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An Illustration of the Irreducible Subjectivity in Interpreting Data—Clinical or Written: A Reply to Philip Bromberg 数据解读中不可约主观性的阐释——临床或书面:对菲利普·布朗伯格的回复
Pub Date : 2002-12-01 DOI: 10.1521/JAAP.30.4.621.24190
I. Hirsch
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引用次数: 1
Commentary on “Bion's Grid: A Tool for Transformation” by Marilyn Charles 对玛丽莲·查尔斯(Marilyn Charles)的《Bion的网格:转型的工具》的评论
Pub Date : 2002-09-01 DOI: 10.1521/JAAP.30.3.447.21974
J. Grotstein
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引用次数: 1
Commentary on “Jihad, McWorld and Enactment in the Postmodern Mental Health World” by Eric M. Plakun 《圣战、麦克世界和后现代心理健康世界的立法》评注,作者:埃里克·m·普拉肯
Pub Date : 2002-09-01 DOI: 10.1521/JAAP.30.3.355.21968
J. Bozzuto
Journal of The American Academy of Psychoanalysis, 30(3), 355–356, 2002 © 2002 The American Academy of Psychoanalysis In his article, “Jihad, McWorld and Enactment in the Postmodern Mental Health World,” Dr. Plakun adds an overall theoretical framework that is useful to us as mental health practioneers. As dynamic psychiatrists and psychoanalysts, we tend to practice in the “Jihad,” as opposed to the “McWorld.” Our tendency to focus on the world of one, to help that individual understand the inner and outer worlds that shape the patient’s existence, forces us to respect and cherish that practice. We all must understand the inner and outer experience of all our patients and as individuals must have a firm grasp of what is “happening” in the world around us. This article has special significance, especially after the tragedy of September 11, 2001. It gives a framework for us as therapists and for our patients. We all share that experience. The world we live in has changed. The theoretical discussion of a changing world affords us insights that could help us understand our patients and ourselves. However, the case discussion used to support his thesis, that if we become angry and hostile to managed care we compromise our treatment with our patients, is misguided. The case presentation is of a man who was seen three times a week for years. This was funded by his insurance company. This is not managed care as we know it. As a member of the American Psychiatric Association’s Managed Care Committee for the past five years, and as Chairman of the Connecticut Psychiatric Society’s Managed Care Committee, I have seen a different managed care, one that is directly responsible for the deaths of multiple patients. Mortality should not be an outcome of utilization review (Bozzuto, 2002). This patient, as presented by Plakun, was highly functional and received generous insurance benefits. To equate this form of “managed care” with the usual and customary is a mistake. The managed care I am familiar with is associated with the following:
《美国精神分析学会杂志》,30(3),355-356,2002年©2002 The American Academy of Psychoanalysis在他的文章《Jihad, McWorld and Enactment In The Postmodern Mental Health World》中,Plakun博士添加了一个整体的理论框架,对我们这些心理健康从业者很有用。作为充满活力的精神病学家和精神分析学家,我们倾向于在“圣战”中实践,而不是在“麦克世界”中实践。我们倾向于关注一个人的世界,帮助那个人理解塑造病人生存的内在和外在世界,这迫使我们尊重和珍惜这种做法。我们都必须了解我们所有病人的内心和外在体验,作为个体,我们必须牢牢把握我们周围的世界正在“发生”什么。这篇文章具有特殊的意义,特别是在2001年9月11日的悲剧之后。它为我们治疗师和我们的病人提供了一个框架。我们都有这样的经历。我们生活的世界已经改变了。对一个不断变化的世界的理论讨论为我们提供了能够帮助我们了解我们的病人和我们自己的见解。然而,用来支持他的论点的案例讨论是错误的,即如果我们对管理式医疗感到愤怒和敌意,我们就会损害我们对病人的治疗。病例介绍是一个男人,他每周被看三次,持续了很多年。这是由他的保险公司资助的。这不是我们所知道的管理式医疗。作为过去五年美国精神病学协会管理护理委员会的成员,以及康涅狄格州精神病学协会管理护理委员会的主席,我看到了一种不同的管理护理,它直接导致了多名患者的死亡。死亡率不应该是利用审查的结果(Bozzuto, 2002)。这个病人,正如Plakun所介绍的,功能很好,并获得了丰厚的保险福利。将这种形式的“管理式医疗”等同于常规和惯例是错误的。我所熟悉的管理式医疗与以下方面有关:
