精神分析与内观的关系The Relationship between Mindfulness and Psychoanalysis
作者: Randall H Paulsen / 8259次阅读 时间: 2010年2月25日
来源: sinopsyche.com
www.psychspace.com心理学空间网

TK s9M)F%^0精神分析与内观的关系
%@ F({9YM5I$r P0

/i_8H S&t-t4k0

J`D0P)UO0The Relationship between Mindfulness (meditation) and Psychoanalysis

)M!K Hr,N"eo.O0Randall H Paulsen, MD心理学空间 Hrh0_K.y/J

  Both mindfulness and psychoanalysis are disciplines of cultivating self-knowledge.They should not be mistaken or substituted for each other, but they can support each other.Mindfulness includes many forms but consists of being present in the moment and being aware of one's physical and mental experience in the moment. It is practiced often alone, with intermittent sessions with a teacher and in group retreats. Psychoanalysis was first developed by Sigmund Freud and has been continually revised in the past 100 years. It is both a science of human psychological life and a therapeutic practice to help alleviate human suffering and facilitate growth and development. What follows is a series of reflections about the relationship between the two disciplines.
yN HA+`S/qm0心理学空间L _Evt-\
 Here are three lists to keep in mind, or perhaps return to, as you read through these reflections. There is a list of similarities, a list of differences, and then four evocative quotes that we will turn to at the conclusion.心理学空间:An ['R&CJ

#T!Isp#N.M-CF0
d tD5U&R P%F-aD0The things that mindfulness and psychoanalysis may be said to share
:
"T!t#K8{*D8vf0
3e-n MF;Y/X01. Growth in self-knowledge by practicing a discipline of focusing attention on certain aspects of present-moment experience.
9yi:b3^ J;_02. Trying to minimize the judgmental qualities in self-observation.
bn*c}f03. Emphasizing a physicality to the practice of awareness, that is, the movement of breath, physical sensations, emotional currents, and sensory awareness.
,O5Q3Z-k*e'F'~P0V04. The use of a structural and temporal framework for the practice of attention – a cushion in meditation, a couch in psychoanalysis. Both practices rely on a set period of time on a daily or almost daily basis.心理学空间)\,lRe6wq-_I
5. Both practices exist at the interface between neuroscience and subjective experience. They seek examination and proof as medical truths, and they provide disciplined paths for personal and spiritual growth.
|B E(^M8c%R E-l0心理学空间0An'vZ2a7w{c#O!N

-v"g5YE!M.HI @0The differences between mindfulness and psychoanalysis
:心理学空间{V6]|.}{8J5y1kV

%mI7x4uXIo)]#D2j$L01.  A one-person framework vs. a two-person framework.
je Z0coM2\2Bq02.  Psychoanalysis relies on transference, where the subject redirects feelings to an observing therapist; mindfulness relies on a relationship with a teacher who guides the work of the self observing the experience of the self.心理学空间 e{+UUmh3?Q| W
3.  Psychoanalysis uses explicit knowing (saying, listening, use of metaphor and perception), while mindfulness employs implicit knowing (noticing, categorizing, non-verbal), that is, noticing where the mind goes.心理学空间%r5G!K&Lx$c){

_$?&p;b-A+O {%t7EE1vH0Evocative phrases
:心理学空间/^'D`X9FW$Z)g|.x$q)X
心理学空间Ye1\? c
1.  “You have to acquire a sense of self before you can lose a sense of self.” Jack Engler, psychotherapist and vipassana meditator in Cambridge, Mass.心理学空间'jT"r9GV3]gF
2.  “Mr. James Duffy … lived at a little distance from his body.” James Joyce, The Dubliners
'A1v)sJH }03.  “One acquires a sense of a center by being centered upon.” Hans Loewald, a psychoanalyst. 心理学空间0CD#Xl$j1b6w
4.  "Wisdom tells me I am nothing. Love tells me I am everything. Between the two, my life flows." Nisargadatta Maharaj
A0T-rql#?0心理学空间.}eN3L9L

8Ng2R9r6Z0  If we think of learning from contemplation, we can picture the person sitting on a meditation cushion as one paradigm. We can picture the other paradigm as a person lying on a couch with a second person sitting in a chair at the head of the couch listening carefully both to the stated experience of the person on the couch, and to his/her own experience as he/she listens.心理学空间;unhLDH
心理学空间@0tUVsr
Mindfulness: The Person on the Cushion心理学空间{.w+r6YG?s J

