早年客体关系中的皮肤体验
作者: Esther Bick / 4082次阅读 时间: 2015年12月09日
来源: 王蕾译 标签: 客体关系
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早年客体关系中的皮肤体验

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王蕾译

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NUS#Re t:J~.}0作者介绍:伊斯特毕克(1901-1983),是一名内科医生和精神分析师。出生于波兰,是一名犹太人。她创始并发展出观察婴儿和年幼儿童的一套方法,这套方法同时兼顾了科学性客观性以及如何使用观察者自己的情绪经验两方面。她接受梅兰妮克莱茵的分析,并于1949年,在约翰鲍比(John Bowlby)的邀请下来到塔维斯托克中心主要负责分析性训练课程的开发,藉此机会,她得以发展出婴儿观察训练并将其发展成为精神分析训练的基础课程。虽然她留世的文章很少,但都引起很大的反响,她的思想在整个英国,直到欧洲,甚至更大范围都有重要的影响力。

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`a ve/W!y0(1968). International Journal of Psycho-Analysis, 49:484-486心理学空间^X Pd&pW iJ)G;l

I9MHs}uf0(1968)国际精神分析期刊

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?4j R(c'E U}0The Experience of the Skin in Early Object-Relations心理学空间!DI*Z$z gwU

1\i_*?)q.C3`0早年客体关系的皮肤体验

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作者:伊斯特.毕克心理学空间'\ N3M:O"NUB-f(l

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;G5?8Mnh^W0The 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.心理学空间(QS4pT&d ]-I'G9S

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这篇短文的核心内容主要在于:婴儿皮肤的原始机能以及原初客体的原始机能,实际上涉及到最为初始的阶段是如何将人格组成的不同部分连接在一起而不是将身体的不同部位连接在一起。这个观点也可以用在精神分析研究移情中的依赖和独立。

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The thesis is that in its most primitive form the parts of the personality are felt to have no binding force 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 the stage is 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.

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+lp'l(C\@0在最为初始的状况下,人格的组成部分如同一盘散沙,彼此之间毫无吸引力,它们只能利用皮肤的边界功能被动的被聚合在一起。但这种涵容自体各个部分的内在功能就完全仰赖于内摄一个外部客体,才有能力去完成这种内在功能。然后,对客体的认同联同上述对自体的涵容一起,将取代婴儿的非整合状态并激发出其对内在空间和外部空间的幻想。只有在这之后,婴儿才会进入梅兰妮克莱恩(Melanie Klein)所描述原始分裂和理想化(自体和客体)阶段。在涵容功能没有完成内摄之前,那么能够包含整个自体在内的空间是不会出现的。内摄功能一旦损害,内在空间中客体的结构就会被损害。

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2~,`!iB0z,d'NY?0In its absence, the function of projective identification will necessarily continue unabated and all the confusions of identity attending it will be manifest.心理学空间Q/T#Q O!x

(MIP$\-Ib0一旦该功能缺失,投射性认同就必须以一种高强度的方式持续存在,以致于存在其中的全部认同困惑将都会被表现出来。

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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".

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在自体和客体的原始分裂和理想化(自体和客体)阶段,现在可以被看做是安顿于这个更加原始发展出的属于自体和客体的容器——各自的“皮肤”下。心理学空间5Fx1t1` ^w:ua8m6@

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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.心理学空间"L#{7jP d:fN6P!?at

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我将通过婴儿观察得到的素材来阐述这种早期阶段的波动。此举立意于区分非整合和去整合。非整合是指完全无助的被动体验,去整合是指在发展历程中通过分裂来实现的一种主动的防御策略。因此我们从经济学的角度来看,对此类情境的妥善处理有利于减少发生在非整合阶段的灾难性焦虑,而不处理的话个体会产生更多限制性的以及特殊的被害和抑郁心理学空间-x0AkUUQJ

%i6KX_b~9K!B z0The 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.心理学空间sVq6k8tKD

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在婴儿期非整合阶段,对涵容客体的需求将会体现在对客体——光线、声音、气味,或其他感官形式的客体——的疯狂寻找中。涵容客体是可以抱持关注的,因此至少可以暂时地让婴儿体验到人格的各个部分被抱持在一起。积极的客体是婴儿口中含着乳头的同时,身边有一直抱持的、说着话的以及气味熟悉的母亲。心理学空间r*];u~|5]aWb

n&dOts,MKE0Material 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.心理学空间+R+a\|sZC

