James S. GrotsteinBut at the Same Time and on Another Level..._. Volume 2, Clinical Applications in the Kleinian_Bionian Mode


作者:James S. Grotstein

粗译:胡尚伟  松原梦空间心理咨询室

1.       Klein and her followers, including Bion, seem often to do otherwise. They consider that the analysis has already begun with the beginning of the consultative interview and, while interested in past history, do not especially ask for it but allow for it to emerge of its own accord. In other words, they follow the prospective analysand’s free associations and interpret transference from the beginning. The latter was my experience in my Kleinian (Albert Mason) and Kleinian/Bionian (Bion) analyses. 克莱因及其后继者,包括比昂,都不这样做(在初次访谈时就和潜在的来访者说明现实的、面对面的咨询与将要做的分析的区别)。他们都认为分析在初始访谈之前就已经开始了,尽管对病人的过去非常感兴趣,但他们建议不要特别询问而是允许它们自然呈现。换句话来说,他们跟随潜在病人的自由联想并在分析一开始就解释移情。这是我先后与克莱因派分析师(Albert Mason)和克莱因比昂派分析师(比昂)一起作分析的经验。

2.       Once psychoanalysis has been agreed upon and I suggest that optimally they should come five times per week, analysands-to-be may be shocked and frightened, especially by associating this frequency with the degree of their psychopathology. I explain that the frequency has nothing to do with their illness but constitutes the nature of the procedure that works optimally under these conditions. I go on to say that when the analysand is seen that often, then emotions and thoughts that an analytic session may evoke can then be dealt with in the following session and/or sessions. Otherwise, they would return to the unconscious and not be dealt with. 一旦分析开始,我建议他们最好每周分析五次,分析者也许会惊吓到,特别是当他们把这种高频率和疾病程度建立正关联的时候。此时我会解释,分析的频率与他们的病情无关,而是与他们所使用的方法的性质相关,这种方法在这种频率的情况下工作最佳。还有,当分析者经常被看到,那么在一个分析小节中被引发的情绪和思考会在接下来的一个小节或几个小节里及时得到处理。否则,他们将会再次回到无意识中去,而没有得到处理。

3.       I also explain to the prospective analysand how he is to proceed once the analysis commences: that the fundamental rule (Freud, 1913[1912–13], p. 207) requires him to say everything that comes to mind, no matter how seemingly irrelevant or embarrassing. With regard to how I shall proceed, I explain that my task is to listen to his freely formed utterances until I have an idea about what the unconscious part of his personality is trying to convey to us. My interventions will mainly be interpretations—that is, my impression at the moment of what their own “interpretations” about themselves seem to be. I may also ask questions about information that is not at my disposal. Sometimes I may try to clarify. I also explain that their own questions to me are to be considered as free associations and may therefore not necessarily be answered directly or perhaps even at all, that this practice is not evasive or rude on the part of the analyst but is due to the fact that a thought, statement, or phantasy had been operant before the question was posed, and that this forerunner of the question (why was this question asked?) takes precedence for analytic consideration.我也会向潜在的分析者解释分析是如何开始的:基本原则是要求分析者说出任何出现在他脑海中的想法,不管这些想法多么荒唐或尴尬。我也会向他解释,我的任务是倾听他自由发出的声音直到我对他试图传达给我们的他自己人格中的无意识部分而我也有想法时。我的干预主要是解释——在我看来,这种解释看起来是他们自己为自己解释。我也会询问一些问题收集信息。有时我也会澄清。他们问我的问题会被看做自由联想,所以我不会直接回答甚至不回答,这样做并不代表分析师在逃避或粗暴而是基于以下事实,一个想法,一个论述,或者一个幻想在问题被提出之前就已经存在了,而从分析的角度来看,这(为什么问这个问题)比那个问题本身更重要。

4.       Bion established the connection between the contact-barrier1 and the analytic frame. Put succinctly, the analytic frame, which mediates the relationship between analysand and analyst, is the external counterpart to and extension of the intrapsychic contact-barrier, which, in turn, mediates the protective separation between Systems Cs.and Ucs. (Bion, 1962b, p. 17). 比昂把分析设置与接触屏障这个概念联系起来。简单来说,分析设置是个体内在接触屏障的外在对应部分及其延伸,分析设置调节的是病人与分析师的关系,而接触屏障调节的是意识和无意识的关系。

5.       The interpretative stance of the analyst is the analyst’s focus on the frame of the analytic relationship between the analysand and himself in the transference ↔ countertransference ↔ reverie situation: that is, he must “frame” both the analytic setting and the analytic process and function within it. He must, in the final analysis, with some legitimate exceptions, conduct the analysis by (a) allowing it spontaneously to unfold and intervene only by way of interpretations, in the broad sense of the term, which would include confrontations, questions (if necessary), and so on. If at all possible, the analyst must not converse with the analysand. In other words, the analyst must vouchsafe the analytic atmosphere. 分析师的解释立场要聚焦于分析框架上,即分析师与病人的移情关系反移情关系入神状态这三者上:也就是说,他必须把分析设置和分析方法以及功能都框在内。最后,除了一些必要的例外之外,他必须这样做分析1)允许分析自然展开,且只能通过解释的方式干预,这种解释在更广泛的意义上来说,包括面质,和提问等等。分析师尽可能地不要与病人谈心。换句话来说,分析师必须提供和维持分析的氛围。