心理学空间i9C+L!PUD

  The person on the cushion is alone with him or herself (although they may be in a group of people sitting on cushions). Their eyes are closed or downcast, letting in light but not focusing on visual things. They are following the direction to “observe the breath.” They do this for a pre-set period of time at regular intervals on a daily basis or many times a day in a retreat setting. By intending to focus on the physical experience of the breath the person’s conscious awareness is drawn into their physical body, its involuntary capacity for rhythmic activity to support life, and, most importantly, the present moment. This practice sets up a dualism within the experience of the person.  On the one hand there is the intention to focus awareness on the breath. On the other hand there are the myriad thoughts, sensations, and emotions that draw the attention away from the breath. The instructions are to observe and take note non-judgmentally of the thoughts, images, and sensations that took the mind away, and then to gently guide the attention back to the rhythmic experience of the breath. Even very experienced mindfulness practitioners like Pema Chodron (who’s CD “Getting Unstuck” provides a vivid description of a Tibetan Buddhist concept of SHENPA, which is very friendly to psychoanalysis) say that they never cease to work with this back and forth.心理学空间sIvd/L6W*S~R3O.l

SZBJn9@(F9}.R0  Mindfulness is thus the practice of trying to follow the breath, and to take serious note of where the mind goes, and then what it takes to bring it back to the breath. This practice, greatly simplified here, on a daily basis can begin to increase one’s ability to be present, to be “awake” (as the Buddha said) to the texture of life, in all its up and down, sad and happy, full and empty, fleeting and timeless moments. Doing this with an innocence – a “beginner’s mind” – without striving for a particular state, without harshness or self-criticism, with compassion for one’s very experience, ethically, patiently, steadfastly, whether one feels like it or not, can have an effect on the function of the brain, the level of stress, the amount of “craving,” and the sense of dissatisfaction with life.
3J+L,d!O8Mi^0
G0Y8`'[n7`[0  This mindfulness practice often requires guidance, instruction, participation in workshops, retreats, and belonging to a group, which sits regularly. A teacher is helpful both in encouragement and in recognizing some of the obstacles to regular practice. But the experience is centered on regular intervals of focusing the attention on the breath. This is a solitary experience. It need not always be still. Many meditation practices include movement such as walking, tai chi type movements, yoga postures, and breathing. Once a person has acquired an ability to train the attention, to work with this back and forth between mental activity and observing breath, the practice of mindfulness can be taken increasingly into all the reaches of one’s life from doing the dishes, to writing, to driving, to swimming, walking, or even listening to patients in psychoanalysis.
P$Mu%i,R0
@)]&|H+{U`0  At first people are struck by the loneliness of the meditation practice. But gradually it is possible to become aware that you are keeping yourself company. If you can strengthen the discipline of self-awareness, you can develop a compassion for yourself. You can also begin to construct awareness of certain levels of mental psychological life. For example you can begin to develop an awareness of the push-pull of emotional reactions to thoughts, memories, and feelings. Certain experiences you like and want to pull them toward you. Other experiences you do not like and want to push them away from you. Seeing this layer of reactivity to the content of the mind begins to bring awareness into the operation of the lived process inside you. You become aware not only of the contents, but also of your reaction to the contents.心理学空间?tW v)^qA
心理学空间epu1M$?'n9U
  The Tibetan Buddhist concept of shenpa is often translated as “attachment,” but as Pema Chodron tells us, the word shenpa is closer to what we mean by getting “hooked.” In Western terms we speak of getting “hijacked” (Daniel Goleman in Emotional Intelligence) by an emotion. If we have built up a discipline of being able to stay in awareness, to keep our focus intact, we can see ourselves getting hooked and we can resist the urge to give in to it completely. We can imagine the consequences of surrendering completely to an emotion, see its origins, and keep it in the realm of contemplation. We can decide how much to put it into action, or into communication. For example, if a loved one wounds us with a slight, or worse, a betrayal, we can reflect. We can become aware of our pain, hurt, and anger. These are all forms of suffering. We can say, (as Thich Nhat Han advises), “My darling, I suffer, and I do not understand why you did (or said) what you did.” This kind of process opens up communication. But it takes great self-discipline to be able to first contain the shame of betrayal, then to put it into words to the very person who has wounded you (my darling, I suffer). And then to put forth the question, the quandary, “I do not understand.” This an open question that demands an answer. All of these relationship skills, and self-awareness capacities can come from this meditative awareness of the reactivity in your self.
&C*M,F\1A'_BYQ0心理学空间%?3M y)]$vo7q1P
  You also can begin to observe the shifts in mood from one day, one week, one hour to the next. This awareness of mood can then be included in your understanding of how the world looks to you at this moment. You can begin to include the effect that your mood has on your perceptions. Your own house, your little place where you meditate, can look beautiful and spacious at a time when you are in a good mood, or it can look small and dingy when you are depressed. You notice the shift in perception, the way your mood can be part of how you construct your experience.心理学空间:s?'~+W1abn
心理学空间nW \,L0k&g
Psychoanalysis: The Person on the Couch with Another Person Listening
心理学空间h6v'i7WORh

