张,放松自己,让你感觉不错。不过就像我说的,我真的不知道你的感受是怎样的。我只是看到它那个样子。近来有些事情相当糟糕吗?(45秒沉默)
C.R:也许今天上午你只希望我闭嘴,也许我该那样做,但是我只是一直觉得我想——我不知道,以某种方式和你联系着。(2分钟21秒沉默)(吉姆打哈欠)
C.R:听起来你有点沮丧或者累了。(41秒沉默)
吉姆:不是,只是觉得很糟糕。
C.R:每件事都糟糕吗,嗯?你感觉到糟糕?(39秒沉默)
C.R:你希望按惯例在星期五中午12点来吗?
吉姆:(打哈欠,嘀咕着,听不清楚)(48秒沉默)
C.R:只是觉得陷下去,深深陷到那些糟糕的情绪里,嗯?-有点象是这样的吗?
吉姆:不是。
C.R:不是?(沉默20秒)
吉姆:不是,我这人只是很不好,对任何人来说,以前是这样,以后也永远这样的。
C.R:现在你是这样觉得,嗯?你对自己来说很不好,对任何人来说都不好,永远对所有人来说,都一点也不好,你完全无价值,嗯?这些可真是糟糕的感受。只是感到你一点长处也没有,嗯?
Jim:Yeah. (Muttering in low, discouraged voice) That’s what this guy I went to town with just the other day told me.
C.R: This guy that you went to town with really told you that you were no good? Is that what you’re saying? Did I get that right?
Jim: M-hm.
C.R: I guess the meaning of that if I get it right is that here’s somebody that-meant something to you and what does he think of you? Why, he’s told you that he thinks you’re no good at all. And that just really knocks the props out from under you. (Jim weeps quietly.) It just brings the tears. (Silence of 20 seconds)
Jim:(Rather defiantly) I don’t care though.
C.R: You tell yourself you don’t care at all, but somehow I guess some part of you cares because some part of you weeps over it.(Silence of 19 seconds)
C.R: I guess some part of you just feels, “Here I am hit with another blow, as if I hadn’t like me. Here’s someone I’ve begun to feel attached to and now he doesn’t like me. And I’ll say I don’t care. I won’t let it make any difference to me-But just the same the tears run down my cheeks.”
Jim: (Muttering) I guess I always knew it.
C.R: Hmm?
Jim: I guess I always knew it.
C.R: If I’m getting that right, it is that what makes it hurt worst of all is that when he tells you you’re no good, well shucks, that’s what you’ve always felt about yourself. Is that-the meaning of that you’re saying? (Jim nods slightly, indicating agreement.) M-hm. So you feel as though he’s just confirming what-you’ve already known. He’s confirming what you’ve already felt in some way. (Silence of 23 seconds)
C.R: So that between his saying so and your perhaps feeling it underneath, you just feel about as no good as anybody could feel. (Silence of 2 minutes, 1 second)
吉姆:是的。(小声嘀咕,沮丧的声音)这是另一天和我一起去城里的那个人告诉我的。
C.R:和你一起进城的那个人真的告诉你你不好吗?这是你所说的意思吗?我的理解正确吗?
吉姆:嗯,是的。
C.R:如果我理解的正确的话,我想那意思是,有那么一个对你来说很重要的人,他是怎么想你的?为什么他告诉你他认为你一点也不好。那把你底下的支柱给打掉了。(吉姆默默地掉眼泪)那让人流泪。(20秒沉默)
吉姆:(相当挑衅地)可我不在乎。
C.R:你对你自己说你一点也不在乎,但我猜某种程度上一部分的你却在乎,因为那部分的你为因此而流泪。(19秒沉默)
C.R:我想你的某些部分这样想:“在这里我被又一次击倒了,好似我从来不曾喜欢自己。这里有一个人铱?几惺艿蕉晕业奈????衷谒?床幌不段摇N一崴担?也辉诤酢N也蝗盟?晕矣惺裁从跋臁???耸崩崴?垂雎湮业拿婕铡!?吉姆:(嘀咕道)我想我一直都知道这些。
C.R:嗯?
