Freud 1912e 对开业从事精神分析的医生的建议
作者: 斑鸠 译 / 6135次阅读 时间: 2016年2月16日
来源: 精神分析理论与临床 标签: 弗洛伊德 精神分析

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Recommendation to physicians pracstising psycho-analasis(1912e)
德文及德文译本 Ratschläge für den Arzt bei der psychoanalytischen Behandlung (1912)

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f(~@6ZAn6|I6ZE0The technical rules which I am putting forward here have been arrived at from my own experience in the course of many years after unfortunate results had led me to abandon other methods. It will easily be seen that they (or at least many of them) may be summed up in a single precept. My hope is that observance of them will spare physicians practising analysis much unnecessary effort and guard them against some oversights. I must however make it clear that what I am asserting is that this technique is the only one suited to my individuality; I do not venture to deny that a physician quite differently constituted might find himself driven to adopt a different attitude to his patients and to the task before him.

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}"TY(?Du7A Z_0我正要提出的这些技术规则,是在那些令人遗憾的结果促使我放弃了其他的方法之后,在许多年的过程中,从我自己的经验里总结得出的。这会很容易看到,它们(或者至少是它们中的许多)是用一个单一的规则总结出来的。我的希望是,对这些规则的遵守会节省开业从事精神分析的医生的许多精力,并且会防止他们的一些疏忽。然而,我必须澄清,我正在主张的东西是这个仅适合我个人的技术。我不敢否认说,一个(理论)构成十分不同医生可能会感觉自己受到驱使而对他的病人和他眼前的任务采取一种不同的态度。心理学空间1M,Ha X\a:pt


(a) The first problem confronting an analyst who is treating more than one patient in the day will seem to him the hardest. It is the task of keeping in mind all the innumerable names, dates, detailed memories and pathological products which each patient communicates in the course of months and years of treatment, and of not confusing them with similar material produced by other patients under treatment simultaneously or previously. If one is required to analyse six, eight, or even more patients daily, the feat of memory involved in achieving this will provoke incredulity, astonishment or even commiseration in uninformed observers. Curiosity will in any case be felt about the technique which makes it possible to master such an abundance of material, and the expectation will be that some special expedients are required for the purpose.

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3Cbtt*p uI'L0这第一个问题,是在一天之中治疗超过一个病人的分析师面临的问题,对他来说似乎是最困难的问题。那是一个记住所有的数不清的名字、日期、详细的回忆和由疾病引起的产物之任务,而这些产物是每个病人在治疗的成年累月的过程中传达的;还是一个不把这些产物与其他病人在治疗下同时或先前产生的相似材料相混淆的任务。如果我们每天需要分析6个、8个或者更多的病人,那么,完成这个任务所需要的记忆之壮举会在无知的观察者中引起怀疑、惊讶甚至同情。无论如何,对于能够掌控如此多的材料的技术,(我们)都会感到好奇,并且会预想,为了这个目的会需要一些特殊的策略。


krGG{3w0The technique, however, is a very simple one. As we shall see, it rejects the use of any specialexpedient (even that of taking notes). It consists simply in not directing one’s notice to anything in particular and in maintaining the same ‘evenly-suspended attention’ (as I have called it) in the face of all that one hears. In this way we spare ourselves a strain on our attention which could not in any case be kept up for several hours daily, and we avoid a danger which is inseparable from the exercise of deliberate attention.心理学空间'U NXXf.}_.w

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ju+Du i0t"H0e Ei0For as soon as anyone deliberately concentrates his attention to a certain degree, he begins to select from the material before him; one point will be fixed in his mind with particular clearness and some other will be correspondingly disregarded, and in making this selection he will be following his expectations or inclinations. This, however, is precisely what must not be done. In making the selection, if he follows his expectations he is in danger of never finding anything but what he already knows; and if he follows his inclinations he will certainly falsify what he may perceive. It must not be forgotten that the things one hears are for the most part things whose meaning is only recognized later on.

