醫學與心理治療86

VII
MEDICINE AND PSYCHOTHERAPY
醫學與心理治療86

Carl Jung
卡爾 榮格

196
The sonorous diagnosis of neuroses secundum ordinem is just a facade, it is not the psychotherapist’s real diagnosis. His establishment of certain facts might conceivably be called “diagnosis,” though it is psychological rather than medical in character. Nor is it meant to be communicated; for reasons of discretion, and also on account of the subsequent therapy, he usually keeps it to himself.

神經症的「依照命令」的語調跨張的預診，僅是一個表面，那不是心理治療師的真實的預診。他證實某些事實，可以被想像地稱為是「預診」，雖然性質上它是心理，而非醫學。它也不是要被用來溝通。因為謹慎的理由，也沒有隨後的治療，他通常必須保持秘密。

Sonorous—音調跨張
Secundum ordinem—依照命令
Façade 表面
Keep it to himself 保持秘密

196b
The facts so established are simply perceptions indicating the direction the therapy is to take. They can hardly be reproduced in the sort of Latin terminology that sounds scientific; but there are on the other hand expressions of ordinary speech which adequately describe the essential psychotherapeutic facts. The point is, we are not dealing with clinical diseases but with psychological ones. Whether a person
is suffering from hysteria, or an anxiety neurosis, or a phobia, means little beside the much more important discovery that, shall we say, he is fils a papa Here something fundamental has been said about the content of the neurosis and about the difficulties
to be expected in the treatment.

這些被證實的事實，僅是指示著治療應該採取的方向的一些感覺。它們很難以聽起來合乎科學的這種拉丁術語來複製。但是在另一方面，會有普通談話的表達，適當地描述基本的心理治療的事實。重點是，我們不是在處理臨床的疾病，而是在處理心理的疾病。無論一個人有沒有患歇斯底里的痛苦，或是焦慮神經症，或是恐懼症，跟這個更重要的發現相形之下，並無關緊要：他是「拒絕長大」的小孩，我們不妨這樣說。在此，有某件基本的東西曾經被說出，關於這個神經症的內容，以及關於在治療時被預料到的困難。

fils à papa = someone young, weak, growing up in the shadow of (or heavily assisted by) his father. 活在父親陰影當中，拒絕長大

196c

So that in psychotherapy the recognition of disease rests much less on the clinical picture than on the content of complexes. Psychological diagnosis aims at the diagnosis of complexes and hence at the formulation of facts which are far more likely than revealed by the clinical picture.

所以在心理治療，對於疾病的體認，與其說是依靠臨床的場面，不如說是依靠情結的內容。心理的預診目標是要朝著情結的預診，因此也朝著事實的說明。這些事實更加有可能比臨床的場面顯示的更多。

The real toxin is to be sought in the complex, and this is a more or less autonomous
psychic quantity. It proves its autonomous nature by not fitting into the hierarchy of the conscious mind, or by the resistance it successfully puts up against the will. This fact, which can easily be established by experiment, is the reason why psychoneuroses
and psychoses have from time immemorial been regarded as states of possession since the impression forces itself upon the naive observer that the complex forms something like a shadow-government of the ego.

在情結的毒素應該被尋找出來，這是一種相當自動的心理力量。它證明是它的自動的特性，因為它無法被套進意識心理的階層，或是違背意志，而成功地建立的抗拒。這個事實，很容易憑藉實驗證實。這就是為什麼從遠古以來，心理神經症及精神變態症，就被認為是一種被附魔的狀態。純真的觀察者會被給予這樣的印象：情結形成某件像是某種陰影在統治著自我。

197
The content of a neurosis can never be established by a single examination, or even by several. It manifests itself only in the course of treatment. Hence the paradox that the true psychological diagnosis becomes apparent only at the end. Just as a sure diagnosis is desirable and a thing to be aimed at in medicine, so, conversely, it will profit the psychotherapist to know as little as possible about specific diagnoses.

神經症的內容從來無法僅靠著一次的檢查，或甚至幾次檢查，就被證實。它只是在治療的過程顯示它自己。因此，會產生這個矛盾：真實的心理預診在最後才會變得明顯。如同在醫學方面，我們渴望並且朝向要有確定的預診這樣的事情，心理治療師恰恰相反，關於明確的預診，他盡可能不要先有成見，反而越有利。

It is enough if he is reasonably sure of the differential diagnosis between organic
and psychic, and if he knows what a genuine melancholy is and what it can mean. Generally speaking, the less the psychotherapist knows in advance, the better the chances for the treatment. Nothing is more deleterious than a routine understanding of
everything.