:Wh}1c2z;G@&fh0皮肤是如何具体地被体验为一种涵容性客体将在素材中显示。不论是适应现实客体的功能不足,还是幻想中的攻击所导致的原始皮肤机能的发育缺陷都会损害内摄机制。原始皮肤的机能紊乱出于创造一个替代的皮肤容器的需要将会导致"次级皮肤"形式的发展。这个需要依赖客体才能发育的功能或许被假性独立所替代,或被不恰当地使用特定的心理功能所替代,或可能被天赋所替代。接下来的素材将会给出一些“次级皮肤”形式的具体例子。

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L8\!vQs'A0Here 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.心理学空间;S anDg#hL

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在此我仅阐述帮助我们获得以上发现的一些临床实例。我公布这些实例是为在接下来的文章中公开这一话题用作细节讨论抛砖引玉。

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a"Q9]-_5v2UD2G0Infant Observation: BABY ALICE

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P.s5Bgx |0婴儿观察:爱丽丝宝宝

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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.心理学空间9D y!m,M8v"HZZ"p

'[%D7i:?u1E:g0对这个并不成熟的年轻妈妈和她的第一个孩子的观察为期一年,直到十二周就已经在"皮肤涵容器"功能方面显示出明显的发展。一旦妈妈能够容受的和孩子的亲密增加,孩子就会爆发出生命力。另外一个明显的结果,孩子的非整合状态就更少出现在观察里,所谓的非整合状态是指:发抖、打喷嚏和一些混乱无章的动作。十二周以后,他们搬到一所正在装修的房子中居住,这严重干扰了母亲的抱持能力并令她疏离了孩子。她开始一边看电视一边喂奶,或者在黑暗的夜里任由孩子独自躺着,而不去拥抱她。心理学空间Gf3nI V^%H/nQ-d

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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 mother called "a boxer" from her habit of pummelling people's faces. We see here the formation of a muscular type of self-containment—"second-skin" in place of a proper skin container.心理学空间6L|dn ~9~

G.z5d.T7T-um0这种方式引发了如潮水般席卷而来的躯体混乱,而且马上非整合状态就更多地出现在孩子身上。父亲又在这个时候生病了,所以母亲不得不考虑重归工作,这无疑是雪上加霜。母亲开始逼孩子进入假性独立,她强迫孩子使用训练杯,整天给她介绍门卫,同时当孩子夜里哭的时候严厉地拒绝回应。母亲现在又退回到早期的趋势,她给予的刺激导致孩子进入到一种暴躁易怒的表现,而这些表现正是妈妈所激起并赞誉的。到六个半月时,爱丽丝是一个极度活跃且具有攻击性的小女孩,她的妈妈管她叫"小拳击手",因为她习惯用手去猛击别人的脸。我们在此可以看到一种皮肤涵容的形式,就是使用肌肉来作为"自体涵容"的次级皮肤以此来替代合适的皮肤涵容器。

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Analysis of a Schizophrenic Girl: MARY心理学空间%Z:Bz W#bAxQ"na

x%gW6zlr9Ix0对一名患有精神分裂症的女孩的分析:玛丽

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7n,_0bfjShR0Some years of analysis, since age 3½, have enabled us to reconstruct the mental states reflected in the history of her 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 breast until 11 months, infantile eczema at 4 months and scratching until bleeding, extreme clinging to mother, severe intolerance to waiting for feeds, delayed and atypical development in all areas.

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玛丽的分析从她三岁半开始,持续了数年。我们藉此得以重建她由于婴儿期所经历的混乱而导致的精神状况。她的成长史如下:难产,早期抓握乳头但很少吃奶,第三周使用了奶瓶喂养,其他的直到十一个月为止是母乳喂养,四个月大的时候罹患婴儿湿疹,会把皮抓破直至流血,特别黏母亲,就连母亲离开准备吃的给她都等不住,各方面发育明显滞后。

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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 the 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).心理学空间 G:n [/S%PD)xy:p;}

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分析时,在第一次休假回来之后开始就表现出严重的分离焦虑,表现出咬紧牙关,不断哭泣并且把所有的东西都摔了。对即刻联系的极度依赖在她的姿态和行动的非整合状态以及想法和沟通中都可以看出,从每次分析的开端,分析过程中的改善,然后离开的时刻又一次出现。她进来的时候弓着背,动作很呆板,姿势也很奇怪,她后来自己把这种状态称之为"麻袋里的马铃薯",她会用缩写的"SSBICK"来说"早安,毕克女士"。这个"麻袋里的马铃薯"看起来一直处于一不小心就会掉出来的危险,对于她来说,这个有洞的、必须要一直把洞抓在手里的麻袋就像是她的"麻袋"客体皮肤,而"马铃薯"则是她的内在部分。(投射性认同)心理学空间K1B8R/v2^SHV

