J Am Psychoanal Assoc. 2022 Jun;70(3):459-484. doi: 10.1177/00030651221104483.
Features of ruthlessness may come into play in the encounter between adolescents who come into the therapeutic space with clear and precise demands to be supported through their gender transition. Winnicott's concept of ruthlessness, extended from the infant-mother matrix to the emotional situation of the clinic, allows a consideration of the conditions under which the analyst can think about adolescent demands. These conditions involve the desire of both patient and analyst for certitude and the analyst's urgency to respond, as well as the adolescent's contradictory desires to both destroy and create gender. The work of Sally Swartz, who brought to Winnicott's conception a notion of ruthlessness in protest, helps us consider the qualities of ruthlessness in constituting gender. A snippet of work with a nonbinary patient shows how questions of gender cannot be understood apart from the intersubjective transferential field. Tying ruthlessness to the enigma of desire illuminates the emotional situation of the clinical encounter between the nonbinary or trans patient and the analyst, a situation that is also libidinal. An analytic move from the question of gender identity to the realm of an emotional situation allows the analyst to meet adolescent ruthlessness. This meeting is an ethical attempt to understand the other, but also reveals one's resistance to giving up something in order to understand.
冷酷无情的特征可能会在青少年进入治疗空间时显现出来，他们带着明确而具体的要求，希望在性别转变过程中得到支持。温尼科特（Winnicott）将冷酷无情的概念从母婴矩阵扩展到临床的情绪情境中，使分析师能够思考满足青少年要求的条件。这些条件涉及患者和分析师对确定性的渴望以及分析师迫切回应的需求，以及青少年在破坏和创造性别方面的矛盾愿望。莎莉·斯沃茨（Sally Swartz）的工作，她将抗议中的冷酷无情观念带入温尼科特的概念中，帮助我们考虑构成性别时冷酷无情的品质。对一位非二元性别患者的工作片段表明，性别问题不能脱离主体间转移领域来理解。将冷酷无情与欲望之谜联系起来，揭示了非二元性别或跨性别患者与分析师之间的临床相遇的情绪情境，这种情境也是性驱力的。从性别认同问题到情感情境领域的分析转移，使分析师能够面对青少年的冷酷无情。这种相遇是一种试图理解他人的伦理尝试，但也揭示了分析师为了理解而抗拒放弃某些东西的倾向。