6.       Should the analyst ask questions? This seems to be a controversial issue. I believe that, as a rule, questions should, if possible, be avoided unless the analyst feels the need for information from the patient about one or another of his associations or about unknown aspects of his past history. The analysand’s associations themselves generally furnish the soughtafter answers. One typical question analysts and/or therapists often put to their analysands is: “Why is it that you always find men (or women) of this character type?” This kind of leading question forces the analysand to become his own analyst. There is another reason for the interdiction against questions, however. The analyst may legitimately and innocently ask a question but may fail to realize that his “innocent” question may be heard by the analysand as a criticism, recommendation, or command—because of the presence of the transference, particularly a superego transference. 分析师应该问病人问题吗?这目前是一个有争议的问题。我认为,通常来说,如果可能的话,分析师应避免问来访者问题,除非分析师感觉非常有必要从病人那里获取有关他的联想的信息或者有关他的成长史方面的信息。病人的联想一般会自己提供答案的。分析师或治疗师经常会问病人的一个典型问题是:为什么总是寻找这种类型的男人(或女人)?这种引导性的问题迫使病人成为自己的分析师。禁止分析师询问病人问题的还有另一个理由。分析师也许合理且无辜地询问病人一个问题,却没有意识到,他的无辜询问却被病人听为一种批评,建议或者命令——这是由于产生了移情,特别是超我移情。

7.       A supervisee presented a clinical case to me of a middle-aged patient who was suffering from bipolar illness (Axis I of the DSM)and a primitive mental disorder (Axis II). For quite some time the patient would characteristically listen and respond positively to the analyst’s interpretations and then go to sleep or enter into a twilight state. The supervisee complained to me that “the patient was dead in the session!” I replied, “No, the patient was not dead. She was dramatically displaying her wish to be dead at that moment in order to avoid the anxiety of the changes that would occur if she fully digested your interpretations.” The supervisee agreed. 一个治疗师找我做督导,他提交的案例是一个中年人,正在遭受双相情感障碍和原发心理障碍的痛苦。很长一段时间,这个病人都在倾听并积极地回应治疗师的解释,之后睡着了或者半醒的状态。治疗师向我抱怨说:者病人在治疗过程中死了!我回应说,不,这个病人没有死。如果她完全接受你的解释,将要发生的改变给她带来较大的焦虑。为了回避这个焦虑,她只是戏剧性表达在那个时刻她要死的愿望。治疗师同意我的说法。

8.       I have become aware during many psychoanalyses of a need to rethink the rules of the analytic frame—rules that I had taken so much for granted from my psychoanalytic training that they had become an unthinking catechism. Having reflected on the subject, I have developed considerations of my own. When the analytic frame (setting with boundaries) is intact and vouchsafed by the analyst’s demeanour, the unconscious seems to feel freer to surface and express itself. It is as if the unconscious knows that psychoanalysis is a special form of play in which the boundaries must be in place for the sacred and most personal drama to emerge to be played out. It finally occurred to me during the analysis of a young woman who was in an erotized transference to me that the boundaries had to be in place and the rule of abstinence in effect so that she could experience the fuller nature of her libidinal self without the interference of her self-discovery by the actuality of intercourse. In other words, it is as if there are two forms of sexual intercourse: the form that takes place between two real lovers in the external world, and the other, which can only take place in psychoanalysis—in the internal world in the reveries of the analysand and analyst over the sacred network guarded by the rule of abstinence. The rule of abstinence and the covenantal protection offered by the analyst’s maintaining the frame provide the optimum opportunity for the analysand to experience the full range of sexual entelechy (inherent potential). 做了许多的分析,我渐渐意识到需要重新思考分析框架中的一些规则——这些规则在我的精神分析培训中那是理所当然,就该是那样的,现在它们变成了缺乏思考的选择了。在这方面我做了很多的反思,我渐渐形成了自己的看法。只有分析师努力提供和维护分析框架(设置与边界),无意识才能够自由地浮现并表达自己。就好像无意识知道精神分析就是这样一种特别的戏剧形式,在这种戏剧中必须维持其边界最隐私的个人面具才可以演绎出来。最后我想到了我第一个女个案,她对我产生了性欲移情,正是我维持住了边界并实施了有效的节制原则,如此她才能够更加重复体验她的力比多自体的本性,而没有受到现实意义上的性交对她的自我探索的干扰。换句话来说,就好像有两种形式的性交:一种发生在外在世界,两个真正的爱人在做爱;另一种,只发生在精神分析过程中——在内在世界,病人与分析师的遐想当中,在这里由分析师的节制原则所保护着。分析师所维持的框架所包含的节制和契约保护为病人体验完整的性心理活动提供了机会。

9.       Analysts have gradually become aware that the analytic frame imposes a sense of constancy for the analysand and becomes Tustin’s (1990) “rhythm of safety”. It represents an invariant in the psychoanalytic process against which, or within which, the psychoanalytic variables—impulses, affects, life circumstances—contend. 分析师渐渐意识到,分析框架是向病人传达一种恒定感或者就是Tustin所说的安全的节奏。在精神分析治疗中,它代表着一种不变的参数,来对抗或平衡那些精神分析的变量——冲动、情感、生活环境——竞争。

10.   After my analytic experience with Wilfred Bion and then with Albert Mason, both of whom, I felt, approached the ideal for the conduct of an analysis, I would recommend that the analyst should confine his interventions mainly to interpretations—as much in the transference as possible—and avoid explanations or educative remarks. 根据我分别与比昂和马森两位分析师分析的经验,我觉得他们都非常接近我所认为的一个分析师如何做分析的理想状态,因此我建议,分析师应该把他的干预主要放在解释上——尽可能地解释移情——同时要避免做说明或教育性的评论。

11.   I recall a highly intelligent, extremely well-read, articulate “wunderkind”who entranced me with his gifts many years ago. I found myself idealizing him and then realized that our roles had become switched. My self-analysis of the situation was as follows: Before I had entered medical school to become a psychoanalyst, I had wanted to pursue a career in English literature. After my career change, I still continued to feel that I had lost something in my life, and I looked upon my erstwhile career choice with fondness. The analysand represented my abandoned career in English literature. Unconsciously, I had been living vicariously through my analysand and thus failed to analyse how he was using his field as an analytic resistance. I had been in a folie à deux with him. Once I realized my vicarious involvement with him and his career, I was able to become separate from him and to offer meaningful interpretations to help end the analytic stalemate. 我想起了一个非常聪明、极其博学又很善于表达的神通,很多年前,我被他的才华所着迷。我发现我理想化了他并意识到我们双方的角色发生了转变。于是我就对我当下的处境进行自我分析:在我进入医学院并成为精神分析之前,我本想从事英国文学的。后来我的职业发生了变化,可这让我感觉在我的生命中丧失了些什么,以前的职业我依然很喜爱。这位病人就象征着我放弃的英国文学。不知不觉中我已经开始通过病人过自己的文学美梦,结果没有能够对病人的职业做阻抗分析。我理想化了他。一旦我意识到我卷入了他的职业感受,我就能够从那里分隔开来并能够提供有意义的解释来帮助结束这个分析僵局。

