In this article，I suggest recent sources of influence on psychoanalysis and describe a contemporary relational self psychology that is my personal attempt at integration. Even with this integration, I struggle to find the right “therapeutic” balance between my essential but imperfect instrument for empathic listening, on the one hand, and the risks of authentic engagement, on the other. These dialectical tensions in me mirror those in the psychoanalytic community as a whole, poised between a scientifically based practice and a healing “art”--or between a complex but teachable methodology or discipline-- and an ordinary (yet extraordinary) human relationship in which spontaneity and even improvisation play a role. Complicating this balancing act, there is new evidence from neuroscientists, attachment theorists, and infant-caregiver researchers that, from birth onward, bidirectional influences on brain and psychic development create contingent and unpredictable outcomes in every intimately related dyad. Thus, the contemporary analyst must expect to be changed by the work and--while taking full responsibility for his or her own contribution--must recognize patient and analyst as co-creators of the psychoanalytic project. At the same time that we now recognize contingency, complexity, and chaos at the heart of human minds and relationships, we also acknowledge the central importance of a sense of continuity and coherence as the individual undertakes the pursuit of goals and relationships in life. What kind of relationship can facilitate these qualities in the sense of self? That is the question that this article undertakes to answer.
Influences on psychoanalysis in recent years have come from unlikely sources including biology, physics, and postmodern philosophy, among others. Although these sources and the changes they have effected in psychoanalysis are too many to address, I shall mention a few.
From biology has come a view of the mind as a nonlinear dynamic system in which small changes in any part of the system are likely to have far-reaching effects on the whole. Biological systems theory further suggests that in human relationships—including the psychoanalytic relationship—-each partner constitutes a “system" in its own right, but the two systems together form a larger and more complex system, functioning as a whole. Meanwhile from quantum mechanics have come new recognitions of randomness unpredictability, emergence, uncertainty and chaos in the “laws” of the universe, ideas that have seeped into our psychoanalytic conceptualizations of how the human mind develops and how human relationships evolve and grow. These ideas have not replaced earlier ideas concerning the organization and coherence of the human mind but are held in dialectical tension with them.
Especially germane to our current view of analytic process is the acknowledgment that observation or measurement irrevocably changes what is observed or measured. With all these ideas, the prior ideal of the analyst as a neutral observer, standing outside the turmoil brought by the patient, has fallen away. In its place, we see the analyst unique and irreducible subjectivity, interacting with the patient’s psyche under conditions of constant, simultaneous, mutual influence. While this view of the analytic relationship tends to undermine our earlier views of the analyst professional expertise and authority, it also sets the stage for a richer more creative process in which the two partners to the analytic dyad uniquely participate to co-construct something quite unforeseeable and new.
From postmodern philosophy the influences on psychoanalysis have been equally thoroughgoing and unexpected, especially in regard to the “self”. The self is now seen as without a core and forever in process, an evolving distillation of its ongoing interactions with others and the world. Postmodern theory questions the very possibility of meaning, other than what individuals can create or negotiate with others, on the basis of their immediate experience. As radical as all these ideas might seem at first glance, it turns out that Kohut’ss (1971) description—of a sense of self constructed originally through the individual relationships and sustained by them throughout life—fits well with many of the late 20th and early 21st century changes in psychoanalysis. In the ongoing construction of this self, the meaning that matters is the unique and affectively laden personal narrative that has been recognized or affirmed by important others.
Human development is an ongoing process, optimally continuing throughout a lifetime. It is because of this open endedness of psychic growth that change is possible through psychoanalysis at any time during the life cycle. Although a direct link between early development and later change is not recognized in all psychoanalytic theories, it is inconceivable to me that the pathways and processes through which individuals first lay down patterns of experience and behavior could be entirely different from those through which individuals undergo psychological change in adult life. Still the adult personality is infinitely complex and multilayered, and the adaptations and solutions of a lifetime must somehow be challenged and destabilized in order to make room for the new. Also, for individuals who have suffered early trauma, there is an understandable fear of retraumatization and, therefore, a diminished openness to new experience. In combination, these conditions can make therapeutic change difficult to achieve.
