Segal H
Int J Psychoanal. 1993 Feb;74 ( Pt 1):55-61.
Freud's concept of the death instinct is often considered as a purely biological speculation, and very few psychoanalysts consider it useful in clinical work. Yet Freud was led to it by purely clinical problems. Klein used Freud's concept of the duality of instinct in her clinical work, but mainly she addressed herself to the conflict between love and hate of the object, considering hate as an expression of the deflected death instinct. I contend that the death instinct from the beginning is directed at both the perceived object and the perceiving self, resulting in such phenomena as pathological projective identification, described by Bion. The defences against the death instinct create vicious circles leading to severe pathology. I try to show in some clinical examples how analysing those vicious circles, and confronting the death instinct in the stable setting of analytic work, can lead to a mobilisation of the life forces in the patient.
弗洛伊德的死亡本能概念常被视为纯粹的生物学推测，很少有精神分析学家认为它在临床工作中有用。然而，弗洛伊德是由纯粹的临床问题而引出这一概念的。克莱因在她的临床工作中运用了弗洛伊德的本能二元性概念，但她主要关注的是对客体爱与恨之间的冲突，将恨视为被转移的死亡本能的一种表现。我认为，死亡本能从一开始就指向被感知的客体和感知着的自我，从而导致了诸如比昂所描述的病理性投射性认同等现象。对死亡本能的防御会形成恶性循环，进而导致严重的病理状态。我试图通过一些临床实例展示，分析这些恶性循环，并在稳定的分析工作情境中直面死亡本能，如何能够调动患者的生命力量。