12.   I have written about Bion’s use of the frame elsewhere (Grotstein, 2007). An example of it from my analysis with him shows him in action: Once, during a moment of negative transference, I criticized Melanie Klein (his analyst). Bion’s response was as follows: “Oh, did you know Melanie Klein? How did you know her?” Bion was not being sarcastic: he was showing how completely he maintained the frame in the session. Rather than directly interpreting my negative transference at that moment and seeing that I was emotionally and epistemically closed up—that is, couldn’t think, only rail at him—he sought to open me up in order to clear an empty, unsaturated space for thinking. He was indirectly reminding me that I had not known Melanie Klein, because I had never met her, let alone analysed her! 比昂如何使用框架我在别处已经写过。有一个我接受他分析时的例子: 有一次,当时我对他产生了负性移情,我批评梅兰妮克莱因(他的分析师)。比昂的回应是:噢,你认识梅兰妮克莱因吗?你是如何认识她的?比昂的回应并没有嘲讽的味道:他在向我展示他如何维持了分析框架。在那个时刻,他没有直接解释我的负性移情也没有直接指出我情感和认识上的闭塞——也就是说,不动大脑,只是一根筋地认为——而是,他试图把我打开,清理出一个空的,没有饱和的空间供我思考。它也是在间接地提醒我,我并不认识梅兰妮克莱因,因为我从来没有见过她,更不要说分析她了。

13.   It will be seen that the rule of giving equal notice to everything is the necessary counterpart to the demand made on the patient that he should communicate everything that occurs to him without criticism or selection. . . . The rule for the doctor may be expressed: “He should withhold all conscious influences from his capacity to attend, and give himself over completely to his ‘unconscious memory’”. Or, to put it purely in terms of technique: “He should simply listen, and not bother about whether he is keeping anything in mind.” 我们将看到,同等对待分析师中所发生的事情也适用于病人,他应该说出所有的事情而无需评判或选择。。。。。 适合分析师的表达可以是这样的:他应该克制住所有的意识层面能力的影响,把自己完全交给他的无意识’”。或者,更简单点说:他只是听就好,不用操心是否记得住。

14.   From the Narrative we learn that Klein believed that the infantile transference begins even in the first session and should be interpreted—not only the negative transference but the positive transference as well. After pondering the rationale for her advising interpreting the positive transference as well as the negative, I came up with the idea that she was seeking to protect the healthier cooperative part of the analysand’s personality from the negating part: the latter would be more clearly differentiated from the positive. In other words, the negative part of the personality is being placed in “quarantine”. What is of utmost importance, however, is that the Kleinian analyst is always seeking to locate the unconscious dependent infant and track him and his anxieties throughout the session.从《儿童精神分析的故事》这本书中我们了解到,克莱因认为,儿童的转移在第一小节就已经开始了,而且在开始就应该做出解释——不但是负性移情还包括正性移情。对此进行思考后,我发现她是努力保护病人人格中健康合作的部分不受负性(病态)部分的伤害:后者可以很清晰其区分出来。换句话说,人格中的负性部分被隔离了起来。最重要的是,克莱因派分析师一直在寻找那个无意识依赖的婴儿,然后在整个分析过程中跟踪他和他的焦虑。

15.   Interpretation of the maximum unconscious anxiety Klein believes that one should interpret the maximum (not necessarily the deepest) unconscious anxiety along with the defences against them. It became clear to me upon reading the Narrative that Klein (1961) was analysing unconscious anxiety as much as unconscious impulses, which she often felt were defences against them. Her therapeutic stance was interesting. When classical Freudian analysts first interpreted the defences, they thought these guarded against the drives. Furthermore, they saw the analytic task as interpreting the defences so that the repressed could become conscious. In a way it seemed that the analysand was the actual analyst and that the nominal analyst was a surgical midwife who removed the defensive adhesions to the emergence of the unconscious (Glover, 1931; Fenichel, 1941; Greenson, 1967). Klein, on the other hand, believed that defences were mainly erected against unconscious anxiety associated with relations with internal and external part-objects and whole objects. 解释最强烈的无意识焦虑 克莱因认为分析师应该解释最强烈的焦虑(不必是最深的)及其防御。从《儿童精神分析故事》中我渐渐发现,克莱因分析无意识焦虑和无意识冲动一样多,那些焦虑是对冲动的防御。她的这个治疗角度很有趣。当经典弗洛伊德派分析师首次解释防御时,他们认为这些防御时防御本能驱力。另外,他们把分析任务看做是对防御的解释,如此被压抑的内容才能意识化。从这个角度来说,病人才是真正的分析师,被称为分析师的这个人只是一个接生婆,她解除了防御,无意识自然出现。另外,克莱因还认为,防御主要针对的是无意识焦虑以及相关的内在与外在的部分客体和整体客体之间关系。

16.   When I was in analysis with Bion, he frequently emphasized that I may be in danger of thinking of him as the authority and of his interpretations as authoritative. I should, instead, he cautioned, “Listen to yourself listening to me. Your emotional response to what I say is the authority”. For Bion, the quintessence of technique is for the analyst to pay exquisite “attention” (listen) to him or herself in the act of passively listening to the analysand. That is what he really means by “reverie”. 在我与比昂做分析的时候,他经常强调我也许处在某种危险当中,即把他看作权威,把他的解释看作权威性的解释。我应该反过来,他提醒我说:在听我说的时候你要听听你自己。你对我所说的的情感感受就是权威。对于比昂来说,一个分析师的标准做法就是在被动地倾听病人的时候对他自己或她自己也要多加留意。这就是他所说的遐想的真正含义。