TT|qoeq0Improvement 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 on identification with a containing object.心理学空间 U4G`.k` J ?i

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伴随着她广泛性的极度的依赖减少,她的驼背姿势也得到了纠正。这些躯体姿势的进步更加仰赖于她自己的肌肉发达的次级皮肤而不是与涵容客体的认同。

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Analysis of an Adult Neurotic Patient

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3j3DVzgO(Kb0对一名成年神经症患者的分析

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|5X v Ul(U_ cX0The 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, the patient was aggressive, tyrannical, scathing, and relentless in following his own way. Both states were related to the "second-skin" type of organization, dominated by projective identification. The "hippopotamus" skin, like the "sack" were a reflection of the object's skin inside which he existed, whilst the thin-skinned, easily bruised, apples inside the sack, represented the state of parts of the self which were inside this insensitive object.心理学空间6VH8n1T \[ e

#U"N}0C1gX ]0有两种交替出现的自我体验,可以被用来研究移情和分离体验的质量。这两种体验是:"一麻袋的苹果"和"河马",两者都和混乱的进食经历有关。在"一麻袋苹果"状态,病人表现为敏感,自负,需要不断给予关注和赞誉的满足,极易受挫并一直预感会发生灾难,比如从躺椅上起来的时候房子突然塌了。在"河马"状态,病人表现为易怒,专横,不近人情,而且凡事都要按照他的方式来。这两种状态被投射性认同控制,都与组织的次级皮肤类型有关。"河马"皮肤的存在也和"麻袋"皮肤一样,是内在客体皮肤的反应物,厚皮肤、易受挫、麻袋里面的苹果,都是代表同一自体的不同部分,也就是来自内在那个麻木的客体的部分。

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Analysis of a Child: JILL心理学空间4K`$Nsp+@YM e1R I s

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一例儿童分析:吉儿

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`$o)a0`N&GW}6Nj|0Early in the analysis of a 5-year-old child, whose feeding period had been characterized by anorexia, skincontainer problems presented themselves, as in her constant demand from mother during the first analytic holiday, that her clothes should 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!"心理学空间DM-B3ZTZ

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当我分析了一个五岁的孩子,这个孩子的进食方面具有厌食症的特征。在分析初期,皮肤容器的问题就自发的出现了,如在分析中经历的第一个假期,她固执地坚持一定要把衣服裹得严严实实,鞋子也要紧紧绑好。后来的一些素材也显示出她强烈的焦虑感和要把自己和玩具以及洋娃娃们区分开来的需要。她这样描述,玩具和我不一样,他们坏了之后就修不起来了。他们没有皮肤。我们有皮肤。心理学空间 Fq{E0pZg0j+\

yo1?O3es0SUMMARY

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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 "second skin" phenomenon which replaces first skin integration, manifests itself as either partial or total type of muscular shell or a corresponding verbal muscularity.

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所有原初皮肤混乱的患者,通过分析性重建都会表现出明显的进食混乱,但并不是所有父母都会发现这一变化。这种错误的皮肤形式导致了在未来发展中会出现在整合和组织上的广泛性脆弱。该形式所表现出的与典型的部分退行或整体退行有所不同的状态是非整合。这种非整合状态包括非整合的身体、姿势、运动、以及心智的一致性功能,尤其是沟通。替代了原初皮肤的"次级皮肤"现象,有的是部分形式,有的是整体形式;比如肌肉外壳或者我们说的肌肉发达。

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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.心理学空间8l"r {r&L

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分析性调查次级皮肤现象只会导致暂时的非整合状态的出现。只有当一个分析能够持续不断地修通患者和其母性客体之间的原初依赖才能加固这种根本的脆弱。因此对分析者在分析情境中所能够提供的涵容有非常高的要求,其中设置和娴熟的技巧占了非常重要的位置。

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F0q5k1\ T*{6};F8|M0译者介绍:王蕾,国家二级心理咨询师,在精神专科医院从事动力取向心理咨询及心理治疗十年,现于匠心心理工作室执业,参加Tavistock(由Tavistock中心M7课程导师Silvina带领)婴儿观察小组训练。曾参加过中挪班、中法儿童青少年精神分析班等连续培训班,母婴精神分析、创伤心理治疗、儿童青少年动力取向心理治疗等学习,个案小时数6000小时,长期接受督导。

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