终止与非终止的精神分析

Analysis Terminable and Interminable
精神分析终止与不终止
Sigmund Freud
弗洛伊德

Experience has taught us that psycho-analytic therapy—the liberation of a human being from his neurotic symptoms, inhibitions and abnormalities of character—is a lengthy business. Hence, from the very beginning, attempts have been made to shorten the course of analysis.

经验教导我们,精神分析的治疗—一个人从他的神经症的征状,潜抑与人格的异常里解放出来—这是一段漫长的历程。因此,从一开始,各种企图被从事,为了缩短精神分析的过程。

Such endeavours required no justification: they could claim to be prompted
by the strongest considerations alike of reason and expediency. But it may be that there lurked in them some trace of the impatient contempt with which the medical profession of an earlier day regarded the neuroses, seeing in them the unnecessary results of invisible lesions.

这些企图并不需要任何正当理由。它们能够宣称被理性与权宜之计的光明正大的共同考虑所引起。但是可能是因为潜藏在这些理由里面,会有某种的不耐烦的轻蔑的痕迹。早期的医学专业都轻蔑地看待这些神经症者。在他们身上,早期的医学专业看见隐形病变的不必要的结果。

If you were obliged to deal with them, you simply aimed at getting rid
of them with the utmost despatch. Basing his procedure on the theory formulated in Das Trauma der Geburt (1924) Otto Rank made a particularly determined attempt to shorten analysis. He assumed that the cardinal source of neurosis was the experience of birth, on the ground of the possibility that the infant’s ‘primal fixation’ to the mother might not be surmounted but persist in the form of ‘primal repression’.

假如你们不得不处理这些结果,你们目标仅是要尽最大力量驱除它们。奥图 蓝克将他的程序,以给伯特(1924)阐述的理论作基础。他从事一个特殊的决心的企图,来缩短精神分析。他假定,神经症的主要的来源是诞生的经验。理由是,婴孩的“原初的固著”于母亲,很有可能没有被克服,而是持续下来,以“原初的潜抑”的形式。

His hope was that, if this primal trauma were overcome by analysis, the whole neurosis would clear up, so that this one small piece of analytic work, for which a few months should suffice, would do away with the necessity for all the rest. Rank’s argument was certainly bold and ingenious but it did not stand the test of critical examination.

他的希望是,假如这个原初的创伤由精神分析来克服,整个的神经症将会烟消云散。这样,这一小部分的精神分析的工作,几个月就足以完成。它将会让其余的那些必要的工作都被废除。蓝克的主张确实是大胆而聪明的。但是这个主张并没有经过批评检视的考验。

Moreover, it was a premature attempt, conceived under the stress of the contrast between the post-War misery of Europe and the ‘prosperity’ of America, and designed to accelerate the tempo of analytic therapy to suit
the rush of American life. We have heard little of the clinical results of Rank’s plan.

而且,这是一个尚未成熟的企图,在这个对照的压力之下被构想,在欧洲的战后的悲惨与美国的“繁荣”的对照的压力之下。这个尚未成熟的企图被设计来加速精神分析治疗的节奏,为了迎合美国人生活的匆促方式。我们很少听见蓝克的计划有何临床的结果。

– 373 — 373 –
Probably it has not accomplished more than would be done if the men of a fire-brigade, summoned to deal with a fire from an upset oil-lamp, merely removed the lamp from the room in which the conflagration had broken out.

可能,它并没有完成它将会被完成的工作,假如消防队被召唤来处理因为油灯倾覆造成的火灾。他们仅是将油灯从火灾发生的房间移除。

Much less time would certainly be spent in so
doing than in extinguishing the whole fire. The theory and practice of Rank’s experiment are now things of the past—as is American ‘prosperity’.

就扑灭整个的火灾而言,当他们这样做时,所耗费的时间远不足够。蓝克的理论与实践现在已是昨日黄花。如同美国的“繁荣”一样。

Before the War, I myself had already tried another way of speeding up analysis. I had undertaken to treat a young Russian, a rich man spoilt by riches, who had come to Vienna in a state of complete helplessness, accompanied by physician and attendant.1

在战争之前,我自己经尝试另外一种方式加速我的精神分析。我曾经从事治疗一位年轻的俄国人,一位被财富宠惯的富裕的人。他前来维也纳,处于完全无助的状态,由医生与助理伴随着。

It was possible in the course of several years to restore to him a considerable measure of independence, and to awaken his interest in life, while his relations to the principal people in his life were adjusted. But then we came to a full stop.

这是可能的,在好几年的过程,将让他恢复相当程度的独立,并且唤醒他对于生活的乐趣。他跟他的生活里的主要的人们的关系被调整。但是,我们遭遇到完全的停顿。

We made no progress in clearing up his childhood’s neurosis, which was the basis of his later illness, and it was obvious that the patient found his present situation quite comfortable and did not intend to take any step which would bring him nearer to the end of his treatment.

我们并没有任何进步,当我们清除他的童年的神经症。这个童年的神经症是他后来的疾病的基础。显而易见地,病人发现目前的情况非常舒服,并没有意图要採取任何步骤,来引导他更加靠近他的治疗的终止。

It was a case of the patient himself obstructing the cure: the analysis was in danger of failing as a result of its—partial—success. In this predicament I resorted to the heroic remedy of fixing a date for the conclusion of the analysis.

