Arlow J A
Psychoanal Q. 1991 Oct;60(4):539-63.
The challenges presented in treating patients with so-called borderline and narcissistic personality disorders have revived interest in the subject of reconstruction, because many analysts believe that these difficulties originate in the events of the earliest preverbal phase of development. They feel that contributions from direct observation of neonates and knowledge gained from "infant psychiatry" may enable analysts to effect reconstructions that previously appeared to be only speculative. The methodological problems in applying this approach, however, may lead to foisting upon clinical observation preconceived paradigms of pathogenesis. Reconstruction depends upon a disciplined interpretation of the dynamic record of the patient's associations, which demonstrate how the past is embedded in the present. The validity of the reconstruction depends upon the application of appropriate and disciplined psychoanalytic methodology. Reconstructions constitute a special form of interpretation and are part of the psychoanalytic process.
治疗所谓边缘型和自恋型人格障碍患者时所面临的挑战,重新唤起了人们对重构主题的兴趣,因为许多精神分析学家认为,这些困难源于发展的最早非言语阶段的事件。他们觉得,对新生儿的直接观察所提供的信息以及从“婴儿精神病学”中获得的知识,可能会使精神分析学家能够进行以前似乎只是推测性的重构。然而,应用这种方法时的方法论问题,可能会导致将预先设定的发病机制范式强加于临床观察之上。重构依赖于对患者联想动态记录的严谨解读,这些记录展示了过去是如何融入到当下之中的。重构的有效性取决于适当且严谨的精神分析方法的应用。重构构成了解读的一种特殊形式,并且是精神分析过程的一部分。