Meissner W W
Int J Psychoanal Psychother. 1984;10:567-98.
This paper reviews the fascinating case material of Freud's "Fragments of an Analysis of a Case of Hysteria" and the subsequent material that has come to light about Dora. The analytic material is reinterpreted in the light of more contemporary analytic perspectives. The difficulties can be considered in terms of the problem of diagnosis, in terms of the dynamics inherent in Dora's personality structure, and finally in terms of the difficulties in the transference-countertransference interaction that played such a significant role in the premature termination of the case. Dora is far from simply a case of hysterical neurosis, but her pathology not only reflects the dynamics of the paranoid process, but also falls within the range of the borderline spectrum of personality disorders that have been described previously (Meissner 1982b.). Moreover, the borderline quality of her psychopathology gave rise to certain transference-countertransference interactions that lend themselves to more adequate formulation in terms of the paranoid process (Meissner 1978b). This gives rise to a variety of theoretical and therapeutic considerations that bear on our understanding of the nature of hysteria and of the psychoanalytic process itself.
本文回顾了弗洛伊德《癔症病例分析片段》中引人入胜的病例资料以及后来发现的关于朵拉的更多资料。根据更当代的精神分析视角对这些分析资料进行了重新解读。这些困难可以从诊断问题、朵拉人格结构中固有的动力学以及最终在移情 - 反移情互动中所遇到的困难等方面来考虑,而这种互动在该病例的过早结束中起到了重要作用。朵拉远非仅仅是一个癔症神经症病例,但其病理不仅反映了偏执过程的动力学,还属于先前描述过的人格障碍边缘谱系范围(迈斯纳,1982b)。此外,她精神病理学的边缘性质引发了某些移情 - 反移情互动,从偏执过程的角度来看,这些互动更易于得到充分阐述(迈斯纳,1978b)。这引发了各种理论和治疗方面的思考,这些思考与我们对癔症本质和精神分析过程本身的理解相关。