Stern D N, Sander L W, Nahum J P, Harrison A M, Lyons-Ruth K, Morgan A C, Bruschweiler-Stern N, Tronick E Z
Children's Hospital, Boston, MA 02115, USA.
Int J Psychoanal. 1998 Oct;79 ( Pt 5):903-21.
It is by now generally accepted that something more than interpretation is necessary to bring about therapeutic change. Using an approach based on recent studies of mother-infant interaction and non-linear dynamic systems and their relation to theories of mind, the authors propose that the something more resides in interactional intersubjective process that give rise to what they will call 'implicit relational knowing'. This relational procedural domain is intrapsychically distinct from the symbolic domain. In the analytic relationship it comprises intersubjective moments occurring between patient and analyst that can create new organisations in, or reorganise not only the relationship between the interactants, but more importantly the patient's implicit procedural knowledge, his ways of being with others. The distinct qualities and consequences of these moments (now moments, 'moments of meeting') are modelled and discussed in terms of a sequencing process that they call moving along. Conceptions of the shared implicit relationship, transference and countertransference are discussed within the parameters of this perspective, which is distinguished from other relational theories and self-psychology. In sum, powerful therapeutic action occurs within implicit relational knowledge. They propose that much of what is observed to be lasting therapeutic effect results from such changes in this intersubjective relational domain.
如今人们普遍认为，要实现治疗性改变，仅靠解释是不够的。基于近期对母婴互动、非线性动力系统及其与心理理论关系的研究，作者们提出，这“更多的东西”存在于互动主体间过程中，这种过程会产生他们所谓的“隐性关系认知”。这个关系性程序领域在心理内部与符号领域不同。在分析关系中，它包括患者与分析师之间发生的主体间时刻，这些时刻不仅能在互动者之间创造新的组织，或重组他们之间的关系，更重要的是能改变患者的隐性程序知识，即他与他人相处的方式。这些时刻（现在称为“相遇时刻”）的独特品质和后果，根据他们所称的“向前推进”的序列过程进行了建模和讨论。在这一视角的框架内，讨论了共享隐性关系、移情和反移情的概念，该视角与其他关系理论和自体心理学有所不同。总之，强大的治疗作用发生在隐性关系知识之中。他们提出，观察到的许多持久治疗效果都源于这个主体间关系领域的此类变化。