17.   I have learned from my own experience and from that of my colleagues and supervisees that the act of monitoring the analysand’s text has become more complicated over the years. Freud (1912b, pp. 11–12) suggested that the analyst should listen with even hovering attention to the analysand’s manifest content until he is able to discern a pattern that he feels able to interpret. Bion (1970, p. 31) suggests the same with his idea of abandoning memory, desire, understanding, and preconceptions. In fact, Bion often suggested, following a letter from Freud to Lou Andreas Salomé (1966, p. 45), that one should “cast a beam of intense darkness into the interior so that something hitherto obscured by the dazzling illumination can glitter all the more in the darkness” (personal communication,1 1974). I advise the beginning psychoanalyst and/or psychotherapist to respect this intuitive mode of listening but not to follow Freud’s and Bion’s advice strictly until they are far enough along in their training and experience. Freud’s and Bion’s advice is based on their taking for granted that the analyst/ therapist had already been schooled and drilled in the basics aspects of analytic theory. A tennis professional recently informed me that, in his opinion, to attain proficiency with my backhand stroke, I would have to hit 2,500 consecutive backhand strokes before I could “forget it and take it for granted”. The same principle applies to conducting psychoanalysis and psychotherapy: Yes, one must forget theory—but only once one has learned and mastered it! One cannot forget a theory one has not yet learned!根据我的个人经验以及我的同事还有被我督导过的人经验,我了解到,多年以来,如何做到更好地注意病人的诉说变得越来越复杂了。弗洛伊德认为,分析师应该均匀地注意病人的诉说直到他能够有能力辨别某种模式,一种他能够做出解释的模式。比昂提出了类似的主张,即无欲无忆,没有理解,没有先入为主的观念。事实上,比昂经常提到弗洛伊德写给莎乐美的一封信,在那封信中说道,人应该把一黑暗之光照到自己的内心,如此有些东西才能黑暗中更加清晰显现出来,因为这些东西此前一直被耀眼的光芒给掩盖住了。我个人建议,新手分析师或治疗师要尊重自己的直觉倾听模式而不必生硬地跟随弗洛伊德或比昂的主张,直至他们有足够的训练和经验为止。弗洛伊德和比昂的主张是建立在他们想当然地认为分析师或治疗师在基本理论方面接受了足够的训练。最近一个网球专业人员告诉我,在他看来,要想达到熟练反手击球的水平,在我能够忘记且认为是理所当然之前我要连续击打2500次。同样的做法也适用于精神分析和心理治疗行业:是的,我们必须忘掉理论——但只有我们学会了并精通掌握了它我们才能够做到忘掉它!我们不可能在没有学会之前就能做到忘记它!

18.   Simultaneously with “right-hemisphere” listening, the analyst/psychotherapist should also do his best to enter into a state of meditative reverie—a waking dream state—that is, allow himself to enter a hypnotic spell, so as to become totally immersed in his own experience of the analysand’s total presence and being as his (the analysand’s) associations are flowing. Bion (1962b, p. 15) varyingly calls this latter process “dreaming the session” or “becoming” the analysand. They belong to the broader concept of containment of the contained (Bion, 1962b, p. 91). The concept of “becoming” the analysand—a notion that I believe he borrowed from Plato’s Theatetus (Jowett, 1892, Vol. 2, p. 155)—requires some elucidation. It is my belief that many of Bion’s terms suffer from condensation and from being stated in veritable shorthand. When he says, for instance, that the mother must “become” her infant or the analyst must “become” his analysand, it is my belief that what he really means is that the mother must allow her own pertinent, relevant, symmetrically (contingently) corresponding unconscious emotions and object experiences, which are her own O (native to her), to resonate with the O that she experiences to be present in her infant—after having introjectively partially counter-identified with the infant’s distress. When her own O is thus selectively summoned, the mother’s native O is found to be symmetrical and resonant with that of her infant (Grotstein, 2004a) (Schore, 2003a, 2003b) refers to this process as “right-hemisphere- to left-hemisphere” communication (p. 76). 在用右脑倾听的同时,分析师或治疗师也应该尽力进入冥想状态——醒着做梦的状态——也就是,允许自己进入催眠状态,如此才能够完全沉浸于他对病人的整个出现及其联想的状态的全然体验中。比昂把这种状态先后称作梦出这次分析成为病人。他们都包含更具广泛意义的术语容器容纳中。成为病人这说法值得多说一些。 在我看来,比昂的很多书术语都过于凝缩和简洁。比如,当我说,妈妈必须要成为她的婴儿或者分析师必须要成为他的病人,这里比昂要传达的真正含义是,妈妈必须要允许她自己的及相关无意识情绪和客体体验,即她自己的O,与她体验到的她孩子的O产生共鸣——在部分内摄地认同了婴儿的痛苦之后。当她自己的O体验被选择性地诱发,将会发现妈妈的O体验与她孩子的O产生共振,这种过程被称作是右脑与左脑的交流。

19.   The taking of notes is problematic. Bion exhorts analysts not to take notes because the very act of note-taking is honouring memory, which Bion eschews. The only justification for taking notes is for supervision or for research, such as publishing or presenting a clinical paper—or even for the sake of one’s being able to take a “second look” at what had happened that one had missed. Analysts and psychotherapists, however, are now mandated by state practice laws to take notes for protection against malpractice and/or for the sake of third-party insurance companies. It is an open question. My own point of view is that one should not be forced to take notes, but should voluntarily do so only if one feels the need or desire to, strictly for one’s own purposes. 记笔记是有问题的。比昂劝告分析师不要记笔记,因为记笔记是为了要回忆,而这是比昂所要回避的。记笔记唯一的理由是在接受督导的,或者为了研究,比如发表或提交文章——甚至是为了在错过后能够再看一遍。但是,国家法律要求分析师或治疗师记录笔记以免其渎职或者第三方保险公司要求记笔记。这是一个开放的问题。我个人的观点是,一个人不应该被强迫记笔记,但如果他个人出于自己的需要感觉必须、或者渴望记笔记,应该是可以自愿去记笔记的。