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8S\'xdW/d.L0因为,任何人一旦故意地把他的注意力集中到某个程度,他就会从他眼前的材料开始挑选;一个点将会特别清晰地固定在他的脑海中,并且,一些其他的点会被相应地忽视,在做这个选择时他将会跟随他的预期或者爱好。然而,这恰恰是不允许做的。在这个选择时,如果他跟随他的预期,那么,他就处在除了发现他已经知道的东西而决不会发现任何东西的危险之中;而如果他跟随他的爱好,那么,他将必定会歪曲他可能感知到的东西。必须不能忘记,我们所听见东西多半是只有后来才能识别它们的含意的东西。心理学空间f+f4rzZ O Noe { A

H-y { `w)w)FX0It 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. If the doctor behaves otherwise, he is throwing away most of the advantage which results from the patient’s obeying the ‘fundamental rule of psycho- analysis’. 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.’ What is achieved in this manner will be sufficient for all requirements during the treatment.

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Those elements of the material which already form a connected context will be at the doctor’s conscious disposal; the rest, as yet unconnected and in chaotic disorder, seems at first to be submerged, but rises readily into recollection as soon as the patient brings up something new to which it can be related and by which it can be continued. The undeserved compliment of having ‘a remarkably good memory’ which the patient pays one when one reproduces some detail after a year and a day can then be accepted with a smile, whereas a conscious determination to recollect the point would probably have resulted in failure.

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,a {x-H A)E u [)r;Z0已经形成了一个连贯的脉络的材料的那些部分将会任凭医生的意识处理;那些剩下的部分,当时还是不连贯的、秩序混乱的部分,似乎开始时是潜在水下的(潜在意识之下的),但是,一旦病人谈到某个与之相关的东西,那些混乱的部分就容易浮现在(医生的)回忆中,并且,通过谈到的那个东西,那些混乱的东西就能够继续(浮现)。当整整一年过后我们复述一些细节时,那时病人给予我们的拥有一个“非常好的记忆”这个不应得的称赞,会被(我们)用一个微笑来接受,然而,对于回忆这个要点,一个有意识的决定,将很可能导致(回忆)失败。心理学空间 J ?8K b^}.v.v

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Mistakes in this process of remembering occur only at times and places at which one is disturbed by some personal consideration (see below) - that is, when one has fallen seriously below the standard of an ideal analyst. Confusion with material brought up by other patients occurs very rarely. Where there is a dispute with the patient as to whether or how he has said some particular thing, the doctor is usually in the right.

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;{2t o SFOPe:Jf01 A patient will often assert that he has already told the doctor something on a previous occasion, while the doctor can assure him with a quiet feeling of superiority that it has come up now for the first time. It then turns out that the patient had previously had the intention of saying it, but had been prevented from performing his intention by a resistance which was still present. His recollection of his intention is indistinguishable to him from a recollection of its performance.心理学空间eq-p }f3|v l





F$Fb-P\@-C0(b) I cannot advise the taking of full notes, the keeping of a shorthand record, etc., during analytic sessions. Apart from the unfavourable impression which this makes on some patients, the same considerations as have been advanced with regard to attention apply here too. A detrimental selection from the material will necessarily be made as one writes the notes or shorthand, and part of one’s own mental activity is tied up in this way, which would be better employed in interpreting what one has heard. No objection can be raised to making exceptions to this rule in the case of dates, the text of dreams, or particular noteworthy events which can easily be detached from their context and are suitable for independent use as instances. But I am not in the habit of doing this either. As regards instances, I write them down from memory in the evening after work is over; as regards texts of dreams to which I attach importance, I get the patient to repeat them to me after he has related them so that I can fix them in my mind.心理学空间hcg]hH



