內視,同理心,及精神健康的半圓 04

Introspection, Empathy, and the Semi-Circle of Mental Health. (1982)
Int. J. Psycho-Anal., 63:395-407 (IJP)
Introspection, Empathy, and the Semi-Circle of Mental Health
Heinz Kohut



But now, after sharing with you this personal information about the triggers that prompted me to embark on an inquiry into experience-distant theory, I will attempt to enumerate those factors that justified the 1959 examination on substantial, intrinsically scientific grounds. I am using the word ‘substantial’ advisedly, because I would like to do what I can to prevent having my 1959 thoughts brushed aside, whether in ridicule or with respect, as being the unnourishing fruit of pedantry or purism (see Kohut, 1980, pp. 477f).


Thus, had it been only for the fact that I felt that Alexander’s psycho-biology and Alexander’s and Hartmann’s socio-psychology had introduced concepts into the framework of analysis which, belonging to a different world of scientific discourse, were foreign bodies there and could not be accommodated, I would still have been inclined to welcome these, in and of themselves, valuable and impressive contributions to science. I would not have felt the need to outline the operationally-determined borders of psychoanalysis and thus to define the essence of this science.


If it were not the need for theoretical exactitude and harmony, what was it that in fact impelled me to set out in 1959 on this excursion into epistemology? And what sustained my interest in pursuing my goal, however subordinated to other tasks, since then (see Kohut, 1977, Chapter 7) ? I have no doubt that it was the fact that this unacknowledged shift in the quintessentially significant basic stance of the analyst had led not only to changes in theory but also and this is the substantial issue for me to a covertly proceeding, gradually increasing distortion of the analyst’s perceptions in his function as a researcher in the applied field and, most importantly, in his therapeutic function as a professional practitioner.


Leaving aside for this occasion the by no means second-in-importance responsibility of the psychoanalyst vis-a-vis such fields as literary criticism, medicine, anthropology, sociology, and, par excellence, political science and history, I will turn directly to the prevalent task of the analyst: the therapeutic analysis. How have the aforementioned foreign bodies in depth psychology the biologically understood concept of ‘drive’, the socio-psychologically understood concepts of ‘dependence’ and ‘adaptation’ led, as I think they did, to the decisive shift of the essence of analysis, to an alteration of the analyst’s basic stance that is more significant in the long run than external threats, such as that via its absorption by psychiatry, which are openly faced and resisted?

為了這個場合,我擱置精神分析師決非是此要的責任,那就是要面對這些領域,諸如文學批評,醫藥,人類學,社會學,尤其重要的,政治科學與歷史。我將直接轉向精神分析師最為盛行的工作:治療的精神分析。在深度心理學,以上所提的外來的身體,諸如,「欲望驅力」的觀念,從生物立場來瞭解,「依賴」及「適應」的觀念,從社會-心理學的立場來瞭解,依照我對於它們的實際看法,它們會導致精神分析學本質的決定性改變,導致精神分析師基本的態度的改變。這種改變最後將是比外在的威脅更加重要嗎?例如,公開被面對及阻抗的外在威脅 :精神分析學被併入精神病學。

The answer, broadly speaking, is that they have done so by becoming the unacknowledged and unquestioned basis of an unacknowledged and unquestioned value system and of an unacknowledged and unquestioned total view of the essence of man and of the essence of his life. Despite innumerable protestations to the contrary analysis has, under the influence of the aforementioned concepts become less of a science and more of a moral system, and psychoanalysis as therapy has become simultaneously less of a scientific procedure based on the elucidation of dynamic and genetic relationships and more an educational procedure, aiming at predetermined and thus extraneous goals which, again, are unacknowledged and unquestioned toward which the patient is led and which, on the basis of an unacknowledged and unquestioned dimension of his transference, the patient tries to reach.


What are these values of traditional psychoanalysis which have been directing the analyst’s focus of attention and thus, secondarily, the goals that he pursues, both as researcher and therapist? No one familiar with my writings of recent years can be unacquainted with my answer. It is the fact that knowledge values and independence values have been the leading values of the psychoanalyst, and that they have guided him toward selective perception and selective action within the psychological field in which he has his home. It is not that I object to these values. Indeed, I subscribe to them. Yet, I believe that their unacknowledged influence distorts the depth-psychological scientist’s perception and here the effects are even more palpable that their unacknowledged presence interferes with the analyst’s ability to allow his analysands to develop in accordance with their own nuclear programme and destiny.


I am aware of the hold that the aforementioned ideals have had on Western Man, and, as a deeply-rooted member of Western civilization, I am, myself, strongly influenced by them. I know how difficult it is for us even to be aware of these basic ideals and thus to make them the target of our scrutiny. And, within certain limits, I do indeed not question them. What I do question is their abiding primacy in the hierarchy of Man’s values their primacy at all times and under all conditions.


However great their importance for Western Man, they cannot serve as the ultimate guidepost by which the depth-psychological researcher evaluates Man and as the scale on which the depth-psychological therapist marks the goals and measures the degree of success or failure of the psychoanalytic treatment. On the contrary, I hold the view that these two values have prevented us from recognizing the central position of the self and its vicissitudes in Man’s psychological make-up and, above all as concerns the man of our time and his era-specifically prevalent psychopathology. They have prevented us, in other words, from acknowledging the significance of the innermost programme of the self, and the importance which the realization or non-realization of its potential has for the individual in deciding whether he feels psychologically ill or whether he feels that he is healthy.



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