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引用次数: 0
Commentary on " Mortal Gifts: A Two-Part Essay on the Therapist' s Mortality" by Ellen Pinsky 评爱伦·平斯基的《凡人的礼物:治疗师的必死性两篇随笔
Pub Date : 2002-06-01 DOI: 10.1521/JAAP.30.2.205.21957
A. Silver
Dr. Pinsky has written eloquently about a subject that I feel psychoanalysis has avoided, the nature of what used to be called the “ real relationship” between analyst and analysand. Our myths of neutrality and abstinence converge in a myth of termination. We assert that our analytic patients will eventually resolve their perceptions of us based in their transferences and see us as merely guides who have done a job and who are no longer needed in their lives. On the other hand, there is evidence that transferential feelings about an analyst can resurface years later with minimal stimulation, and perhaps our analysands who do “ terminate” their work with us and go on with their lives carry internalizations of us with them that sustain them. Dr. Pinsky says that our field denies the mortality of the analyst; I suggest that we deny mortality by positing an imaginary end to the analytic relationship. In most cases, we can believe that the analytic relationship does end; most of our analytic patients do stop coming to see us. Even then, we deny a significant degree of the “ reality” of the relationship. How many of us are comfortable discussing our mourning for a patient we have worked with for years, over the course of which we came to an intimate knowledge of the patient. We cannot deny that our long-term patients also come to know much about us in the shared subjectivity that comes into existence in the matrix of transference and countertransference— and shared experience and affect. It is in the very special relationship between analyst and those analysands who become analysts that our myths most significantly break down. When we finish our training, many of us analysts have gone on to teach and train new candidates and to work with our “ former” analysts in various ways in our analytic societies and institutes and in other professional organizations. We cannot avoid encountering our analysts outside their offices, the claustra in which analysis occurs. I know of analysts who have written extensively about the work of their analysts, openly acknowledging the relationship and its effect on them and their own thinking; they seem truly “ professional children.” When I have asked about how this relationship is handled— professionally and so
平斯基博士雄辩地论述了一个我觉得精神分析学一直回避的主题,即过去被称为分析师与被分析者之间“真实关系”的本质。我们关于中立和节制的神话汇聚成一个关于终结的神话。我们断言,我们的分析型病人最终会根据他们的移情来解决他们对我们的看法,把我们仅仅看作是完成了工作的向导,他们的生活中不再需要我们。另一方面,有证据表明,对分析师的移情可以在几年后以最小的刺激重新出现,也许我们的分析师“终止”他们与我们的工作,继续他们的生活,他们携带着我们的内化,以维持他们。平斯基博士说,我们的领域否认精神分析师的死亡;我建议我们通过假设分析关系的假想终点来否认死亡。在大多数情况下,我们可以相信分析关系确实结束了;大多数精神分析病人都不再来找我们了。即便如此,我们还是在很大程度上否认了这种关系的“真实性”。我们中有多少人能够坦然地谈论我们对一个共事多年的病人的哀悼,在这个过程中,我们对病人有了深入的了解。我们不能否认,我们的长期病人也在移情和反移情的母体中产生的共同主体性中对我们有了更多的了解,以及共同的经验和情感。正是在分析师和那些成为分析师的分析师之间的特殊关系中,我们的神话最显著地被打破了。当我们完成培训后,我们中的许多分析师会继续教授和培训新的候选人,并在我们的分析协会和研究所以及其他专业组织中以各种方式与我们的“前任”分析师一起工作。我们无法避免在分析师办公室外遇到他们,这是进行分析的场所。我认识一些分析师,他们写了大量关于自己分析师工作的文章,公开承认这种关系及其对自己和自己思维的影响;他们似乎是真正的“职业儿童”。当我问他们是如何处理这段关系的——专业的
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引用次数: 0
Commentary on “Behind, Beneath, Above, and Beyond: The Historical Unconscious,” by Timothy J. Zeddies 对蒂莫西·j·泽迪斯的《背后、下面、上面和超越:历史的无意识》的评论
Pub Date : 2002-06-01 DOI: 10.1521/JAAP.30.2.233.21959
A. Horner
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引用次数: 1
FRONTLINE—Toward a New Name, Toward a New Mission 前线——走向一个新的名字,走向一个新的使命
