Richard-Jodoin R M
Department of Psychiatry, McGill University.
J Am Acad Psychoanal. 1991 Fall;19(3):339-51. doi: 10.1521/jaap.1.1991.19.3.339.
This essay attempts to resolve some of the ambiguities regarding the differentiation of psychoanalytic psychotherapy from psychoanalysis. It argues that they result from a failure to recognize that psychotherapy, although it is grounded in psychoanalytic knowledge, is fundamentally different from psychoanalysis in that it does not have as its goal an uncovering of the unconscious and therefore does not use the psychoanalytic method devised for this purpose. Psychotherapy, in this view, is understood as a reality-oriented process that helps a person understand the present in continuity with a consciously accessible past and that promotes the integration of divergent but alternatively conscious aspects of the self and the object. The conceptual framework for psychotherapy thus understood is to be found in developmental psychology, object relations theory, and the psychology of the self. The essentially analytic aspects of such a process reside in the psychoanalytic knowledge of human development that guides our understanding of the clinical material but also the limits of our therapeutic endeavors; in the analytic attitude of openness to the accessible and individual meaning of a patient's communications that guards against imposing cognitively deduced interpretations of supposedly unconscious meanings; and in the engagement of, and respect for, the patient's observing ego.
本文试图解决一些关于精神分析心理治疗与精神分析之间差异的模糊之处。文章认为,这些模糊之处源于未能认识到心理治疗虽然基于精神分析知识,但在根本上与精神分析不同,因为它的目标不是揭示无意识,因此不使用为此目的而设计的精神分析方法。从这个角度来看,心理治疗被理解为一个以现实为导向的过程,它帮助一个人在与有意识可及的过去相连续的情况下理解当下,并促进自我和客体不同但同样有意识的方面的整合。如此理解的心理治疗的概念框架可在发展心理学、客体关系理论和自我心理学中找到。这样一个过程的本质分析方面在于人类发展的精神分析知识,它指导我们对临床材料的理解以及我们治疗努力的限度;在于对患者交流中可及的个体意义持开放态度的分析态度,这种态度防止强加对所谓无意识意义的认知推导解释;还在于对患者观察自我的参与和尊重。