癔症研究05

癔症研究05
IV
第四章

THE PSYCHOTHERAPY OF
HYSTERIA 257
癔症的心理治疗

(FREUD)
弗洛伊德

IV. PSYCHOTHERAPY OF HYSTERIA (FREUD) 261

I should not like it to be wrongly thought that I do not wish
to allow that hysteria is an independent neurotic affection,
that I regard it merely as a psychical manifestation of anxiety
neurosis and that I attribute to it ‘ideogenic’ symptoms only
and am transferring the somatic symptoms (such as hystero-
genic points and anaesthesias) to anxiety neurosis. Nothing of
the sort. In my opinion it is possible to deal with hysteria, freed
from any admixture, as something independent; and to do so
in every respect except in that of therapeutics.

我不想要错误地被认为,我并不希望可,癔症是独立的神经症的情感。我仅是将它视为是焦虑神经症的心灵的展示。我仅是将“观念起源”的症状归属于它,我正在将身体的症状(譬如癔症起因点与麻痹),转移成为焦虑神经症。根本就不是这个样子。依照我的意见,处理神经症,作为某件独立的东西,免除任何的混杂,这是可能的。我们可能在每个层面这样做,除了治疗学的层面。

For in therapeutics we are concerned with a practical aim, with getting
rid of the pathological state as a whole. And if hysteria generally
appears as a component of a mixed neurosis, the situation
resembles that in which there is a mixed infection, where pre-
serving life sets a problem which does not coincide with that of
combating the operation of one particular pathogenic agent.

因为在治疗学那里,我们关心的是实际的目标,整体地废除病理的状态。假如癔症通常出现,作为混合神经症的成分,这个情况类似混合感染的情况。在那个情况,保存生命触发一个难题。这个难题并没有符合格斗特殊的病因代理者的运作的难题。

It is very important for me to distinguish the part played by
hysteria in the picture of the mixed neuroses from that played
by neurasthenia, anxiety neurosis and so on, because, once I
have made this distinction, I shall be able to express concisely
the therapeutic value of the cathartic method.

非常重要地,我必须区别癔症扮演的角色,在混合神经症的画面里,跟神经衰弱,焦虑神经症,等等,扮演的角色的差异。因为我一旦从事这个区别,我将能够明确地表达清涤疗法的治疗价值。

For I am inclined to venture the assertion that that method is as a matter of theory very well able to get rid of any hysterical symptom,
whereas, as will be easily understood, it is completely powerless
against the phenomena of neurasthenia and is only able rarely
and in roundabout ways to influence the psychical effects of
anxiety neurosis. Its therapeutic effectiveness in any particular
case will accordingly depend on whether the hysterical com-
ponents of the clinical picture do or do not assume a position
of practical importance in comparison with the other neurotic
components.

因为我倾向于提出这个主张:就理论而言,那个方法完全能够废除癔症的症状。但是,如同轻易就可理解的,要对抗神经衰弱的现象,那个方法完全是无力的。它仅能够勉强地,用迂回的方式,来影响焦虑神经症的心灵的情感,它在任何特殊个案的治疗的效果,因此依靠临床画面的癔症的成分是否具有实用的价值的立场,跟其他的神经症的成分比较起来。

There is another obstacle in the way of the effectiveness of
the cathartic method, which we have already indicated in the
‘Preliminary Communication’ [p. 17]. It cannot affect the
underlying causes of hysteria: thus it cannot prevent fresh
symptoms from taking the place of the ones which had been got
rid of. On the whole, then, I must claim a prominent place
for our therapeutic method as employed within the framework
of a therapy of the neuroses; but I should like to advise against
assessing its value or applying it outside this framework. Since,
however, I cannot in these pages offer a ‘therapy of the neuroses’
of the sort needed by practitioners, what I have just said is
equivalent to postponing my account of the subject to a possible
later publication. But I am able, I think, to add the following
remarks by way of expansion and elucidation.

还有另外一种阻碍,使这个清涤疗法无法产生效果。在“初步沟通”的那个章节,我们已经指示过。它无法影响到癔症的潜在原因。因此,它无法阻止新的症状不取代已经被废除掉的那些症状的位置。因此,大体上,我必须宣称我们的的治疗方法具有优势的地位,因为它被运用在神经症的治疗的架构里面。但是我想要劝告不要在这个架构的外部评估它的价值或应用它。因为,在这几页里,我无法提供执业医师所需要的这种“神经症的治疗”。我刚刚所说的相当等于是拖延我对于这个主题的描述,尽可能晚一点出版。但是我认为我能够补充以下的谈论,作为扩充与诠释。

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

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