Pub Date : 2002-03-01 DOI: 10.1521/jaap.30.1.1.21989
D. Ingram
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引用次数: 0
Commentary on "A Streetcar Named Desire — Psychoanalytic Perspectives" by Joseph Silvio 评论约瑟夫·西尔维奥的《欲望号街车——精神分析的视角》
Pub Date : 2002-03-01 DOI: 10.1521/JAAP.30.1.145.21981
M. Eckardt
Most psychoanalysts respond to dramatic literary productions with great fascination and enthusiasm. These novels, plays, or poems allow our knowledge to come alive in brilliant colors and seem to affirm our professional identity. Our imagination is stimulated and characters take on, in our minds, flesh, blood, recognition, a past, and a future. Ten analysts deeply stirred by a Williams play will create ten different versions of such come-to-life characters, but while these versions may show some kinship, they would be merely cousins. Never would they be identical. The vividness of our experience can easily blur the distinctions between artistic creation and reality, seducing us into interpretive flights. We may seek to justify these visions while this same vividness of experience blurs our awareness of the many caveats, the many facts and forces that determine a creative product. Art, no matter what its source material, is transmuted not only by the artist’ s creativity but also by the rules of the particular creative form. A play compresses time, space, and character. It selects. The play opens and ends. There is no tomorrow and no yesterday. We experience framed time and framed space and through our imaginative interaction with these devices we feel at ease with them and translate them into a meaningful semblance of life. Tennessee Williams was a fascinating person and one of the most outstanding playwrights of this last century. His topics depict powerful intricate interpersonal enmeshments, topics of great attraction to us psychoanalysts. Joseph Silvio, deeply impressed by the personality and the plays of Tennessee Williams, enhanced by further research, demonstrates this attraction, but also may stimulate us to wonder about the dangers of blurring the distinction between creation and reality. Williams’ s biographers agree in their emphasis on the importance of Williams’ s conflicted relationships to his father and his sister Rose. Dr. Silvio takes this further and suggests a theme of unconscious guilt and shame as motivational in Williams’ s writing A Streetcar Named Desire. This motivation, Dr. Silvio writes, arose in response to the successful reception of The Glass Menarerie. Success was experienced
大多数精神分析学家对戏剧文学作品有着极大的迷恋和热情。这些小说、戏剧或诗歌让我们的知识变得绚丽多彩,似乎肯定了我们的职业身份。我们的想象力被激发,人物在我们的脑海中呈现出血肉、认知、过去和未来。十位深受威廉姆斯戏剧影响的分析家将为这些栩栩如生的人物创造出十个不同版本,但尽管这些版本可能会表现出一些亲缘关系,但他们仅仅是表兄弟而已。它们永远不会完全相同。我们体验的生动性很容易模糊艺术创作与现实之间的区别,诱使我们进入解释性飞行。我们可能会试图为这些愿景辩护,而这种生动的体验模糊了我们对决定创意产品的许多警告、许多事实和力量的认识。艺术,不管它的来源是什么,不仅被艺术家的创造力所改变,而且被特定创作形式的规则所改变。戏剧压缩了时间、空间和人物。它选择。这出戏开场结束。没有明天也没有昨天。我们体验到被设定的时间和空间,通过我们与这些设备的想象互动,我们对它们感到自在,并将它们转化为有意义的生活表象。田纳西·威廉姆斯是一个迷人的人,也是上个世纪最杰出的剧作家之一。他的主题描绘了强大而复杂的人际关系,这些话题对我们精神分析学家极具吸引力。约瑟夫·西尔维奥对田纳西·威廉姆斯的个性和戏剧印象深刻,经过进一步的研究,证明了这种吸引力,但也可能激发我们思考模糊创作与现实之间的区别的危险。威廉姆斯的传记作者们都强调了威廉姆斯与父亲和妹妹罗斯之间矛盾关系的重要性。西尔维奥博士对此进行了进一步的研究,他认为威廉姆斯的作品《欲望号街车》的动机是无意识的内疚和羞耻。西尔维奥博士写道,这种动机是对“玻璃动物园”的成功接待的回应。成功是有经验的
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引用次数: 0
FRONTLINE--is there life after psychoanalysis? On retirement from clinical practice. 前线——精神分析之后还有生活吗?从临床实践退休。
Pub Date : 2002-01-01 DOI: 10.1521/jaap.30.3.325.21970
Althea J Horner
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引用次数: 1
Psychoanalytic peregrinations IV: what is phenomenology? 精神分析漫游4:什么是现象学?