他只要合理地確定，生理器官與心理之間的差異預診，以及他知道真正的憂鬱是什麼跟意味著什麼，這樣就足夠了。一般說起來，心理治療師預先知道得越少，療瘉的機率就越高。將每一樣東西都當成例行事務來瞭解，是傷害最大的事情。

Nothing is more deleterious than a routine understanding of everything.
= Nothing is so deleterious as a routine understanding of everything.
= A routine understanding of everything is the most deleterious thing.
將每一樣東西都當成例行事務來瞭解，是傷害最大的事情。

198

We have now established that the anamnesis appears more than usually suspect to the psychotherapist, and that clinical diagnosis is, for his purposes, well-nigh meaningless. Finally, the therapy itself shows the greatest imaginable departures from the views commonly accepted in medicine. There are numerous physical diseases where the diagnosis also lays down the lines for a specific treatment; a given disease cannot be treated just anyhow.

我們現在已經證實，就一般來說，心理治療師並不全然相信成立案例。就他的目標而言，臨床的預診也幾乎是沒有意義的。最後，治療的本身顯示，出乎我們的想像之外，它會偏離醫學界共同被接納的觀點。有無數的生理上的疾病，預診也會確認明確治療的界限。某種的疾病就是無法用某種方法來治療。

Well-nigh—almost 幾乎
Suspect to –Regard as untrustworthy;

198b

But for the psychoneuroses the only valid principle is that their treatment must be psychological. In this respect there is any number of methods, rules, prescriptions, views, and doctrines, and the remarkable thing is that any given therapeutic
procedure in any given neurosis can have the desired result.

但是對於心理神經症而言，唯一有效的原則是：它們的治療必須是從心理層面。在這一方面，有許多的方法，規則，診斷處方，觀點及信條。值得注意的是：在任何特定的神經症患者，所用的任何特定的治療程式，都會獲得渴望中的效果。

The various psychotherapeutic dogmas about which such a great fuss is made do not, therefore, amount to very much in the end. Every psychotherapist who knows his job will, consciously or unconsciously, theory notwithstanding, ring all the changes that do not figure in his own theory. He will occasionally use suggestion, to which he is opposed on principle.

因此，各種的心理治療的信條，會造成混亂雜遝，到最後並不完全相等。每一位對於自己工作內行的心理治療師，無論是有意識或是無意識，會不顧理論，迴響各種原先並不存在自己理論裏的改變。有時他會使用在原則上他是反對的建議。

There is no getting round Freud’s or Adler’s or anybody else’s point of view. Every psychotherapist not only has his own method –he himself is that method. Ars requirit totum hominem, says an old master.” The great healing factor in psychotherapy is the doctor’s personality, which is something not given at the start; it represents his performance at its highest and not a doctrinaire blueprint. Theories are to be avoided, except as mere auxiliaries.

我們不可能繞過佛洛伊德或阿德勒，或是任何其他人的觀點。每一位心理治療師不但擁有他自己的方法，他自己就是那個方法。「藝術要求完整的人。」如同一位耆老大師所說，心理治療的最大療瘉力量是醫生的人格。這是某件開始所沒有被給予的東西。它代表他最高層次的成就，而不是一個教條主義的藍圖。理論應該被避免，除了僅是充當輔助。

Ars requirit totum hominem. (“The art requires the total man.”) 藝術要求完整的人。

As soon as a dogma is made of them, it is evident that an inner doubt is being stifled. Very many theories are needed before we can get even a rough picture of the psyche’s complexity. It is therefore quite wrong when people accuse psychotherapists of being unable to reach agreement even on their own theories. .Agreement could only spell one-sidedness and desiccation. One could as little catch the psyche in a theory as
one could catch the world. Theories are not articles of faith, they are either instruments of knowledge and of therapy, or they are no good at all.

只要一個信條是由理論組成，顯而易見的，內在的懷疑就會被悶住。在我們能夠粗略地瞭解心靈的複雜性之前，我們需要許多的理論。人們批評心理治療師，即使對於他們自己的理論，都無法達成一致性，這種批評因此是完全錯誤。一致性只是指示著單面性及庸俗化。僅憑理論，我們幾乎無法理解心靈，如同我們幾乎無法理解世界。理論並不是一大堆信仰，它們僅是知識及治療的工具，要不然就是它們根本就沒有用途。

雄伯譯
32hsiung@pchome.com.tw
https://springhero.wordpress.com