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[外部现实对精神分析情境的重要性。对精神分析设置问题的贡献]

[Importance of external reality on the psychoanalytic situation. Contribution to the problem of psychoanalytical setting].

作者信息

Nerenz K

出版信息

Z Psychosom Med Psychoanal. 1977 Apr-Jun;23(2):152-69.

PMID:868312
Abstract

This paper deals with the influence of the "external" arrangement of the psychoanalytic setting on transference/counter-transference. It is based upon a comparison between the classical psychoanalytic situation and that of the analytically orientated treatment in the hospital. Its theme is that the theory behind the psychoanalytic technique contains no concept for handling a variable external reality. Continuing Leo Stones study of the psychoanalytic situation, in this paper the "immanent suggestion" of the structure of the external arrangement is more closely investigated and defined as a primary and general valence of transference. A particular emphasis of this study lies in the discussion of that specific level of information exchange between analyst and patient which is dependent on setting and which is stimulated by the "positional structure" of the external arrangement. Positional structure is defined and described in detail. Further the following questions are discussed: to which forms of communication does the psychoanalytic setting per se give most support; which forms of transference and counter--transference follow "logically" from the external arrangement and are consciously or unconsciously allowed by analyst and patient in the selection of the classical psychoanalytic setting? The paper reaches the conclusion that the setting of the psychoanalytic situation reproduces primarily pre-oedipal conflicts and early experiences of separation in the mother-child-relationship. In contrast, the face-to-face situation reproduces primarily pre-oedipal conflicts and early experiences of bring into focus a priori oedipal conflicts. Both analyst and patient are subject to the influence of the setting on the unconscious. This study suggests further investigations of those transference and counter-transference valences which are dependent on setting and to take into consideration their technical implications.

摘要

本文探讨精神分析环境的“外部”安排对移情/反移情的影响。它基于经典精神分析情境与医院中以分析为导向的治疗情境之间的比较。其主题是,精神分析技术背后的理论不包含处理可变外部现实的概念。继利奥·斯通对精神分析情境的研究之后,本文更深入地研究了外部安排结构的“内在暗示”,并将其定义为移情的一种主要和普遍效价。这项研究的一个特别重点在于讨论分析师与患者之间特定水平的信息交流,这种交流取决于环境,并受到外部安排的“位置结构”的刺激。文中对位置结构进行了详细的定义和描述。此外,还讨论了以下问题:精神分析环境本身最支持哪些沟通形式;从外部安排“逻辑上”会产生哪些移情和反移情形式,以及在选择经典精神分析环境时,分析师和患者有意识或无意识地允许了哪些形式?本文得出的结论是,精神分析情境的环境主要再现了前俄狄浦斯冲突以及母婴关系中早期的分离经历。相比之下,面对面情境主要再现前俄狄浦斯冲突,并将先验的俄狄浦斯冲突聚焦于早期经历。分析师和患者都受到环境对无意识的影响。这项研究建议进一步调查那些取决于环境的移情和反移情效价,并考虑它们的技术含义。

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