Bürgy M
Psychiatric Hospital, University of Heidelberg.
Am J Psychother. 2001;55(1):65-73. doi: 10.1176/appi.psychotherapy.2001.55.1.65.
Freud's intrapersonal concept of anal-sadistic regression is set against the interpretation of obsessive-compulsive neurosis as a structural ego deficit. The interpersonal dimension that comes to the fore as a result of this, becomes clear if we focus on obsessive-compulsive behavioral disorder: Persons suffering from obsessive-compulsive neurosis lack the self-assessment factor. It needs another person as part of their own ego who accepts and supports them in their behavior. A clinical example illustrates this narcissistic function of compulsion together with the changes in the psychodynamic approach and resulting therapy. Against DSM-classification with the concept of obsessive-compulsive disorder, which contains an unspecific symptomatology that occurs both in neurosis, schizophrenia, melancholia, and organic psychosis, this article advocates the specific and differentiated concept of obsessive-compulsive neurosis.
弗洛伊德关于肛门施虐退行的个体内部概念与将强迫性神经症解释为结构性自我缺陷形成对照。如果我们关注强迫行为障碍,由此凸显出来的人际维度就会变得清晰:患有强迫性神经症的人缺乏自我评估因素。他们需要另一个人作为自身自我的一部分,来接受并支持他们的行为。一个临床实例说明了强迫的这种自恋功能,以及心理动力学方法的变化和由此产生的治疗。针对将包含在神经症、精神分裂症、忧郁症和器质性精神病中均会出现的非特异性症状学的强迫障碍概念进行的DSM分类,本文主张采用特定且有区别的强迫性神经症概念。