The Experience of the Skin in Early Object Relations
早期客体关系中的皮肤体验
Esther Bick(1968)
This classic, highly condensed paper about the conditions that are necessary for Klein’s “splitting and idealization” to take place, was read to the 25th International Psychoanalytic Congress in Copenhagen in 1967 and has been extremely influential, especially regarding the understanding of two-dimensional features of personality structure. According to Shirley Hoxter, Bick intended it “as a preliminary communication only but she was never contented with attempts to expand it in later writings.” (Hoxter 1988, p. 103)
这篇关于克莱因“分裂和理想化”发生之必要条件的经典浓缩论文于1967年在哥本哈根举行的第25届国际精神分析大会上宣读，并且非常具有影响力，尤其是关于人格结构二维特征的理解。根据Shirley Hoxter的说法，Bick打算“仅仅作为初步的沟通，但她从未满足于在其后期著作中对其扩展的尝试。”(Hoxter 1988, p. 103)
The central theme of this brief communication is concerned with the primal function of the skin of the baby and of its primal objects in relation to the most primitive binding together of parts of the personality not as yet differentiated from parts of the body. It can be most readily studied in psychoanalysis in relation to problems of dependence and separation in the transference.
这份简短通信的核心议题关注于婴儿皮肤的原始功能，以及皮肤与那些仍未从身体各部位分化的、最原始的、粘连在一起的诸多人格部分有关的主要客体的原始功能。这些可以在与移情之中的分离与依赖问题有关的精神分析中进行研究。
The thesis is that in its most primitive form the parts of the personality are felt to have no binding force （约束力）amongst themselves and must therefore be held together in a way that is experienced by them passively, by the skin functioning as a boundary. But this internal function of containing the parts of the self is dependent initially on the introjection of an external object, experienced as capable of fulfilling this function. Later, identification with this function of the object supersedes the unintegrated state and gives rise to the fantasy of internal and external spaces. Only then is the stage set for the operation of primal splitting and idealization of self and object as described by Melanie Klein. Until the containing functions have been introjected, the concept of a space within the self cannot arise. Introjection, i.e. construction of an object in an internal space is therefore impaired. In its absence, the function of projective identification will necessarily continue unabated and all the confusions of identity attending it will be manifest.
本文认为，人格各个部分的最初形态都觉得彼此之间没有粘连的力量，因此他们必须通过被动的体验，通过作为边界的皮肤功能维系在一起。涵容自我碎片的内部功能最初依赖于外部客体的内摄，体验了这一功能的胜任。随后，对这个客体功能的认同替代了非整合的状态，并产生了内部和外部空间的幻想。只有这样，为最初的分裂和自体和客体的理想化创造了条件，正如Klein所说的。在涵容功能完成内摄之前，不会出现自我的空间概念。内摄，即，处于内部空间的客体结构因此受损。在其缺席的情况下，投射性认同的功能一定会持续下去，并且所有参与其中的认同困惑都会显露出来。
The stage of primal splitting and idealization of self and object can now be seen to rest on this earlier process of containment of self and object by their respective “skins”.
现在可以依赖于自体与客体各自“皮肤”最初的涵容过程，观察到它们的原始分裂与理想化的阶段。
The fluctuations in this primal state will be illustrated in case material from infant observation, in order to show the difference between unintegration as a passive experience of total helplessness, and disintegration through splitting processes as an active defensive operation in the service of development. We are, therefore, from the economic point of view, dealing with situations conducive to catastrophic anxieties in the unintegrated state as compared with the more limited and specific persecutory and depressive ones. The need for a containing object would seem, in the infantile unintegrated state, to produce a frantic search for an object—a light, a voice, a smell, or other sensual object—which can hold the attention and thereby be experienced, momentarily at least, as holding the parts of the personality together. The optimal object is the nipple in the mouth, together with the holding and talking and familiar smelling mother.
可以通过婴儿观察的案例资料来说明原始阶段的波动，为了说明作为非整合的完全无助的被动体验与作为造福于发展的积极防御活动的通过分裂而失整合状态之间的不同。 因此我们，通过经济观点的视角，处理有利于灾难性焦虑的处境，在非整合的状态下与 the more limited and specific persecutory and depressive ones比较。在婴儿期未整合的阶段，对包容性客体的需求似乎是去发狂寻找造出一个客体，一点亮光，一个声音，一个气味，或者其他的感觉客体，可以维持注意并能因此体验到的。至少一段时间内可以控制人格不同部分的稳定。最好的客体是嘴里的乳头，并与抱持着，说着话有着熟悉气味的母亲在一起。
Material will show how this containing object is experienced concretely as a skin. Faulty development of this primal skin function can be seen to result either from defects in the adequacy of the actual object or from fantasy attacks on it, which impair introjection. Disturbance in the primal skin function can lead to a development of a “second-skin” formation through which dependence on the object is replaced by a pseudo-independence, by the inappropriate use of certain mental functions—or perhaps innate talents—for the purpose of creating a substitute for this skin container function. The material to follow will give some examples of “second-skin” formation.