20.   In other words, the analyst (like the mother) must allow him or herself to enter into a wakeful dream state so that in his daydreaming he can become so immersed in the atmospherics of the analytic session—including the analysand’s essence, being, and affects—that he can, in her or his meditatively protected emptiness (unsaturated “no-thought” place) allow himself to become suffused with his own native reconstruction of his experience of the analysand. The reader will notice that I emphasize reconstruction within the self of an experience with the other rather than introjection, except for the initial step: introjective counteridentification, and I even suspect that: because, following Llinás (2001) and Damasio (1999, 2003), I have come to believe that introjection—and, for that matter, projection as well—are illusions! What Llinás and Damasio believe really happens is that the subject artistically reconstructs and reassembles the likeness of the stimulus object within himself. I would add that we then alter the reconstructed or reassembled image secondarily by our affects, this latter process being tantamount to what has come to be known as projective identification. Behind this argument is the consideration that psychoanalysis is divided into theory and clinical practice: thus, we must consider such phenomena as introjection, projection, and many other mechanisms and phenomena as being divisible into experiential and metapsychological considerations. My conclusion is that the patient (and the analyst) believes experientially that he has introjected or projected an object, but metapsychologically he has either reconstructed the image of the object within himself (introjection) or displaced emotional cathexis from his self-representation to his object representation (projection) (Jacobson, 1964). 换句话来说,分析师(就像妈妈)必须允许他或她自己进入到白日梦的状态,这样他才能够沉浸于整个分析的氛围中——包括病人的本质、存在与情感——在这个冥想受保护的空间(未饱和的没思维的空间)他能允许自己弥漫在一种氛围中,在这种氛围里,分析师重构了他与病人在一起的体验。读者将会留意到,我强调在自体内部重构与他者在一起的体验,而不是内摄,除非是在初始时:内摄不认同,我甚至怀疑:根据Llinás (2001) and Damasio (1999, 2003)的观点,我渐渐认识到,内摄——还有投射——都是幻觉。Llinás (2001) and Damasio (1999, 2003)他们认为真正的过程是,主体创造性地重建和重构了位于内在的客体表象。我还要补充的是,之后我们还要通过情感重建或重构这种表象,后面的这个过程就相当于是我们所谓的投射性认同。这么说是考虑到精神分析包括理论和临床实践:这样,我们必须考虑诸到把诸如内摄、投射以及许多其他的机制和现象看作是经验与元心理学的。我的结论是,病人(和分析师)从体验上感受到他已经内摄或投射了一个客体,但从元心理学上则是他要么是重构了内在客体的表象(内摄)或把情感投注从他的自体表象转移到了客体表象那里(投射)。

21.   Bion’s concept of “dreaming” the analytic session can be associated with his other concept of the analyst’s “‘becoming’ the analysand”, not identifying or fusing with but exquisitely and intimately simulating the analysand’s emotional state. In other words, “becoming” is not the same as at-one-ment, fusion, or identification! One must be separate from the object one empathizes with (becomes) so that one’s separate mind can function. 比昂的梦出这次分析这个概念可以联系到他的另一个概念分析师成为病人,不是认同也不是融合,而是带有情感地模仿病人的情感状态。换句话来说,成为不是成为那一方面,也不是融合,更不是认同。我们在同理(成为)客体的时候必须保持与其分离,这样我们的头脑才能发挥功能。

22.   “My mother won’t take the dog because she has too much work.” “My mother” may be understood as a reference to the real external mother, the “dog” to a real external dog and the “work” to the “mother’s occupation”. On another level, the characters could be considered in transference terms as parts of the patient, as projected internal images . . . “我妈妈不会带着狗了因为她有太多的工作要做。” “我妈妈可以被理解成真实的现实中的母亲的一个参照,这里的现实中的那条狗工作妈妈的职业也是如此 从另外一个层面上说,我们可以把这些表征从移情的角度上看做是病人的一部分,是其内在意象的投射。。。。

23.   Too often analysts of all schools, including the Kleinian, may be predisposed to offer stale, predictable interpretations about, say, the weekend or vacation/holiday break, about omnipotence, destructiveness, and so on. The interpretation should, if possible, emerge from surprising,unpredictable sources and be a surprise to the analysand as well as the analyst. The analyst’s predicable, prosaic, formulaic interpretations often unconsciously indicate to the analysand that the former has become saturated with and is now vulnerable to O. 各流派的分析师,包括克莱因派,经常倾向于给出陈旧、可以预测的相关解释,比如关于周末或假期的,全能感,破坏性的等等。真正解释,要做的话,应该是出于令人吃惊、不可预测的地方,不管是对病人还是分析师,这种解释都是一个惊讶。分析师的可预测的、乏味的、刻板的解释经常是下意识地向病人表明,这种解释已经饱和,现在已经成为了易受攻击的O

24.   Having been analysed by Bion, I am familiar with how he intervened with me, but I was not privy to his state of reverie, nor did know when he entered and/or left it. 我接受过比昂的分析,非常熟悉他如何做解释,但我却不了解他的遐想状态,也不知道他是什么时候进入遐想状态又是什么时候离开的。

25.   My own suggestion is that, as the analyst listens to a patient, he should respect his conscious—known or unknown—narratives and try to put himself into the patient’s shoes, so to speak. That place is, after all, where the patient is “consciously” located. Then, at the appropriate clinical moment, the analyst may say: “What you say may be true, and it is important, but at the same time and on another level I believe . . .” 我认为,当分析师倾听病人时,他应该尊重他意识层面诉说的——不管是知道的还是不知道的——的故事,并要努力把自己(的脚)放进病人的鞋里(即努力站在病人的角度去理解它)。毕竟那是病人有意识的落脚点。然后在分析中的一个合适的时刻,分析师可以说:你说的也许是真的,这也很重要,但与此同时在另一个层面上我认为。。。。。。

