Looked at in the light of the need to restore a failing self, the patient actively turned to Guntrip and looked for the selfobject functions—the “psychological milk”—he needed to strengthen an endangered self. The need for a cohesion-promoting self–selfobject bond was sexualized and took the form of a compulsive voyeuristic symptom to regain cohesion. That is to say, the need to take in cohesionrestoring sustenance was sexualized (the need and the fulfillment were symbolically represented as the “good breast”); the symptom was both an unconscious emergency defensive measure and the clue to the forward edge—trying to remain attached to go on as a self.
从重建失败的自体的角度来看，病人主动转向了冈特里普，并在寻找自体客体功能——“心理奶水”（“psychological milk”）——他需要加强濒临危险的自体。需要增强凝聚的自体-自体客体连接的需要被性化了，并采取了强迫式的窥阴症状的形式来重新获得聚合感。也就是说，吸收恢复聚合的物质需要是性化的（需要和满足被符号性的表征为“好的乳房”）；症状既是无意识的紧急防御措施，也是前行端的线索——试图继续保持联结，作为自体得以延续。
The patient initially complied with the analyst's interpretation of his regressive wishes and suppressed the symptom. The fantasies that followed suggested that he felt criticized for his “childish needs” and experienced the interpretation as a further assault from which he had to protect himself. He withdrew and began to fortify himself with his own mental devices—the needed fantasy of being strong and invulnerable. Then he withdrew from the inadvertent analytic assault altogether. The unseen tendrils of a maturational push to get help and hold on to his very being could not take hold.
起初病人遵从了分析家对他退行愿望和压抑症状的解释。随之而来的幻想显示，他感到因为他“孩子般需要”而受到指责，并把解释体验为他不得不保护自己的进一步攻击。他撤回并开始通过一些精神装置来加强自身——变得强大和不脆弱的需要的幻想。然后，他完全从无意的分析攻击中撤回。这样，未见的寻求的帮助和坚持他存在的驱力的“卷须”，就无法被固定下来了。
The vignette highlights a critical issue for all therapies, whether analysis or psychotherapy, whether long-term and intensive or short-term and brief: it is essential to understand remaining health and revived needs for selfobject functions, no matter how fragmented or sexualized the expression of the need is. When we learn to see the consequences of self-fragmentation and understand the turn toward the breast/selfobject as a fragment of health, of clinging to life, we can begin to interpret it as such. Then, “the interrupted maturational push … will begin to reassert itself spontaneously as it is reactivated in analysis in the form of [forward edge] selfobject transferences” (Kohut, 1984, p. 78) that are strengthened through interpretation and genetic reconstruction.
这个简介对所有的治疗师来说，都强调了一个重要议题，即不论是精神分析还是心理治疗，不论是密集的长程的，还是短程的简明的，很重要的是理解保持健康和复活的自体客体需要的功能，不论他需要的表达是如何的碎片化和性欲化。当我们学会观察自体破碎的结果，理解把对乳房/自体客体的转向看作是健康的一个片段，对生活依恋的一个片段，我们就开始了这样的解释。于是，被中断的成熟驱力……将开始自发的重新评估自身，就如同以前行端自体客体转移为形式来再次活化的那样(Kohut, 1984, p. 78)，这其中的自体客体转移是通过解释和起源的重建来得到加强的。
The Manifest Disorder Looked at Through a Self-Psychological Lens
通过自体心理学透镜来观察明显的障碍
When he was almost eight years old, Matt was referred for analysis (Egan and Kernberg, 1984) at the strong recommendation of his school. (A year of once-weekly psychotherapy had not led to improvement.) Looked at from the standpoint of normal development of the self: (1) Matt suffered from symptomatic and characterological difficulties that are hallmarks of an already entrenched form of pathological grandiosity (regardless of theoretical orientation, none of us would mistake these for the normal development of narcissism or, as I would prefer to say, for the normal development of the self); (2) the grandiosity is not simply a defense against feelings of helplessness and inadequacy—it is a sure sign of more primary “structural deficits”—of failures in the expectable transformation of naïve childhood grandiosity into reliable pride and self-esteem; and (3) the primary psychological task of the treatment is to foster the process that fills in the deficits enough for normal development to resume—a process that takes place in connection with seeing and responding analytically to the still-remaining healthy idealizing and mirroring needs that he demonstrates in his first meeting with the analyst.
在马特只有8岁的时候，他就在学校的强烈建议下被送来做分析。(Egan and Kernberg, 1984)（分析频次为一周一次，持续了一年的心理治疗并没有带来什么改善。）从正常的自体发展的立场出发来看：（1）马特遭遇了性格和症状上的困难，这些困难标志着他已经根深蒂固的病理性夸大自体的形式（不考虑理论起源，没有人能把这些自恋的正常发展，混淆成自体的正常发展，或者我宁愿这样说）；（2）夸大自体不仅仅是对无助和不充分的情感防御——更主要的“结构性赤字”的确定信号——在预期中，幼稚的儿童期夸大自体没能转变成可靠的自豪和自尊；（3）治疗的主要心理任务是，培养让正常发展重新开始，来填补赤字的治疗过程——这个过程发生在对依然-健康的理想化和镜映需要的分析性观察和回应的联系上，这在他与分析家的首次会谈中就表现了出来。
Pathological Grandiosity as a Sign of Structural Deficits
病理性夸大作为结构性赤字的信号
Matt's intelligence was superior but his school work was mediocre. He had no friends and, in fact, “everyone at school hated him” (Egan and Kernberg, 1984, p. 42). He treated his teacher as though she were his colleague, and he mistreated his peers, with whom he was totally out of step. Awkward, anxious, and ashamed to do anything physical, Matt was unable to participate with them in any everyday eight-year-olds' play. He could neither ride a bike, swim, skate, nor throw a ball. He was domineering, arrogant, and demeaning with schoolmates and with his five-year-old brother. He ordered them around like slaves or possessions and they either avoided or scapegoated him. Matt's problems were longstanding: he had had problems with other children at nursery school and day camp, and he was unable to acquire in-phase skills. It seems likely that extreme self-consciousness about his body played an extremely important role in his physical awkwardness and inhibitions. For example, he could not participate in swimming lessons because he would not undress and put on a bathing suit in front of other boys at camp.
马特的智力很出众，但学业成绩却平平。他没有朋友，事实上，“学校的每个人都讨厌他。” (Egan and Kernberg, 1984, p. 42)他将自己的老师看作是他的一个同事，他欺负同学，和同学们相比完全不合拍。因为做任何身体的活动他都会感到尴尬、焦虑和羞愧，因此马特不能参加任何与8岁儿童年龄的同学的游戏活动中。他不能骑自行车，游泳，溜冰，甚至连投球都不行。与同学和他5岁的弟弟一起，他是那么的专横跋扈、自大和脾气暴躁。他把他们当作是奴隶或者物品来驱使，周围的朋友和弟弟要不躲着它，要不成他的替罪羔羊。马特的问题是长期存在的：他在幼儿园和夏令营中就和别的孩子之间有问题，他无法获得同相的能力。似乎对身体的极端的自我意识，在他的身体笨拙和限制上，扮演了极其重要的角色。例如，他无法参加游泳课，因为他无法在其他的夏令营男孩身前，脱下衣服穿上泳衣。
Failures of Expectable Mirroring and Idealization, and Deficits in the Proud Self
期望中的的镜映和理想化的失败，夸大自体中的赤字
Matt's father, a publisher of some standing, was a shadowy man in the family. Deferring to his articulate wife, he let her speak for him. Both parents agreed that Matt was a “magnificent” child, and both actively encouraged the hypertrophy of his intellect and discouraged physical activity. Both derived great pleasure from his intellectual precocity. In fact, they were so impressed with Matt that they had to overcome their reluctance to have a second child, worried that no sibling could compare favorably to Matt or compete with him. Neither parent seemed worried about his awkwardness and inhibitions, his friendlessness, and his isolation.