'|$k G@U.D0  These examples of the accumulation of self-awareness through the practice of contemplation also provide a bridge to how we might think of psychoanalysis as a two-person practice of mindfulness. There are several basic building blocks that we should list as we turn our attention from mindfulness toward psychoanalysis.心理学空间IOt9x3D;]+g,Pj
心理学空间%KLX|ZBXxR
1.  People who sit in close proximity engaged in a structured interaction can sense how the other person is feeling at the moment. Current psychoanalysis refers to this as intersubjectivity.心理学空间6n(t*lINz4|-l{
2.  One of the basic ways that human beings grow and form a sense of the world is through their attachments to other human beings: child and parent, husband and wife, student and teacher, friend and friend, analyst and patient.
dn&p0x r:Q*m03.  The way we perceive current relationships is largely determined by our histories and past relationships. That is, if close relationships have largely been predictable and trustworthy, our approach to future relationships will tend to be trusting. If our intimate relationships have been seductive, exploitative, or traumatic, we will tend to experience others in new experiences as if they are going to treat us similarly.
F(ds6n2kH9Ms04.  The human brain is capable of great change throughout the life cycle. This capacity for brain growth is enhanced by conditions of low stress, opportunities for self-reflection, and by the participation of a skilled guide.
iP#[*Q CS&G;[Zp05.  The optimal condition for changing an ingrained habit of relating to others is when the relationship with the guide feels as if it is a repetition of the past; the difference is, however, the conscious process of observing that familiarity with the guide, and the understanding that the guide is functioning as a “ghost” of the past. This is called “transference.” As the ghostlike quality dissipates through the psychoanalytic dialogue, the guide is seen more clearly.  This is called “working through” of the transference.
CU7_Nq_+Y0
JOo6sW'h0 
T)~ n7E'U n,q._3w}"]0  One important theme that joins psychoanalysis with the practice of mindfulness is contained in the word: reverie. Bion states it as the therapist approaching the patient “without memory or desire.” Reverie can be defined as awake awareness of inner and other process, intact connection to physical, preverbal, visual, emotional, and verbal (metaphoric) information. It is the capacity for reverie in the psychoanalyst, which provides the container in which psychoanalysis can occur. This capacity for compassionate, attentive reverie – in the face of such emotions as pain, distress, trauma, and shame – provides a basic medium for growth in analytic patients.
,pj/a'r8Y.s]0
[9QfW$[0  But reverie itself is not enough to foster growth in the psychoanalytic paradigm. There are two other elements. One is provided by what the patient says from his/her experience. And the third element is provided by what the analyst says from his/her experience of what the patient is saying, what he/she thinks is going on between the two of them, and what he/she is sensing from the patient. These statements of the analyst may also contain perceived connections, possible meanings, and the noticing of interruptions, shifts, or links between various moments in the dialogue. A day of psychoanalytic practice is like a series of two-part meditations, where the analyst allows him/herself to be filled with undigested bits from the mental world of the patient. These bits (an idea from Wilfred Bion) are not only contained but also mentioned, noted, talked about, “processed” in the dialogue between analyst and patient. The digestion does not only occur in the pot of mindfulness within the analyst’s reverie. It also occurs in the recognizing efforts of the analyst’s statements and the patient’s reactions to those statements. Sometimes the patient will resist the emerging memory, awareness or understanding. The analyst and patient will need to work with this natural tendency to fight off new insights or painful realizations. The process becomes a conversation with a high degree of attentiveness on the part of both the analyst and the patient. Thus, the unconscious becomes conscious in several ways. Some elements of the experience of the past are seen for the first time. Some capacity for reflection, for “staying” (Pema Chodron’s word) with the painful experience as it is recounted, or even re-experienced on the couch, may literally increase over time in the interaction. This is a process of becoming more “awake” through growth in the interaction (numbers 3,4, and 5 above).
%n0z#^UD0
}PK(d1y#Z0|s0  I once asked my analyst what insight he had into what I had said. “Insight,” he said, “that’s your department.” This occurred in a context where I felt held in his containing presence, his occasional questions and reflections. But it also prevented me from placing the responsibility for my learning on his head. In his reverie state he made a place for my out loud, verbal and nonverbal meditative musings. His attention, combined with a gentle refusal to take the wheel of my life provides both nourishment for my coming into wakefulness, and an insistent recognition of my ability to learn meaningfully from my own relayed experience. In this brief example from my experience, I am describing a kind of “growing up” in the psychoanalytic relationship. Then I experience a kind of relationship between the analytic growth, which has become part of who I am as a person, and the meditation practice, which I have been practicing over many years now. As I practice meditation, yoga, mindful walking, and doing, I find that my capacity for reverie with my patients, for reverie with myself, is getting better, broader, and more stable. I keep finding new reserves for staying vital, calm and attuned for the next patient – and the next. And this, in turn, feels like a way to renew my connection to the developmental growth and self-knowledge that occurred in my own psychoanalysis.
so1O|I M0
sC-Q+|WZiz@]O/P0Evocative Statements
心理学空间 K` U l k?$[d1}6a \
心理学空间5B{7\xEQ_ [(cM"g"v j,[Q
You have to acquire a sense of self before you can lose a sense of self.” Jack Engler, psychotherapist and vipassana meditator in Cambridge, Mass心理学空间;`!H^C9Q{ v
心理学空间4d?5[:Vn
  There is a great deal of discussion in the meditation/mindfulness community about the wisdom of this statement. Partly this debate stems from the fact that mindfulness is based on a goal of transcending the Self, or transcending Ego, as it is often referred to. Ego, as a word, and as a concept, means two very different things to a meditator and to a psychoanalyst. In mindfulness, or Buddhism, the Ego is seen as source of suffering, of selfishness, greed, and craving. This form of self should fade during the days, months and years of a disciplined mindfulness practice. In psychoanalysis this kind of self would be called “narcissism” – preoccupation with greed, and insecurity masked by pompous, selfish, judgmental, impatient, heartless behavior. If we align the mindfulness term ego with the psychoanalytic term narcissism, then the two disciplines can be said to have the same goal: the diminishment of this kind of self which promotes unhappiness and suffering in the person, in their family, and by extension, in the world.心理学空间qK_$D }

