Lane R C, Hull J W, Foehrenbach L M
Psychoanal Rev. 1991 Fall;78(3):391-410.
In this paper, we have described a type of resistance that has attracted increasing psychoanalytic attention in recent years. Patients exposed to intense negativity during early life may develop an addiction to negative experience as adolescents and adults, and this may constitute a central organizing feature of their personality. In almost all patients, however, some moments of negativity may be observed. We have traced the developmental origins of an attachment to negativity, drawing especially on psychoanalytic investigations of preoedipal pathology. Manifestations and derivatives of early negativity include anhedonia, attachment to physical pain, fear of success, masochism, deprivation of self and others, and negative voyeurism. In discussing the dynamic functions of negativity, we place particular emphasis on two motives: the patient's desires for revenge against early objects that have been a source of deprivation and frustration; and the defensive function of negativity in helping to express as well as ward off dangerous wishes to merge with the object. Deviant forms of autoerotism are likely to be used by these patients to deal with the reactivation of early experiences of neglect and rejection. When negativity is used as a defense or method of relating to others it can lead to a severe disruption of the psychotherapeutic relationship. We have reviewed suggestions for the management of extreme negativity in treatment. Resolution of the therapist's countertransference reactions, especially induced feelings of frustration, rage, and helplessness, is crucial. Emphasis also has been placed on the patient's desires for revenge against self and object, and the manner in which these may be understood and eventually resolved. Only when patient and therapist begin to investigate the adaptive functions of extreme negativity can this pathological symptom be resolved and the patient's awareness of self and sense of autonomy be enhanced.
在本文中,我们描述了一种近年来在精神分析领域日益受到关注的阻抗类型。早年经历过强烈负面情境的患者,在青少年和成年期可能会对负面体验上瘾,这可能构成其人格的核心组织特征。然而,几乎在所有患者身上,都能观察到一些负面时刻。我们追溯了对负面情境依恋的发展起源,特别借鉴了对前俄狄浦斯期病理的精神分析研究。早期负面情境的表现和衍生物包括快感缺失、对身体疼痛的依恋、对成功的恐惧、受虐癖、自我与他人的剥夺以及负面窥淫癖。在讨论负面情境的动态功能时,我们特别强调两种动机:患者对早年曾是剥夺和挫折来源的客体进行报复的欲望;以及负面情境在帮助表达和抵御与客体融合的危险愿望方面的防御功能。这些患者可能会利用异常形式的自体性欲来应对早年被忽视和被拒绝经历的再次激活。当负面情境被用作防御或与他人建立关系的方式时,它可能会导致心理治疗关系的严重破裂。我们回顾了治疗中极端负面情境管理的相关建议。解决治疗师的反移情反应,尤其是由此引发的挫折感、愤怒感和无助感,至关重要。同时也强调了患者对自我和客体的报复欲望,以及理解并最终解决这些欲望的方式。只有当患者和治疗师开始探究极端负面情境的适应功能时,这种病理症状才能得到解决,患者的自我意识和自主感才能得到增强。