Doi Takeo
Seishin Shinkeigaku Zasshi. 2002;104(11):1017-23.
This paper was originally given as a lecture in English at the XII World Congress of Psychiatry held in Yokohama, August 2002. Its primary aim was to introduce Morita therapy and the amae psychology to participants from abroad, not as something exotic, but as something intrinsically relevant to them. In my opinion, Morita therapy is based upon Morita's discovery that certain neurotics, whom he eventually named as shinkeishitsu, can recover spontaneously from severe anxiety when placed in isolation and forced to rest in bed without any diversion under the doctor's strict supervision. In other words, only those patients who follow the doctor's advice faithfully through initial isolation and subsequent work-stages can benefit from Morita therapy. It is further argued that it does not do justice to Morita to speculate that he developed his theory and therapy under the influence of Zen. Apropos of the amae psychology what is most noteworthy about it is that its genuine feeling can be conveyed only nonverbally unlike love which one can express verbally when one says "I love you". It is understood that ambivalence refers to the co-existence of love and hate. This love, however, had better be called amae since it is usually nonverbal and not even acknowledged. Narcissism also entails amae, in fact amae turned upon itself, because narcissism consists in denying one's virtual dependence. Interestingly, the word amae alone may suggest a narcissistic state when it is used in the sense of self-indulgence, the usage which is now becoming quite common. Apart from elucidating two psychiatric terms, the concept of amae turns out to be quite handy in describing what transpires in the psychotherapeutic situation including that of Morita therapy. The concluding remark is to emphasize the importance of psychological concepts against the prevailing view of evidence-based psychiatry. It is argued that the objectivity of scientific findings is in the final analysis a postulate guaranteed by the conscience of individual scientists. If so, the same kind of objectivity may be attributed to the observations made by the doctor when he maintains the psychotherapeutic relationship against all odds and also without any compromise of his conscience.
本文最初是于2002年8月在横滨举行的第十二届世界精神病学大会上用英文发表的演讲。其主要目的是向国外参会者介绍森田疗法和“依存性”心理学,并非将其作为某种奇特的事物,而是作为与他们内在相关的内容。在我看来,森田疗法基于森田的发现,即某些神经症患者,他最终将其命名为“神经质症”,当被隔离并在医生严格监督下卧床休息且无任何消遣时,能够从严重焦虑中自发康复。换句话说,只有那些在最初隔离及后续工作阶段忠实地遵循医生建议的患者才能从森田疗法中受益。进一步而言,推测森田在禅宗影响下发展其理论和疗法是对他的不公。关于“依存性”心理学,最值得注意的是,与可以用言语表达“我爱你”的爱不同,其真实情感只能通过非言语方式传达。人们理解矛盾情感指的是爱与恨的并存。然而,这种爱最好被称为“依存性”,因为它通常是非言语的,甚至不被承认。自恋也包含“依存性”,事实上是“依存性”的自我转向,因为自恋在于否认自己实际上的依赖性。有趣的是,当“依存性”一词用于自我放纵的意义时,它本身可能暗示一种自恋状态,这种用法如今正变得相当普遍。除了阐释两个精神病学术语外,“依存性”概念在描述包括森田疗法在内的心理治疗情境中所发生的事情时也相当有用。最后的评论是强调心理概念相对于循证精神病学主流观点的重要性。有人认为,科学发现的客观性归根结底是由个别科学家的良知保证的一种假设。如果是这样,当医生不顾一切且不违背自己的良知维持心理治疗关系时,他所做的观察也可归因于同样的客观性。