Dewald P A
St. Louis University School of Medicine, MO.
Am J Psychother. 1994 Spring;48(2):221-30. doi: 10.1176/appi.psychotherapy.1994.48.2.221.
Multiple external life events and vicissitudes can impinge upon the traditional privacy and isolation of the usual psychotherapy situation and relationship. Among these are major illness and disability in the therapist, which will activate conscious and unconscious responses in both patient and therapist. If worked with and well handled by the participants, such events may stimulate therapeutic growth and working through of multiple issues related to illness, separation, death, anxiety, and fantasies of omnipotence and idealization. However, multiple factors in both patient and therapist may combine to foster avoidance of the conflicts that have been activated. To the extent that countertransference responses in the therapist interfere with his/her ability to bring conscious attention to these issues, a potentially valuable therapeutic opportunity may be lost. It is important for therapists to therapists to anticipate such situations, and to make use of colleague consultation to assist in managing them.
多种外部生活事件和变迁可能会冲击传统心理治疗情境与关系中的隐私性和隔离性。其中包括治疗师身患重病和残疾，这会引发患者和治疗师有意识和无意识的反应。如果参与者能够应对并妥善处理此类事件，这些事件可能会促进治疗的进展，并解决与疾病、分离、死亡、焦虑以及全能和理想化幻想相关的多个问题。然而，患者和治疗师的多种因素可能共同导致对已被激活的冲突的回避。如果治疗师的反移情反应干扰了其将有意识的注意力带到这些问题上的能力，那么一个潜在的宝贵治疗机会可能就会丧失。治疗师提前预见到此类情况，并利用同事间的咨询来协助处理这些情况，这很重要。
