Spurling Laurence S
Birkbeck College, University of London, School of Psychosocial Studies, Malet Street, London WC1E 7HX.
Int J Psychoanal. 2008 Jun;89(3):523-40. doi: 10.1111/j.1745-8315.2008.00058.x.
The author uses his own failure to find a place for the idea of therapeutic regression in his clinical thinking or practice as the basis for an investigation into its meaning and usefulness. He makes a distinction between three ways the term 'regression' is used in psychoanalytic discourse: as a way of evoking a primitive level of experience; as a reminder in some clinical situations of the value of non-intervention on the part of the analyst; and as a description of a phase of an analytic treatment with some patients where the analyst needs to put aside normal analytic technique in order to foster a regression in the patient. It is this third meaning, which the author terms "therapeutic regression" that this paper examines, principally by means of an extended discussion of two clinical examples of a patient making a so-called therapeutic regression, one given by Winnicott and the other by Masud Khan. The author argues that in these examples the introduction of the concept of therapeutic regression obscures rather than clarifies the clinical process. He concludes that, as a substantial clinical concept, the idea of therapeutic regression has outlived its usefulness. However he also notes that many psychoanalytic writers continue to find a use for the more generic concept of regression, and that the very engagement with the more particular idea of therapeutic regression has value in provoking questions as to what is truly therapeutic in psychoanalytic treatment.
作者以自己未能在临床思维或实践中为治疗性退行这一概念找到立足之地为基础,对其意义和实用性展开调查。他区分了“退行”一词在精神分析话语中的三种用法:作为唤起原始体验水平的一种方式;作为在某些临床情境中提醒分析师不进行干预的价值;以及作为对某些患者分析治疗阶段的一种描述,在这个阶段分析师需要抛开正常的分析技术以促使患者退行。本文主要通过对温尼科特和马苏德·汗给出的两个患者出现所谓治疗性退行的临床案例进行详细讨论,来审视作者所定义的第三种意义上的“治疗性退行”。作者认为,在这些案例中,治疗性退行概念的引入使临床过程变得模糊而非清晰。他得出结论,作为一个重要的临床概念,治疗性退行的观念已不再有用。然而,他也指出,许多精神分析作家继续在使用更一般化的退行概念,并且对更具体的治疗性退行观念的探讨在引发关于精神分析治疗中真正具有治疗作用的因素的问题方面具有价值。