Meissner W W
Boston Psychoanalytic Institute, MA.
Am J Psychother. 1993 Spring;47(2):184-93. doi: 10.1176/appi.psychotherapy.1993.47.2.184.
My purpose here has been to provide no more than a brief overview of an approach to the therapy of borderline patients in the framework of a spectrum view of this complex pathology. While the perspective, generated within a tripartite framework of alliance, transference, and countertransference, allows the therapist a sense of orientation and direction in pursuing the therapeutic work with these patients, it can provide little more than guidelines, a theoretical context for thinking about the therapeutic vicissitudes that challenge and frustrate all of us. Within this perspective, I would emphasize the importance of flexibility. The complexity of therapeutic interactions and the wide scope of variation, seen not only in the borderline spectrum itself but in individual patients, calls for an unusual degree of flexibility and therapeutic adaptability to the immediate demands of the ongoing therapeutic interaction. If therapists, as they are being buffeted about by the storms and unsuspected undercurrents of the therapeutic ocean, can at least keep their bearings and know when they are being pulled out of their therapeutic role and function, their ability to deal with and help their patients will be immeasurably enhanced. I would hope that these few guidelines would provide a workable compass for the task.
我在此的目的仅仅是在对这种复杂病理的谱系观点框架内，对边缘型患者的治疗方法做一个简要概述。虽然在联盟、移情和反移情的三方框架内产生的这种观点，能让治疗师在对这些患者进行治疗工作时有方向感和指引，但它所能提供的不过是一些指导方针，一个思考挑战并困扰我们所有人的治疗变迁的理论背景。在这个观点中，我想强调灵活性的重要性。治疗互动的复杂性以及广泛的变异性，不仅在边缘谱系本身中可见，在个体患者中也可见，这就需要不同寻常程度的灵活性以及对正在进行的治疗互动的即时需求的治疗适应性。如果治疗师在治疗海洋的风暴和意想不到的暗流冲击下，至少能保持方向，知道自己何时被拉离治疗角色和功能，他们应对并帮助患者的能力将得到极大提高。我希望这几条指导方针能为这项任务提供一个可行的指南针。
