Sugarman Alan
San Diego Psychoanalytic Society and Institute, San Diego, CA, USA.
Psychoanal Q. 2008 Jul;77(3):799-833. doi: 10.1002/j.2167-4086.2008.tb00360.x.
Psychoanalytic opinion continues to be dichotomized in regard to the role of trauma versus intrapsychic conflict as contributing to pathogenesis. This paper emphasizes the importance of conflict in both the experience and processing of trauma, so that problems in talking about it and processing it verbally are taken as evidence of conflict and defense. Cumulative trauma and its analysis in children are emphasized. While children in analysis find remembering and talking about their traumas difficult, they can know such experiences and modulate the anxiety of knowing when they do so in play. A clinical vignette is presented to demonstrate this way of using play to promote more advanced mentalization or insightfulness.
在创伤与心理内部冲突对发病机制的影响方面，精神分析观点仍然存在分歧。本文强调冲突在创伤体验和处理过程中的重要性，因此将谈论创伤和通过言语处理创伤时出现的问题视为冲突和防御的证据。文中强调了儿童累积性创伤及其分析。虽然接受分析的儿童发现记住并谈论他们的创伤很困难，但他们能够了解这些经历，并在游戏中这样做时调节知晓带来的焦虑。文中呈现了一个临床案例来说明利用游戏促进更高级心理化或洞察力的这种方式。
