温尼科特-反移情中的恨.doc

温尼科特：反移情中的恨Hate in the Countertransference1947IN 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 analysts 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(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 the too 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 the mental 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(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。 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。 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 for him 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 countertransference needs to be understood by the psychiatrist too. However much he loves his patients he cannot avoid hating them and fearing them, and the better he knows this the less will hate and fear be the motives determining what he does 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 analysts personal experiences and personal development which provide the positive setting for his analytic work and make his work different in quality from that of any other 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, or if this is difficult, the analysts 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 must be 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。这其中也包括恨。在精神分析中，反移情现象有时将成为一件很重要的事情。I wish to suggest that the patient can only appreciate in the analyst what he himself is capable of feeling. In the matter of motive: the obsessional will tend to be thinking of the analyst as doing his work in a futile obsessional way. A hypo-manic patient who is incapable of being depressed, except in a severe mood swing, and in whose emotional development the depressive position has not been securely won, who cannot feel guilt in a deep way, or a sense of concern or responsibility, is unable to see the analysts work as an attempt on the part of the analyst to make reparation in respect of his own (the analysts) guilt feelings. A neurotic patient tends to see the analyst as ambivalent towards the patient, and to expect the analyst to show a splitting of love and hate; this patient, when in luck, gets the love, because someone else is getting the analysts hate. Would it not follow that if a psychotic is in a coincident love-hate state of feeling he experiences a deep conviction that the analyst is also only capable of the same crude and dangerous state of coincident love-hate relationship? Should the analyst show love, he will surely at the same moment kill the patient.我认为，病人仅仅能够欣赏分析师身上那些他自己能感觉到的东西。就动机而言，强迫症患者倾向于认为分析师是用一种无用的、强迫的方式在工作。轻躁狂的患者不会感到抑郁，除非是在剧烈的情绪转换状态下，对于这些在情感发展中抑郁状态尚未占得上风，无法感受深刻的内疚感，也无法感受关切与责任感的病人来说，他们不会把分析师的工作看做是分析师修复他自身内疚感的一种尝试。一个神经症患者倾向于认为分析师对患者持有矛盾(的态度)，并希望分析师展现出一种分裂的爱与恨；这个病人，幸运的时候会得到爱，因为其他某些人得到的是分析师的恨。依次类推，如果一个精神病患陷入到一种“爱恨并存”的感觉中，他是不是会深深地确信，分析师也只能同样陷入一种粗鲁而危险的爱恨并存的关系状态当中呢？一旦分析师表现出爱，他无疑将同时杀死病人。This coincidence of love and hate is something that characteristically recurs in the analysis of psychotics, giving rise to problems of management which can easily take the analyst beyond his resources. This coincidence of love and hate to which I am referring is something distinct from the aggressive component complicating the primitive love impulse, and implies that in the history of the patient there was an environmental failure at the time of the first objectfinding instinctual impulses.在对精神病患者分析过程中，这种爱恨同时存在是特征性地反复出现的，它给分析师带来超乎他对病人的管理（management）的问题。我指的爱恨并存，是一种与爱的原始冲动并发的侵略性成分所截然不同的东西，它意味着在病人经历里，第一次寻找客体的本能冲动的时侯存在着环境的匮乏。