#aF1xybO-r*j0(c) Taking notes during the session with the patient might be justified by an intention of publishing a scientific study of the case. On general grounds this can scarcely be denied. Nevertheless it must be borne in mind that exact reports of analytic case histories are of less value than might be expected. Strictly speaking, they only possess the ostensible exactness of which ‘modern’ psychiatry affords us some striking examples. They are, as a rule, fatiguing to the reader and yet do not succeed in being a substitute for his actual presence at an analysis. Experience invariably shows that if readers are willing to believe an analyst they will have confidence in any slight revision to which he has submitted his material; if, on the other hand, they are unwilling to take analysis and the analyst seriously, they will pay no attention to accurate verbatim records of the treatment either. This is not the way, it seems, to remedy the lack of convincing evidence to be found in psycho-analytic reports.心理学空间"XXG a#n(wAk

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,EXL:YX\p0(d)One of the claims of psycho-analysis to distinction is, no doubt, that in its execution research and treatment coincide; nevertheless, after a certain point, the technique required for the one opposes that required for the other. It is not a good thing to work on a case scientifically while treatment is still proceeding - to piece together its structure, to try to foretell its further progress, and to get a picture from time to time of the current state of affairs, as scientific interest would demand. Cases which are devoted from the first to scientific purposes and are treated accordingly suffer in their outcome; while the most successful cases are those in which one proceeds, as it were, without any purpose in view, allows oneself to be taken by surprise by any new turn in them, and always meets them with an open mind, free from any presuppositions.


R8Z` u[!M9\$?0毫无疑问,精神分析特有的其中一个主张是,在它的践行中研究和治疗是一致的。


m uB;jW/k*b0当治疗仍旧在进行时,在学术上致力于这个案例不是一件好的事情—如同科学兴趣所要求的,把案例的结构拼合起来、试图预言它进一步的发展和不时地获取当前的状况的一个图景。从一开始就被奉献给科学的目的并被相应地治疗的个案,在它们的结果中受到损害;而最成功的案例是那些,在其中,我们似乎没带任何在考虑的目的而进行治疗,我们允许自己惊讶于任何新的变化,并总是以开放的思想面对他们,免除任何预想。 心理学空间t N.I2Ji

8@hq1M Q~0f9I0The correct behaviour for an analyst lies in swinging over according to need from the one mental attitude to the other, in avoiding speculation or brooding over cases while they are in analysis, and in submitting the material obtained to a synthetic process of thought only after the analysis is concluded. The distinction between the two attitudes would be meaningless if we already possessed all the knowledge (or at least the essential knowledge) about the psychology of the unconscious and about the structure of the neuroses that we can obtain from psycho-analytic work. At present we are still far from that goal and we ought not to cut ourselves off from the possibility of testing what we have already learnt and of extending our knowledge further.心理学空间:G^/rr,l





?'WM%?g,^M/?W'i0(e) I cannot advise my colleagues too urgently to model themselves during psycho-analytic treatment on the surgeon, who puts aside all his feelings, even his human sympathy, and concentrates his mental forces on the simple aim of performing the operation as skilfully as possible. Under present-day conditions the feeling that is most dangerous to a psycho-analyst is the therapeutic ambition to achieve by this novel and much disputed method something that will produce a convincing effect upon other people. This will not only put him into a state of mind which is unfavourable for his work, but will make him helpless against certain resistances of the patient, whose recovery, as we know, primarily depends on the interplay of forces in him. The justification for requiring this emotional coldness in the analyst is that it creates the most advantageous conditions for both parties: for the doctor a desirable protection for his own emotional life and for the patient the largest amount of help that we can give him to-day. A surgeon of earlier times took as his motto the words: ‘Je le pansai, Dieu le guérit.’1 The心理学空间a eT8b;HXO["T


analyst should be content with something similar.

