Aguayo Joseph
Int J Psychoanal. 2011 Oct;92(5):1117-36. doi: 10.1111/j.1745-8315.2010.00360.x. Epub 2010 Oct 25.
The author historicizes one aspect of Betty Joseph's ongoing technical contributions in terms of its originating London kleinian context. Early on she drew upon both the patient's remembered history and unconscious past, linking these experiences in past-to-present transference interpretations in order to effect psychic change. In evolving the technique of 'here and now' analysis, Joseph came to emphasize a communicative definition of projective and introjective identification as well as the significance of enactments while marginalizing the use of part-object anatomical interpretative language. She gradually set aside directly linking the patient's past with the present, compelled now by making direct contact with her patients. She now tracked how difficult patients acted in and responded to interpretations from moment to moment. The author maintains that the explicit and implicit conceptual work of Wilfred Bion as well as Joseph's continuous group workshop for analysts led to an increased understanding of the patient's projective impact on the analyst's countertransference responses, and thereby increased the analyst's capacity with 'difficult to treat' narcissistic spectrum patients described by her colleague, Herbert Rosenfeld. In recent work, while Joseph continues to elucidate what patients recall about their early past, she formats her understanding in terms of a direct analysis of the structure of the patient's projected internal object relations in the transference. The analyst works with the patient's communications and enactments, with a greater emphasis on a more 'inside-to-outside' understanding of transference in contrast to the earlier 'past-to-present' work associated with both Freud and Klein. This investigation concludes with one example of Betty Joseph's significant impact on contemporary kleinian technique by taking up some of Michael Feldman's work. Now the analyst listens to the 'past presented,' the patient's projected internal world, as well as tracks how the patient hears and subtly mishears interpretations for defensive, equilibrium-maintaining purposes, as the analyst attempts to effect psychic change by widening the ego's perceiving functions.
作者从贝蒂·约瑟夫最初在伦敦的克莱因派背景出发，对她持续的技术贡献的一个方面进行了历史化分析。早期，她借鉴了患者记忆中的历史和无意识的过去，在从过去到现在的移情解释中把这些经历联系起来，以实现心理改变。在发展“此时此地”分析技术时，约瑟夫开始强调投射性和内摄性认同的一种交流性定义，以及行为表现的重要性，同时将部分客体解剖学解释性语言的使用边缘化。她逐渐不再直接将患者的过去与现在联系起来，现在是受与患者直接接触的驱使。她现在追踪难处理的患者在每时每刻对解释的行为表现和反应。作者认为，威尔弗雷德·比昂的显性和隐性概念工作，以及约瑟夫为分析师举办的持续小组研讨会，增进了对患者投射对分析师反移情反应的影响的理解，从而提高了分析师处理其同事赫伯特·罗森菲尔德所描述的“难治疗”自恋谱系患者的能力。在最近的工作中，虽然约瑟夫继续阐明患者对其早期过去的回忆，但她将自己的理解构建在对移情中患者投射的内在客体关系结构的直接分析之上。分析师处理患者的交流和行为表现，与早期与弗洛伊德和克莱因相关的“从过去到现在”的工作相比，更强调对移情进行更‘由内而外’的理解。这项研究以贝蒂·约瑟夫对当代克莱因派技术的重大影响的一个例子作为结尾，即借鉴了迈克尔·费尔德曼的一些工作。现在，分析师倾听“呈现出来的过去”，即患者投射的内在世界，同时追踪患者如何出于防御和维持平衡的目的去倾听并微妙地误解解释，而分析师试图通过拓宽自我的感知功能来实现心理改变。