马特的父亲，一个颇有地位的出版社工作人员，是家庭中的隐身人。他服从他能言善辩的妻子，让她同孩子讲话。父母两个人都同意“马特是一个杰出的孩子”，都主动地鼓励他的智力活动，对他的身体活动却持有不鼓励的态度。这导致他从智力早熟中获得了更多的享乐，事实上，他们是那么的重视马特以致于他们不得不克服要第二个孩子的不情愿，因为他们担心没有兄弟姐妹能与他相比和竞争。似乎父母都不担心孩子的身体笨拙和限制、缺少朋友和他的孤立。
Matt's mother, according to the analyst, was exceedingly controlling, intrusive, and demanding, on the one hand, and doting, fostering over-closeness, and encouraging of his arrogance, on the other. Unaware that her expectations for control over Matt's body-mind-self were out of phase, she appeared oblivious to her psychological impact on her child and their often stormy battles over dominance and control. For example, thinking that her demand for control over her child was necessary and correct, she complained that Matt's insistence on wearing his belt too tight made her angry and frustrated. The mother's failure to recognize that she undermined the child's autonomy and the father's inability to provide alternative mirroring that resonated with a growing boy's independent initiative were compounded by both parents' inability to recognize his needs for a noncoercive form of connectedness with his brother and his peers. These are simply gross markers that show the serious and ongoing deficiences and faults in the child's selfobject environment that undermined healthy strivings, the forward edge of the self, and the push to complete normal development.
依照分析家所说，马特的母亲，是一个极度控制、侵入的和苛责的母亲，一方面，对孩子却很溺爱、过度亲密的培养，以及鼓励他对他人的自大态度。对孩子身体-精神-自体的控制的期望是那样的不协调，在这点上，她是一无所知，对孩子的心理影响和她主导和控制的暴风骤雨般的战斗常常忽略不见。例如，对孩子的控制和要求是必要和正确的，她抱怨到马特总是腰带系的太紧，这让她很生气和很有挫败感。母亲无法认识到她破坏了孩子的自立，及父亲无法提供替代性镜映，与替代性镜映共振的儿童的逐渐增长的独立精神，被父母双亲的无能所破坏，无法识别他对于他兄弟和同学联系的非强制形式。这仅仅是在儿童的自体客体环境中，严重和不间断的缺陷和错误的显而易见的标记物，这个自体环境破坏了健康的努力，自体的前行端以及完全正常发展的驱动力。
Matt's developmental history—the history of his self–selfobject experiences—suggests that he suffered primarily from thwarted needs and expectations for expectable selfobject responsiveness. Thus, he failed to establish, maintain, and restore a genuine sense of pride in himself, of in-phase control over himself and others. The lack led to arrest and fixation on pathological grandiosity, to distortion of his selfobject needs, and to deprivation of a genuine in-phase sense of feeling effectual, of deriving “accomplishment pleasure” from his body-mind-self, from who he was and what he could do. The thwarted mirroring needs and the lack of pride in himself did not stop there: his lack of a reliable source of self-esteem and pride in himself made him exceptionally vulnerable to feeling deflated, ashamed, and painfully exposed. To protect himself from these dangers to the self, Matt hid his vulnerability and shame. (His refusal to undress at age five is an overt manifestation of hiding himself from exposure.) As will be seen shortly, for many months, he defensively hid his vulnerability and his needs to be helped to catch up.
马特的发展历史——他自体的历史——自体客体经验——显示他主要遭受来自对意料中的自体客体回应的挫败的期望和需要。如此一来，他无法建立，维持和重建真正的自豪感，或者同相（in-phase）地对自己和他人的控制感。这缺失导致病理性夸大的捕获和固着，自体客体需要的扭曲，以及真正的共相感觉适宜的感觉的剥夺，从他的身体-精神-自体中，从“他是谁”和“他所能做的事情”中得到真正的“成就快乐”（accomplishment pleasure）。被挫败的镜映需要和缺少自豪感在此并没有阻止他：缺少自尊的稳定来源和缺乏自尊让他感到极其脆弱，他感觉自己很泄气，羞耻和痛苦的暴露。为了让他自身免于这些自体的危险，马特藏起了它的脆弱和羞耻感。（5岁时他拒绝坦露身体，就是他把自己藏起来的一种公开表现。）接下来我们很快会看到，在数月的时间里，他防御性的隐藏他的脆弱，以及自己需要帮助能被别人捕获到。
Can the Forward Edge of Development Be Remobilized?
发展的前行端能被激活么？
Although the aim of the defensive effort to hide the vulnerable self is to protect whatever self-organization there is, this defensive measure, like others, also aggravates the primary self-esteem disorder and leads secondarily to greater vulnerability and to a vicious cycle of more rejection and more failure. Thus Matt was doubly deprived. For example, because he was too uncomfortable and ashamed of himself and his body to learn to swim, he was deprived of obtaining pleasure from his own body and what he could accomplish; then, unable to keep up with peers, he was deprived of the self-expanding pleasures of kinship and was thrown back even more into the world of his parents. Matt was caught in a vicious intrapsychic cycle—a “prisoner” (Miller, 1981) of his particular developmental deficits, his greatly intensified childhood mirroring needs, and the defensive measures he used to save the only self he had.
尽管他防御性的隐藏脆弱自己的努力，是处于保护的目的，但不论自体的组织是什么样子，像其他的防御性的措施一样，主要会加重关于自尊的心理障碍，其次会导致更严重的脆弱以及更多拒绝和失败的恶性循环。因此，马特是被双重的剥夺了。例如，因为他对他自己和学习游泳的身体感到不适和羞耻感，他被剥夺了从自己身体上能获得的快乐；然后，无法与跟上同辈的步伐，他被剥夺了亲密关系中自体扩展所带来的愉悦感，从而被更多地重新丢回了于父母的内在世界。他被捕获在“内精神”的恶性循环中，是他特定的发展赤字的“囚徒”，他愈演愈烈的儿童期镜映需要的“囚徒”，过去常常挽救他唯一的自体的防御性措施的“囚徒”。
The most important diagnostic question to be asked is whether the child or adult patient can respond to and connect with an emotionally available therapist, that is, a therapist who can grasp and respond appropriately to his in-phase needs. Put in more theoretical terms, can the child, met partway by the therapist's selfobject functions, establish any of the development-remobilizing forward edge transferences? The form of the transference and the defensive measures used to ward off the dangers of the transference (intense shame, humiliation, fragmentation, and depletion) are critical indicators of whether the forward edge strivings and forward developmental momentum can be remobilized. Specifically, the questions for Matt are: (1) Are his needs and strivings for expectable mirroring, idealization, and/or twinship experiences (any one of these can be the route to self-expansion and restoration) still sufficiently intact to be remobilized? (2) Is mutuality and give and take, resiliency, ability to recover from injuries and bounce back (self-right) and regaining initiative still a viable potential? How do we answer these questions clinically?