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XEgQaK P9^r0我也不能强烈地建议我的同行在分析治疗中模仿外科医生,一个外科医生会把他所有的感觉,甚至他的人类的同情,搁置在一边,并把他的精神力量集中在尽可能熟练地实施手术这个简单的目标上。在现今的情况中,对一个精神分析师最危险的感觉是这个治疗的野心:通过这个新奇的、备受争议的方法来得到某个会对其他人产生一种令其信服的影响的东西。这不仅会使分析家进入一种不利于他的工作的思想状态,而且会使他在与病人的某些阻抗对抗时感到无能,这个病人,正如我们知道的,他健康的恢复主要取决于他体内的力量的相互作用。在分析师的中需要这种情感冷淡的理由是,它为两个当事人创造了最有利的条件:对于医生的一种对他情感生活的有利的保护、对于病人的我们今天能够给予他的最大量的帮助。一个早期的外科医生把这句话作为他的座右铭:“Je le pansai, Dieu le guérit。”1分析师应该满足于某个相似的东西。

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,@@_XtI2S6D B8l;[0(f) It is easy to see upon what aim the different rules I have brought forward converge. They are all intended to create for the doctor a counterpart to the ‘fundamental rule of psycho-analysis’ which is laid down for the patient. Just as the patient must relate everything that his self-observation can detect, and keep back all the logical and affective objections that seek to induce him to make a selection from among them, so the doctor must put himself in a position to make use of everything he is told for the purposes of interpretation and of recognizing the concealed unconscious material without substituting a censorship of his own for the selection that the patient has forgone. To put it in a formula: he must turn his own unconscious like a receptive organ towards the transmitting unconscious of the patient. He must adjust himself to the patient as a telephone receiver is adjusted to the transmitting microphone. Just as the receiver converts back into sound waves the electric oscillations in the telephone line which were set up by sound waves, so the doctor’s unconscious is able, from the derivatives of the unconscious which are communicated to him, to reconstruct that unconscious, which has determined the patient’s free associations.

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@iIk"GB{ v"v.cd01 [‘I dressed his wounds, God cured him.’]心理学空间8X.}b^g'Z;lH4H

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很容易明白,我所提出的这些不同的规则集中于什么目标。它们都是打算为医生创造一个 与“精神分析基本规则”匹配之物,而这个基本规则是为病人准备的。正如病人必须讲述一切他的自我观察能够察觉的东西,并且阻止所有逻辑上的、情感上的反对,那些设法诱使他从自我观察中作出挑选反对,所以,为了解释的目的,并为了在医生没有用自己的稽查取代病人已抛弃的挑选之情况下识别隐藏的无意识材料,医生必须把自己放置在一个位置上以利用他所被告知的一切。以常规的话来说:医生必须使他自己的无意识像一个善于接纳的器官一样转向传递病人的无意识。如同一个电话接收器被调整以适应这个传递(声音)的话筒一样,他必须调整自己以适应病人。如同电话接受器在为声波设立的电话线中把声波转换成电信号一样,因此,医生的无意识能够,从向他传递的无意识的派生物中,重建支配病人的自由联想的那种无意识。


+bLhG q01【我包扎他的伤口,上帝来治愈他】。


But if the doctor is to be in a position to use his unconscious in this way as an instrument in the


0v3j`*[w,a1F0^3x#SJ0analysis, he must himself fulfil one psychological condition to a high degree. He may not tolerate any resistances in himself which hold back from his consciousness what has been perceived by his unconscious; otherwise he would introduce into the analysis a new species of selection and distortion which would be far more detrimental than that resulting from concentration of conscious attention. It is not enough for this that he himself should be an approximately normal person. It may be insisted, rather, that he should have undergone a psycho-analytic purification and have become aware of those complexes of his own which would be apt to interfere with his grasp of what the patient tells him. There can be no reasonable doubt about the disqualifying effect of such defects in the doctor; every unresolved repression in him constitutes what has been aptly described by Stekel as a ‘blind spot’ in his analytic perception.