If the analyst is going to have crude feelings imputed to him he is best forewarned and so forearmed, for he must tolerate being placed in that position. Above all he must not deny hate that really exists in himself. Hate that is justified in the present setting has to be sorted out and kept in storage and available for eventual interpretation.如果分析师将要承受归罪于他的粗鲁的感情的话，他最好做好有备无患，因为他必须忍受被放置在这个位置上。首先，他绝对不能否认他自身真实存有的恨。在当前场景下合乎情理的恨，需要被区分并且保存下来，留待最终的解释。If we are to become able to be the analysts of psychotic patients we must have reached down to very primitive things in ourselves, and this is but another example of the fact that the answer to many obscure problems of psycho-analytic practice lies in further analysis of the analyst. (Psycho-analytic research is perhaps always to some extent an attempt on the part of an analyst to carry the work of his own analysis further than the point to which his own analyst could get him.)如果我们将要成为精神病患的分析师的话，我们必须能深入接触到我们自身非常原始的东西，这再次证明，许多精神分析实践中的晦涩问题的关键答案就在于分析师自身的更多的分析。（精神分析的研究或许总是在某种程度上，是分析师的一种尝试，努力使他自己的分析工作超越其分析师使他所能领悟到的程度）A main task of the analyst of any patient is to maintain objectivity in regard to all that the patient brings, and a special case of this is the analysts need to be able to hate the patient objectively: 分析师的主要任务，是对病人带来的一切保持客观，而其中的一个特殊情况是分析师能够客观地去恨病人：Are there not many situations in our ordinary analytic work in which the analysts hate is justified? A patient of mine, a very bad obsessional, was almost loathsome to me for some years. I felt bad about this until the analysis turned a corner and the patient became lovable, and then I realized that his unlikeableness had been an active symptom, unconsciously determined. It was indeed a wonderful day for me (much later on) when I could actually tell the patient that I and his friends had felt repelled by him, but thathe had been too ill for us to let him know. This was also an important day for him, a tremendous advance in his adjustment to reality.不是有很多情况下我们的日常分析工作中分析师的恨是合理的吗?我的一个病人，极为强迫，在好多年里都是令我非常排斥的。我对此感觉不太好，直到分析出现了转变，病人变得可爱，然后我意识到，他的不可爱一直是活跃的、无意识决定的症状。（很久以后）当我终于可以告诉病人说我和他的朋友们曾对他感到厌烦的时候，这的确是一个美好的日子，但他过去曾经病得很严重以至于我们没办法告诉他。对他来说，这也是一个重要的日子，（表明）他朝向现实的调整有了惊人的进步。In the ordinary analysis the analyst has no difficulty with the management of his own hate. This hate remains latent. The main thing, of course, is that through his own analysis he has become free from vast reservoirs of unconscious hate belonging to the past and to inner conflicts. There are other reasons why hate remains unexpressed and even unfelt as such:在通常的分析中，分析师管理他自己的仇恨并不困难。这种恨是潜伏的。当然，主要是通过他自己的分析，他能从那些属于过去以及内在冲突的，无意识的巨大的恨中解脱出来。恨之所以不能表达甚至不能被感知的其它原因如下：Analysis is my chosen job, the way I feel I will best deal with my own guilt, the way I can express myself in a constructive way.精神分析是我选择的工作，是我能够最好地处理我的内疚感的渠道，是我能够用建设性的方式表达自己的渠道。I get paid, or I am in training to gain a place in society by psychoanalytic work.I am discovering things.我获得报酬，或者为了通过精神分析的工作在社会上取得一个地位，我正处于训练中。我正在探索一些事情。I get immediate rewards through identification with the patient, who is making progress, and I can see still greater rewards some way ahead, after the end of the treatment.我通过认同正在进步的病人即时获得回报，还有我能在治疗结束以后看到前面某种持续的更大的成就。Moreover, as an analyst I have ways of expressing hate. Hate is expressed by the existence of the end of the hour.此外，作为一个分析师，我也有我表达恨的方法。恨通过存在着的分析的结束来表达出来。