Spence D P
Dept. of Psychiatry, Robert Wood Johnson Medical School, Piscataway, New Jersey 08834-5635.
Int J Psychoanal. 1994 Dec;75 ( Pt 5-6):915-25.
Psychoanalytic facts are almost always capable of being put into words and they include things the patient tells us, things we tell the patient, and things we tell our colleagues. They include various combinations of observation and theory, evidence and hearsay, dream and reality. In contrast to the more usual facts of the everyday world, a psychoanalytic fact is almost never based on pure observation and it is partly for this reason that a dispute over facts frequently conceals a dispute over theory. It also follows that bare facts are almost never presented by themselves; when they are presented (as in a publication), they are almost never quite the same as when experienced in the session. Some meanings are lost in publication; others are inadvertently added by the reader, as he tries to fill in the gaps of a vague report. 'Clinical' facts (which have just been described) should be distinguished from 'contextual' facts, which colour the way we hear the patient's reports, and from 'latent' facts, which cannot be detected by the analyst in the session but must be measured by other techniques. Because the proportion of theory to observation is probably greater in clinical facts than in latent facts, the latter may provide more reliable measures of a clinical happening. Greater reliance on latent facts may also reduce our dependence on metaphor and smooth the transition from clinical moment to published account.
精神分析事实几乎总是能够用语言表述出来，它们包括患者告诉我们的事情、我们告诉患者的事情以及我们告诉同事的事情。它们包括观察与理论、证据与传闻、梦境与现实的各种组合。与日常世界中更为常见的事实不同，精神分析事实几乎从不基于纯粹的观察，部分正是由于这个原因，关于事实的争论常常掩盖了关于理论的争论。由此还可以推断，单纯的事实几乎从不单独呈现；当它们被呈现时（如在出版物中），它们几乎与在治疗过程中所经历的事实不完全相同。有些意义在出版过程中丢失了；而其他意义则是读者在试图填补模糊报告的空白时无意中添加的。“临床”事实（刚刚描述过的）应与“背景”事实区分开来，后者会影响我们听取患者报告的方式，还应与“潜在”事实区分开来，后者在治疗过程中分析师无法察觉，但必须通过其他技术来衡量。由于临床事实中理论与观察的比例可能比潜在事实中更大，所以后者可能为临床事件提供更可靠的衡量标准。更多地依赖潜在事实也可能减少我们对隐喻的依赖，并使从临床时刻到出版报告的过渡更加顺畅。
