精神分析技术的基本原则 p139

Fundamentals of Psychoanalytic Technique

布魯斯 芬克

How to Handle Transference

As Freud ( 1 9 1 6- 1 9 1 7/1 963, p. 443) said, we “need not bother about [the transference] so long as it operates in favour of the joint work of analysis.” According to Gill ( 1 982, p. 8 1 ), Ferenczi, Rank, and Reich all maintained that “a strong positive transference, especially near the beginning of analysis, is only a symptom 病徵of resistance 阻抗which requires unmasking 揭發 ” hence they would presumably 假定argue that it is necessary to intervene 介入 in such a way as to temper 緩和 the analysand’s enthusiasm 熱心. Reich, in fact, believed that positive transference always hides a more fundamental, primordial 原初, negative transference.


Recall that psychoanalysis began with a love story: Anna O. (whose real
name was Bertha Pappenheim) came up with 想出 the “talking cure” out of love for Joseph Breuer, the attentive young doctor who made house calls morning and night to work with her for hours at a time. He was the only person whose presence she would notice and the only person she would speak with during certain phases 時期 of her treatment (Freud & Breuer, 1 893-1 895/1955, pp. 2 1-47).


In the beginning (of psychoanalysis) was love. And her love was inspired 啟發 by a man who, whether she found him good-looking or not, was a well-respected physician whom she could assume 假定 knew something about her condition and how to heal 治療 her (even though, as history shows, she was the one who had virtually all the knowledge and he was simply smart enough to follow her lead ).


Even though the parties to the love story from which psychoanalysis was born did not live happily ever after together, the fact remains that love, inspired by a belief that the other party possesses 擁有 knowledge, was the mainspring 主要動機 of the treatment Anna O. invented.


Many of the graduate students in clinical psychology whom I supervise 督導 are quick to try to dispel 驅散 a patient’s belief that they have considerable 相當 knowledge of what ails 苦惱 him. They often do so in the interest 利益, so they say, of honesty and to assure the patient that he has as much power in the relationship as the clinician 臨床醫生.


As laudable 讚賞 as their goals may be-and it is indeed the patient who has the lion’s share of the knowledge, the practitioner having very little, especially at the outset of the treatment-they often end up undermining 損壞 the patient’s faith in their ability to help him. Rather than “empowering” him, they end up disempowering 解除力量 him, making him feel dejected 沮喪 and despondent 沮喪. He feels that he has no knowledge that is of any use in this domain; if he did, he would not be in the predicament 困境 in which he finds himself in the first place.


It is often very important for him to believe that someone else has the knowledge that can help him; dispelling 驅散 that belief is to take away his last shred 一點 of hope.


Hence, this attempt to intervene 介入in the patient’s transference of knowledge onto the analyst can lead to despair 絕望.


Trying to convince the patient right from the outset 開始that he has as much, if not more, knowledge than the clinician is most likely to succeed when the clinician herself is young and working in a training facility 能力 where all the therapists are either seeing their very first patients or have only a year or two of experience.


“For in such cases, patients are usually aware that they are getting
what they are paying for, so to speak–that their therapist has comparatively 比較 less “expertise” 專門知識 than other therapists they might seek out in the community who have been practicing for many years.

Nevertheless, in numerous cases the patient simply feels that the clinician “doth protest 抗議 too much” and is just being modest 謙虛 or trying to spare 省掉 his feelings of inferiority.


Socrates’s claim 宣稱to know nothing (except about love) never convinced his disciples 門徒 , who continued to believe that he was a veritable 可驗證的 fount 泉源 of knowledge. This points to an extremely important facet of psychoanalytic technique: The attempt to dissipate 驅散 or “liquidate” 消除the analysand’s transference is doomed 駐定 to failure, because the analyst’s disclaimer 拒絕–for example, “I can’t possibly know what the problem is, you’re the one who has the knowledge here”-is heard by the analysand as coming from the person whom he projects her to be: a very knowledgeable person (otherwise, he asks himself, why would she be a clinician in the first place?).

蘇格拉底宣稱什麼都不知道(除了關於愛),但是他的門徒從來不這樣認為。他們繼續相信他,他是知識的可驗證的來源。這指向精神分析技術一個極端重要的面貌:企圖驅散或「消除」受分析者的移情是註定失敗,因為分析師的拒絕承認,例如,「我不可能知道問題是什麼,你才是這裏擁有這個知識的人。」在受分析者聽起來,會當著來自他投射她在上面的這個人:一位非常有知識的人 (否則,他問他自己,為什麼是她首先當臨床醫生?)

The attempt to mitigate 緩和 some of the more cumbersome 麻煩的aspects of the transference by commenting on 評論 or interpreting 解釋it from within the transference (that is, when one is the object of the􀒡 analysand’s transference as opposed to 相對 a third party, such as a friend, colleague同事, or consulting 諮商 physician 醫生) is generally doomed to failure for the very same reason. Should, for example, the analysand have the sense that the analyst is angry at him and the analyst deny 否認 any such anger, her denial will nevertheless be heard by the analysand as coming from someone whom he presumes 假定to be angry; indeed, he may take the denial 否認itself as a sign 跡象 of anger!



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