吉姆:我想我一直都知道。
C.R:如果我理解的正确的话,之所以受到极大伤害,是当他告诉你是不好的,百无一用时,那就是你一直觉得自己的样子。那正是你所说的意思吗?(吉姆轻轻地点点头,表示赞同。)嗯。所以你好像是觉得他证实了你已经知道的东西。他以某种方式证实了你已经感受到的某种东西。(23秒沉默)
C.R:因此在他这样说的和你心中所感受到的之间,你感到自己和他人感到的一样不好。(2分1秒沉默)
C.R: (thoughtfully) As I sort of let it soak in and try to feel what you must be feeling-it comes up sorta this way in me and I don’t know-but, as though here was someone you’d made a contact with, someone you’d really done things for and done things with. Somebody that had some meaning to you. Now, wow! He slaps you in the face by telling you you’re just no good. And this really cuts so deep, you can hardly stand it. (Silence of 30 seconds)
C.R: I’ve got to call it quits for today, Jim. (Silence of 1 minute, 18 seconds)
C.R: It really hurts, doesn’t it? (This is in response to his quiet tears.) (Silence of 26 seconds)
C.R: I guess if the feelings came out you’d just weep and weep and weep. (Silence of 1 minute, 3 seconds)
C.R: Help yourself to some Kleenex if you’d like-Can you go now? (Silence of 23 seconds)
C.R: I guess you really hate to, but I’ve got to see somebody else. (Silence of 20 seconds)
C.R: It’s really bad, isn’t it? (Silence of 22 seconds)
C.R: Let me ask you one question and say one thing. Do you still have that piece of paper with my phone numbers on it and instructions, and so on? (Jim nods.) OK. And if things get bad, so that you feel real down, you have them call me. ‘Cause that’s what I’m here for, to try to be of some help when you need it. If you need it, you have them call me.2
Jim: I think I’m beyond help.
C.R: Huh? Feel as though you’re beyond help. I know. You feel just completely hopeless about yourself. I can understand that. I don’t feel hopeless, but I can realize that you do. Just feel as though nobody can help you and you’re really beyond help.3 (Silence of 2 minutes, 1 second)
C.R: I guess you just feel so, so down that-it’s awful. (Silence of 2 minutes)
C.R:(思虑地)当我让自己沉浸进去感受你正感受到的东西时 - 在我这里有几分感觉了, 我不知道 - 不过, 好像有一个人, 你曾经联系过、一个和你一起做事的,一个你为他做事的, 对你有意义的一个人。现在, 哦! 他扇了你一巴掌,——他告诉你你真是不好。这真是伤你至深,使你几乎无法承受。(30秒沉默)
C.R:今天我必须结束了, 吉姆(1分18秒沉默)
C.R:这真很伤痛, 不是吗?(这是对他默默流泪的回应)(26秒沉默)
C.R:我想如果这样的情绪涌现,你就只有一直哭啊哭啊哭。(1分3秒沉默)
C.R:如果你愿意,用一些面巾纸自己擦擦泪吧-现在你能离开吗?( 23秒沉默)
C.R:我想你真的不愿离开,但我必须得去见另外的人.( 20秒沉默)
C.R:这真的很糟糕,是吗?( 22秒沉默)
C.R:让我问你一个问题,再说一件事情。你还保存着那张写着我的电话号码、指南等的纸片吗?(吉姆点头)好, 如果事情变得糟糕,以致你感到非常沮丧,你可以打电话给我。这就是我之所以在这里的原因,在你需要的时候,尽量给予你一些帮助。如果你需要,你可以打电话给我。2
吉姆:我想我是在可帮助范围之外的。
C.R:嗯?感觉好像你是在可帮助范围之外的。我知道,你对自己完全感到绝望。我可以理解这些。我不感到绝望,但我能意识到你感到绝望。只是感觉好像没有人能帮你,你完全在可帮助的范围之外。3(2分1秒沉默)
C.R:我想你感觉如此低落,如此低落,这糟糕透了。(沉默2分钟)
C.R: I guess there’s one other thing too. I, I’m going to be busy here this afternoon’til 4 o’clock and maybe a little after. But if you should want to see me again this afternoon, you can drop in around about 4 o’clock, OK?-Otherwise, I’ll see you Friday noon. Unless I get a call from you. If you-if you’re kind of concerned for fear anybody would see that you’ve been weeping a little, you can go out and sit for a while where you waited for me. Do just as you wish on that. Or go down and sit in the waiting room there and read magazines-I guess you’ll really have to go.
Jim: Don’t want to go back to work.
C.R: You don’t want to go back to work, hmm?
This is the end of the interview. Later in the
day the therapist saw Jim Brown on the hospital grounds. He seemed much more cheerful and said that he thought he could get a ride into town that afternoon.
The next time the therapist saw Jim Brown
was 3 days later, on Friday. This interview follows.
C.R:我想还有另外一件事情。我,我这里今天下午会一直忙到4点,也可能还要晚一点。不过如果你想今天下午再见到我。你可以在大约4点钟左右顺便来看我,好吗?- 否则,我们星期五中午见。除非我得到你的电话。如果你-如果你有些担心害怕别人会看出你流过一些眼泪,你可以出去在等我的那个地方坐一会儿,在那里你就随意了。或者往下走坐在候诊室看杂志 - 我想你真的必须得走了。
吉姆:不想回去工作。
C.R:你不想回去工作,嗯?