提问的最重要的诊断问题，是不论孩子或者成人病人是否能与治疗师回应或者建立情感性的连接，治疗师都能理解并恰当回应病人的同相需要。用更理论化的术语来说，孩子能通过治疗师的自体客体功能来相遇，建立前行端转移中任何的发展-再动员（development-remobilizing）么？被用来规避转移危险的转移和防御措施的方式，是重要的指示物，不论前行端的努力和向前的发展动力是否被动员。特别地，马特的问题在于：（1）他的对期待中的镜映、理想化和/或孪生关系经验（这其中的任一都可以被看作是通向自体扩大和重建的道路）的需要和努力仍然完整无损，还可以被动员么？（2）相互关系、索取、弹性、从疾病中恢复的能力以及重新振作和恢复计划是否还有可行的潜力呢？在临床上我们如何回答这些问题呢？
The Forward Edge of the Selfobject Transference: Matt's Wish to Keep Up
自体客体转移的前行端：马特想要不落后的愿望
When Matt first met the analyst, he started by demonstrating an aspect of the trailing edge of his development, namely pathological accommodation to his parents' complaints about him: he quickly and dutifully listed his bad habits, such as picking his nose and wiping his fingers on his sleeve, picking his fingernails, keeping his desk messy, and covering the door to his room with papers and signs. (He listed relatively minor complaints, to be sure, considering the school's concerns.) However, after the litany of his bad habits that said, in effect, “see what a mess I am,” Matt proffered a “tendril” of health. The analyst noted it in his case report but did not see its significance as a bit of remaining healthy self with its own agenda, rather than that of parents trying to heal their own hidden sense of defectiveness with a “magnificent” child and his intellectual prowess.
在马特于分析家的首次会面中，他是通过演示他发展的滞后端的一个方面开始的，也就是说，对父母的抱怨的病理性适应：他快速地、尽职尽责地列出了他的坏习惯，例如抠鼻子。用袖子擦拭手指，抠指甲，桌子一团糟，用各类纸张和标志盖住门。（他列出了父母们相对次要的抱怨，学校关心的事情还未确定。）然而，在他的坏习惯的长篇累渎之后，事实上是在说“瞧瞧我有多么的糟糕。”马特提供了一个健康的“卷须”。分析家在他的个案报告中注意到了这点，但是并没有把它的重要性看作是他自己议事日程中保持健康的自体的一个点，而是看作父母试图通过一个“杰出”的孩子和他的知识能力来治愈他们自身隐藏的缺陷感。
The tendril that eventually formed the core of a reparative selfobject transference was Matt's immediate, intense interest in the analyst, in what he had and what he was. This is the form that the tentative reaching toward the analyst took: Matt noticed flowers on the analyst's desk and asked if they were real. In a great hurry (the reason will be apparent) he did not wait for an answer. Hurrying on, he noted that the analyst's clock was eight minutes ahead of his watch. “I wish,” he said, “[that] my watch could keep up with your clock” (italics added). The analyst noted (to himself) that Matt was expressing his competitiveness (cf. the vignette Miller, 1985, reported). When we place the needs of the healthy self in the center of our analytic thinking, the wish can be understood as a powerful metaphorical expression (unconscious) to catch up and keep up, so he could live psychologically in the world, instead of in his own mind and the world of his parents, where he was trapped. The wish was of such great importance to him that he repeated it three more times in the first session!
最终，构成补偿性的自体客体转移的核心，是马特对分析家、“它曾拥有”和“他曾是谁”的直接强烈兴趣。这就是朝向分析家的假设：马特注意到了分析家桌子上的花，并询问到他这些花是不是真的。这很匆忙（原因将会明显），他并不等待答案。很快他又注意到了分析家的时钟比他的手表快了8分钟。“我希望”，他说到，“我希望我的手表能跟上你的时钟”。分析家注意到马特在表达他的竞争性。(cf. the vignette Miller, 1985, reported)。当他把健康的自体需要放在我们分析思考的核心时，这个愿望可被理解为想要被捕获和维持的强大的隐喻性表达（无意识的），因此精神性的在这个世界上生活，而不是被捕获在在他自己的思想内或者在父母的世界里。这个愿望对他来说，是如此重要，以致于在初次会谈中，他足足重复了三遍之多。
This minute bit of a future-oriented agenda denotes a remobilizable forward edge to be given impetus in an expectable self–selfobject environment. Matt, indeed, is a self-proclaimed mess (the expression of the trailing edge of his development and the defensive measures he needed for protection from intense shame for being behind). However, his own agenda includes a search for the real, for the alive world from which he is barred (“are the flowers real,” he asks), and it includes the welcome wish/hope that he'll get in sync with the analyst and “catch up.” The analyst did not welcome the tendrils because he did not understand them as such. (I might say, “Yes, I can see you really want your watch to catch up with mine.”) The lack of response led Matt to a more ambiguous overture to the analyst—at one and the same time, a tendril of a forward edge transference to an idealizable, accessible parent and a defensive denial of his inadequacy: Matt asked the analyst if he were in publishing. The analyst parried the question with a question that most analysts learn is intended to preserve analytic anonymity and neutrality—the “Why do you want to know?” question. More often than not, it is far from neutral as far as the patient is concerned—usually it is construed to mean, “Keep out,” that is, an unintended rebuff.
这个未来指向日程表的时间点，在预期中的自体客体环境中，表明了想要动力的重新动员中的前行端。事实上，马特存在自我标榜的混乱。（一方面是他发展的滞后端表达，另一方面是因为落后而强烈的羞耻感的需要保护的防御性措施的表达。）然而，他自己的议程表中，包含了对现实的搜寻，因为他被生机勃勃的世界禁锢在外，（他问道，“这些花是真的么？”），这包括了受欢迎的愿望/希望，在愿望/希望中，他能与分析家保持一致，从而被捕获。分析家并不欢迎这个“卷须”，因为他并不能同样地理解他们。（我可能会说，我看你真的想你的手表能追上我的表。）回应的不足，使得马特的愿望变成了对分析家模棱两可的开场白——在那个时刻同时是，对理想化的、易接近的父母和他不足的防御性否认的前行端转移的“卷须”：马特问分析家，他是否从事过出版业的工作。分析家会回避这个问题，因为多数的分析家意图保持分析的匿名性和中立性——“为什么你想要知道呢？”通常，如果涉及到病人的话，这就不仅仅是中立的问题了，通常这被解释为“不让进”，一个无意识的断然回绝。
“Are you in publishing?” could be motivated by an effort to whistle in the dark and boast after telling his parents' complaints, or as I would think, the question can possibly mean, “Are you approachable as a real, alive father?” In any case, the analyst's “Why do you ask?” inadvertently discouraged the forward edge—Matt gave voice at this point to the lonely grandiose fantasies of the most pathological aspect of his development: he announced that he himself is president and editorin-chief of a publishing company, that he has a number of men working for him, and that he has trouble keeping them on the job. They quit (i.e., his peers won't play). The gross identification with his publisher father is not merely “grandiose” and a continuation of denial of weakness in fantasy beyond the age when it is in-phase (A. Freud, 1965). Gross identification, sometimes a precursor of the actual inner capacities we eventually acquire for ourselves, in Matt's case is a signal that he needs the strengths and support of a substantial father; lacking these, he is the father in fantasy. Again, in theoretical terms, there is now a “vertical split”—on the one hand, a weakened, shame-prone self that nevertheless still needs genuine mirroring, idealization, and twinship experiences to sustain further growth, and on the other hand, an isolated, walled-off, manifestly pathological, grandiose self that is inaccessible to change unless treatment remobilizes the forward edge tendrils that poked up at the very beginning of the treatment.
