Jones E E
University of California at Berkeley 94720, USA.
Int J Psychoanal. 1997 Dec;78 ( Pt 6):1135-50.
The dialectic in psychoanalysis between theories about the mutative effects of interpretation and psychological knowledge and those concerning the effects of interpersonal interaction constitutes an important tension for approaches to psychoanalytic technique. This essay briefly summarises the thinking around these alternative conceptualisations of therapeutic action, and introduces a new empirically derived model, that of 'repetitive interaction structure', which attempts to bridge therapeutic action by insight and by relationship. Interaction structure is a way of formulating those aspects of the analytic process that have come to be termed intersubjectivity, transference-countertransference enactments and role responsiveness. The concept operationalises important aspects of interpersonal interaction, and can help specify the two-person patterns that emerge in an analysis. Patient and analyst interact in repetitive ways; these patterns of interaction, which are slow to change, probably reflect the psychological structure of both patient and analyst, whether psychic structure is conceptualised in terms of object-representations or compromise formations and impulse-defence configurations. Therapeutic action is located in the experience, recognition and understanding by patient and analyst of these repetitive interactions. Interaction structures stress the importance of the intrapsychic as a basis for what becomes manifest in the interactive field. Clinical illustrations from a psychoanalysis are provided, and research on repetitive interaction structures is described.
精神分析中，关于阐释的变化效果及心理知识的理论与关于人际互动效果的理论之间的辩证关系，构成了精神分析技术方法的一个重要张力。本文简要总结了围绕治疗作用的这些不同概念化方式的思考，并介绍了一种新的基于实证得出的模型，即“重复性互动结构”模型，该模型试图通过洞察和关系来搭建治疗作用的桥梁。互动结构是一种表述分析过程中那些已被称为主体间性、移情 - 反移情表现及角色反应性等方面的方式。这一概念将人际互动的重要方面加以操作化，有助于明确分析中出现的二人模式。患者与分析师以重复的方式互动；这些互动模式变化缓慢，可能反映了患者和分析师双方的心理结构，无论心理结构是依据客体表征、妥协形成还是冲动 - 防御构型来概念化的。治疗作用存在于患者和分析师对这些重复性互动的体验、识别和理解之中。互动结构强调心理内部因素作为互动场域中显现内容之基础的重要性。文中提供了一个精神分析的临床例证，并描述了关于重复性互动结构的研究。
