Gans Jerome S
Psychiatry, Harvard Medical School.
Int J Group Psychother. 2011 Apr;61(2):218-37. doi: 10.1521/ijgp.2011.61.2.218.
Unwitting self-disclosures (USDs), unconscious yet observable parts of personality, are often behavioral relics of past suffering and, as such, constitute valuable though frequently underutilized clinical information. While ego-syntonic aspects of personality can be commented on with impunity, dealing therapeutically with patients' USDs--manifestations of their blind spots--requires sensitivity, empathy, and timing. Providing many clinical examples of patient and therapist USDs from individual and group psychotherapy, this report discusses the origins, possible meanings, and the countertransference and empathic challenges encountered in the handling of these blind spots. The importance of establishing a narcissistic alliance and of employing the methods of the existential school of psychotherapy in processing USDs is described. Self-aware therapists can minimize the clinical impasse that may result when therapist-patient blind spots overlap.
不经意的自我表露（USDs），即人格中无意识却可观察到的部分，往往是过去痛苦经历的行为遗迹，因此构成了虽常未被充分利用但却很有价值的临床信息。虽然可以毫无顾忌地评论人格中与自我和谐一致的方面，但从治疗角度处理患者的不经意自我表露——他们盲点的表现——则需要敏感度、同理心和时机把握。本报告通过提供个体和团体心理治疗中患者及治疗师不经意自我表露的诸多临床实例，探讨了这些盲点的起源、可能的含义，以及在处理这些盲点时遇到的反移情和同理心挑战。文中还描述了建立自恋同盟以及运用存在主义心理治疗学派方法来处理不经意自我表露的重要性。有自我意识的治疗师能够将治疗师与患者盲点重叠时可能导致的临床僵局降至最低。