资料将展示包容性客体是如何被具体的体验为一个皮肤。原始皮肤功能有缺陷的发展可以视为实际客体的胜任缺陷或对其幻想性攻击的结果，它会损害内摄。干扰原始皮肤的功能会导致“第二皮肤”的发展形成，通过不恰当地使用某些心理功能、或者与生俱来的天分，所依赖的客体被一个伪独立取而代之，为了的是创造这个皮肤容器功能的一个替代。以下资料将给出“第二皮肤”的例子。
Here I can only indicate the types of clinical material upon which these findings are based. My present aim is to open up this topic for a detailed discussion in a later paper.
在这里我只能说明这些发现是基于临床资料。我现在的目标是开拓这一主题，在后面的文章将详细讨论。
Infant observation: Baby Alice
婴儿观察：小婴儿艾利斯
One year of observation of an immature young mother and her first baby showed a gradual improvement in the “skin-container” function up to twelve weeks. As the mother’s tolerance to closeness to the baby increased, so did her need to excite the baby to manifestations of vitality lessen. A consequent diminution of unintegrated states in the baby could be observed. These had been characterized by trembling, sneezing, and disorganized movements. There followed a move to a new house in a still unfinished condition. This disturbed severely the mother’s holding capacity and led her to a withdrawal from the baby. She began feeding whilst watching television, or at night in the dark without holding the baby. This brought a flood of somatic disturbance and an increase of unintegrated states in the baby. Father’s illness at that time made matters worse and the mother had to plan to return to work. She began to press the baby into a pseudo-independence, forcing her onto a training-cup, introducing a bouncer during the day, whilst harshly refusing to respond to the crying at night. The mother now returned to an earlier tendency to stimulate the child to aggressive displays which she provoked and admired. The result by six and a half months was a hyperactive and aggressive little girl, whom her mother called “a boxer” form her habit of pummelling people’s faces. We see here the formation of a muscular type of selfcontainment—“second-skin” in place of a proper skin container.
一年的观察不成熟的年轻母亲和她的第一个孩子，在多达十二个星期内表现出逐步改善的“皮肤容器”功能。由于母亲耐受于和宝宝亲近的增加，所以没她需要给宝宝以激发活力降低的表现。所以她也需要激发宝宝活力降低的表现。可以观察到随之而来的婴孩不整合状态的减少。这些的特征是颤抖，打喷嚏，和混乱的的运动。随后搬到了一个尚未完成的新房子。这严重干扰了母亲的涵容能力并致使她从宝宝哪儿撤回（其功能）。她就开始在哺乳的时候看电视，或在夜晚的黑暗中不去抱婴儿。这给婴带来了躯体的的紊乱，并加重了在婴儿增加不整合的状态。当时父亲的疾病让事情变得更糟，而母亲不得不打算重返工作岗位。她开始给宝宝压力导致了伪独立， forcing her onto a training-cup, introducing a bouncer during the day, 同时晚上拒绝回应婴儿的哭闹，母亲现在回到了以往的癖好，去刺激孩子挑衅的表现来惹怒和赞赏她。六个半月的结果是一个多动和好斗的小女孩，她母亲称为“拳击手”，用拳头打别人脸的癖好。我们在这里看到肌肉型的自我遏制 “第二皮肤”以代替正常的皮肤容器。
Analysis of a schizophrenic girl: Mary
精神分裂的女孩玛丽的分析
Some years of analysis, since age three and a half, have enabled us to reconstruct the mental states reflected in the history of Mary’s infantile disturbance. The facts are as follows: a difficult birth, early clenching of the nipple but lazy feeding, bottle supplement in the third week but on the breast until eleven months, infantile eczema at four months with scratching until bleeding, extreme clinging to mother, severe intolerance to waiting for feeds, delayed and atypical development in all areas.
从三岁半开始的几年分析，使我们能够重建体现在玛丽婴儿期紊乱的历史心理状态。事实如下：难产，早期撕咬乳头但不愿意吃，第三周开始奶瓶辅助喂养同时又哺乳到11个月，四个月时的婴幼儿湿疹并搔抓到出血为止，异乎寻常的依附母亲，严重不能容忍哺乳等待，所有领域的发展滞后并不合常规。
In the analysis, severe intolerance to separation was reflected from the start, as in the jaw-clenched systematic tearing and breaking of all materials after the first holiday break. Utter dependence on the immediate contact could be seen and studied in the unintegrated states of posture and motility on the one hand, and thought and communication on the other, which existed at the beginning of each session, improving during its course, to reappear on leaving. She came in hunched, stiff-jointed, grotesque like a “sack of potatoes” as she later called herself, and emitting an explosive “SSBICK” for “good morning, Mrs Bick”. This “sack of potatoes” seemed in constant danger of spilling out its contents, partly due to the continual picking of holes in her skin representing the “sack” skin of the object in which parts of herself—the “potatoes” —were contained (projective identification). Improvement from the hunched posture to an erect one was achieved, along with a lessening of her general total dependence, more through a formation of a second skin based on her own muscularity than through identification with a containing object.
