温尼科特:反移情中的恨Hate in the Countertransference[1947]IN THIS PAPER I wish to examine one aspect of the whole subject of ambivalence, namely, hate in the countertransference. I believe that the task of the analyst (call him a research analyst) who undertakes the analysis of a psychotic is seriously weighted by this phenomenon, and that analysis of psychotics becomes impossible unless the analyst's own hate is extremely well sorted-out and conscious. This is tantamount to saying that an analyst needs to be himself analysed, but it also asserts that the analysis of a psychotic is irksome as compared with that of a neurotic, and inherently so.在这篇文章里,我希望考查关于矛盾情感这整个主题的其中一个方面,即:反移情①(Countertransference)中的恨。
我相信,这一现象加重了从事精神病人分析工作的分析师(称他为研究分析师)的任务,并且除非这些分析师意识到自己的恨是被处理得非常好,否则他的分析工作是不可能进行的。
这相当于说,分析师自己需要被分析,但同时也宣称了,相比于神经症,精神病人天然地令人生厌。
Apart from psycho-analytic treatment, the management of a psychotic is bound to be irksome. From time to time I have made acutely critical remarks about the modern trends in psychiatry, with the too easy electric shocks and thetoo drastic leucotomies. (Winnicott, 1947, 1949.) Because of these criticisms that I have expressed I would like to be foremost in recognition of the extreme difficulty inherent in the task of the psychiatrist, and of themental nurse in particular. Insane patients must always be a heavy emotional burden on those who care for them. One can forgive those engaged in this work if they do awful things. This does not mean, however, that we have to accept whatever is done by psychiatrists and neuro-surgeons as sound according to principles of science.除去精神分析治疗外,对精神病人的管理②(management)也注定是令人生厌的。
关于现代精神病学过于容易(使用)的电休克治疗和过于极端的前额脑白质切除手术的发展趋势,我也时常会有尖锐的批评。
(温尼科特,1947,1949)因为这些批评,我更愿意最先承认精神病医师,特别是精神科护士的工作属性本来就是极端的艰难的。
疯癫的病人总是给那些照顾他们的人带来沉重的情感负担。
我们(甚至)可以原谅那些致力于此工作的人(可能)做出的(任何)可怕的事情。
但这并不意味着我们必须接受精神病专家和神经外科医生所有听起来像是有科学依据的所作所为。
①译者注:依照弗洛伊德的德文原意,transference应译为转移, 同理countertransference应译为反转移。
这里译作反移情仅仅是为了方便国内读者理解,遵从国内心理学界的普(cuo)遍(wu)译法。
下同。
②译者注:管理一词是温尼克特的特有术语,一般用于在精神病治疗环境中,对病人的护理上。
同样适用于在儿童和反社会倾向的青少年的治疗中,分析师把管理作为一种抱持环境的使用。
Therefore although what follows is about psycho-analysis, it really has value to the psychiatrist, even to one whose work does not in any way take him into the analytic type of relationship to patients.因此,尽管下文是有关精神分析治疗的,它实际上对精神病医生是有价值的,即使是对那些其工作中,无论如何也不可能与病人建立起与分析类型的关系的精神科医师们也是如此。
To help the general psychiatrist the psycho-analyst must not only study forhim the primitive stages of the emotional development of the ill individual, but also must study the nature of the emotional burden which the psychiatrist bears in doing his work. What we as analysts call the countertransferenceneeds to be understood by the psychiatrist too. However much he loves his patients he cannot avoid hating them and fearing them, and the better heknows this the less will hate and fear be the motives determining what hedoes to his patients.为了能促进到常规的精神科医生,精神分析师不但必须替他(精神科医生)研究病人的个体情感发展原初阶段,也要研究精神病医生在工作中肩负的情感负担的本质。
精神病医生也要理解我们分析师所谓的反移情。
不论他有多爱他的病人们,他都不能避免恨他们和惧怕他们,越了解这些,恨与恐惧就越不会成为他对待病人的决定性动机。
One could classify countertransference phenomena thus:我们可以把反移情现象做如下分类:1. Abnormality in countertransference feelings, and set relationships and identifications that are under repression in the analyst. The comment on this is that the analyst needs more analysis, and we believe this is less of an issue among psycho-analysts than among psychotherapists in general.1、反移情感受中的异常,让(分析中)的关系与认同被分析师所压抑。
这意味着分析师需要更多的个人分析,我们相信,相比于一般的心理治疗师,这在精神分析师那里不是一个大问题。
2. The identifications and tendencies belonging to an analyst's personal experiences and personal development which provide the positive setting forhis analytic work and make his work different in quality from that of anyother analyst.2、出于分析师个人经历与发展的认同与行为倾向,这种认同与倾向为分析师的分析工作设置并使其工作有别于其他分析师。
3. From these two I distinguish the truly objective countertransference, orif this is difficult, the analyst's love and hate in reaction to the actual personality and behaviour of the patient, based on objective observation.3、从以上两点,我辨识出真正的客观的反移情,或者说,(尽管是很困难的),基于客观观察的分析师对病人的实际人格和行为所作出的爱与恨的反应。
I suggest that if an analyst is to analyse psychotics or antisocials he mustbe able to be so thoroughly aware of the countertransference that he can sort out and study his objective reactions to the patient. These will include hate. Countertransference phenomena will at times be the important things in the analysis.我建议若一个分析师要分析精神病患者或者是反社会型人格患者的话,他必须要有能力完全意识到自己的反移情才行,以便他能整理并且研究他对病人的客观反应。