26.   Generally, the analyst (psychotherapist) is silent much of the time, his silence being part of the technique: it creates a speech vacuum that the analysand feels compelled to fill. 一般来说,分析师(治疗师)大多数时候是沉默的,他的沉默正是治疗的一部分:分析师的沉默在分析时创造了一种说话的真空,病人会觉得要填补这个真空。

27.   Thus, anxiety—and the defences against it—constitute the objects of interpretation. 焦虑及其防御是解释的目标。

28.   It is striking, too, that to Klein impulses may themselves constitute defences against anxieties (except for the death instinct), whereas in classical thinking defences defend generally against the drives. Bion (1963) conflated the drives with emotions, and the latter thereupon became the content of the repressed. 在克莱因看来,冲动(死本能除外)本身就是对焦虑的防御,而经典精分则认为防御一般防御的是驱力(本能)。比昂则是把两者混合在一起了,他认为防御的是带有情绪的驱力,如此情绪就成了被压抑的内容。

29.   First of all, following Freud and Fenichel, I would say that, generally speaking, the only thing an analyst should express is his opinion as to what the analysand may be preconsciously and consciously experiencing—that is, thinking and feeling. Otherwise his own opinions do not belong to the analysis. 首先,根据弗洛伊德和费尼切尔的看法,我要说,一般来讲,分析师所表达的唯一的事情就是有关他的病人在前意识和意识层面的体验——也就是说,病人的思想和感受,有关这些的看法。否则他所表达都不属于分析。

30.   A 27-year-old single male analysand had long been fighting the awareness of his dependency needs by minimizing the importance of the analysis and the analyst (me). He also treated his relationship with his girlfriend in a similar way. He reported an incident in which, while he was angry with her, he drove his car, with her sitting next to him, at a dangerous speed that frightened her. I confronted his recklessness in the following way: “I believe that not only were you sadistically trying to scare and dominate A (his girlfriend), but you were also defiantly demonstrating your contempt for me and control over me by relating the incident to me in which you were using A as a hostage to show me how impotent I am with regard to you. But I also think that, at the same time, you’re frightened that I won’t be able to handle that demon in you that has control over you.” After a few moments’ silence the analysand said: “I either can’t stand myself or can’t stand you and A. I’m afraid of surrendering. But I hear you to say that I’ve already surrendered to my own demon.” 一个27岁单身男性个案长期针对他的依赖型需要做斗争,其方式是贬低分析和分析师(我)的重要性。他也是使用同样的方式对待他的女朋友。他说一件事,当时他在生她的气,然后他开着车,他女友就坐在他旁边,把车速开到了非常危险的程度,吓坏了他的女友。 我用下面的方式面质了他这一鲁莽的行为:我认为你不仅施虐性企图吓唬和操控你的女友,你也是大胆地向我挑战,轻视我,控制我,你把这件事和我联系起来,在这件事中你使用你女友作为人质,来显示我对你多无助。但是我也认为,与此同时,你也被吓坏了,因为我没有能力对付你心中的这个魔鬼,它已经控制了你。沉默了一会儿,病人说道:我不能忍受自己,也不能忍受你和我女友。我害怕屈服。但我听你说我已经向我心中的魔鬼屈服了。

31.   The operative thinking of classical analysts was that, in effect, the analysand’s unconscious was really the authentic analyst, the one who knew the truth and who was always urgent in its need to reveal itself, whereas the analyst of record was more of a midwife whose task it was to clear away the analysand’s resistances and defences so that his unconscious could speak for itself. Thus, I feel that I was trained to accept that in classical analysis the process consisted of a monitored soliloquy: I was not to intervene precipitously and was especially to encourage the analysand to arrive at the proper meaning of his associations after I, the analyst, had cleared away the resistances. 经典精神分析认为,事实上,病人的无意识才是真正的分析师,病人的无意识才是真正知道真相的人,才是总是急于想揭露自己的人,然而分析关系中的分析师只是一个接产婆,他的任务是解除病人的阻抗和防御,这样病人的无意识才能够为自己说话。如此一来,我觉得我受训是要接受这样的看法,在经典精神分析中,精神分析就是一系列有监控的独白:我不能突然做干预,特别是在我,作为分析师,解除了病人阻抗后,我要鼓励病人自己理解他自由联想的意义。

32.   As a terminating patient aptly put it: “This is my life and this is my place in life. I must accept it as it is. My omnipotent expectations of being great are sadly melting away. I have come to accept myself as I am wherever that is in life’s pecking order.” 当一个要结案的病人很恰当地说道:这就是我的人生,这就是我在生活中的位置。我必须接受当下的状态。想成为伟大的人的全能期望现在化开了,有些伤感。我渐渐地接受在生命的链条中我就是在这样一个位置上。

33.   D. A diminishment of the superego taken place (Strachey, 1934). A terminating patient had a dream in which a tricky policeman was chasing him, but he, the policeman, turned out to be the murderer. This patient also reported that he was sadly becoming more realistic about me, that I had become demystified, which made him feel somewhat encouraged and also disappointed. In another dream I had become a big, friendly whale and then a smaller but helpful dolphin. (另一条结案时所表现出的特征是)超我出现的几率减少。一个要结案的病人做了一个梦,在梦里,有一个很狡猾的经常正在追他,但是他,这个警察,结果变成了凶手。这个病人说他对我越来越现实,这让他有些伤感,我不再那么神秘,这让他感受到鼓舞也感到有些失望。在另外一个梦里,我变成了巨大且友好的鲸,然后我又变成了比较小但很有帮助的海豚。

34.   E. One of the results of a successful analysis is that the analysand has incorporated a great deal of understanding of himself. The more traditional way of putting this is that the analysand has introjectedhis analyst. I would put it, following Bion, that the analysand has “become” more nearly completely himself, has achieved much of his entelechy, and has significantly evolved as a result of the impact of the influence of the analysis and the analyst. He is then better able to do some moderate form of self-analysis. 分析成功的结果之一就是,病人对自己有了大量的理解。用比较传统的说法就是,病人已经内化了他的分析师。按照比昂的说法,我觉得是,病人更加成为那个几乎完整的自己,达到了自己的圆满,是在分析师和分析师的影响下的衍变。他能够更好滴进行自我分析。