这是一个病人自己阻碍治疗的案例。精神分析处于失败的危险,由于它的部分获得成功的结果。在这个困境当中,我诉诸于英勇的补救方式:给精神分析的结论确定一个日期。

At the beginning of a period of treatment I told the patient that the coming year was to be the last of his analysis, no matter what progress he
made or failed to make in the time still left to him. At first he did not believe me, but, once he was convinced that I was in dead earnest, the change which I had hoped for began to take place.

在治疗的时期的开始,我告诉病人,未来的一年将是他的精神分析的终止。在依旧剩余给他的这段时间里,无论他成功或失败于任何进展。起初,他并不相信我,但是,当他一旦相信,我的态度是认真诚恳,我原先期望的改变开始发生。

His resistances crumbled away, and in the last months of treatment
he was able to produce all the memories and to discover the connecting links which were necessary for the understanding of his early neurosis and his recovery from the illness from which he was then suffering. When he took leave of me at midsummer, 1914, unsuspecting, as we all were, of what was so shortly to happen, I believed that his cure was complete and permanent.

他的抗拒崩溃。在治疗的最后的几个月,他能够产生所有的记忆,并且发现这些必要的关联的脉络,为了理解他早年的神经症,并且让他从他当时遭受痛苦的疾病恢复。当他在1914年的仲夏,跟我告辞时,我们大家都不怀疑,不久将会发生的事情。我相信,他的治疗是完整而且永久的。

Probably it has not accomplished more than would be done if the men of a fire-brigade, summoned to deal with a fire from an upset oil-lamp, merely removed the lamp from the room in which the conflagration had broken out.

可能,它并没有完成它将会被完成的工作,假如消防队被召唤来处理因为油灯倾覆造成的火灾。他们仅是将油灯从火灾发生的房间移除。

Much less time would certainly be spent in so
doing than in extinguishing the whole fire. The theory and practice of Rank’s experiment are now things of the past—as is American ‘prosperity’.

就扑灭整个的火灾而言,当他们这样做时,所耗费的时间远不足够。蓝克的理论与实践现在已是昨日黄花。如同美国的“繁荣”一样。

Before the War, I myself had already tried another way of speeding up analysis. I had undertaken to treat a young Russian, a rich man spoilt by riches, who had come to Vienna in a state of complete helplessness, accompanied by physician and attendant.1

在战争之前,我自己经尝试另外一种方式加速我的精神分析。我曾经从事治疗一位年轻的俄国人,一位被财富宠惯的富裕的人。他前来维也纳,处于完全无助的状态,由医生与助理伴随着。

It was possible in the course of several years to restore to him a considerable measure of independence, and to awaken his interest in life, while his relations to the principal people in his life were adjusted. But then we came to a full stop.

这是可能的,在好几年的过程,将让他恢复相当程度的独立,并且唤醒他对于生活的乐趣。他跟他的生活里的主要的人们的关系被调整。但是,我们遭遇到完全的停顿。

We made no progress in clearing up his childhood’s neurosis, which was the basis of his later illness, and it was obvious that the patient found his present situation quite comfortable and did not intend to take any step which would bring him nearer to the end of his treatment.

我们并没有任何进步,当我们清除他的童年的神经症。这个童年的神经症是他后来的疾病的基础。显而易见地,病人发现目前的情况非常舒服,并没有意图要採取任何步骤,来引导他更加靠近他的治疗的终止。

It was a case of the patient himself obstructing the cure: the analysis was in danger of failing as a result of its—partial—success. In this predicament I resorted to the heroic remedy of fixing a date for the conclusion of the analysis.

这是一个病人自己阻碍治疗的案例。精神分析处于失败的危险,由于它的部分获得成功的结果。在这个困境当中,我诉诸于英勇的补救方式:给精神分析的结论确定一个日期。

At the beginning of a period of treatment I told the patient that the coming year was to be the last of his analysis, no matter what progress he
made or failed to make in the time still left to him. At first he did not believe me, but, once he was convinced that I was in dead earnest, the change which I had hoped for began to take place.

在治疗的时期的开始,我告诉病人,未来的一年将是他的精神分析的终止。在依旧剩余给他的这段时间里,无论他成功或失败于任何进展。起初,他并不相信我,但是,当他一旦相信,我的态度是认真诚恳,我原先期望的改变开始发生。

His resistances crumbled away, and in the last months of treatment
he was able to produce all the memories and to discover the connecting links which were necessary for the understanding of his early neurosis and his recovery from the illness from which he was then suffering. When he took leave of me at midsummer, 1914, unsuspecting, as we all were, of what was so shortly to happen, I believed that his cure was complete and permanent.