“你在出版业么？”可以被黑暗中吹口哨或者在告知父母抱怨之后自吹自擂的努力所激发，我也许会说，这个问题可能意味着“你是一个像现实活着的父亲那样可接近的人么？”不论如何，分析家的“为什么要提这个问题呢”都在无意间阻碍了前行端——在他的发展最病理的一面的孤独的夸大幻想的点上，马特发声了：他宣称自己是出版公司的董事长和总编辑，手下有很多员工为他工作，但是让他们工作对他来说存在着困难。他们辞职了。（也就是说他的同辈们不和他一起玩。）与他的在出版社工作的父亲显而易见的认同，可以看出这并不仅仅是幻想中缺点拒认的“夸大”和连续体，这超越了共相的年龄(A. Freud, 1965)。这个显而易见的认同，有时是我们终究要求我们自身的内在实际能力的前导，在马特的个案中，是他需要强大的父亲的力量和支持的信号；因为缺少这些，他就是幻想中的父亲。如果再用理论术语来表述的话，存在着“垂直分裂”（vertical split）——一方面，变弱的、易于羞耻的自体仍然需要真正的镜映、理想化和孪生关系来支撑进一步的发展，而另一方面，除非治疗激活在治疗初期就戳中的前行端的“卷须”被孤立、被隔绝、显然是病理的夸大自体就变得难以接近了。
Inadvertent Repetition of the Trailing Edge
滞后端的无意间重复
In the first eight months of the treatment, the theoretical tilt to recognizing pathology and overlooking health led to accenting the trailing edge: the analyst wanted Matt to talk about his problems and worries, he probed for dreams, and he interpreted the meaning of drawings Matt made. Matt's response to these well-intended efforts to ferret out his pathology was not unlike Guntrip's patient's response: he had himself and his inner world. In other words, he resorted to unconscious defensive efforts to ward off the threatened invasion of his fortress-mind, the feared exposure of his vulnerabilities, and the self-shattering shame. The defensive measures to avoid these dangers to the self hardened. Being an eight-year-old, he did not hurl boulders. Instead, he became enraged, withholding, and withdrew into the books he brought to his hours. “I prefer to read,” he told the frustrated analyst. Or he warded off what he perceived as invasion and attack by isolating himself in self-absorbed elaborate drawings. The weakened self sought illusory mastery and effectance pleasure in pathological grandiosity with its unmistakable arrogance, tyranny, and pseudo self-sufficiency. Matt was good at shutting the analyst out, hour after hour, and the thwarted needs and strivings of the healthy self and its forward edge were nowhere to be seen.
在治疗的最初8个月里，识别病理学而忽视健康方面的理论倾向，导致强调滞后端的结果：分析家想要马特讨论他的问题和困扰，分析家研究了他的梦，解释了马特画的意义。马特对于这些有意的搜出他病理学努力的回应，并不像是冈特里普的病人回应：他有自己的内在世界。换言之，我们诉诸于无意识的防御，来规避他的“堡垒思想入侵”的威胁，对暴露他自己脆弱的恐惧，以及自体破碎似的羞耻感。这些防御措施是为了避免这些危险，而让自体变得坚硬。对一个八岁的孩子来说，他都无法投掷石块。相反，他变得易怒、抑制，把自己的时间都撤回到书籍上。他告诉受挫的分析家道：“我更喜欢看书。”要么他将精力放在在专心的、煞费苦心的绘画中，通过将自己隔离，将他与看作是入侵和攻击的东西隔离。变弱的自体在同明显的自大、专横和假性自足（pseudo self-sufficiency）关系中，寻找在病理性夸大中的幻觉性掌控以及有效享乐。马特擅长持续地把分析家排除在外，擅长挫败健康自体的需要和努力以及让它的前行端无处可寻。
A Frequent Countertransference: Anger as a Signal of the Analyst's Failure to Understand
频繁的反转移：生气作为分析家理解失败的标志
In the context of assessing the strengths and weaknesses of the childself, the early course of the treatment demonstrates the point I am making about psychoanalytic theory: we are more inclined by our training to see and address pathology and to overlook or fail to grasp the meaning of still healthy strivings. When we place the self and its valid needs in the center of our clinical thinking, we are more likely to recognize the thwarted needs and strivings, the primary psychological configurations that give rise to overt grandiosity, rage, arrogance, depreciation, competitiveness, and the entire spectrum of self-disturbance. Matt's overt grandiosity and his covert hiding of his vulnerable self got worse as the thwarted needs of a psychologically deprived self went unrecognized.
在评估孩子自体的优势和弱点时，治疗的早期过程说明了我正在做的精神分析的点：通过培训我们更容易看到和处理病理学，却忽视或者无法理解仍然健康的努力的意义。当我们把自体及它有效的需要放在我们临床思考的核心，我们更倾向于识别出受到挫折的需要和努力、产生明显夸大（overt grandiosity）、暴怒、贬值、竞争性以及自我干扰的整个谱系的主要心理建构。马特的明显夸大和对脆弱自体的隐藏，随着心理上的被剥夺的自体受挫的需要未能被认出，而变得越来越糟。
For eight long months, Matt lorded it over the analyst—he came out of hiding behind his books and drawings only to counterattack. He berated the analyst if he were a minute late, he ordered him around, and he went to great lengths to show that the analyst was of absolutely no importance to him. You will not be surprised to learn that Matt's therapist began to feel like Matt's peers. He felt angry and “progressively more helpless, useless, and weak. [His] speech was more hesitant and tentative and his comments more vague and imprecise. [He] came to dread the sessions as he foresaw yet another hour of being made to feel worthless, bored and irritated” (Egan and Kernberg, 1984, p. 47).
在八个月的时间里，马特都在对分析家摆架子——他躲在书和画之后只是为了反攻。如果有一分钟的迟到，他都会斥责分析家，都会调头，竭尽全力来显示，分析家对他来说一点都不重要。看到马特的治疗师开始像他的同辈时，你也不会感到惊讶。他感到愤怒，并逐步感到更多的无助、无用感以及虚弱。【他的】谈话越来越迟疑和具试探性，他的评论越来越模糊和不精确。他害怕来到会谈中，因为他预见到了这是他另一个他感觉无价值、无聊和易怒的时间。
The point I want to emphasize is that the therapist responded with what I have come to see as frequent countertransference signals: all of us can use such feelings as anger, dread, floundering, and so on to alert us to the fact that we have not yet understood a disdainful patient who makes us feel useless and ineffectual. Pathomorphic theory (see Emde's [1981] important contribution on the problem with psychoanalytic theories of normality that are based on pathological development) prompted the analyst, in this case, to look for what was wrong with Matt. Matt's lordliness, his self-protective “resistance” to further infringement on what little control he had over himself and his world, worsened as he experienced in his treatment a new version of his mother's invasiveness instead of a resonant response to his agenda to keep up. Reproducing the pathogenic experience with his mother in a trailing edge transference was not therapeutic. The way out of the analyst's feeling of anger and ineffectualness and of Matt's helplessness and fear of further humiliation lay in accessing the forward edge of the transference.
