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关于给患者的制剂。

On formulations to patients.

作者信息

Israël P

出版信息

Int J Psychoanal. 1994 Dec;75 ( Pt 5-6):1051-67.

PMID:7713645
Abstract

For the author, the psychoanalytic clinical fact can only be an arbitrary fragment detached from the totality of the situation, which alone specifies it and which comprises the different forms of formulations that are proposed to patients. Using the difference established by Freud between what is and what is not analysable as a starting point, he distinguishes between two radically different analytic situations. To illustrate, he extracts, from the same cure, a 'fact' constituted of two moments; one 'this side of analysability, the other at its limits. He calls 'homogeneous' the neurotic moment in which transference and countertransference are similar in nature, and he calls 'heterogeneous' the 'limit' situation in which predictabüity is absent, and in which change, when it occurs, is one of divine surprise. The author advances an hypothesis on the factors at work in the changes that subsequently occurred, particularly in the case of the 'limit' situation, drawing from the therapeutic experience of the 'psychoanalytic psychodrama' and from the work of Jean Laplanche. A single generating principle would thus be involved, based on the action of the unconscious seduction contained in the unknowable, 'enigmatic', part of verbal and nonverbal messages, it grounds its transforming action in the following sequence: unconscious seduction, limited traumatic penetration, symbolisation, i.e. the emergence of meaning in the aftermath.

摘要

对于作者而言,精神分析临床事实只能是从情境总体中分离出来的任意片段,唯有情境总体才能明确该事实,且情境总体包含了向患者提出的不同形式的表述。他以弗洛伊德所确立的可分析与不可分析内容之间的差异为出发点,区分了两种截然不同的分析情境。为了说明这一点,他从同一治疗过程中提炼出一个由两个时刻构成的“事实”:一个处于“可分析范围之内”,另一个处于“可分析范围的极限处”。他将移情和反移情本质相似的神经症时刻称为“同质的”,而将缺乏可预测性、变化(若有变化)是一种神奇意外的“极限”情境称为“异质的”。作者基于“精神分析心理剧”的治疗经验以及让·拉普朗什的著作,对随后发生的变化,尤其是“极限”情境下的变化所涉及的因素提出了一个假设。这样一来,可能会涉及一个单一的生成原则,该原则基于言语和非言语信息中不可知的“神秘”部分所包含的无意识诱惑的作用,其转化作用基于以下顺序:无意识诱惑、有限的创伤性渗透、象征化,即在之后意义的浮现。

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