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但是,如果医生在分析中要处在一个位置以用这种方法把无意识当做一个工具使用,他自己必须高程度地达到一种心理学的标准。他不能宽恕在他身上的任何阻抗,这些阻抗从意识中抑制他的无意识所察觉到的东西;否则,他将会把分析引导入一种新的挑选和扭曲,这种挑选和扭曲远比有意识的集中注意力所导致的(挑选)更有害。为此,(医生)他自己是一个接近正常的人,这还不足够。更确切地说,应该强调,他本应该经历一个精神的分析的净化,并意识到他自己的那些情结,那些情结会倾向于干扰他对病人所告诉他的东西的理解。关于在医生身上的这些缺点给他带来不合格的影响,这不存在任何合理的疑问;在他身上每一个未解决的压抑在他的分析的感觉中构成了被Stekel恰当描述为“盲点”的东西。心理学空间\ f1Pzp4W6G

#n7Q~|j6p.Z0Some years ago I gave as an answer to the question of how one can become an analyst: ‘By心理学空间7D,V&E3Z3U'V8A


analysing one’s own dreams.’ This preparation is no doubt enough for many people, but not for


&|7z|}R0everyone who wishes to learn analysis. Nor can everyone succeed in interpreting his own dreams without outside help. I count it as one of the many merits of the Zurich school of analysis that they have laid increased emphasis on this requirement, and have embodied it in the demand that everyone who wishes to carry out analyses on other people shall first himself undergo an analysis by someone with expert knowledge.

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几年前,我曾就一个人怎样能够成为一个分析师这个问题给出过一个答案:“通过分析一个人自己的梦。”这个准备毫无疑问对很多人是足够的,但是不是对每一个想要学习精神分析的人。也不可能每个人在没有外部的帮助下都可以成功地解释他自己的梦。精神分析的苏黎世学派已经更加地强调这个必要条件,并且在这个要求中,即每个想在其他人身上实施分析的人他自己应该首先在某个有内行知识的人那里经历一个分析,具体体现了。我把这视为的他们许多优点中的一个。心理学空间i Gdw^0YU

3qi+m/\S qps0Anyone who takes up the work seriously should choose this course, which offers more than one advantage; the sacrifice involved in laying oneself open to another person without being driven to it by illness is amply rewarded. Not only is one’s aim of learning to know what is hidden in one’s own mind far more rapidly attained and with less expense of affect, but impressions and convictions will be gained in relation to oneself which will be sought in vain from studying books and attending lectures. And lastly, we must not under-estimate the advantage to be derived from the lasting mental contact that is as a rule established between the student and his guide.



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An analysis such as this of someone who is practically healthy will, as may be imagined, remain incomplete. Anyone who can appreciate the high value of the self-knowledge and increase in selfcontrol thus acquired will, when it is over, continue the analytic examination of his personality in the form of a self-analysis, and be content to realize that, within himself as well as in the external world, he must always expect to find something new. But anyone who has scorned to take the precaution of being analysed himself will not merely be punished by being incapable of learning more than a certain amount from his patients, he will risk a more serious danger and one which may become a danger to others. He will easily fall into the temptation of projecting outwards some of the peculiarities of his own personality, which he has dimly perceived, into the field of science, as a theory having universal validity; he will bring the psycho-analytic method into discredit, and lead the inexperienced astray.

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^)m8Ug*Y-a {o S0一个分析,比如实际上是健康的某人的分析,如同可以想象的,依然是不完整的。任何一个能够欣赏自我认识和后天获得的自我控制的增强之价值的人,在分析结束时,将会以自我分析的形式继续对他的人格进行分析性检查,并心甘情愿去体会:在他的内部,也在外部世界中,他总是期望去发现某个新的东西。但是任何一个轻蔑地去提防自己被分析的人,将不只是受惩罚于不能从他的病人那里学习许多东西,而且他会冒一个更严重的危险,一个威胁到他人的危险。按照在科学领域有普遍的正确性的一个理论,他很容易掉进向外投射他自己人格的一些特性的诱惑中,这些特性是他已经朦胧地感觉到的;他会败坏精神分析方法的名声,并使没有经验的人误入歧途。

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(g) I shall now add a few other rules, that will serve as a transition from the attitude of the doctor to the treatment of the patient.