我想要强调的点是，我已经看到的分析家作为经常发生的反转移的信号的回应：我们大家都使用诸如愤怒、恐惧和挣扎等等这样的感觉，来让我们留意这样的事实：我们并未理解一个倨傲的病人，这个病人让我们感觉自己很没用。病理形态学理论（Pathomorphic theory，见艾穆德（Emde）关于常态的精神分析理论的问题的重要贡献中，这个理论是基于病理发展建立起来的。）在这个个案中，提示分析家去寻找马特做错了什么。马特的高傲，他进一步地在他对自身和他的世界中较少控制侵犯的自我保护式的“阻抗”，随着“他在治疗中体验到母亲的入侵”的新版本，而不是想要跟上日程表的共振型回应而变得恶化。在滞后端转移中重构与母亲的致病经验，并不具有治疗意义。由于分析家愤怒和无效的感觉，以及马特的无助感以及害怕遭受进一步的羞辱，他们的作用在于接近转移的前行端。
A Glimpse of the Structural Deficit: Recognition of Matt's Injury and Powerlessness
结构性赤字的一瞥：识别马特的受伤和无力感
After eight or nine months of suffering from the anger and dread of ineffectualness as a therapist, the analyst explained Matt's lordliness (grandiosity as a defense) as a way of making the analyst feel helpless and useless because Matt himself felt powerless and helpless. (To put this in theoretical terms, the grandiose defense signals a deficiency in the internal structure that confers a usable sense of strength and confidence; the scathing depreciation of the therapist that can be so enraging is a secondary complication of the vulnerable self that is humiliated by exposure and both hides and attacks back to protect the self from further humiliation at any cost.)
作为治疗师，在经历了八或九个月的愤怒和对无效的恐惧的困扰之后，分析家将马特的倨傲（作为防御的夸大）看作是让分析家感到无助和无用的一种方式，因为马特自己就感觉到无力和无助。（用更理论化的术语来讲，夸大的防御标志这在内在结构的缺陷，这个内在结构提供了可用的力量感和自信感；让人感到愤怒的分析家受到损伤的贬低，是通过暴露而被羞辱的脆弱自体的次要并发症。两者都隐藏和再次袭击，用来不计代价地保护自体免于受到进一步的羞辱。）
After some time (unspecified) Matt accepted the part of the interpretation that accurately mirrored what he felt, and regaining healthy initiative, he added a crucial element of his own to it: the world for him is divided into powerful and helpless, and he often feels helpless, especially around his mother. Matt's forceful and energetic response to the analyst's overdue understanding of his manifest arrogance and depreciation (the over-”grandiose defense”) leaves little doubt that the warded off feelings of powerlessness and ineffectuality are the signs of unrecognized injury to the self and that the defensive character traits that are so enraging to the therapist, to peers, and to others in his world are serious intermediate complications deriving from the trailing edge pathology of the vulnerable self.
一段时间之后（未明），马特接受了部分精确地镜映了他的感受的解释，重新获得了健康的主动性，并自己给它增加一个重要的元素：对他来说，世界被划分成有力的和无力的两个部分，他经常感觉到无力，尤其是他在母亲周围的时候。马特对分析家关于自己明显的傲慢和贬低（过度-“夸大防御”）(the over-”grandiose defense”)迟到的理解报以坚强的、有活力的回应，这个回应对无力感和无效感的屏蔽是自体未被识别的伤口的信号，以及防御性的性格特点是如此容易地激怒治疗师、同伴以及他的世界的其他人，这是严重的起到媒介作用的并发症，它源自脆弱的自体的后滞性病理学。
Reinstatement of the Forward Edge: Repair, Beginning Mutuality, and Play
前行端的恢复：修复，彼此开始和游戏
The analyst's recognition of his deficit, that is, accurate mirroring and validation of the chronic self state of helplessness, acted, for Matt, as a crucially needed mirroring experience that breathed life into his own independent initiative and reactivated a vital component of the normal self. Matt now expected a resonant response from the analyst and he took the initiative in the shift from the accent on pathology to the possibility of psychoanalysis of normal development and his own agenda: Matt brought in a ball and asked the analyst to play catch. Thus, catching up in development began with the reinstatement of previously missing reciprocity, mutuality, and playfulness—Matt and the analyst, self and selfobject, played ball, on and off, for several weeks.
分析家对于他的赤字的识别，是长期无助的自体状态的精确镜映和验证，对于马特来说，是一个重要的、被需要的体验，将生命注入到他独立的自主中，再次激活正常自体的重要组成部分。马特现在期待从分析家那得到共振性的回应，他已经主动从强调病理转向正常发展的精神分析的可能性和自己的日程表中：马特带来了一个球，并和分析家玩起了传球的游戏。从而，追赶上发展始于早前丢失的相互关系、亲密关系和玩笑的恢复——马特和分析家，自体和自体客体，断断续续的持续了几周的时间。
Another crucial mirroring response occurred: the analyst recognized with 、Matt that he felt intense shame when he did not perform well. He also told Matt that he wanted the analyst to miss the ball or drop it. I think Matt took this part of the interpretation with a grain of salt: his devaluating the analyst, like his defensive hiding and inability to play, was not a primary psychological configuration. Rather, devaluation (like his other character defenses) belonged to an intermediate area and was driven by the terrible shame associated with deficits and ineffectualness.
另外一个重要的镜映式回应发生了：分析家认为，当自己做不够好的时候，马特会感受强烈的羞耻感。他还告诉马特他希望分析家错过皮球或者球掉了。我认为，马特对这部分的解释持有保留意见：他对分析家的贬低，就像他的防御性躲藏以及无法游戏一样，并不是一个主要的心理结构。不如这样说，贬低（就像他的其他性格防御属于中介区域，它是被可怕的羞耻感所驱使，同时伴随着赤字和无效状态。
Matt's healthy strivings were given further impetus when the analyst recognized Matt's shame. Unlike the parents, who undermined the eight-year-old's phase-appropriate control over himself and his world, the analyst's selfobject functions were sufficiently in tune with healthy strivings to be effectual. The balance of the transference was tipping away from the pathological self–selfobject repetition of faulty mirroring. The mirroring selfobject transference was becoming a source of missing vitalizing ingredients, real recognition, encouragement, and help to catch up. Responding now to Matt's own initiatives and expectations for a response, the mirroring, idealized, alter-ego analyst played ball (all of these selfobject functions are part of playing ball and part of the transference).