他的抗拒崩溃。在治疗的最后的几个月,他能够产生所有的记忆,并且发现这些必要的关联的脉络,为了理解他早年的神经症,并且让他从他当时遭受痛苦的疾病恢复。当他在1914年的仲夏,跟我告辞时,我们大家都不怀疑,不久将会发生的事情。我相信,他的治疗是完整而且永久的。

– 374 –

In a postscript to this patient’s case-history (1923) I have already reported that I was mistaken. When, towards the end of the War, he returned to Vienna, a refugee and destitute, I had to help him to master a part of the transference which had remained unresolved.

在病人的个案历史(1923)的附记里,我已经报导,我是错误。将近战争的末期,当他回到维也纳,他是一位难民与穷人,我必须帮助他掌控始终没有被解决的移情。

Within a few months this was successfully accomplished and I was able to conclude my postscript with the statement that ‘since then the patient has felt normal and has behaved unexceptionably, in spite of the War having robbed him of his home, his possessions and all his family relationships’. Fifteen years have passed since then, but this verdict has not proved erroneous, though certain reservations have had to be made.

在几个月的时间内,这件工作成功地被完成。我能够替我的附记作一结论,用这个陈述:「因为病人已经觉得正常,并且行为跟常人一样。尽管战争曾经剥夺掉他的家园,他的财产,与他的家庭的关系。」自从那时,十五年已经过去,但是这个判断结论并没有证明是错误。虽然某些的保留必须要有。

The patient has remained in Vienna and has made good, although in a humble social position. Several times, however, during this period, his satisfactory state of health has broken down, and the attacks of neurotic illness from which he has suffered could be construed only as offshoots of his original neurosis. Thanks to the skill of one of my pupils, Dr. Ruth Mack Brunswick, a
short course of treatment has sufficed on each occasion to clear up these attacks.

病人始终在维也纳,并且发展起来,虽然是处于卑微的社会地位。可是,好几次,在这段期间,他的令人满意的健康的状态曾经崩溃,他曾经遭受痛苦的神经症,仅能够被解释为所他的原初的神经症的发展的结果。由于我的一位学生,布伦维克医生的技术,一个短期的治疗过程,已经足够在每个场合,清理这些症状的发作。

I hope Dr. Mack Brunswick herself will report on this case before long. Some of these relapses were caused by still unresolved residues of the transference; short-lived though the attacks were, they were distinctly paranoid in character.

我希望,不久,布伦维克医生她自己将会报导这个个案。这些复发的症状有些是由于仍然没有被解决的移情的残渣所引起。虽然它们的发作的时间很短,它们的性质显而易见是偏执狂。

In other instances, however, the pathogenic material consisted of fragments from the history of the patient’s childhood, which had not come to light while I was analysing him and which now came away (the comparison is obvious) like sutures after an operation or small pieces of necrotic bone.

可是,在其他的例子,病因的材料由病人的童年的历史的碎片组成。当我正在分析他时,这些历史的碎片并没有豁然开朗。现在,则是像裂缝一样地张开,经过手术后,或经过小块的细菌感染的骨头(这样的比喻是明显的)。

I have found the history of this man’s recovery almost as interesting as that of his illness. Since then I have employed the method of fixing a date for the termination of analysis in other cases and I have also inquired about the experience of other analysts in this respect.

我曾经发现这个人的康复的历史,几乎跟他的生病的病历一样有趣。自然那时,我一直使用确定日期限的方法,来作为其他的个案里,精神分析的终止。我也研究这方面的其他精神分析家的经验。

There can be only one verdict about the value of this device for putting pressure on the patient. The measure is effective, provided that one hits the right time at which to employ it. But it cannot be held to guarantee perfect accomplishment of the task of psychoanalysis.

关于给病人施用压力的这个技术的价值,仅能够有一个判断结果。这个策略是有效的,只要我们用对正确的时间,来运用它。但是,它无法被认为是保证完美的成就,对于精神分析的工作。

On the contrary, we may be quite sure that, while the impending termination of
the treatment will have the effect of bringing part of the material to light, another part will be walled up, as if buried, behind it and will elude our therapeutic efforts.

相反地,我们可以相对确定说,当治疗的逼近的终止将会有这个效果,让部分的材料豁然开朗。另外一个部分将会被围堵起来,好像被埋葬一般,在它的背后,然后避开我们的治疗的努力。

Once the date for discontinuing the treatment has been fixed we must not extend the time; otherwise the patient will lose all his faith in the analyst. The most obvious expedient is to let him continue his treatment with another analyst, although we know that a change of this sort involves a fresh loss of time and the sacrifice of some of the results of the work already done.

一旦作为中断治疗的这个期限已经被确定,我们一定不要延伸那个时间。否则,病人将会丧失他对精神分析家的所有的信任。最明显的权宜之计是让他继续他的治疗,跟另外一位精神分析家。虽然我们知道,这种的改变牵涉到时间的重新损失与已经被完成的工作的某些结果的牺牲。

No general rule can be laid down as to the right time for resorting to this forcible technical method: the analyst must use his own tact in the matter. A mistake, once made, cannot be rectified. The saying that the lion springs once and once only must hold good here.

关于採有这个强制的技术性的方法的适当的时间,我们无法制定一般的通则。在这件事情,精神分析家必须使用他自己的技巧。错误一旦被形成,就无法被修正。;如格言所说,狮子作势一博。在此,这一博必须有效。

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

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