There are of course multiple pathways along which psychic development proceeds as well as a broad and variegated range of conditions under which individuals can psychologically thrive and grow. This multiplicity of pathways and conditions contributes to competing explanations of how individuals develop and change. Change processes can be viewed along many dimensions as well as at several levels of abstraction. Additionally, the fact that most developmental and psychic processes take place largely out-of-awareness means that it is impossible to pinpoint much that goes on in early development or in psychoanalytic treatment. For all these reasons, curative factors remain elusive and ambiguous, and any theory of how people change in psychoanalysis is necessarily multifaceted yet incomplete.
By their training, analysts are well versed in developmental theories and have some sense of the range of “expectable” human experience when beginning to work with any patient. At the same time, the absolute singularity of every individual requires that analysts also be prepared to respond creatively to what is unique in each patient’s experience and life trajectory. In addition to the inevitable limitations of general theory as a guide to individual treatments, it is also true that in lived experience every psychological problem and all attempted solutions for that problem are ineluctably interwoven with the individual’s most enduring strengths and adaptive strategies. Patients may, therefore, understandably feel that to rid themselves of their problems and of their less-successful solutions is also to tamper with their most sustaining qualities of self and their most familiar and favored patterns of behavior.
While certain earlier established feelings, attitudes, and patterns of behavior may now be getting in the way of the patient attaining chosen life goals，these same attitudes and behaviors may have been the most creative adaptations possible in the face of difficult or painful childhood circumstances or may have been valiant measures undertaken for self-preservative purposes against what would otherwise have been experienced as unbearable developmental setbacks or blows. In other words, the patterns of feeling, behavior，and “self-defense” that are now in need of change may be the very ones that enabled the patient to survive and prevail in the face of less-than- optimal developmental conditions.
So the question becomes what processes—or what kinds of relationship—can help an individual give up what might feel like an essential self-invented key to whatever stability and adequate functioning—or even to whatever good times and fun—have thus far been achieved in life? What allows a person to take a leap into the psychic unknown on just the promise that the treatment—costly in both time and money— will help to develop more effective strategies by which to live and get more of what is needed and wanted in life? The analyst must certainly earn the patient’s trust; and the first step in this process is usually for the analyst to listen very attentively, trying to learn everything he or she can about the patient that might be harnessed toward “cure.” The analyst should expect that the patient will be listening attentively as well, no doubt asking, “Who is this person to whom I am entrusting my lifers secrets? And how is this talking ever going to help with my life outside of here?”
Goals of Psychoanalysis 精神分析的目标
The goals of psychoanalysis are broad and encompassing, playing out differently from one individual to the next. At the most generic level, we might say that people seek psychoanalytic treatment when they have been unable on their own to transform painful or problematic feelings about self and others or to change painful or ineffective patterns of feeling and behavior. Most contemporary psychoanalytic theories understand experiential and behavioral problems to involve emotional life in some way; either too much or too little intensity of feeling, with concomitant difficulty in using one’s emotional life as a guide to making more satisfying and effective life choices. From this viewpoint, individuals seeking psychotherapy are in large part either overwhelmed by undesirable feelings and need help with emotional containment and processing or they have lost touch with aspects of their emotional experience, which— if recognized, accepted, and integrated—could contribute to living a life more fully informed by and expressive of who the individual feels he or she is and can be.
As an integral part of our emotional lives, we also develop early and long-standing ideas about our individual limits and possibilities, our desirability and worth, as well as convictions based on early relational experience about what to expect in our intimate connections with others. These expectations and convictions evolve during our most formative years and, although not always in awareness, they play a central role in how we live our lives.
