Kernberg Otto F
Columbia University Center for Psycho-analytic Research and Training, USA.
J Am Psychoanal Assoc. 2003 Spring;51(2):517-45. doi: 10.1177/00030651030510021101.
Affect storms are a frequent complication in the psychoanalytic approach to borderline patients. The descriptive, psychodynamic, and structural characteristics of these storms are explored, and the verbal, nonverbal, and countertransference manifestations that permit the formulation of interpretations under such conditions are described, as are the interventions required to maintain the treatment frame as a precondition for an analytic approach. The principal theoretical formulations regarding the affect pathology of borderline patients are reviewed and related to a proposed interpretive approach. An apparently opposite development, the utter absence of emotional developments in the sessions, is examined, and its defensive function of avoiding affect storms is explored. Clinical case material illustrates the proposed approach to these storms, and clinical evidence is given to support the approach, which centers on systematic analysis of the primitive internalized object relations of these patients in the transference, the use of countertransference analysis without countertransference communication to the patient, and the repeated restoration of technical neutrality in the service of protecting the treatment frame.
情感风暴是精神分析治疗边缘型人格障碍患者时常见的并发症。本文探讨了这些风暴的描述性、心理动力学和结构性特征，描述了在这种情况下有助于形成解释的言语、非言语和反移情表现，以及为维持治疗框架作为分析方法的前提条件而需要采取的干预措施。回顾了关于边缘型人格障碍患者情感病理学的主要理论表述，并将其与一种提议的解释方法相关联。研究了一种明显相反的情况，即治疗过程中完全没有情感发展，并探讨了其避免情感风暴的防御功能。临床案例材料说明了针对这些风暴的提议方法，并给出了临床证据来支持该方法，该方法的核心是系统分析这些患者在移情中原始的内化客体关系，在不与患者进行反移情交流的情况下运用反移情分析，并反复恢复技术中立性以保护治疗框架。