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)R%q]3Ok ^y0现在,我应该添加一些其他的规则,这些规则会充当一个从医生的态度到病人的治疗的过渡。

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-rN!m B0DTR0Young and eager psycho-analysts will no doubt be tempted to bring their own individuality freely into the discussion, in order to carry the patient along with them and lift him over the barriers of his own narrow personality. It might be expected that it would be quite allowable and indeed useful, with a view to overcoming the patient’s existing resistances, for the doctor to afford him a glimpse of his own mental defects and conflicts and, by giving him intimate information about his own life, enable him to put himself on an equal footing. One confidence deserves another, and anyone who demands intimacy from someone else must be prepared to give it in return.心理学空间 S!u!md/~L



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dVQ)gd6D0WFD~0But in psycho-analytic relations things often happen differently from what the psychology of

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{/y x EHv0consciousness might lead us to expect. Experience does not speak in favour of an affective technique of this kind. Nor is it hard to see that it involves a departure from psycho-analytic principles and verges upon treatment by suggestion. It may induce the patient to bring forward sooner and with less difficulty things he already knows but would otherwise have kept back for a time through conventional resistances. But this technique achieves nothing towards the uncovering of what is unconscious to the patient. It makes him even more incapable of overcoming his deeper resistances, and in severer cases it invariably fails by encouraging the patient to be insatiable: he would like to reverse the situation, and finds the analysis of the doctor more interesting than his own.

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0?:d4Xvy l0但是,在精神分析的关系中,事物的发生经常不同于意识的心理学可能引导我们预想的东西。经验没有表明支持这种类型的情感的技术。这也不难看到,这种技术包含了对精神分析原则的一种偏离,并且用暗示来接近治疗。这可能使得病人提前时机,并以较小的困难获得他已经的知道的但在其他方面由于常见的阻抗被抑制了一段时间的事物。但是这个技术没有得到任何朝向揭开对病人来说是无意识的东西的帮助。它甚至使得病人更加不能克服他的更深层的阻抗,并且在更严重情况中,它因为鼓励病人变得不知足而失败:病人想要扭转情境,相比自己的分析他更感兴趣于寻找对医生的分析。心理学空间(N|0kv&Ib7R;ONm

y#t#\/WP$e.R U5L1rE0The resolution of the transference, too - one of the main tasks of the treatment - is made more difficult by an intimate attitude on the doctor’s part, so that any gain there may be at the beginning is more than outweighed at the end. I have no hesitation, therefore, in condemning this kind of technique as incorrect. The doctor should be opaque to his patients and, like a mirror, should show them nothing but what is shown to him. In practice, it is true, there is nothing to be said against a psychotherapist combining a certain amount of analysis with some suggestive influence in order to achieve a perceptible result in a shorter time - as is necessary, for instance, in institutions. But one has a right to insist that he himself should be in no doubt about what he is doing and should know that his method is not that of true psycho-analysis.


移情的解决—其中一个主要的治疗任务—也因为在医生的角色中一种亲密的态度而变得更加困难,因此,一开始在那里的任何收获到最后却是十分沉重的负担。因此,在谴责这种技术不适当时,我毫不犹豫。医生对他的病人应该是不透明的,并且应该像一面镜子,除了展示病人向他展示的东西外,不展示任何的东西。实际上,确实,对于一个精神治疗师,为了在一个更短的时间内获得一些得到一种可察觉的结果而使一定量的分析结合一些暗示性的影响,这没有什么非议—例如,在(治疗)体系中这是必要的。但是,我们有权利坚持,他对他自己正在做的事情应该完全明白,并且应该知道,他的方法不是真正的精神分析的方法。心理学空间;Q Y ?W },j

}? Ua,G#f0(h) Another temptation arises out of the educative activity which, in psycho-analytic treatment,心理学空间;fn0~!p;n^

b+`S-nT0devolves on the doctor without any deliberate intention on his part. When the developmental心理学空间U ]_r8y-YcR0[%O/}

