Kantrowitz J L
Boston Psychoanalytic Institute.
J Am Psychoanal Assoc. 1993;41(4):1021-50. doi: 10.1177/000306519304100405.
Many impasses occur in treatment when the patient fears that analysis will repeat frightening or disappointing experiences. These stalemates result from the patient's conviction that the analyst has confirmed a preexisting belief that is central to the patient's primary conflict. Frequently, this belief involves an unacceptable or frightening self- or object representation. At these times, intense resistance and strong negative transference/countertransference reactions may develop. Impasses are differentiated from these strong negative reactions only by virtue of the fact that they remain unanalyzed. The factors that create these negative states can best be understood in instances where the potential impasse is resolved. When impasses persist, most often patients leave treatment. Under these circumstances, we can try retrospectively to understand what has gone wrong, but without the patient's confirmation, our conclusions must remain speculative. Four cases illustrate varying degrees of analysis and resolution of resistance and transference/countertransference binds.
当患者担心分析会重现令人恐惧或失望的经历时，治疗中就会出现许多僵局。这些僵局源于患者坚信分析师证实了一种预先存在的信念，而这种信念是患者主要冲突的核心。通常，这种信念涉及到一种不可接受或令人恐惧的自我或客体表征。在这些时候，可能会出现强烈的抵抗以及强烈的负性移情/反移情反应。僵局与这些强烈的负性反应的区别仅在于它们未得到分析。只有在潜在的僵局得到解决的情况下，才能最好地理解造成这些负性状态的因素。当僵局持续存在时，大多数情况下患者会离开治疗。在这种情况下，我们可以尝试通过回顾来理解哪里出了问题，但没有患者的确认，我们的结论必然仍是推测性的。四个案例说明了对抵抗以及移情/反移情束缚的不同程度的分析和解决。