在分析中，从一开始就反应出对分离的极度不耐受， 就像在咬紧牙关的系统中，在第一个假期之后撕毁并打破所有的东西。可以看出对立即接触的完全依赖，另一方面，学习姿势和运动不完全整合的状态，以及存在于每个会谈的开始阶段时对他人的思考和沟通，在过程中改进，离开后又重现。她来的时候弯腰驼背，僵硬的关节，如同她后来称自己为，怪诞的像“一袋土豆”，并且发出一个爆破音“SSBICK”以表示“Bick女士，早上好”。“这袋土豆”似乎常常处于交代出其内容的危险之中，部分是由于在她皮肤中连续的孔洞，以客体“麻袋”皮肤为代表的，属于她自己的——土豆——被包含于其中（影射性认同）。实现了从驼背到挺直的改善，伴随着她总体依赖的减轻，更多的是凭借第二皮肤的形成基于其自身的强壮，而不是通过认同一个涵容的客体。
Analysis of an adult neurotic patient
一个成人神经症患者的分析
The alternation of two types of experience of self—the “sack of apples” and the “hippopotamus”—could be studied in regard to quality of contact in the transference and experience of separation, both being related to a disturbed feeding period. In the “sack of apples” state, the patient was touchy, vain, in need of constant attention and praise, easily bruised and constantly expecting catastrophe—such as a collapse when getting up from the couch. In the “hippopotamus” state of [another, adult] patient, he was aggressive, tyrannical, scathing, and relentless in following his own way. Both states relate to the “second-skin” type of organization, dominated by projective identification. The “hippopotamus” skin, like the “sack”, reflects the object’s skin inside which he existed, whilst the thin-skinned, easily bruised, apples inside the sack [of the previous patient] represented that state of parts of the self which were inside this insensitive object.
两种自我体验的交替——“一袋苹果”和“河马”——可以研究对于在移情中接触和分离体验的质量，两者都涉及早期抚养的扰乱。在“一袋苹果”状态，患者是敏感的，徒劳的，在不断的需要关注和赞扬，易擦伤的，一直希望灾难——例如从沙发上起来时的崩溃。在“河马”状态（另一个，成人）患者，他是积极的，专横的，严厉的，无情的，以自己的方式。两种状态涉及“第二皮肤”的组织类型，被影射性认同占据。“河马”皮肤，就像麻袋，反应了存在于他内部的客体皮肤，以及皮薄皮，易碰伤，（之前的患者）袋子里的苹果代表了处于敏感客体内部的部分自我的状态。
Analysis of a child: Jill
儿童Jill的分析
Early in the analysis of a five-year-old child, whose feeding period had been characterized by anorexia, skin-container problems presented themselves, as in her constant demand of mother during the first analytic holiday that her clothes be firmly fastened, her shoes tightly laced. Later material showed her intense anxiety and need to distinguish herself from toys and dolls, about which she said: “Toys are not like me, they break to pieces and don’t get well. They don’t have a skin. We have a skin!”
在一个五岁的孩子的早期分析中，她在早期养育阶段已经有了厌食症的特征，出现了皮肤容器问题，因为在分析的第一个假期，她持续的需要妈妈，她的衣服紧扣着，她的鞋子紧紧的系着。后期的资料显示了她的紧张焦虑，以及需要从玩具和洋娃娃中区分出自己。关于这些，她说：“玩具和我不一样，他们打碎成一片片的而且不能恢复。他们不想要皮肤。我们有皮肤。”
Summary 总结
In all patients with disturbed first-skin formation, severe disturbance of the feeding period is indicated by analytic reconstruction, though not always observed by the parents. This faulty skin-formation produces a general fragility in later integration and organizations. It manifests itself in states of unintegration—as distinct from regression—involving the most basic types of partial or total unintegration of body, posture, motility, and corresponding functions of mind, particularly communication. The “secondskin” phenomenon which replaces first skin integration, manifests itself as a partial or total type of muscular shell, or a corresponding verbal muscularity.
在那些第一皮肤的形成被扰乱的病人中，分析性的重构表明了其哺育期的严重扰动，尽管并非总是由父母观察到。这种缺损的皮肤形式，引起之后整合和组织的普遍脆弱性。它通常表现为未整合阶段—作为独特的退行—涉及最基本的部分或全部类型的身体、运动、姿势以及相应的心理功能的整合不能，尤其是沟通。“第二皮肤”取代第一皮肤整合的现象，表现为部分或全部的肌肉外壳，或相应的口头强壮。
Analytic investigation of the second skin phenomenon tends to produce transitory states of unintegration. Only an analysis which perseveres to thorough working-through of the primal dependence on the maternal object can strengthen this underlying fragility. It must be stressed that the containing aspect of the analytic situation resides especially in the setting and is therefore an area where firmness of technique is crucial.
对第二皮肤现象之分析性的研究往往会产生失整合的过渡状态。只有对原初依赖的母亲客体持之以恒的彻底的修通分析， 才可让潜在的脆弱性变坚强。但必须强调的是，分析情景所属的领域，尤其在设置之中，因此是技术至关重要的坚定的领域。
First published in International Journal of Psychoanalysis (1968), vol. 49, pp. 484-86.
最初发表于国际精神分析期刊(1968), vol. 49, pp. 484-86.
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