谈话到此结束。那天的后来,治疗师在医院空地上看到了吉姆。他看上去精神好了一些,他说在那天下午他可以乘车去城里。
治疗师再一次看见吉姆是三天以后,星期五。这次谈话如下。
Friday
C.R: I brought a few magazines you can take with you if you want.4 (Silence of 47 seconds)
C.R: I didn’t hear from you since last time. Were you able to go to town that day?
Jim: Yeah. I went in with a kid driving the truck.
C.R: M-hm. (Voices from next office are heard in background.) (Silence of 2 minutes)
C.R: Excuse me just a minute. (Goes to stop noise.) (Silence of 2 minutes, 20 seconds)
C.R: I don’t know why, but I realize that somehow it makes me feel good that today you don’t have your hand up to your face so that I can somehow kind of see you more. I was wondering why I felt as though you were a little more here than you are sometimes and then I realized well, it’s because-I don’t feel as though you’re hiding behind your hand, or something. (Silence of 50 seconds)
C.R: And I think I sense, though I could be mistaken, I think I do sense that today, just like some other days when you come in here, it’s just as though you let yourself sink down into feelings that run very deep in you. Sometimes there’re very bad feelings like the last time and sometimes probably there’re not so bad, though they’re sort of – I think I understand that somehow when you come in here, it’s as though you do let yourself down into those feelings. And now-
Jim: I’m gonna take off.
C.R: Huh?
Jim: I’m gonna take off.5
C.R: You’re going to take off? Really run away from here? Is that what you mean? Must be some-what’s the –what’s the background of that? Can you tell me? Or I guess what I mean more accurately is I know you don’t like the place but it must be that something special came up or something?
星期五
C.R:我带来了几本杂志,如果你愿意,你可以带走。4(47秒沉默)
C.R:自从上次以来,我没有收到关于你的信息,那天你能去城里了吗?
吉姆:是的。我和一个驾驶卡车的年轻人一起去的。
C.R:嗯。(背景中听到隔壁的办公室里传来的声音)(2分钟沉默)
C.R:对不起,稍等一下。(去制止喧闹声)(2分钟20秒沉默)
C.R:我不知道为什么,但我意识到今天你没有把你的手放在脸上,这使我某种程度上看到你更多,这使我感觉较好。我不知道为什么我感觉好像你今天人更在这里, 然后——我意识到那是因为你好像不再把自己藏在你的手背后, 或者什么别的原因。(50秒沉默)
C.R:并且我想我觉察到 - 尽管我可能是错误的,我想我觉察到,就好像其它时间你来这里的时候, 你让自己沉浸于你内心深处的情绪中。有时这些是些坏情绪,就像上次一样,有时候可能没有如此糟糕,尽管有几分 - 我想我以为当你来到这里的时候,好像你确实让自己沉浸于那些情绪中。现在-
吉姆:我要走了。
C.R:嗯?
吉姆:我要走了。5
C.R:你要走了?真的要离开这儿吗?你这是什么意思?一定有一些-是什么? 这样做的背景是什么?你能告诉我吗?或者我想,我的意思更准确地说是,我知道你不喜欢这个地方,但一定是有一些特殊的事情发生的,还是别的什么事?
Jim: I just want to run away and die.
C.R: M-hm, m-hm, m-hm. It isn’t even that you want to get away from here to something. You just want to leave here and go away and die in a corner, m-hm. (Silence of 30 seconds)
C.R: I guess as I let that soak in I really do sense how, how deep that feeling sounds, that you-I guess the image that comes to my mind is sort of a, a wounded animal that wants to crawl away and die. It sounds as though that’s kind of the way you feel that you just want to get away from here and, and vanish. Perish. Not exist. (Silence of 1 minute)
Jim: (almost inaudibly) all day yesterday and all morning I wished I were dead. I even prayed last night that I could die.
C.R: I think I caught all of that, that-for a couple of days now you’ve just wished you could be dead and you’ve even prayed for that-I guess that- One way this strikes me is that to live is such an awful thing to you, you just wish you could die, and not live. (Silence of 1 minute, 12 seconds)
C.R: So that you’ve been just wishing and wishing that you were not living. You wish that life would pass away from you. (Silence of 30 seconds)
Jim: I wish it more’n anything else I’ve ever wished around here.
吉姆:我只想逃走并且死去。
C.R:恩,恩,恩,你甚至不是因为某些事情而想离开,你仅仅想要离开这里,走开然后死在一个角落里,恩。(30秒沉默)
C.R:我想当我让自己处于你的位置上时,我真的感受到那是多么深的情绪,我的脑子里可以想像这种画面:有几分像, 一只想要慢慢爬开而死去的受伤的动物。听来象是这样一种感觉: 你要从这里走开,消失,死亡,不再存在。(1分钟沉默)
吉姆:(几乎听不见)昨天一整天和今天早上我都希望我死了。昨天晚上我甚至祈祷我能死掉。