Yarom N
Int J Psychoanal. 1997 Dec;78 ( Pt 6):1119-34.
The psychoanalytic literature of the last decades on hysteria is reviewed and its overemphasis on pre-oedipal concepts is demonstrated. A matrix of hysteria, which is a contemporary re-reading of Freud's basic conceptualisation, is presented. It integrates oedipal concepts with others borrowed from object-relations theories, self-psychology and the intersubjective approach. In this way the focus on the issues of gender and sexuality in hysteria is continued, without the original roots being lost. The focus is on the content, and the structure may vary. Within the first axis of the matrix, the author proposes to identify the conflict of gender and sexual identity as the unconscious and conscious solutions that a hysteric adopts to the question 'am I a man or a woman?' In an attempt to identify hysteria's particular psychic dynamics, a range of concepts is suggested. Repression and conversion are incorporated to constitute the second and third axes of the matrix. Repression, denial, dissociation and fantasy are shown to be employed in the context of gender and sexuality and along a continuum of personality structures. In this context, the turning to the body, the conversion, still acts as an effective language, to which we have to listen.
回顾了过去几十年精神分析文献中关于癔症的内容,并指出其对前俄狄浦斯概念的过度强调。提出了一个癔症矩阵,这是对弗洛伊德基本概念的当代重新解读。它将俄狄浦斯概念与从客体关系理论、自体心理学和主体间性方法中借鉴的其他概念整合在一起。通过这种方式,在不失去其根源的情况下,继续关注癔症中性别和性取向的问题。重点在于内容,结构可能会有所不同。在矩阵的第一个轴线上,作者建议将性别和性身份冲突确定为癔症患者对“我是男人还是女人?”这个问题所采取的无意识和有意识的解决方案。为了试图确定癔症独特的心理动力学,提出了一系列概念。压抑和转换被纳入构成矩阵的第二和第三个轴。压抑、否认、解离和幻想被证明在性别和性取向的背景下以及沿着人格结构的连续体中发挥作用。在这种背景下,转向身体,即转换,仍然是一种有效的语言,我们必须倾听。