Lefebvre P
Int J Psychoanal. 1988;69 ( Pt 1):43-53.
In this paper the clinical case of a patient with ulcerative colitis is described, to illustrate how the vicissitudes of affects and fantasies, and the intensity of drives can set limits to the capacity for change in psychoanalysis. Drive intensity at all zonal levels is discussed. The author describes two unconscious fantasies which fuelled the resistance to progress, because of their inevitable links with traumatic and disavowed affects, and with libidinal and aggressive drives. The first fantasy described is that of the narcissistic impasse, in which the patient could not orchestrate an optimal distance with the object, who always seemed too perilously near or far. The second fantasy, giving rise to the first, is that of the Faustian bargain, according to which the patient repeated an infantile disposition to effect a trade-off with a needed but elusive ideal object, resulting in pathological splitting, a loss of a sense of ownership of the Psyche and the Soma, and eventual somatic vulnerability.
本文描述了一位溃疡性结肠炎患者的临床病例，以说明情感和幻想的变迁，以及驱力的强度如何为精神分析中的改变能力设定限制。文中讨论了所有区域层面的驱力强度。作者描述了两种无意识幻想，它们因与创伤性及被否认的情感，以及与力比多和攻击性驱力有着必然联系，从而加剧了对进展的抵抗。所描述的第一种幻想是自恋僵局，患者无法与客体协调出最佳距离，客体似乎总是要么过于危险地靠近，要么过于遥远。第二种幻想引发了第一种幻想，即浮士德式交易，据此患者重复了一种幼稚的倾向，即与一个需要但难以捉摸的理想客体进行权衡，导致病理性分裂、丧失心理和身体的自主感，最终导致身体易损性。
