Shapiro D
Psychiatry. 1985 Nov;48(4):311-7. doi: 10.1080/00332747.1985.11024292.
It is our aim in psychotherapy to introduce the neurotic person to himself. He is in some sense cut off from certain of his feelings, wishes and intentions as a result of internal conflict and, in fact, he is cut off from the nature of that conflict itself, sometimes even from an awareness of its existence. He experiences the symptoms of that conflict but he is in no position to resolve it. Our aim, however, is not to introduce the neurotic person to himself merely in the sense of informing him about the existence, nature or history of such conflict; that would probably not help him much more than telling him his diagnosis. It is rather to actually enlarge his experience of himself, specifically to enlarge his experience of and to make articulate the feelings and thoughts involved in that conflict and in this way to create the conditions for its resolution. I wish to propose that the effectiveness of this process depends upon the recognition or articulation by the therapist of feelings or thoughts of the patient that are in a certain sense already conscious, are actually within conscious subjective experience, yet are not and for certain dynamic reasons cannot be fully articulated or recognized by the patient himself. In proposing this--I shall give an example in a moment--I am calling attention to a kind of self-estrangement and a level of subjective experience and mental activity that, though I believe perfectly well known to all of us, are not distinguished by the traditional psychoanalytic division of mental processes into conscious, preconscious and unconscious.(ABSTRACT TRUNCATED AT 250 WORDS)
心理治疗的目标是引导神经症患者认识自我。由于内心冲突,他在某种程度上与自己的某些情感、愿望和意图相隔绝,实际上,他与冲突的本质本身相隔绝,有时甚至对其存在毫无察觉。他体验到冲突的症状,但却无力解决。然而,我们的目标并非仅仅是让神经症患者了解这种冲突的存在、本质或历史,因为这可能并不比告诉他诊断结果对他有更多帮助。而是要切实扩大他对自我的体验,具体而言,扩大他对冲突中所涉及的情感和思想的体验,并使其清晰表达出来,从而为解决冲突创造条件。我想提出,这一过程的有效性取决于治疗师对患者在某种意义上已经有意识的情感或思想的识别或表达,这些情感或思想实际上存在于有意识的主观体验中,但由于某些动态原因,患者自己无法完全清晰表达或识别。在提出这一点时——我稍后会举个例子——我提请大家注意一种自我疏离以及一种主观体验和心理活动的层面,尽管我相信我们大家都非常熟悉,但传统精神分析将心理过程分为意识、前意识和无意识时并未对其加以区分。(摘要截选至250字)