Giovacchini P L
J Am Acad Psychoanal. 1990 Spring;18(1):5-17. doi: 10.1521/jaap.1.1990.18.1.5.
There is a continuum from primitive, undifferentiated feelings that are simply the manifestations of homeostatic balance and imbalance to highly differentiated, pleasurable erotic feelings that characterize mature, intimate love relationships. Sensory reactions are elevated from simple reflex levels to highly complex, sophisticated affects that involve wide areas of the psyche. Thus, affects are associated with integration and organized psychic structure. Consequently they may function in various ways. Freud developed a continuum for anxiety as initially functioning as a conversion reaction enabling sexual feelings that cannot reach mentational levels or be consummated in erotic activity to be discharged. It reaches a final level of organization where it serves as a signal calling various defenses into play as emerging instinctual impulses threaten to upset psychodynamic equilibrium. I have focused on how affects, erotic feelings in particular, have an organizing function that binds a primitive inner agitation that occurs during what is called a prementational stage of the neonatal period. This is a stage that precedes psychological processes. Sexual feelings are generated as an attempt to bind inner chaos that stems from an amorphous, inchoate psychic state. Erotic feelings are experienced in order to smoothe inner tension. The patient tries but seldom achieves calm because the affective binding and structuralizing process, in itself, becomes painful and disruptive. I present several clinical incidents and also refer to so-called treatment relationships where the therapist absorbs the patient's chaos and then acts out sexually which leads to a total breakdown of the therapeutic setting.
从仅仅是体内平衡的平衡与失衡表现的原始、未分化的感觉到表征成熟、亲密恋爱关系的高度分化的愉悦的性欲感觉,存在一个连续统一体。感觉反应从简单的反射水平提升到涉及心理广泛领域的高度复杂、精致的情感。因此,情感与整合和有组织的心理结构相关联。因此,它们可能以各种方式发挥作用。弗洛伊德提出了一个焦虑的连续统一体,焦虑最初作为一种转换反应起作用,使无法达到心理层面或在性活动中得到满足的性感觉得以释放。它达到最终的组织水平,在这个水平上,当新出现的本能冲动有可能打破心理动力平衡时,它作为一种信号促使各种防御机制发挥作用。我关注的是情感,尤其是性欲感觉,如何具有一种组织功能,这种功能能够约束新生儿期所谓的心理前阶段出现的原始内心躁动。这是一个先于心理过程的阶段。性感觉的产生是为了约束源于无定形、未成形心理状态的内心混乱。体验性欲感觉是为了缓解内心紧张。患者努力尝试但很少能达到平静,因为情感的约束和结构化过程本身就变得痛苦且具有破坏性。我呈现了几个临床事件,还提到了所谓的治疗关系,在这种关系中,治疗师吸收患者的混乱,然后进行性发泄,这导致治疗环境完全崩溃。