"P6|{FOc*O.mU0  When we use the term ego in the psychoanalytic sense we are talking about functions of a human being. A healthy ego is self-aware, compassionate, able to observe self-experience, to care for the body, and for others. One important example to understand Jack Engler statement occurs in the instance of great trauma, either in childhood, or disaster, or war. When a human being is subjected to trauma, one primary coping strategy is to dissociate, to “send the self away.” A victim of childhood abuse will describe “watching it happen as if I was on the ceiling, outside my body.” This is a damaged self. Such people suffer greatly in the world, in their relationships. If they suddenly find themselves in a meditation class, being asked to pay close to attention to their breathing, they may bolt for the door in a state of great panic. Remember the reference to “undigested bits of experience.” This person suffers from this and finds their way into psychoanalytic treatment, perhaps feeling suicidal, or “not knowing who they are.” They may need some time in psychoanalytic treatment to develop ways of living with memories and feelings that don’t involve disconnecting. They become ready to inhabit their body, as it were. They have acquired a “sense of self” and that may make it possible for them to begin a mindfulness practice that provides a practice of being on more intimate terms with their present moment experience. 心理学空间D&BE3y[.Zh1r;u3a

lm7{"X;f#s0“Mr. James Duffy … lived at a little distance from his body.
” James Joyce, The Dubliners心理学空间y ? u%k*_.vXfK
 