35.   F. Often in the terminal phase of an analysis I have found an interesting phenomenon: The patient begins to experience painful and/or shameful memories from the remote as well as from the recent past. We are always averse to those shameful memories that wash ashore on the beaches of our consciousness that seem to have a homing instinct to return to us so that we may rescue our lost, alienated undead, alter selves from the dungeons of memory. 在分析结案阶段我发现了一个非常有趣的现象:病人开始能够从或远或近的回忆中体会到痛苦或羞耻。我们并不愿意被羞耻的回忆洗刷我们的意识,但这些羞耻的回忆好像有一种要返回来的本能,正是如此,我们才能够拯救那个被囚禁在回忆中的已经失去、疏远但还没有死去还没有改变的自己。

36.   Steiner (1993) found that analysts generally interpret what they believe to be the patient’s inner thoughts and phantasies, but that in patients suffering from primitive mental disorders it may be necessary to address the patient’s belief of what the analyst was thinking. For examplethe analyst may interpret to the patient: “I think you are angry with me for my being absent and not being available to you over the weekend” versus: “I think that you think that I didn’t want to be here with you over the weekend.” (两种解释方式,一种以分析师为中心,一种以病人为中心)Steiner发现,分析师一般的解释是他们认为病人的内在想法和幻想是什么,而不是正在承受着原发心理障碍痛苦的病人,在他们那里他们认为分析师在想什么,对他们来说,这是有必要了解的。举个例子,分析师向病人解释:我认为你在生我的气,因为我要离开,那么在这个周末你不能见到我了。我认为,你觉得我不想和你一起过周末。

37.   The analytic session is to be considered as equivalent to a dream. Consequently, transference (and countertransference) is pervasive. Furthermore, individuals mentioned in the text of the session do not exist in their own right within the psychic reality of the analytic session. They are signifiers or displacements for (projective identifications of) objects of the analysand’s internal world and manifestations of the transference, including the analysand’s conscious and/or unconscious experiences of the analyst’s countertransference. (比昂克莱因技术的基本假设之一)每一个分析小节都被看做是一个梦。如此,移情(和反移情)是普遍存在的。还有,在分析中,每个小节从心理现实上考虑是不存在有着他们自己的权利的个体的,他们都是病人内在世界所投射出的符号或替代物,他们都是移情的表现,包括病人有意识的部分,以及分析师反移情的体验。

38.   As this parallel process progresses, the analyst is also allowing himself to suspend memory, desire, preconceptions, and understanding so as to become sensitively aware of his own unconscious emotions → feelings that harmonically resonate with the analysand’s emotions that perfuse his associations and being. 与此同时,分析师允许自己悬置记忆、欲望、预想和理解,如此才能敏锐地感受自己的无意识情绪情感——那些被病人的情绪所滋养所培育出来的共鸣的感受。

39.   I get angry, deny my anger, and fall into the black hole—I’m afraid of exploding, so I close down. 我很生气,却加以否认,于是我掉入了深渊——因为我害怕爆发,所以我关闭了它。

40.   Analyst : When you feel inadequate in the presence of another person, such as myself, who is important to you, one on whom you depend but who has the autonomy to leave you, an autonomy that the infant–you does not yet have—you doubly withdraw, you join the departing me and withdraw into yourself and also split off and attribute what you feel to be your inferior self to L, intimidating yourself as her. 分析师(作解释):当你在另一个人面前感到自卑时,这个人比如是我,一个对你很重要的人,一个你要依赖的人,而他却可以随时选择离开你,而这种自主权,婴儿——你还没有——你更加退缩,你要离开我,退入到自己的世界里,并把让你感觉到自卑的部分归因于你的妻子L,像吓她一样吓自己。

41.   Analysand: I’m too scared of my anger. If it’s a self-defence mechanism, why do I turn it against myself? I must have felt impotent as a child with my parents. I was exhausted and humiliated and had gotten no response from them. 病人:我太害怕愤怒了。如果说这是一种防御机制的话,为什么我要这么对自己?我一定是感觉到了与父母在一起时的无力感。我感到精疲力尽,我羞愧极了,忘记了对他们做出回应。

42.   Analyst : Your fear of your anger and your rage is not only because of their destructive powers but mostly because of their impotence. When you are angry, you reveal how much you care—and, when there is no positive effect, you feel humiliated and shamefully ineffective. You’re afraid of being angry with me also for fear I’ll analyse it rather than my being affected by it. Analysand: Boy, are you right. Yes, and worse than that, you could talk me out of it. Then I’d really feel foolish. I’m thinking now of my LSD experience when I was in the American Foreign Service. I remember how angry I felt about being abandoned. I was in a rage about that. It was a deadly situation—and I was all alone. Analyst: That was an example of your rage being so great that you felt that you’d “killed” your family, and then you were stuck being an orphan and also your fear that your rage could kill me for having been gone—as if you were trying to show me how I killed you off by being gone. 分析师:你害怕愤怒和暴怒不只是因为它们的破坏性,还有多数是因为它们背后的无助。当你感到生气的时候,你就会发现你有多在意——当你感觉这没用的时候,你会感觉到羞辱和羞耻。你害怕对我生气还因为我会分析它而不是静静地感受它的影响。 病人:你说的很对,分析师。就是这样,比这更糟糕的是,你会向我把它说出来。然后我会觉得我蠢死了。这让我想到那次吃摇头丸的感觉,当时我在美国外交部任职。我记得我有多么生气,我被抛弃了。我为此暴怒。那是一种濒死的状态——而且只剩我一人。 分析师:这就是你暴怒的例子,如此暴怒以至于你觉得你要杀死你的家人,然后你被迫困在了一个孤儿的状态里,你额害怕你的暴怒会杀了我,因为我要离你而去(度假)——就像你努力向我展示我通过离开你是如何杀了你的一样。