7\5za/mZ*[ }0inhibitions are resolved, it happens of itself that the doctor finds himself in a position to indicate new aims for the trends that have been liberated. It is then no more than a natural ambition if he endeavours to make something specially excellent of a person whom he has been at such pains to free from his neurosis and if he prescribes high aims for his wishes. But here again the doctor should hold himself in check, and take the patient’s capacities rather than his own desires as guide. Not every neurotic has a high talent for sublimation; one can assume of many of them that they would not have fallen ill at all if they had possessed the art of sublimating their instincts.心理学空间]#HG2\5sx A0R9Jk



T m*q S2v0j)RHU4W0If we press them unduly towards sublimation and cut them off from the most accessible and convenient instinctual satisfactions, we shall usually make life even harder for them than they feel it in any case. As a doctor, one must above all be tolerant to the weakness of a patient, and must be content if one has won back some degree of capacity for work and enjoyment for a person even of only moderate worth. Educative ambition is of as little use as therapeutic ambition. It must further be borne in mind that many people fall ill precisely from an attempt to sublimate their instincts beyond the degree permitted by their organization and that in those who have a capacity for sublimation the process usually takes place of itself as soon as their inhibitions have been overcome by analysis. In my opinion, therefore, efforts invariably to make use of the analytic treatment to bring about sublimation of instinct are, though no doubt always laudable, far from being in every case advisable.心理学空间6z`u nA[

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如果我们不当地推挤他们朝向升华,并且把他们与最易接近的、最方便的本能满足隔绝,我们通常会使得生活比他们在任何情况下感觉到更困难。作为一个医生,首先,我们必须容忍一个病人的弱点,并且,如果我们因为一个只有普通价值的人而为工作和乐趣重获某种程度的能力,我们应当满足。教育的野心和治疗的野心一样是没什么用的。必须更加牢记,很多人罹患疾病(神经症)恰恰是因为超过他们的组织所允许的程度而试图升华他们的本能,还有,在那些有能力去升华的人中,一旦他们的抑制被分析克服,这个过程会自然发生。因此,在我看来,利用分析治疗来引起本能升华的努力,虽然毫无疑问是值得赞赏,但并不是在任何情况都是适当的。心理学空间s} {cI+Iz"U

7E ]RH8h0(i) To what extent should the patient’s intellectual co-operation be sought for in the treatment? It is difficult to say anything of general applicability on this point: the patient’s personality is the determining factor. But in any case caution and self-restraint must be observed in this connection. It is wrong to set a patient tasks, such as collecting his memories or thinking over some particular period of his life. On the contrary, he has to learn above all - what never comes easily to anyone - that mental activities such as thinking something over or concentrating the attention solve none of the riddles of a neurosis; that can only be done by patiently obeying the psycho-analytic rule, which enjoins the exclusion of all criticism of the unconscious or of its derivatives.心理学空间3`#y9@^$F

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.Z3|o5xO0One must be especially unyielding about obedience to that rule with patients who practise the art of sheering off into intellectual discussion during their treatment, who speculate a great deal and often very wisely about their condition and in that way avoid doing anything to overcome it. For this reason I dislike making use of analytic writings as an assistance to my patients; I require them to learn by personal experience, and I assure them that they will acquire wider and more valuable knowledge than the whole literature of psycho-analysis could心理学空间y F6Zic0]4X!}:b

Zy6m&_t S.c vS7p*T0teach them. I recognize, however, that under institutional conditions it may be of great advantage to employ reading as a preparation for patients in analysis and as a means of creating an atmosphere of influence.

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I must give a most earnest warning against any attempt to gain the confidence or support of parents or relatives by giving them psycho-analytic books to read, whether of an introductory or an advanced kind. This well-meant step usually has the effect of bringing on prematurely the natural opposition of the relatives to the treatment - an opposition which is bound to appear sooner or later - so that the treatment is never ever begun.



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Let me express a hope that the increasing experience of psycho-analysts will soon lead to agreement on questions of technique and on the most effective method of treating neurotic patients. As regards the treatment of their relatives I must confess myself utterly at a loss, and I have in general little faith in any individual treatment of them.心理学空间 _!Q]K'|LZ-gn


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