Martinez D
Department of Psychiatry, University of Texas Health Science Center, San Antonio.
J Am Psychoanal Assoc. 1989;37(1):89-115. doi: 10.1177/000306518903700105.
The forced termination of psychoanalysis, such as occurs when the analyst makes a geographic move, uniquely disrupts the analytic setting. This paper recounts the author's experience of terminating a full-time private practice of psychoanalysis and psychoanalytic therapy for such a move. The limited literature on the subject is reviewed with a focus on the use of technical variation in the forced termination situation. The author delineates three areas of interaction with patients where technical variation proved in her experience to be of value: dealing with countertransference and counter-reaction, providing information about the move, and the consideration and process of referral for continued therapy. As opposed to what would be predicted from a classical psychoanalytic perspective, the use of such technical maneuvers seemed to facilitate rather than impede analytic work. These variations in technique served at crucial times to maintain the analytic alliance, to preserve the patient's capacity to recognize and make use of transference, and to provide avenues for resolving past traumas in the transference and the actual loss of the analyst. The concept of the analyst as a new or useable object is proposed as providing a theoretical framework for understanding these observations.
精神分析的强制终止，比如分析师因迁居而导致的终止，会独特地扰乱分析情境。本文讲述了作者因迁居而终止全职私人精神分析及精神分析治疗业务的经历。本文回顾了关于该主题的有限文献，重点关注在强制终止情境下技术变通的运用。作者阐述了在她的经验中技术变通被证明有价值的与患者互动的三个领域：处理反移情和反反应、提供关于迁居的信息以及转介继续治疗的考量和过程。与经典精神分析视角所预测的情况相反，使用这些技术手段似乎促进而非阻碍了分析工作。这些技术变通在关键时刻有助于维持分析联盟、保留患者识别和利用移情的能力，并为在移情中解决过去的创伤以及分析师实际离去提供解决途径。本文提出将分析师视为一个新的或可用对象的概念，为理解这些观察结果提供一个理论框架。
