Yakeley Jessica
Portman Clinic, The Tavistock and Portman NHS Foundation Trust, 8 Fitzjohns Avenue, London, NW3 5NA, UK.
Int J Psychoanal. 2013 Aug;94(4):667-88. doi: 10.1111/1745-8315.12014. Epub 2013 Mar 15.
The paper explores the impact of the analyst's pregnant body on the course of two analyses, a young man, and a young woman, specifically focusing on how each patient's visual perception and affective experience of being with the analyst's pregnant body affected their own body image and subjective experience of their body. The pre-verbal or 'subsymbolic' material evoked in the analyses contributed to a greater understanding of the patients' developmental experiences in infancy and adolescence, which had resulted in both carrying a profoundly distorted body image into adulthood. The analyst's pregnancy offered a therapeutic window in which a shift in the patient's body image could be initiated. Clinical material is presented in detail with reference to the psychoanalytic literature on the pregnant analyst, and that of the development of the body image, particularly focusing on the role of visual communication and the face. The author proposes a theory of psychic change, drawing on Bucci's multiple code theory, in which the patients' unconscious or 'subsymbolic' awareness of her pregnancy, which were manifest in their bodily responses, feeling states and dreams, as well as in the analyst s countertransference, could gradually be verbalized and understood within the transference. Thus visual perception, or 'external seeing', could gradually become 'internal seeing', or insight into unconscious phantasies, leading to a shift in the patients internal object world towards a less persecutory state and more realistic appraisal of their body image.
本文探讨了分析师怀孕的身体对两位患者(一名年轻男子和一名年轻女子)的分析过程的影响,特别关注每位患者对与怀孕分析师相处时的视觉感知和情感体验如何影响他们自己的身体形象和身体主观体验。分析中唤起的前语言或“亚符号”材料有助于更深入地理解患者在婴儿期和青春期的发展经历,这些经历导致他们成年后都带着严重扭曲的身体形象。分析师的怀孕提供了一个治疗窗口,借此可以启动患者身体形象的转变。本文详细呈现了临床材料,并参考了关于怀孕分析师的精神分析文献以及身体形象发展的文献,特别关注视觉交流和面部的作用。作者借鉴布奇的多重编码理论提出了一种心理变化理论,在该理论中,患者对她怀孕的无意识或“亚符号”认知,体现在他们的身体反应、情感状态和梦境以及分析师的反移情中,可以在移情中逐渐被言语化并得到理解。因此,视觉感知,即“外部观察”,可以逐渐转变为“内部观察”,即洞察无意识幻想,从而使患者的内部客体世界向不那么受迫害的状态转变,并对他们的身体形象有更现实的评估。