精神分析学家的秘密生活。

R. Chessick
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引用次数: 9

摘要

在这篇文章中,我讨论了哲学家们正式称之为次悖论的东西。潜意识状态是一种无意识状态,这种无意识状态会导致有意识的信念和有意识的体验。在精神分析领域,沙利文(1953)“恶意转换”就是一个简单的例子。我们都知道,那些无意识地经历了这种对人的信念转变的病人,往往表现得或多或少是公开的,这取决于他们隐藏得有多好,偏执、多疑、愤怒、不信任每个人,结果是他们有意识的行为和态度疏远了人们,把他们赶走了,结果是他们的经历有助于验证病人的信念。我们希望,精神分析学家更微妙。因为他们在很少有共识验证和公众监督的情况下工作,所以对“完整性妥协”或“部分私人图式”等综合症的诱惑非常强烈,导致对患者和分析师都有害的制定,并最终导致倦怠,正如我在本文中所描述的那样。因此,对于分析师来说,有必要仔细检查他们有意识的价值体系和信念,并对形成这些信念的次级因素进行持续的自我分析。对患者隐瞒这一点是不可能的,我们必须假设患者迟早会非常了解分析师。分析人士表现出刚才提到的综合症,这些综合症比普通的性格病理更微妙,比如形成了无处不在的自恋分析人士,如果他们不保持持续的自我审视,如果他们不密切关注病人的材料,他们甚至可能意识不到自己在这样做。这些材料——患者在分析过程中的梦、自由联想、行为和行为——通常不仅反映了移情,而且还构成了对分析师无意识和有意识价值系统的回应,而这些价值系统又基于使分析师成为他或她的人的亚心理因素。一些患者甚至可能引发危机或其他考验分析师价值体系的情况,迫使分析师在无法避免的即时决策中展示他或她的秘密自我。如果病人受到精神分析师秘密自我中的因素的惊吓或可怕的威胁,这一点尤其正确;在这种情况下,病人可能表现得像一个孩子,知道他或她的父亲或母亲在看似平静的外表下真的很生气,结果孩子故意把父母的愤怒表现出来,把它发泄出来,解决它,减少孩子的焦虑。我已经呼吁对不同文化中分析师对理论取向的选择进行系谱研究,在此我呼吁对每个分析师的理论取向中的次变量因素进行研究。每一种理论取向都是基于一种价值体系和一组欲望,这些欲望决定了精神分析师有意无意地希望患者在治疗过程中实现的目标,以便精神分析师感到他或她催化了一次“成功”的治疗。这是一个初步的公式。需要进一步的工作来区分我们今天通常使用这个概念的意义上的反移情,以及这些决定分析师的理论取向和价值体系的次转移因素,以及增加我们对这些因素的一个子类的关注,例如海德格尔已经确定的文化氛围和背景实践,对于分析师的自我以及患者的自我的形成至关重要。
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The secret life of the psychoanalyst.
In this article I have discussed what philosophers formally call subdoxastic about. Subdoxastic states are unconscious states about something that lead to conscious beliefs and conscious experiences. In the field of psychoanalysis Sullivan's (1953) "malevolent transformation" is a simple example of this. We all known how patients who have unconsciously undergone this kind of transformation of beliefs about people often appear more or less openly, depending on how well they are able to hide it, to be paranoid, suspicious, angry, and mistrustful of everybody, with the result that their conscious behavior and attitude alienate people and drive them away, resulting in experiences serving to verify the patients' beliefs. Psychoanalysts, we hope, are more subtle. Because they operate in a situation where there is little consensual validation and public scrutiny, the temptation to such syndromes as "compromise of integrity" or "partial private schemata" is very strong, leading to enactments that can be damaging to both patient and analyst and ultimately to burnout, as I have described it in this article. It is necessary, therefore, for analysts to keep a careful check on their conscious value systems and beliefs and to maintain continuing self-analysis for the subdoxastic factors that shape such beliefs. It is not possible to hide this from patients, and we must assume that sooner or later the patient gets to know the analyst pretty well. Analysts displaying the syndromes just mentioned, which are more subtle than ordinary character pathology such as that which forms the all-too-pervasive narcissistic analyst, may not even be aware they are doing so if they do not maintain a continual self-scrutiny, and if they do not pay close attention to their patients' material. This material--the patients' dreams, free associations, behavior, and enactments in the analytic process--often reflects not only transference but also constitutes a response to the analyst's unconscious and conscious value systems, which in turn are based on the subdoxastic factors that make the analyst the person that he or she is. Some patients may even precipitate crises or other situations that test the analyst's value system and force the analyst to display his or her secret self in immediate decisions that cannot be avoided. This is especially true if the patient is frightened or terribly threatened by factors in the secret self of the analyst; in this situation the patient may behave like a child who knows his or her father or mother is really very angry under a seemingly calm exterior, and as a result the child deliberately precipitates a display of that parental anger to get it out on the surface, get it over with, and reduce the child's anxiety. I have called for a genealogical study of analysts' choices of theoretical orientation in various cultures, and herein I am calling for a study of the subdoxastic factors in each individual analyst's theoretical orientation. Every theoretical orientation is based on a value system and a set of desires that determine the goals the analyst consciously or unconsciously wishes for the patient to actualize in the treatment process in order for the analyst to feel that he or she has catalyzed a "successful" treatment. This is a preliminary formulation. Further work is needed to distinguish between countertransference in the sense that we ordinarily use that concept today, and these subdoxastic factors determining the analyst's theoretical orientation and value systems, as well as to increase our focus on a subclass of these factors, the cultural ambience and background practices that Heidegger, for example, has identified as being crucial in the formation of the analyst's self as well as that of the patient.
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