Many patients come to psychoanalysis with a generally negative experience of themselves because of events that occurred in their lives that were totally beyond their control but for which they nevertheless implicitly blame themselves. In such cases, the fullest elaboration of these early experiences may contribute to the their ultimate understanding that as an infant or child they were not responsible for how they were treated or for events that were in fact beyond their control. Such events might include a sibling’s birth; a parent’s or sibling’s physical or mental illness or even death; the parents‘s fighting, separation or divorce; the family’s financial setbacks; any kind of abuse—emotional or physical—visited on the child by a sibling, parent, or other adult; or socioeconomic or historical/political events and conditions as they intersect with family life. These early experiences—and our adaptations to or defenses against them—can somehow trip us up in our current lives. Psychotherapy or psychoanalysis offers a second chance to explore and reorganize these views of ourselves and the world. Working with another person who is trained to listen and respond in facilitative ways, the patient is helped to relive problematic aspects of his or her life in a new context and to make sense and meaning of them in new ways. The process is intended to change both concept and feeling about self and the relational world—and to make changes in behavior possible, where such change is desired.
When a patient’s most pressing problems have to do with disruptive excesses of feeling, the new experience of repeatedly expressing and sharing these very feelings with another whose emotional responses convey genuine resonance and understanding—but also provide a more modulated rendering of the same emotions—may in time enable the patient to internalize or to take over (as his or her own) these new ways of processing emotional experience. The very act of repeatedly sharing what feels “too much” when alone can often, by itself, facilitate modulation of the experience.
When the patient’s most pressing problems are related more to a sense of impoverishment in the patient’s emotional or relational life or to actions that somehow do not lead to the achievement of satisfying relationships or life-enhancing goals, the experience of gradually being helped to articulate and express more of one’s thoughts and feelings in the presence of an empathically responsive other—someone committed to “getting it” from the patient’s own viewpoint and reflecting it back in increasingly detailed and nuanced ways—may ultimately make possible the integration of previously warded-off experience, which can then be brought to bear on life choices that bring the patient closer to what has always been hoped for—or closer to what the patient had never even dared to hope.
But psychoanalysis is not only about the content of what the patient tells the analyst nor necessarily about the patient's life history (which nevertheless remains important because the repeated linking of past and current experience does enhance self-understanding and integration); it is also about lived experience in the relationship between patient and analyst and how this new experience fosters not only self- and mutual understanding but also the transformation of life beyond the therapeutic relationship. While the analyst uniquely responds to the specificity of who each patient is, the analyst is also at every juncture listening and responding in keeping with his or her own distinctive subjectivity and personhood; in this way, experiences of both similarity and difference are built into the process.
但是，精神分析不仅仅是病人告诉分析师的内容，也不一定关于患者的生活史（尽管仍然是重要的，因为重复联系着过去和现在的经验的确增强了自我理解和整合）; 还有关于患者与分析师之间关系的生活经验，以及这种新体验如何不仅促进了自我和相互理解，而且促进了超越治疗关系的生活转型。分析师独特地回应了每个患者的特异性，分析师也在每一个特定时刻聆听和响应，以符合他或她自己独特的主体性和人格; 通过这种方式，经验既是相似的又是不同的构建到这个过程中。
The sense of self originally develops and is continually enhanced through transformative qualities of the earliest caretaking relationships (Kohut, 1971). These same qualities optimally prevail in the psychoanalytic relationship as well, but there is more that gets in the way of an adult patient’s capacity to make use of them than in original development. When things go wrong at any point in development, the individual must find a way to move forward in other areas of psychological functioning, even if the problematic situation and the child’ s best solutions for it have to be built right into the fabric of the developing personality. The bumps and twists of life thereby become the bumps and twists of the psyche—some of which will have to be later disentangled in a psychoanalytic treatment relationship. To this end, the analytic relationship sometimes becomes a reliving of the challenges or setbacks of childhood but in a protected environment whose very purpose is to attain understanding and mastery over the earlier hurts, disappointments, and solutions that are interfering with the patient’s life today.
