Pirlot Gérard, Corcos Maurice
Service pedopsychiatrie, Institut M. Monsouris, 42 Boulevard Jourdan, 75014, Paris, France.
Int J Psychoanal. 2012 Dec;93(6):1403-25. doi: 10.1111/j.1745-8315.2012.00657.x.
The object of this paper is to provide a metapsychological definition of alexithymia as described in 1967 in terms of operational thinking and negative hallucination. This is a familiar and established concept in the fields of psychopathology, psychology, and of clinical and psychosomatic medicine. From a psychoanalytic and psychosomatic point of view, the term is conceptually close to P. Marty's "operative thinking", as described in 1963, even though we know they do not belong to the same epistemological field: on one hand Neuroscience, Psychiatry and the objectalization of the symptom at different levels, and on the other, as regards mechanical functioning, a psychoanalytic clinical approach within the dynamics of the relationship between transference and counter-transference. The present authors consider that Freudian metapsychology, as now complexified by Andrè Green, allows for a metapsychological approach to alexithymia insofar as it relates to Marty's operative thinking. Thus does Green's conceptualization of the mother's negative hallucination, of negative introjection, of a psychically 'dead (and insecure) mother', now provide us with the opportunity to describe, in metapsychological terms, the genesis of this particular mode of psychical functioning. Given the mother's negative hallucination produces a host structure as a background to negativity that will fit future object representations, we will assume that in the case of … future operational or alexithymic …?, this negative hallucination will pathologically and defensively involve the endo-psychic perception of affect.
本文的目的是根据操作性思维和阴性幻觉，给出1967年所描述的述情障碍的元心理学定义。这在精神病理学、心理学以及临床和心身医学领域是一个为人熟知且已确立的概念。从精神分析和心身医学的角度来看，该术语在概念上与1963年所描述的P. 马蒂的“操作性思维”相近，尽管我们知道它们不属于同一认识论领域：一方面是神经科学、精神病学以及症状在不同层面的客观化，另一方面，就机械功能而言，是在移情与反移情关系动态中的精神分析临床方法。本文作者认为，由安德烈·格林进一步深化的弗洛伊德元心理学，使得对述情障碍进行元心理学探讨成为可能，因为它与马蒂的操作性思维相关。因此，格林对母亲的阴性幻觉、阴性内摄、精神上“死亡（且不安全）的母亲”的概念化，现在为我们提供了一个机会，用元心理学的术语来描述这种特殊心理功能模式的起源。鉴于母亲的阴性幻觉产生了一个作为消极背景的主体结构，这一结构将适配未来的客体表象，我们将假定，在……未来操作性或述情障碍性的……情况下，这种阴性幻觉将在病理上和防御性地涉及情感的内心感知。