}5aa9w:]-n5E:P%a-b _6UB&E0One general impression people have of psychoanalysis is that it is very heady, very intellectual, and focused on thoughts, interpretations, and meaning. This view overlooks how much the actual practice of psychoanalysis is grounded in an awareness of the body. Freud states, “The Ego is first and foremost a bodily Ego.” When I began my own psychoanalysis, I was pleasantly surprised to hear my analyst describe the basic instructions as follows: “Try to say whatever comes to mind: thoughts, feelings, memories, dreams, perceptions, and bodily sensations.” Thus the analysis included a focus on bodily experience, which could include moments of being “out of body” as in dissociation. This grounds the analytic dialogue in the present moment, and it lays the framework for James Duffy to, perhaps, decrease the distance between his subjective experience and his body.
S/}%w@8zw&Y4c0心理学空间OA s(pJ;Z,NQo
Likewise, mindfulness bases its approach on attention to the physical body. The rhythm of the breath is a felt, physical medley of sensations. The dialogue in meditation between attention to the breath, and the noticing of where the attention was taken off to is a conversation across that “distance” that James Duffy lived from his body. By including an emphasis on refraining from judgment, the practice of mindfulness makes room for those who begin with a sense of great difficulty sitting still, or attending to physical phenomena. Walking meditation, yoga postures, tai chi movements, and many others attempt to provide ways for restless, dissociated people to begin to enter a conscious relationship with their bodies.  As stated above, some traumatized people may require a period of psychoanalysis, or supportive group work, or even medication (SSRI’s can be very useful in calming a traumatized nervous system) before they feel safe enough to fully enter an attentive conversation with their own interior physical experience.
,zSo|M4s7^0心理学空间n(A.nr Pzoo3jM
“One acquires a sense of a center by being centered upon.
” Hans Loewald, a psychoanalyst心理学空间0Mo9s,NV1GCoG l
心理学空间VB1N9^:pUU
This presents another angle on the importance of secure attachment between a person and their caregiver. Daniel Siegel (The Mindful Brain) who has studied attachment theory (a branch of study within psychoanalysis of the process of connection in early human life) with Peter Fonagy and others points out the relationship between mindfulness practice (meditation) and human needs for secure attachment.  On the journey of meditation, one begins to form a more enduring sense of attachment to one’s basic existence.心理学空间8pm[oQ#M {-i d@ R
心理学空间N.{:\*Uo:@+BAo
Psychoanalysis, in Hans Loewald’s view, provides an opportunity for patients to resume their own development. Because human beings, from cradle to grave, are profoundly equipped for relationships, the framework of an attuned, listening analyst coupled with the patient who seeks relief from suffering can be seen as a dyad which is analogous to a child and a caregiver. Because the patient lies on the couch (metaphorically as well as actually) their attention and expressed experience of the relationship is freed from too much pre-occupation with the reality of the analyst. It is profoundly different from a conversation with a friend. It is more like a friendly (or sometimes not so friendly) conversation with one’s ghosts. The analyst participates in this by having prepared his/her self (by their own extensive analytic work on themselves) to be a flexible participant in this re-creation of traumas, unmet needs, abandonments, seductions, and amnesia. The process is often stalled. Sometimes the search for understanding feels more like a search for a lost child. And the patient sometimes does not feel so much “figured out” as they feel “found.” They acquire a “center by being centered upon.”
+v)@%g-_(A F0心理学空间_4{"V(tB8b
"Wisdom tells me I am nothing. Love tells me I am everything. Between the two, my life flows." Nisargadatta Maharaj
ED.U;d.z0
[Eav9b/iKw0Both psychoanalysis and mindfulness, as disciplines of human awareness, have to make room for the lifelong ebb and flow between reason and desire, between thought and body. It is not conducive to a full and honest view of human life to pretend that this constantly flowing relationship between love and wisdom is ever over, at a standstill, or resolved. The awareness, which is cultivated in mindfulness, needs to be a compassionate awareness, with room to observe the urges of the heart. The consciousness, which is cultivated in psychoanalysis, needs to include some work on conflicts, which prevent one from honest expression, from taking risks and stands. The experience of shame keeps the self hidden and restricts one’s ability to fully participate in life. By reconnecting with an attentive other there can be a freeing of one’s flow, of one’s effort to understand and to love. Freud’s best hope for psychoanalysis was that it would help people in their “work and love.” 心理学空间pRyMv/m|

心理学空间6X?FZ7c6qk6F:@x?

6Ng!^1A0ud0www.psychspace.com心理学空间网
«灵性权威(spiritual authority)与修行~超个人心理学学者的观点 佛教与心理咨询
《佛教与心理咨询》
关于《精神分析与佛学》»