Olinick S L
Georgetown University School of Medicine, Washington, D.C.
J Am Psychoanal Assoc. 1989;37(3):639-54. doi: 10.1177/000306518903700303.
The author outlines his clinical observations during the "middle game" of psychoanalysis, leading to recognition that structural change is taking place. "Middle game," "structure," process, and content are defined and critically discussed. Illustrative clinical vignettes are offered. The presentation emphasizes the importance of an active and resolving transference "struggle"; in addition, more traditionally noted criteria are briefly touched on, e.g., development of observing ego and treatment alliance, changes in dream function and communication, and the reviewing of the neurosis and transference during the termination phase as instances of mourning and working through. The concept of optimal psychobiological function in the service of a homeostatic principle is discussed.
作者概述了他在精神分析“中场阶段”的临床观察，从而认识到结构正在发生变化。对“中场阶段”“结构”“过程”和“内容”进行了定义并展开批判性讨论。文中提供了具有说明性的临床案例。该演讲强调了积极且具有解决力的移情“斗争”的重要性；此外，还简要提及了一些更为传统的显著标准，例如观察性自我和治疗联盟的发展、梦的功能及交流的变化，以及在终止阶段将神经症和移情作为哀悼及修通实例进行回顾。文中还讨论了服务于稳态原则的最佳心理生物学功能这一概念。
