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精神性皮肤:精神病性防御、边缘性过程与妄想

Psychic skin: psychotic defences, borderline process and delusions.

作者信息

Schmidt Martin

出版信息

J Anal Psychol. 2012 Feb;57(1):21-39. doi: 10.1111/j.1468-5922.2011.01949.x.

Abstract

In this paper, I apply the concept of psychic skin to analytic work with people suffering from personality disorders and psychoses. When psychoses emerge, the defensive skin which protects the ego is breached and violent unconscious forces rip through the personality. Some of the patients diagnosed as schizophrenic with whom I work have identified with archetypal characters such as Christ, Satan, John Lennon and the Queen. I attempt to show how the adoption of these inflated personas can serve as secondary psychic skins. Such delusional identifications can provide a protective shield to hide the denuded self and prevent intrusion from the external world. Through clinical example, I try to demonstrate how these archetypal 'second skins' can preserve life until internal and external conditions make it possible for the self to emerge. I contrast such psychotic identifications with 'thin-skinned' and 'thick-skinned' narcissism as well as 'defences of the self' in borderline states where the psychic skin may be damaged but does not disintegrate. I also look at the ways in which Jung's own personal experience was different from this and how he managed to avert psychotic breakdown.

摘要

在本文中,我将心理皮肤的概念应用于对人格障碍和精神病患者的分析工作。当精神病出现时,保护自我的防御性皮肤被突破,暴力的无意识力量贯穿人格。我所治疗的一些被诊断为精神分裂症的患者认同诸如基督、撒旦、约翰·列侬和女王等原型人物。我试图展示采用这些膨胀的人格角色如何能起到次级心理皮肤的作用。这种妄想性认同可以提供一个保护盾,以隐藏被剥去外皮的自我,并防止外部世界的侵入。通过临床实例,我试图证明这些原型“第二层皮肤”如何能维持生命,直到内部和外部条件使自我得以出现。我将这种精神病性认同与“薄皮”和“厚皮”自恋以及边缘状态下的“自我防御”进行对比,在边缘状态中,心理皮肤可能受损但不会瓦解。我还探讨了荣格自己的个人经历与这一情况的不同之处,以及他是如何设法避免精神崩溃的。

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