43.   Analyst : My being gone yesterday and your believing that I attended an important scientific meeting with our mutual friend and a really important scientist, a Nobelist, may have caused you not only to feel left out but also to feel very unimportant to me. I had more interesting and more worthwhile people to relate to than you, you felt. I also think that you tried to comfort yourself by a make-believe phantasy that, if you stacked the books together that were written by these other two important men who are associatively connected with you, you could pretend that you were not left out and were also important. Being left out occurred again when your wife asked you to accompany her alone on vacation and leave your son, S, with whom you are closely identified, alone—like you here now with regard to me. I feel that you are angry with me at the present moment, not just because I abandoned you but because you feel that I’m not sorry about it. I’d rather be famous and socialize with famous people than stay at home and take are of you. 分析师(作解释):昨天我离开了,你认为我和我们共同的朋友,一个非常重要的科学家,诺贝尔奖获得者,一起去参加会议,这不仅让你觉得你被剩下了而且你还觉得你对我并不重要。你觉得,我有比你更有趣且更有价值的人要交往。我还觉得,你在用一种幻想努力安慰自己,这个幻想就是,如果你把那两个重要朋友写的书放在一起,这样你就可以假装你没有被剩下,你也很重要。还有一件事让你感到被剩下,你妻子要你独自陪着她度假,把你儿子,你最爱的孩子,独自留下——就像你和我的状态似的。我觉得你现在对我很生气,不是因为我抛弃了你,而是因为你觉得我没有为此对你说抱歉。我选择了和有名的社交人物,而没有选择留在家里照顾你。

44.   The seasoned psychoanalytic reader may wonder why my interpretations are often, but not always, lengthy. I have found over the years that I have been more effective with analysands when I “spell out” the details of their unconscious phantasies and do not leave out ideas that are to be taken for granted. In other words, I now disapprove of “shorthand” comments and tend towards complete interpretations, which do not necessarily need to be lengthy, only complete. The virtue lies, not in their length, but in their aim towards thoroughness. 有精神分析经验的读者也许会好奇为什么我的解释频率那么高却又不长。多年来我发现,当我读出病人无意识幻想的细节且不保留那些想当然的想法,这么做对病人是有效的。换句话说,我现在反对速记式评论而倾向于完整的解释,这种解释不必很长,只要完整。解释的秘诀,不在于他们的长度,而在于他们的目标完整。

45.   Analyst: You seem to have taken my interpretation as an attack on your point of view, possibly because of the way I presented it. You thought that I thought you were selfish and wrong. If so, then I can understand your “confession”, which I believe was really a submission, underneath which must be a lot of anger and a feeling of my not having understood you. What I was trying to say was that you remain identified with S as the one left out. It isn’t that you want to separate me and my scientific partners or your parents of once upon a time (Note: I think I finally got it!), but that you don’t want to be left out, abandoned, which is both frightening and humiliating to you. But the cost of not allowing for your parents, past and present, to be alone is that you mysteriously, unconsciously absorb separated–apart parents into your internal world who then disallow your thinking your own thoughts clearly–that is, who don’t leave you alone with your own thoughts and unconsciously cause you to split your own family. 你好像是拿我的解释来攻击自己的观点,这可能是因为我解释的方式导致的。你觉得我认为你是自私的,是错的。如果确实是这样的话,那么我就能理解你的坦白,我认为那是一种顺从或屈服,它的下面肯定有着大量的愤怒并且觉得我没有理解你。我一直试图在说的是,你把你儿子S看作是了那个被剩下的人,你并没想把我和我参加会议的伙伴或者曾经你的父母分割开来,而是你你是不想被剩下,不想被抛弃,因为这让你感到害怕和羞耻。不允许你父母单独在一起,不管是过去还是现在,这样的代价是你潜移默化地把你要分割开的父母内化到心理,这个内化的父母不允许你有独立的思考——也就是说,不想让你和你自己的思想单独在一起,这导致你与你的小家庭的分裂。

46.   In his own unique way Bion often said to me, “I am not a psychoanalyst, youknow. I am only trying to become one!” 比昂用他独特的方式经常对我说:我不是一个精神分析师,你知道的,我只是在努力成为一个精神分析师。

47.   As for the issue of the Bionian influence in the clinical material: first of all, I addressed the analysand’s associations not only from the perspectives of the day’s residues (immediate past) and of reconstruction from the remote past, but also—and here is Bion’s (and Joseph’s influence)—from the perspective of the here and now: that is, what is going on between us right now. 关于比昂在临床材料中的影响:首先是,我提交病人的自由联想不仅是从日间残余(刚刚发生过的)和对遥远的过去的重构这样的视角,而且——也就是比昂(和贝蒂约瑟夫)的影响——还从此时此地这个角度:也就是正在我们(咨访)之间发生的事情。

48.   In Kleinian theory the moment when the good breast–mother (part-object) leaves her infant, the bad mother instantly appears (unconsciously). What accounts for this negative transformation? According to my reading of Kleinian theory, it is explained by an unconscious phantasy in the deserted infant in which the latter suddenly begins to hate mother because, if she knew how much he needed her to remain with him, she wouldn’t have left. The fact that she did leave means that she hates the infant and sadistically wants to torment him with her absence—to prove how omnipotent and desirable she is by making him suffer. 在克莱因的理论中,在好乳房-妈妈(部分客体)离开了婴儿的时候,坏妈妈会立即出现(无意识地)。如何解释这种负性的转变?根据我对克莱因理论的理解,这会通过处在饥饿中的婴儿的无意识幻想来解释。在幻想中,婴儿会开始恨妈妈,因为,她要是知道他多么渴望她和他在一起,她就不会离开。事实是她确实离开了,这意味着她(妈妈)恨他(婴儿)并且用她的离开想施虐性折磨他——通过让他痛苦来证明她有多么厉害。



标签: 克莱因  精神分析  比昂  解释 

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