当分析家识别出马特的羞耻感时，马特的健康的努力被注入了更多动力。孩子父母破坏了一个8岁的孩子对于他自己和他的世界的与阶段相适合的控制，与他们不同的是，分析家的自体客体功能足以协调健康的努力，让他们变得有效。转移的平衡不会为错误镜映的自体-自体客体的病理性效力。镜映的自体客体转移变成了丢失的、富有生命力的成分，真正的认识，镜映，理想化，“另一个我”（alter-ego）的玩球的分析家。（所有的这些自体客体功能部分在于玩球，部分在于转移。）
Another step in the development of independent initiative and getting in sync came when Matt noticed the analyst's book on making airplanes. He made a bid for a response to his phase-appropriate needs—he asked for help, and the idealized analyst who could help responded in kind: together they built airplanes. Matt was no longer a helpless prisoner of childhood self–selfobject experience gone awry. He was no longer so entirely alone and lonely in his splendid isolation—his treatment established a self–selfobject transference that reinstated phase-expectable encouragement, mirroring, and guidance. The analyst was a “usable selfobject,” if you will, and Matt was enabled to make use of his multiple development-enhancing functions, including his function of interpretation. Interpretations were not hurled away like boulders; they were usable. For example, the analyst explained to Matt that it was so difficult for him to ask for help because it made him feel ashamed and worthless, that the only way he could feel strong was to do everything for himself. The analyst was on his wavelength; now he recognized Matt's shame and lack of pride in himself and willingly participated in the forward edge of development and Matt's agenda— his effort to keep up.
当马特注意到分析家关于制作飞机的书籍之后，独立的主动性的发展的另一步同时来了。他想要得到它，作为他这个合适阶段的需要的回应——他寻求帮助，并理想化了分析家，把分析家看作是用帮助他的方式来回应他：一起建造飞机。马特不再是自体在童年期的无助的“囚徒”——自体客体经验出了岔子。他不再在他杰出的孤独中完全的孤零零——他的治疗建立了一个自体-自体客体转移，它恢复了预期中阶段的鼓励、镜映和引导。分析家是一个“能用的自体客体”，如果你愿意，马特能充分使用他的多样的加强发展（development-enhancing）的功能，包括解释的功能。解释不会像扔石子那样被浪费掉，他们是有用的。例如，分析家向马特解释道，对他来说求助是如此的困难，因为这让他感到羞耻感和无用，能让他感觉到自己强大的唯一办法是什么事情都亲历亲为。分析家在他的波长上；现在分析家认识到了马特的羞耻感和缺少自豪感，并愿意参加到发展的前行端和马特的日程表中来——不落后的努力。
The Intermediate Sequence: Two Episodes of Inevitable Disruption and Repair
中间的次序：不可避免的崩坏和修复的两则插曲
Matt was threatened with a return to his lonely, isolated plight—he was going away for an eleven-day spring trip with his family. The impending loss of the strengthening experience of the transference prompted Matt's preoccupation with complicated fantasies of how to prevent losing things. In the last hour before his vacation, he described the visual path to the brain and told the analyst how he would keep an image of him in his mind. The analyst said that then he wouldn't be so lonely. Although the focus on the trailing edge—the loneliness—is more than understandable, Matt himself also had the forward edge in mind: he asked for the “gleam” in the mirroring parent's eye by asking the analyst if he would like to hear him play his trumpet. The analyst, now a new version of an expectable mirroring selfobject, said he would, thus welcoming the tendrils of the naïve proud self that spontaneously offers itself for acceptance and applause. Matt's transference experience was now a world apart from the chronically faulty self–selfobject environment that shaped the trailing edge of his development. Because he could use available selfobject functions, Matt left on his trip with far more than simply an image of the analyst in his mind. He carried away his expectations of the “gleam,” his hope and anticipation of bringing his trumpet and continuing the enlivening therapeutic duet he played with the analyst, who had helped him to reinstate normal self-development.
马特遭遇了想要回到孤独的、隔离的困境的威胁——他与家庭一起，在春游中一起离开了11天。即将发生的转移的加强经验的缺失，使得马特全神贯注于他如何防止丢东西的复杂幻想中。在假期的最后几个小时里，他描述了头脑中栩栩如生的道路，并告诉分析家他是如何牢记这些图片的。分析家说到，那样他就不会感到孤独了。尽管聚焦于滞后端——孤独——这是大于可被理解的。）通过询问分析家是否愿意听他吹喇叭，来请求在镜映父母眼中的“微光”（gleam）。分析家，现今是期望中的镜映自体客体的新版本，他可能会说，愿意欢迎天真自豪的自体“卷须”，这同时给了它接纳和掌声。马特的转移经验现在成了远离长期的有缺陷的自体-自体客体环境的世界，这个曾将有缺陷的自体-自体客体环境构成了他发展的滞后端。因为他可用能用的自体客体功能，马特离开在旅行中伴随的是可不仅仅是在脑海中保留分析家的形象。他带走了（他眼中）“闪光”的期望，他的希望以及参与到“带来喇叭”的活动中，不断的让他与分析家上演的二重奏保持活力，在其中分析家帮助他恢复了正常的自体发展。
The analyst's five-week summer vacation posed another threat of disruption: in large part, Matt's revived capacity for spontaneity and mutuality required continuing mirroring participation. Matt developed a vocal tic, followed by a cough, before the coming interruption. His mother was enraged. She believed that he could control the tic if he wanted to. Matt himself was embarrassed by the symptom, and he asked the analyst to help him get rid of it. Safer in a viable self–selfobject transference now, Matt was less afraid of self-exposure and more expectant of receiving the kind of help he needed: for the first time in the analysis he told a dream. In the dream, someone was leaving him. This person turned into a gingerbread man, and Matt ate him up.
分析家为期五周的暑假构成了另一个破坏的威胁：在很大程度上，马特的恢复的自发和亲密的能力，需要持续的镜映参与。马特出现了声音的抽搐，这常常在咳嗽之后，恰好在接下来的终止之前。母亲震怒了。她认为只要他想控制就能控制这个抽搐。马特也为他的症状感到很尴尬，并请求分析家帮助他除去它。现在在一个安全的可行自体客体转移中，马特不再害怕暴露自己，也更期待得到他想要的这类帮助：他第一次在分析中讲述了一个梦，在梦中，有人离开了他。那个人变成了姜饼人，马特吃掉了他。
Matt's distress and his request for help led the analyst to make an interpretation. Although he doubted that Matt would understand it, he wanted to help him and tried. He told him his tic and cough represented the wish to eat the analyst up and the defense against the wish. The self-psychological view of the emergency symptom and the dream would emphasize that Matt was afraid of the loss of the analyst's selfobject functions and needed to keep the good feeling of being acknowledged and encouraged “inside” of him: hence the dream work turned the analyst into an edible selfobject, into the gingerbread man he could keep with him while the analyst was away. The “oral incorporative” wish (as well as the castration wishes and fears the analyst emphasized later in the treatment) is the manifest content of the need to fill a structural deficit. The “oral” impulse, as with Guntrip's patient, is one of the bits and pieces of the injured self that begins again to experience fragmentation anxiety, depletion depression, and a lowered sense of effectualness. All the more need for some form of “glue.” The analyst's interpretation was close enough to Matt's continuing mirroring needs, Matt took it in, and it served as needed glue.