Pub Date : 2002-01-01 DOI: 10.1521/jaap.30.4.673.24201
Richard D Chessick

This article proposes to clarify the use of phenomenology as a complementary approach to the psychoanalytic process. Because phenomenology is defined and used differently by many different authors, it is here specifically juxtaposed to the DSM-IV approach for purposes of comparison and elucidation. Phenomenology attempts to complement the objectivation and mathematization of reality by the sciences with allowing things to speak for themselves. This requires an attitude of acceptance of whatever appears from the patient in the consulting room without filtering it through judgements or presuppositions that we are all taught in our training. So, for example, such concepts as "empathic linkage," the "infectiousness" of anxiety, the "feel" of the schizophrenic ambiance as described by various authors come across more directly in an encounter based on the phenomenologic approach. This can be used in addition to DSM-IV and other approaches to gain new information. A brief review of how phenomenology arose and the use of it by certain well-known thinkers is presented.

本文建议澄清现象学作为精神分析过程的补充方法的使用。因为现象学被许多不同的作者不同地定义和使用,为了比较和阐明的目的,这里特别将其与DSM-IV方法并列。现象学试图通过允许事物为自己说话来补充科学对现实的客观化和数学化。这需要一种接受诊室里病人的一切的态度,而不是通过我们在培训中所学到的判断或预设来过滤它。例如,诸如“共情联系”、焦虑的“传染性”、精神分裂症氛围的“感觉”等概念,由不同作者在基于现象学方法的遭遇中更直接地描述。除了DSM-IV和其他获得新信息的方法之外,还可以使用这种方法。简要回顾现象学是如何产生的,以及某些著名思想家对现象学的使用。
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引用次数: 8
Mortal gifts: a two-part essay on the therapist's mortality. Part I: untimely loss. 凡人的礼物:一篇关于治疗师死亡的两部分文章。第一部分:不合时宜的损失。
Pub Date : 2002-01-01 DOI: 10.1521/JAAP.30.2.173.21949
E. Pinsky
The absence of theoretical and practical provisions for the patient whose therapist dies or becomes seriously ill reflects underlying problems regarding termination. Therapy is unique among human intimacies in that its goal is separation, a paradox that informs both the near-silence of early termination theory and the confusion in more recent writing. The therapist's emotional involvement must be understood through the therapeutic relationship as part of "mortal" life, that is, as a specialized category within ordinary human interactions. The profession has neglected the therapist's mortality, in figurative as well as literal senses. This neglect, a covert grandiosity, is the "Olympian Delusion." On one level, inadequate termination theory underlines failure to confront the therapist's mortality; more profoundly, failure to confront the therapist's mortality underlies deficiencies in termination theory. The mystique of the superhuman therapist can lead to a professional reticence that is less than fully human, abrogating the patient's right to a decent, human leave taking.
对于治疗师死亡或病情严重的患者,缺乏理论和实践规定反映了有关终止治疗的潜在问题。治疗在人类亲密关系中是独一无二的,因为它的目标是分离,这是一个悖论,既说明了早期终止理论的近乎沉默,也说明了最近写作中的困惑。治疗师的情感参与必须通过治疗关系来理解,作为“凡人”生活的一部分,也就是说,作为普通人类互动中的一个特殊类别。这个行业忽视了治疗师的死亡,无论是在比喻意义上还是在字面意义上。这种忽视,一种隐蔽的夸大,就是“奥林匹斯妄想”。在一个层面上,不充分的终止理论强调了面对治疗师死亡的失败;更深刻的是,未能直面治疗师的死亡是终止理论的缺陷。超人治疗师的神秘感可能会导致一种不完全人性的专业沉默,从而剥夺了患者体面地告别的权利。
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引用次数: 21
期刊
The Journal of the American Academy of Psychoanalysis
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