Incest as trauma has received much recent attention, and psychoanalytic study of its victims indeed illustrates the basic dynamic of internalization of an object relation dominated by hatred. In exploring these psychodynamics we have to keep in mind that the sadomasochistic component of sexual excitement permits the recruitment of aggression in the service of love. But this is a response that, when a sexual response is overwhelmed by rage and hatred, may be transformed into sexual sadomasochism in which love is recruited in the service of aggression. That is, sexual intercourse may become a symbolic gratification of sadomasochistic tendencies, replicating in the sexual area the interactions I have described in relationships dominated by hatred.
乱伦作为创伤近期获得了很多关注,精神分析对其受害者的研究阐明了一个内化的、被恨控制的客体关系的基本动力。在探索这些心理动力中我们必须记住:性兴奋时的施虐受虐部分让爱在性中补偿了恨。但当一个性反应被愤怒和恨淹没时,这会转化为性施虐受虐,在其中爱被用于服务攻击。性交会成为一种施虐受虐倾向的象征性满足,在性领域中复制我之前描述的在被恨所控制的关系中的互动。
Not
all sexual abuse is experienced as aggressive; unconscious infantile sexuality,
the excitement, gratification, and triumph resulting from breaking oedipal barriers,
and the guilt such triumph produces, complicate the psychological effects of
sexual abuse. Nevertheless, the distortion of superego structures brought about
when cross-generational (in particular, parent-child) incest occurs destroys the
potential for integrating sadistic parental images into the superego. The
conflict between sexual excitement and guilt is thus transformed into one
between frail idealization and overwhelming aggression, creating a truly
traumatic situation in which libidinal and aggressive strivings can no longer
be differentiated. The unconscious identification with the victimizer and the
victim may become confused. The repetition compulsion of incest victims who
transform their later sexual life into a chain of traumatophilic experiences
often makes it difficult to determine whether the patient was the victim or the
victimizer.
不是所有的性虐待都被体验为攻击;由突破俄狄浦斯屏障所导致的潜意识的婴儿化性欲、性兴奋、满足和胜利等,和这样的胜利导致的内疚,复杂化了性虐待中的心理影响。然而当代际间(尤其是父母与儿童间)的乱伦出现时,引发的超我扭曲会破坏施虐父母影像整合进超我。性兴奋和内疚的冲突因此转变成脆弱的理想化和淹没性攻击相结合的超我,创造了一个真实的创伤情景,在其中力比多和攻击性不再被区分。潜意识中对施害者和受害者的认同会变得混淆。强迫性重复地将他们后来的性生活转变成一连串创伤癖体验的乱伦受害者,经常难以区分他们究竟是受害者还是施害者。
In
the clinical situation, such incest victims reactivate the identification wit
the victim-victimizer dyad and unconsciously attempt to reproduce the traumati
situation in order to undo it and to recover the ideal object behind th
persecutor. In addition, the repetition compulsion expresses the desire for
revenge the rationalization of hatred of the seducer, and the potential
sexualizatio of the hatred in the form of efforts to seduce the seducer. The
psychoanalytic treatment of incest victims who have had sexual experiences with
forme therapists sometimes repeats these experiences with uncanny clarity.
Unconsciou envy of the current therapist, not involved in the chaotic mixture
of hatred and sexuality in which the patient experiences himself as hopelessly
mired, is another source of negative therapeutic reactions.
在临床情景中,这样的乱伦受害者再次激活了对受害-施害配对的认同,潜意识地试图再次创造创伤情景来消除它,恢复迫害者背后的理想化客体。另外,强迫性重复表达了想要报复,合理化对诱惑者的恨,以诱惑引诱者的形式潜在地将恨性欲化。对有与之前的治疗师有性经历的乱伦受害者的动力学治疗中有时候异常清晰地重复了这些体验。潜意识嫉妒当下的治疗师(不包括卷入混乱的恨和性欲混合,在其中患者体验自己为无助地陷入泥潭)是另一种负性治疗反应的来源。
Recent research by
Paris (1994b)
confirms the importance of a history of sexual abuse in patients with
borderline personality disorder as well as their tendency toward dissociative
reactions. Paris also points out that a predisposition to dissociative
reactions does not seem to be secondary to sexual trauma. In clinical practice,
both types of problems are seen together with some frequency. Some borderline
patients present dissociative reactions in the form of amnesias, depersonalization
states, and even multiple personalities, of which the patients are cognitively
aware but which are affectively split.
Paris(1994b)最近的研究确认了性虐待历史在边缘人格障碍以及他们倾向于解离反应的重要性。Paris也指出,解离反应倾向并不就是性创伤的次发反应。在临床实践中,两种问题类型经常会一起看到。一些边缘患者呈现健忘、人格解体状态、甚至多重人格等形式的解离反应,患者能在认知上对此有觉察,但情感上是分裂的。
What
is often striking in such dissociative states is the patient’s remarkable
indifference to what seems to be a dramatic psychopathological phenomenon: Indeed,
some patients present an almost defiant affirmation of the “autonomy” of their
split-off personalities while refusing to consider any personal responsibility for
these phenomena. Often, the mutual dissociation of alternate personality states
raises the question of why some apparently not incongruous personality states
appear to be split from each other.
在这些解离反应中经常令人惊讶的是患者对一些看起来戏剧性的心理现象明显地漠不关心:实际上,一些患者表现出一种几乎藐视性的断言,认为他们的人格分裂是自动性的,拒绝认为需要为这现象负任何个人责任。经常,交替人格的解离会引起疑问:为什么一些看上去不协调的人格状态会相互之间处在分离状态。
In
my experience, when the clinician asks how the patient’s central personality, her
sense of awareness, concern, and responsibility, relates to these split-off personality
states, this immediately triggers a new development in the transference. Many
patients develop a paranoid reaction to such inquiry; this evolves into a
specific transference disposition in which the therapist appears as a
persecutory figure in contrast to other persons in the patient’s life,
including other therapists, who are idealized as helpful, tolerant,
nonquestioning, admiring, and supportive. The patient’s alternate personality
states take on more specific meanings in relation to such split object
representations, permitting a clarification of the function of such split
states in the transference. In short, approaching the patient from the position
of an assumed observing, central, “categorical” self illuminates hidden splits
in the transference and permits exploration of the unconscious dynamics
involved in the split personality state that are obscured by the usual, apparently
untroubled enactment of such states.
在我的经验中,当治疗师询问患者的中心人格、她的意识、担心和责任等与这些分离的人格状态是怎样的关系时,这会立即触发一个新的移情发展。很多患者对此提问会发展出一个偏执反应;这发展成一种特殊的移情倾向,在其中治疗师表现为一个迫害者角色,相反于来访者生活中的其他人,包括其他治疗师,他们被理想化为有帮助的、宽容的、不会质疑的、赞赏的和支持的。患者交替的人格状态呈现更多这些分裂的客体表象的特殊意义,可以在移情中澄清这分裂状态的功能。简而言之,从一个假设的观察、中心、“绝对”的自体来面对患者,会阐明在移情中隐藏的分裂,可以探索分裂人格状态中的潜意识动力,而这动力之前被通常的表面上没缘由的激活所掩盖。
The
patient now may be tempted to angrily accuse the therapist of not believing in
the existence of his multiple personalities. The therapist’s concerned and neutral
stand—being interested in the patient’s experience, not questioning its
authenticity, but at the same time evaluating the implications for the
patient’s central self-experience—gradually permits the patient to increase his
self-observing function in contrast to the previous defensive denial of concern
and what might be called blind enactment of dissociative states.