马特的悲痛和请求帮助，让分析家给他做了一个解释。尽管他质疑马特是否能理解它，他仍然想要帮助他，并做了尝试。他告诉马特他的抽搐和咳嗽代表着他想要吃掉分析家的愿望，同时也是对这种愿望的抵抗。这类突发症状和梦的自体心理学观点，强调马特害怕失去分析家的自体客体功能，需要将被承认和鼓励的好的感受放到自己“内部”：因此梦的工作将分析家变成了可食用的自体客体，变成了姜饼人，这样在分析家离开的时候，也能与分析家在一起。这个“口腔合并”（oral incorporative）的愿望（同时也是阉割的愿望，害怕分析在后面的治疗强调它）是想要填补结构性赤字的需要的表面内容。“口腔”冲动，正如冈特里普的病人一样，是重新开始体验分裂焦虑、消耗性抑郁、低层次有效的受伤自体的一点或者一部分。他更加需要“粘合剂”的某些形式。分析家的解释与马特的持续的镜映需要足够紧密，马特吸收了它，它就作为了需要的粘合剂。
When treatment resumed, Matt said the cough was better, and when it occurred, it did not last long. He understood that connected with not seeing his analyst, although he said, “I don't like the idea that you helped me … Actually, I like the help, but my subconscious doesn't…. That cough came back over the weekend. Lucky for you—I mean, lucky for me—thanks to you—its coming back went away” (Egan and Kernberg, 1984, p. 49). Matt and the analyst talked more about the connection between interruptions and the recurrence of the cough, and the analyst asked, “What do you think that's all about?” (Instead of asking Matt a question, I might, in this context, offer an interpretation that he feels surer of himself and of what he can do when the analyst is there to enjoy him.) Matt dismisses the probe, “We figured it out already… remember two or three months ago when you were going on vacation [coughs]. There it is, but I think it'll be better [moves].”
当治疗重新开始时，马特说他的咳嗽好多了，即使发生，也不会持续太久。他的理解是，这与他无法与分析家见面有关，尽管他说：“我不喜欢你帮我的这个主意……事实上我喜欢被帮助，但是潜意识却不……上周末咳嗽又回来了。对你来说是幸运的——我的意思是说，对我很幸运——多亏了你——它的回归消失了。” (Egan and Kernberg, 1984, p. 49)马特讨论了许多关于分析中断和咳嗽重现的关联，分析家问道：“你认为这到底是怎么回事？”（或许在这个背景下，我不应该问马特问题，而是应该给他一个解释，当分析在场并欣赏他时，让他对自身以及“自己能做什么”的确定感），马特对于这个提问不予理睬，“我们已经找到了……记得在两三个月前，当你开始旅行的时候【咳嗽】。就这样，但我认为它会好起来的【位置移动】。
Now Matt changes the subject. That is, he makes the all-important shift from the trailing edge—his fragile self and the symptoms of his structural deficits—to the forward edge: he starts telling the analyst that he is growing and propagating plants by getting cuttings and how he might trade them to make a big garden (a telling metaphor like “tendrils,” which goes back to his first question, “Are the flowers real?”). Then he asks, “Did you know that plants can be used to support life? They give us oxygen, and we give them CO2 . It's a good life-support system.” The analyst replies, “You know, Matt, it is almost as though you were the plant with CO2 .” Matt counters with his growing inphase assertion, “No, it's as though you are the plant that went away, so I don't have oxygen” The analyst persists: “And I think that is why you cough and choke.” Now Matt objects, “That might be why, except there is really a lot of oxygen” (note the reestablishment of reciprocity, mutuality, and the spontaneous ability to disagree and get the analyst to see it his way). Matt is still not satisfied with the metaphorical understanding of an oxygen deficiency as the basis for the disruption of his life-support system. The analyst suggests, “So it must be some other supply you need.” Then Matt takes the ball and runs with it. He is energetic and exact insofar as the selfobject functions he needs are concerned. “It's a supply of Dr. Egan I need more than anything but oxygen or food. Do you know we have only 10 minutes left? The time went so fast” (pp. 49-50).
这个时候马特改变了主题。也就是说，他做出了将滞后端——他的脆弱自体和他结构性赤字的症状——转向了前行端：他开始告诉分析家，他是一株成长中的，充满繁殖力的植物，通过插枝，以及他是如何通过交易建造了一个大花园。（一个就如同“卷须”一样的有效隐喻，这回到了最初的问题，“这些花是真的吗？”）然后他问道，“你知道植物可以用来供养生活么？他们给我们提供氧气，我们给他们提供二氧化碳，这是个优良的生命支持系统。”分析家回应到，“马特你要知道，你就好像是需要二氧化碳的植物。”马特用他的不断生长的同相的论断来说：“它就好像，你是离开的植物，因此我就没有氧气了。”分析家坚持说：“我认为这就是你咳嗽和说不出话的原因。”这时马特反驳道，“这可能是原因，除非这里真有大量的氧气。”（注意相互关系、亲密关系不同意的自发能力，让分析家以他的方式来看待问题）。马特仍然对把“氧气的缺乏”看作是“他生活支持系统的崩塌为基础”的隐喻性理解相当不满意。分析说到，“所以它一定是你需要的其他供给。”接着马特拿起了球，并运球。他充满了活力，确切的在他所需要的自体客体功能被涉及的程度上。“它是伊根医生的供给，我所需要的仅仅是氧气和食物罢了。你晓得我们还剩10分钟了么？时间走得好快。” (pp. 49-50)
Without knowing it, Matt talked self psychology language. In fact, he used one of Kohut's favorite metaphors—Kohut likened the self's psychological requirement for growth-maintaining and restoring selfobject functions to the physiological requirement for an environment that provides enough oxygen. The analyst, on the other hand, continued in an ego psychological and object relations mode, believing that Matt's grandiosity was evidence of narcissistic defenses against oedipal wishes and castration fears. However, in his case, the recognition of the injured, powerless self and the analyst's sufficiently attuned responses to the forward edge facilitated Matt's increasing confidence that his needs for mirroring and strengthening would be met at least part way—in theoretical terms, the analyst unknowingly provided the selfobject experiences needed to get the vulnerable self back on track. When the treatment ended, Matt was well on his way to acquiring capacities that maintained and restored in-phase mutuality, learning, and play—the consequence of structural growth in all the self-sectors that were reactivated and revitalized by the myriad selfobject functions Matt aptly named “a supply of Dr. Egan.”
不知不觉地，马特讨论了自体心理学的语言。事实上，他使用了科胡特最喜欢使用的隐喻——科胡特把自体的 “维持成长”（growth-maintaining）和恢复自体客体功能的心理需要比拟为“提供足量氧气环境”的生理需要。另一方面，分析家，逗留在自我心理学和客体关系的模式中，相信马特的夸大是对俄狄浦斯愿望和阉割焦虑的抗衡的自恋性防御的证据。然而，在他的案例中，识别出受伤的、无力的自体以及分析家共调的对前行端的充分回应，促进马特一点点地增加自信，镜映和被加强的需要起码会在半路上相遇——用理论的术语来说，分析家不知不觉地提供了自体客体的经验，这帮助脆弱的自体重回轨道。当治疗终止的时候，马特正在通向获取保持和恢复共相的亲密关系、学习和游戏的路上——在所有的自体部分中结构性成长的结果，是通过许多的自体客体功能来重新激活和复生的，马特恰当地给起了一个名字：“伊根医生的供给”。
Conclusion: The Changed Accent on Normal Self-Development
结论：正常自体发展的重心改变
I have discussed the reasons for a theoretical shift that places our clinical accent on the normal development of the self and its constructive forward moves. Even though the shift simply calls for a change in emphasis, it is profoundly important because it changes a whole psychological balance—from the trailing edge of pathology of the past to the forward edge of future developmental potential. However, the shift is not easy to accomplish. Most schools of psychoanalytic thought tilt toward pathology by adhering to the now ingrained original tenet: transferences to the analyst are, in essence, a new edition of the formative pathology, an artificial illness. (Ego psychology's construct of the “new object” was an attempt to counter pathomorphic theory. However, the “new object” is essentially a “selfobject” revived in transferences that needed to be understood and explained.) When transferences are thought of as an illness that reinstates childhood pathology, the work of the treatment centers on the cure of pathology rather than the reactivation of normal growth (more and more schools of psychoanalytic thought subscribe to the genetic fallacy that therapeutic action requires the revival and undoing of the earliest pathology of infancy). Self psychology's focus on healthy needs and strivings has been regarded with suspicion and considered to be “just” staying on the surface, “just” doing psychotherapy, “just” strengthening defenses, avoiding core issues of narcissism, sexuality, and aggression.
