Keinanen M
Health Care Centre for Students, Turku, Finland.
Br J Med Psychol. 1997 Dec;70(4):325-38. doi: 10.1111/j.2044-8341.1997.tb01910.x.
This study presents the clinical theory and psychotherapeutic applications of symbolic function in psychoanalytic psychotherapy. The three modes of symbolic function (indexical, iconic and conventional symbolic) form the representations of the self and the object and further the unconscious fantasy, which includes the affective bond between these representations. During his/her development the child absorbs from the mother a new ego capacity (by means of identification), which I call the reflective-integration capacity. Then, the ego of the child has two crucial functions: the fantasy world adopted through the symbolic function and the reflective-integrative capacity. In psychoanalytic psychotherapy our aim is to study the fantasy world of the patient by means of the reflective-integrative capacity, or if this capacity is missing or weak, to promote its development. During psychoanalytic psychotherapy a shared area of reflection-integration is formed, in which the healing changes occur. These healing changes include mainly the formation, consolidation and enrichment of the symbolic function of the patient. The consolidation of symbolic function and the capacity to move within the different modes of symbolic function occur in the area of psychology in which there are incapabilities and/or conflicts (e.g. separation anxiety) in the patient. Clinical case material is presented to illustrate these phenomena.
本研究介绍了精神分析心理治疗中象征功能的临床理论及心理治疗应用。象征功能的三种模式（索引性、象似性和规约性象征）构成了自我和客体的表征，进而构成了无意识幻想，其中包括这些表征之间的情感联结。在其发展过程中，儿童从母亲那里吸收了一种新的自我能力（通过认同），我将其称为反思整合能力。然后，儿童的自我有两个关键功能：通过象征功能采用的幻想世界和反思整合能力。在精神分析心理治疗中，我们的目标是通过反思整合能力来研究患者的幻想世界，或者如果这种能力缺失或薄弱，就促进其发展。在精神分析心理治疗过程中，会形成一个共享的反思整合区域，治疗性的改变就在这个区域发生。这些治疗性改变主要包括患者象征功能的形成、巩固和丰富。象征功能的巩固以及在不同象征功能模式之间转换的能力，发生在患者存在无能和/或冲突（如分离焦虑）的心理领域。文中呈现了临床案例材料以阐释这些现象。
