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精神分析师的欲望和自性阻抗问题 (The Analysts Desire and the Problem of Narcissistic Resistances)

分析师不可避免地会欲求着与病人的特别体验,这常常导向自性基础上的阻抗。这样的欲望形式是值得思考的。 可以检视一下这五种假设: 1 分析师情不自禁地会有欲望,并想要被分析者认可这些欲望; 2 这些欲望经常标识了分析师的理论信仰和技术性干预; 3 自性的欲望及其影响在分析实践中是普遍存在的; 4 病人经常在留心分析师的各种目的;5 病人常常希望分析师将他的欲望放在一边来倾听自己,以使病人能够深入到自己的利益中去。拉康"二元关系"的概念是这一讨论的核心。新克莱因派关于自性阻抗的位置也将被探究,而"分析性第三者"的概念也成为了这一问题的一个潜在解决方式。由此扩展的一个案例阐明了这些主要观点。

Masochism and its Rhythm

Over five years, from 1919 to 1924, Freud dealt with masochism in three texts written in close proximity: "A Child Is Being Beaten," Beyond the Pleasure Principle, and "The Economic Problem of Masochism." Initially Freud explains masochism as incestuous fixation on the father and regression to pregenital, sadistic ways of loving. Subsequently he considers it primarily as subservient to the death drive. This paper starts from an idea present in two of the three texts, but not developed by Freud, in which he refers to the role that the "qualitative" element of rhythm could play in the occurrence of pleasure in masochism. By means of this element traumatic aspects of the primary relationship with the object could be stored as fantasies in the body. In any staged masochistic fantasies of being beaten or in masochistic perversion, the pleasure of pain would lie in the attempt to "dream" the trauma not only in the imagination but also, "aesthetically," in the body.

Changes in Self-Representations Following Psychoanalytic Psychotherapy for Young Adults: A Comparative Typology

Changes in dynamic psychological structures are often a treatment goal in psychotherapy. The present study aimed at creating a typology of self-representations among young women and men in psychoanalytic psychotherapy, to study longitudinal changes in self-representations, and to compare self-representations in the clinical sample with those of a nonclinical group. Twenty-five women and sixteen men were interviewed according to Blatt’s Object Relations Inventory pretreatment, at termination, and at a 1.5-year follow-up. In the comparison group, eleven women and nine men were interviewed at baseline, 1.5 years, and three years later. Typologies of the 123 self-descriptions in the clinical group and 60 in the nonclinical group were constructed by means of ideal-type analysis for men and women separately. Clusters of self-representations could be depicted on a two-dimensional matrix with the axes Relatedness-Self-definition and Integration-Nonintegration. In most cases, the self-descriptions changed over time in terms of belonging to different ideal-type clusters. In the clinical group, there was a movement toward increased integration in self-representations, but above all toward a better balance between relatedness and self-definition. The changes continued after termination, paralleled by reduced symptoms, improved functioning, and higher developmental levels of representations. No corresponding tendency could be observed in the nonclinical group.

Obsessionality: Modulating the Encounter with Emotional Truth and the Aesthetic Object

Experiences with autistic and primitive mental states have significant implications for our understanding of obsessionality. Consequently, obsessionality is seen as an attempt at a massive simplification of experience, in order to deal with the pain inherent in the encounter with intense emotional experience and with the separateness of an enigmatic object that eludes one’s omnipotent control. Moreover, early loss and a precocious awareness of separateness often play roles in the withdrawal to obsessional thinking and verbosity, and to an illusion of omnipotent control of the object. Interpretations focusing on conflicting desires, or linking repressed and displaced parts of the personality with the defenses against them, do not reach these patients in a way that facilitates psychic change. An alternative approach, it is suggested, is to work at primitive, nonsymbolic levels of mental functioning, where experience cannot be verbally communicated and dynamically interpreted, but must first be lived in the here and now of the analysis. This is illustrated through the analysis of a person trying to cope with the experience of early loss by deadening emotion and finding shelter in obsessionality.

Finding Control Cases and Maintaining Immersion: Challenges and Opportunities

Given that surveys, as well as frequent observations by institute faculty, indicate that many candidates have difficulty finding control cases and maintaining immersion and that many graduate analysts face similar challenges, it would seem that psychoanalytic training does not prepare candidates adequately for finding patients and practicing analysis while in training and, for many, after they have graduated. Although external challenges are formidable, it is by identifying and making use of internal challenges to finding cases that candidates can develop an analytic mind: the identity, approach, and skills necessary not only to graduate but to have the choice to practice clinical psychoanalysis post-graduation. Some of the internal challenges and their manifestations in different phases of initiating analysis (referrals, initial consultation, recommendation) are discussed and two detailed examples are offered to illustrate the productive use of candidates’ countertransferences in finding cases and maintaining immersion. Finally, recommendations for institutional solutions are provided.

Erratum

McWilliams, N. (2016). Training Analysts at William Alanson White. Journal of the American Psychoanalytic Association 64(4):NP12. (Original doi: 10.1177/0003065116667506)

精神分析师的欲望和自性阻抗问题 (The Analysts Desire and the Problem of Narcissistic Resistances)

分析师不可避免地会欲求着与病人的特别体验,这常常导向自性基础上的阻抗。这样的欲望形式是值得思考的。 可以检视一下这五种假设: 1 分析师情不自禁地会有欲望,并想要被分析者认可这些欲望; 2 这些欲望经常标识了分析师的理论信仰和技术性干预; 3 自性的欲望及其影响在分析实践中是普遍存在的; 4 病人经常在留心分析师的各种目的;5 病人常常希望分析师将他的欲望放在一边来倾听自己,以使病人能够深入到自己的利益中去。拉康"二元关系"的概念是这一讨论的核心。新克莱因派关于自性阻抗的位置也将被探究,而"分析性第三者"的概念也成为了这一问题的一个潜在解决方式。由此扩展的一个案例阐明了这些主要观点。

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