Bronstein Catalina
British Psychoanalytical Society, United Kingdom.
Int J Psychoanal. 2018 Oct;99(5):1057-1074. doi: 10.1080/00207578.2018.1489706.
This paper looks at the reparative quality of delusional systems. The Author explores and expands Freud's notion of delusion as an 'attempt at reparation'. Even if a delusion is mostly the consequence of hatred of reality and an omnipotent idealized construction to protect the ego from persecutory anxiety stemming from a destructive superego, its content and function show greater complexity. The function of a delusion is not just to protect the ego but also to protect the object (the analyst in the session) from the patient's violence. In order to show the coexistence in delusional systems of manic defensive aspects with proper depressive reparative ones, the Author presents detailed clinical material from the analysis of an adolescent patient who suffered from intense persecuting voices that negated her right to be alive. The paper proposes that understanding the fluctuation and manifestation of reparative unconscious phantasies, the recognition of their depressive aspects and of their specific function as they are lived out in the transference relationship is central to the development of psychic change in psychotic processes.
本文探讨妄想系统的修复性质。作者探究并扩展了弗洛伊德将妄想视为“修复尝试”的概念。即便妄想大多是对现实的仇恨以及一种全能理想化建构的结果,旨在保护自我免受源自具有破坏性的超我的迫害焦虑,但它的内容和功能展现出更大的复杂性。妄想的功能不仅在于保护自我,还在于保护客体(治疗过程中的分析师)免受患者的暴力侵害。为了展现妄想系统中躁狂防御方面与恰当的抑郁修复方面的共存,作者呈现了对一名青少年患者分析的详细临床资料,该患者遭受强烈的迫害性幻听,这些幻听否定了她生存的权利。本文提出,理解修复性无意识幻想的波动与表现,认识到它们在移情关系中呈现时的抑郁方面及其特定功能,对于精神病性过程中心理改变的发展至关重要。