精神分析技术的基本原则 p139

Fundamentals of Psychoanalytic Technique
精神分析技术的基本原则p139

BRUCE FINK
布魯斯 芬克

How to Handle Transference
如何處理移情

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.

如佛洛伊德所說,我們「不需要去煩惱移情,只要它運作有利於精神分析的共同工作。」依照吉爾、菲瑞基、髯客,及瑞奇都主張:「一個強烈的正面移情,特別是靠近精神分析的開始,只是一種阻抗的病徵。它要求揭發出來。」因此,它們假定會主張,以這樣一種方式介入是必須的,這樣才能緩和受分析者的熱心關懷。事實上,瑞奇相信,正面的移情總是隱藏一種更加基本,原始,負面的移情。

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).

回憶一下,精神分析是以一個戀愛故事開始。安娜,奧(她的真正名字是波莎、帕平涵),由於對於約塞弗、布魯爾的愛慕構想出這個「談話的治療」。這位專心的年輕醫生,日夜地打電話到家裏,為了要跟她一起工作,連續好幾個小時。他是唯一的人,她會注意到他的存在,也是唯一的人,她願意跟他談話,在她接受治療的某些期間。

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 ).

精神分析的開始就是愛。她的愛受到一個人的啟發,不管她任為這個人長得好看與否,他是一位受人尊敬的醫生,她假定這位醫生瞭解她的狀況的某件事情,及知道如何治療她(即使,依照歷史所顯示的,她才是是這個人,擁有幾乎所有的知識,而他僅是足夠聰明跟隨她的引導。)

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.

雖然精神分析誕生於這個愛的故事,可是愛的故事的雙方,並沒有從此以後就快樂地生活在一起。這個事實依據存在:靠著信仰對方擁有知識而受到啟發的愛,是安娜、奧發明的治療的原動力。

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.

接受我督導的許多臨床心理學研究生,很快就驅散一位病人的信仰:他們擁有相當的知識,對於他遭受苦惱的原因。據他們說,他們往往這樣做,由於忠於誠實,為了要讓病人確定,在這層關係上,他擁有同樣的力量跟臨床醫生差不多。

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.

雖然他們誠實的目標值得讚賞,而且確實是病人擁有更多部分有關他病徵的知識,開業治療師知道得並不多,特別是在治療開始時,他們的結果往往是逐漸損壞病人對於他們能夠幫忙他的信心。非但沒有「增強」他的信心,他們結果消除他的信心力量,讓他感覺沮喪及灰心。他感覺他並沒有在這個領域有用途的知識。假如他真的擁有,他就不會陷在這種困境,他發現他首先處於的困境。

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.

相信某個其他的人擁有知識能夠幫忙他,對他而言,往往非常重要。驅散那個信仰等於就是拿掉他最後的一絲希望。

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

因此,這個企圖介入病人對於分析師的知識的移情,會導致絕望。

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.

嘗試從一開始就讓病人相信:他擁有跟臨床醫生同樣多,甚至更多的知識,很可能會成功,當臨床醫生自己年輕,而且是在訓練單位工作。在那裏,治療師正在觀察他們第一批的病人,要不就是他們僅有一兩年的經驗。

“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.

在這樣的情況,病人通常知道,他們會獲的他們付錢的所得,也就是說,他們的治療師,擁有比較少的「專門知識」,比起他們在社區可能尋找到其他治療師。在無數的情況,病人僅是感覺到,臨床醫生「確實抗議太多」,態度過有謙虛,或是設法避免他的自卑感。

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!

同樣的原因,要憑藉從移情內部,來評論或解釋它,以緩和移情的某些麻煩的層面,這種企圖通常註定失敗,(換句話說,當我們成為受分析者的移情,相對于第三者,譬如朋友、同事、或諮商醫生。)例如,受分析者應該感覺,分析師對他生氣,而分析師否認任何這樣的憤怒,她的否認仍然會被受分析者聽見,當著是來自他假定是生氣的某個人;的確,他可能接受這個否認本身,當著是生氣的跡象!

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

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