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成人精神分析治疗的结束阶段与精神分析的目标:“探寻关于自我的真相”

The closing phase of the psychoanalytic treatment of adults and the goals of psychoanalysis 'The search for truth about one's self'.

作者信息

Grinberg L

出版信息

Int J Psychoanal. 1980;61(1):25-37.

PMID:7364535
Abstract

The purpose of this paper is to pose doubts and queries about the nature and objectives regarding our work. I am not contributing specific replies to these questions, but rather some ideas so that we may rethink what we are doing and why we are doing it. In the first place, I state the doubts which I have regarding the classical criteria and goals as being the expression of the essence of psychoanalysis. Perhaps we do not realize that we 'saturate' the development of the psychoanalytic relationship with the aprioristic idea of 'leading' our patients to achieve the therapeutic goals we have already fixed for them from the very beginning. We should question if these 'therapeutic objectives' correspond to what should be our 'psychoanalytic point of view', with its search for the truth about oneself regarding our goals. Psychoanalysis is a science with specific and singular characteristics which should not be confused or, indeed equated with medical science or any other natural science. In the second place, I would like to draw attention to the fact that when considering these criteria, the accent has been almost exclusively put on the personality of the analysand. I believe that it is important to take into account also that which concerns the personality of the analyst with his neurotic and/or psychotic remnant and the role which his counter-transference or his projective counter-identification plays and which can disturb his creative work. But I wish to stress, especially, the importance contained in the analyst-analysand interaction in order to understand better the vicissitudes of all which happens in the closing phase of analysis. The achievement of insight is one of the most important goals of psychoanalysis. The concept of insight is related to that knowledge which stems from the experiences of deep change and mental growth helping the patient to get near to 'being his own truth', with the need to accept the corresponding responsibility. It is important to differentiate this authentic insight, so close to the getting near to the truth, from all other types of intellectual knowledge or 'pseudo-insight' which tend towards the opposite, that is, the avoidance of the truth. Finally, I discuss the disadvantages caused, in my opinion, from bearing in mind too much the idea of 'termination' during the carrying out of our task within the analytic situation in the closing phase of analysis. The predominance of the aprioristic thought that the analysis is 'on the point of' or 'should' end would obstruct the ability to detect what is authentically new in the material and what is most feared by the patient, such as getting closer to the search for truth about himself.

摘要

本文旨在对我们工作的性质和目标提出质疑。我并非要对这些问题给出具体答案,而是提供一些想法,以便我们重新思考我们正在做的事情以及为何这样做。首先,我对将经典标准和目标视为精神分析本质的表达表示怀疑。或许我们没有意识到,我们用“引导”患者实现我们从一开始就为他们设定的治疗目标这一先验观念,“充斥”了精神分析关系的发展过程。我们应当质疑这些“治疗目标”是否符合我们基于对自身目标的自我认知所应秉持的“精神分析视角”。精神分析是一门具有独特特征的科学,不应与医学科学或任何其他自然科学相混淆或等同。其次,我想提请注意这样一个事实,即在考虑这些标准时,几乎完全把重点放在了受分析者的个性上。我认为同样重要的是,要考虑到分析师自身的神经质和/或精神病性残余对其个性的影响,以及他的反移情或投射性反认同所起的作用,这些可能会干扰他的创造性工作。但我尤其想强调分析师与受分析者互动的重要性,以便更好地理解分析结束阶段所发生的一切的变迁。领悟的达成是精神分析最重要的目标之一。领悟的概念与源自深刻改变和心理成长经历的那种认知相关,它帮助患者接近“成为他自己的真相”,同时需要承担相应的责任。将这种与接近真相紧密相关的真实领悟,与所有其他类型的知识或“伪领悟”区分开来很重要,后者往往走向相反的方向,即回避真相。最后,我讨论了在分析结束阶段的分析情境中执行任务时,过于看重“结束”观念所带来的弊端。那种认为分析“即将”或“应该”结束的先验思想占主导,会阻碍我们察觉材料中真正新颖的东西以及患者最害怕的东西,比如接近对自身真相的探寻。

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