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自我分析:为患者当傻瓜?

Self-analysis: a fool for a patient?

作者信息

Chessick R D

出版信息

Psychoanal Rev. 1990 Fall;77(3):311-40.

PMID:2126871
Abstract

In this paper I first reviewed the scanty publications on the subject of self-analysis. Although it was recommended by Freud as early as 1910 for every analyst, self-analysis turns out to have many pitfalls and to be quite a complicated and controversial procedure. There is no agreement on the proper technique of self-analysis in the literature, nor is there any discussion of the determinants of the particular choice of technique of self-analysis that is employed, nor even of the reasons why some analysts do not engage in it at all. Using clinical data gathered from written material of many years of self-analysis following the termination of a successful training psychoanalysis, I have attempted to elucidate some of the problems posed by this procedure. These problems are in some ways similar to formal psychoanalysis, but are in some ways contingent on the fact that it is basically a different technique. It is a solitary occupation and therefore suffers from the dangers of disintegration into autism, narcissism, and obsessional rumination. There is no living presence of an analyst to serve either as a transference figure or to make interpretations and stimulate the production of material. The identification with the analyst's analyzing function is far from simple in self-analysis because of the complex nature of the various internalizations of the analyst that take place over years of a formal training analysis. Thus, Ticho (1967) is correct when she claimed that self-analysis is a skill that the analysand has to acquire by himself or herself. An important phase of the beginning of self-analysis involves the working through of the separation from the psychoanalyst and the re-evaluation of the analyst and the analytic process. This results in a heightened sense of independence and autonomy, increased cohesion of the self, and maturation--which is manifested by greater autonomous ego functioning, a more mature sense of identity, and continued transformations of narcissism which highly valuable goals, on the basis of the data I have presented, can be approached through the process of self-analysis. Above all this stands the most important goal of self-analysis, the understanding of one's countertransference reactions. This is especially important in the treatment of seriously disturbed patients who become disruptive, and thus get labeled borderline, often as a response to unconscious countertransference manifestations from the analyst which are then experienced in the self-object transference as failures in empathy.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

在本文中,我首先回顾了关于自我分析主题的稀少文献。尽管早在1910年弗洛伊德就建议每位分析师进行自我分析,但事实证明自我分析存在许多陷阱,是一个相当复杂且有争议的过程。文献中对于自我分析的恰当技术没有达成共识,对于所采用的自我分析技术的特定选择的决定因素也没有任何讨论,甚至对于一些分析师根本不进行自我分析的原因也没有探讨。利用从成功的训练性精神分析结束后多年的自我分析书面材料中收集到的临床数据,我试图阐明这一过程所带来的一些问题。这些问题在某些方面与正式的精神分析相似,但在某些方面又取决于它本质上是一种不同技术这一事实。它是一项独自进行的工作,因此存在陷入孤独症、自恋和强迫性沉思的风险。没有分析师的现场存在来充当移情对象,也无法进行解释并激发素材的产生。由于在多年的正式训练分析过程中分析师的各种内化的复杂性质,在自我分析中认同分析师的分析功能绝非易事。因此,蒂乔(1967)声称自我分析是受分析者必须自己掌握的一项技能,这是正确的。自我分析开始的一个重要阶段涉及梳理与精神分析师的分离,并重新评估分析师及分析过程。这会带来更强的独立感和自主感,自我凝聚力增强,以及成熟——这表现为更强的自主自我功能、更成熟的身份认同感,以及自恋的持续转变。基于我所呈现的数据,通过自我分析过程可以实现这些非常有价值的目标。最重要的是,自我分析的最重要目标是理解自己的反移情反应。这在治疗严重困扰且具有破坏性、因此常被贴上边缘性标签的患者时尤为重要,这种情况往往是对分析师无意识的反移情表现的一种反应,然后在自我客体移情中被体验为共情失败。(摘要截选至400字)

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