我已经讨论了强调将临床重心放在“自体的正常发展和它向前建设性运动”的理论转向的原因。哪怕这个转变仅仅是重点的变化，仍然是极其重要，因为它改变了心理的平衡——从过去的病理学的滞后端转向未来发展潜能的前行端。然而，这个转变并不容易达成。大多数的精神分析学派，认为通过坚持根深蒂固的原初教义而偏向了病理学：对分析家的转移，在本质上，是形成中的病理学的新版本罢了，是伪造的疾病。（自我心理学对“新客体”的建构是对抗病理形态学的尝试。然而，这个“新客体”在本质上是需要被理解被解释为“自体客体”在转移中的复生。）当转移被看作是恢复童年期的病理的疾病，治疗工作中心就被放在病理的治疗而不是正常成长的再激活了。（越来越多的精神分析流派思想同意起源谬误，这个起源谬误是说，分析工作需要重现并解决早期童年的病理学）。聚焦在健康的需要和努力的自体心理学，被怀疑地看待，被认为是“仅仅”停留在表面，“仅仅”在做心理治疗，“仅仅”在加强防御，避免了自恋、性欲和攻击的核心议题。
Children with self disorders like Matt's, as well as other forms of self disorders, immediately make it obvious to therapists that, even if we wanted to, it is impossible to ignore primary structural deficits and their serious consequences—the stunting of the sectors of the self, the persistence of thwarted needs, and the extraordinary tenacity of self-protective measures that are vitally necessary even though they further impede normal development. It is equally impossible to ignore the serious problems that primary deficits and entrenched defensive measures create when reactivated in transferences—like Matt's early transference—that mainly repeat the most traumatic and need-thwarting aspects of development and the most entrenched defenses used to prevent exposure and further humiliation.
像马特这样的自体障碍的孩子，同其他的自体障碍的其他形式一样，对治疗师显而易见的是，甚至说，只要我们愿意，忽略主要的结构性赤字和它们的严重后果是不可能的——自体部分的萎缩，对受挫的需要的坚持，即使严重阻碍了正常发展，却仍然很必要的，异常固执地保护自体的措施。同样地，当它在转移中被激活时，忽略主要赤字和根深蒂固的防御措施所创造的严重问题也是不可能的——就像在马特的早期转移中——主要在重复最具创伤性的、发展的需要受挫方面、以及用以避免暴露和进一步耻辱的最根深蒂固的防御。
Basically, to effectively treat the pathology of development, two new ideas have to be integrated: the idea that cure of pathology takes place in transferences that revive still remaining healthy needs and expectations of responsiveness and the idea that these transferences are by no means limited to the earliest stages of childhood—they include the needs of the self over the entire course of life. In other words, the infantile instinctual wishes and objects and part objects that have received the strongest analytic accent are part of intermediate sequences that are not the deepest layers of the psyche. (See “the area of structural deficits” discussed in Tolpin and Tolpin, 1996.) The deepest layer consists of strivings of the forward edge—once normal needs of the unmirrored self, of the self that suffers from shame and lacks idealized goals, of the self that is chronically enfeebled and/or fragmenting and is in search of idealized strengths, of expanding alikeness experiences with a kindred soul. It is the reactivation of these needs in selfobject transferences that is potentially transforming—the needs and the therapist's responses to them can revitalize the self, restore the urge to complete development, and get development back on track. To return to my title, that is what I mean by doing psychoanalysis of normal development by seeing, encouraging, and analyzing forward edge transferences.
从根本上说，为了有效治疗发展中的病理，两个新观点不得不要统合起来：“病理的核心在恢复健康的需要和回应的期望的转移中发生”的观点，以及“这些转移绝不能仅仅限制在儿童期的早期阶段——他们包括在整个生命历程中的自体需要”的观点。换言之，最得到分析重视的婴儿期的本能愿望、客体、和部分客体，只不过是中间次序的一部分，而这个中间次序并不是精神的最深一层。（见托品的讨论“结构性赤字的领域”，1996）。最深层由前行端的努力——曾经的未镜映的自体的正常需要、遭受羞耻感和缺少理想化目标的自体、长期衰弱的和/或破碎、寻找理想化力量的自体以及与一个类似的灵魂拓展相似经验构成。正是在自体客体转移中这些需要的再激活，才有潜在的变化——治疗师对他们的回应和需要可以让自体恢复生气，恢复完全发展的推动力，将发展送回正轨。回到我的标题，就是我所说的通过观察、鼓励、分析前行端转移来做精神分析。
To sum up: I am proposing a theory of total transference that provides us with an enlarged interpretive framework: the two-sided framework encompasses transference repetitions of nuclear pathology as well as transference reanimation and resurgence of what the patient unconsciously legitimately needs, strives for, seeks, and hopes for from the analyst. Doing psychoanalysis of both sides of transference catalyzes a deeper and more effective therapeutic process: bit by bit, the joint analytic work fosters repetition and in-depth understanding of the decisive pathogenetic factors and encourages the revitalization and forward thrust of the grandiose, idealizing, and twinship self (these constituents of the nuclear self are destined to undergo transformation into independent initiative, self-confidence, ambitions, and goals).
总结：我正在提出的是全转移（total transference）的理论，它将提供给我们扩大的解释框架：两面的框架，既包括核心病理学的转移重复，也包含从分析家那里得来的无意识的正当需要，努力和希望的激励转移和复活转移。做精神分析的转移的两个方面，促进了更深、更有效的分析进程：一点一点地，结合的分析工作促进了致病的决定因素的重复和深度理解，促进复兴，并促进夸大、理想化和孪生关系自体（这些核心自体的组成注定会转变成独立的主动性、自信、雄心和目标。）
Analyzing both sides of transference supports the normal urge to regain momentum and complete development; weakens the grip of pathology; and modulates, buffers, and transforms the childhood needs and strivings into expectable adult forms that (within individual limits) can be integrated into and actualized by a strengthened self-organization. Analyzing forward and trailing edge transferences is the analytic work that provides the necessary conditions for loosening the grip of the nuclear disorder and reestablishing the intrapsychic conditions for resumption of derailed normal development.
分析转移的两面支持了正常获取动力和完成发展的驱动力；削弱了病理学的支配；调节、缓冲并改变了童年期的需要和努力，变成预期中的成人形式——（在个人限制内）成人形式可以被统合，通过加强自体的组织来实现。分析前行端和滞后端是提供必要条件的分析工作，用来松开对核心障碍的紧抓，从而重建对于脱轨的正常发展的恢复的内在精神条件。www.psychspace.com心理学空间网