A successful analysis is expected to increase the patient’s capacities in such realms of life as finding ways to express one’s unique individuality and talents; finding and enjoying meaningful work; finding others with whom to create and sustain satisfying relationships; and perhaps becoming part of, as well as contributing in some way to, a chosen community. According to self psychology, any of these achievements requires a relatively cohesive, continuous, and valued sense of self that is experienced as the center of experience and initiative (Kohut, 1971). The self is forever evolving and in process; it is infinitely complex and multifaceted; and under certain conditions it remains forever vulnerable to fragmentation. But, in order to live, function, and thrive in the world, every individual needs to fed some degree of continuity and coherence in the sense of self.
一个成功的分析可以预期增加患者在以下生活领域的能力：寻找方式来表达个体的独特性和天赋; 找到有意义的工作并享受于其中; 找到与之建立和维持令人满意的关系的他人; 并可能成为所选团体的一部分，并以某种方式在某方面做出贡献。根据自体心理学，上述这些成就都需要具有相对统整的、持续和有价值的自体感，这种自体感被经验为个体体验和自发性的中心（科胡特，1971）。 自体永远在演化和进行中; 它是极其复杂和多层面的; 在某些情况下，它仍然永远易于崩解。但是，为了在世界上生活，发挥作用，和茁壮成长，每个人都需要在自体感上给予一定程度的连续性和统整性。
What are the pathways to such a sense of self that is robust and stable enough to generate unique interests, to identify and develop talents, to set achievable goals, to pursue ambitions and ideals, to develop sustaining relationships, to find meaning in both love and work? All such pathways run through the facilitative human environment—initially through the essentially growth-promoting bonds between children and their parents or later through whatever bond can be forged between patient and analyst. These bonds are called “selfobject” ties by Kohut because in them the “object” is used for the growth of the “self.” Such usage and growth take place spontaneously and out of awareness when relational conditions are right.
In KohutJs theory the “self” is so intricately intertwined with “relationship” that it is understood to have its earliest beginnings in the first interactions between parent and child. Self and relationship then participate in a ceaseless feedback loop from birth onward, and there can be no consideration of the self without consideration of the relationships within and through which the self develops.
Kohut(19’s9,1966,1971,1977,1982,1984) was also specific about what kinds of relationships initially facilitate psychic growth. In the first year of life he believed that children need to be permitted a fantasy of merger with their parenting figures, whom they experience as omnipotent, This idea is similar to Winnicott’s (1960a) British Object Relations concept of the “good enough” mother who meets her baby’s basic needs so well that the baby can entertain the fantasy of being self-sufficient. Both Kohut and Winnicott believed that in the first year of life the child must be allowed fantasies of omnipotence to provide soothing or containment in the face of what would otherwise be overwhelming anxieties caused by the infant’s real dependence on others for survival.
Beyond the first year, Kohut (1971, 1977,1984) identified three more psychological functions that must be adequately provided by the human environment in order for development optimally to proceed. These include the need for emotional resonance and for recognition or affirmation of one’s spontaneous gestures, perceptions, and feelings (the mirroring function); the need for a sense of similarity to and belonging with others (the twinship function); and the need to admire, look up to, or idealize others (the idealizing function). All of these “functions” are two-person processes that occur in a relational context, and, under “good enough” conditions, all of these processes become two-way exchanges.
除了第一年，科胡特（1971，1977，1984）确定了人类环境必须充分提供的三个心理功能，以便恰到好处地进行发展。这其中包括需要情感共鸣，以及承认或肯定个人的自发姿态、感知和感觉（镜像功能）; 需要与他人相似感并归属他人（双生关系功能）; 并且需要欣赏，尊重或理想化别人（理想化功能）。所有这些“功能”是在关系环境中发生的两人过程，在“足够好”的条件下，所有这些过程都成为双向交流。