I think this is true even when there is no difficulty whatever, and when the patient is pleased to go. In many analyses these things can be taken for granted, so that they are scarcely mentioned, and the analytic work is done through verbal interpretation of the patients emerging unconscious transference. The analyst takes over the role of one or other of the helpful figures of the patients childhood. He cashes in on the success of those who did the dirty work when the patient was an infant.我认为这是真实的，即使没有任何困难，病人高兴的离开的时候。在很多的分析中，这些东西都是理所当然的，以至于几乎不会被提到，分析工作通过口头解释病人浮现出来的无意识的移情来达成。分析师扮演了病人童年时代里对他有帮助的人物中的某一角色。分析师最大程度上利用了在病人婴儿期曾做过苦差事的那些人的成就。 These things are part of the description of ordinary psycho-analytic work, which is mostly concerned with patients whose symptoms have a neurotic quality.这些事是精神分析日常工作里所描述的一部分，它们大部分与具有神经症症状的病人有关。In the analysis of psychotics, however, quite a different type and degree of strain is taken by the analyst, and it is precisely this different strain that I am trying to describe.然而，在精神病患的分析中，分析师承受了相当不同类型和程度的压力(strain)，我想要描绘的正是这种不同的压力。Recently for a period of a few days I found I was doing bad work. I made mistakes in respect of each one of my patients. The difficulty was in myself and it was partly personal but chiefly associated with a climax that I had reached in my relation to one particular psychotic (research) patient. The difficulty cleared up when I had what is sometimes called a healing dream. (Incidentally I would add that during my analysis and in the years since the end of my analysis I have had a long series of these healing dreams which, although in many cases unpleasant, have each one of them marked my arrival at a new stage in emotional development.)最近几天来，我发现我的工作做的不好。我在我的每一位病人身上都犯了错。这个困难源自我自身而且有部分私人原因，但主要是关于我与某个精神病患（研究）的关系达到了极限。当我做了一个有时被称为是“有治疗功效”的梦的时候，这困难就明朗化了。（顺便加一句，在我的这次分析中，以及这次分析结束后的几年里，我拥有了一长串这种有治疗功效的梦，尽管很多时候是令人不快的，但它们中的每一个都标识着我在情绪发展中到达了新阶段。）On this particular occasion I was aware of the meaning of the dream as I woke or even before I woke. The dream had two phases. In the first I was in the gods in a theatre and looking down on the people a long way below in the stalls. I felt severe anxiety as if I might lose a limb. This was associated with the feeling I have had at the top of the Eiffel Tower that if I put my hand over the edge it would fall off on to the ground below. This would be ordinary castration anxiety.有这么一个特别的情景，在我醒来后，或者甚至是在醒来前，我就已意识到这梦的意义。这梦拥有两个阶段。在第一阶段，我在戏院中的顶层楼座(gods)远远地俯视小隔间里的人们。我感到强烈的焦虑，好像我可能失去一只手或一条腿。这与我在埃菲尔铁塔顶端的感觉有关：那时我感觉把手放到了边界外面，它就会掉下去。这可能是普通的阉割焦虑。In the next phase of the dream I was aware that the people in the stalls were watching a play and I was now related through them to what was going on on the stage. A new kind of anxiety now developed. What I knew was that I had no right side of my body at all. This was not a castration dream. It was a sense of not having that part of the body.在这个梦的另一个阶段，我意识到人们在正厅的座位上观看着戏剧，也意识到我通过他们与舞台上发生的一切有了关联。一种新型的焦虑产生了。我所确信的是我根本没有右侧的身体。这不是阉割梦。这是一种缺失身体那个部分的感觉。As I woke I was aware of having understood at a very deep level what was my difficulty at that particular time. The first part of the dream represented the ordinary anxieties that might develop in respect of unconscious fantasies of my neurotic patients. I would be in danger of losing my hand or my fingers if these patients should become interested in them. With this kind of anxiety I was familiar, and it was comparatively tolerable.当我醒来，我就意识到，在那个特定的时刻，我已经在一个非常深的层次上理解了我的困难是什么。梦的第一部分代表了普通的焦虑，一种与我的神经症患者的无意识幻想有关并从中发展出的焦虑。如果这些病人变得对我的手或者手指感兴趣，我或许会有失去它们的危险。这种焦虑是我熟悉的，它是相对可忍受的。The second part of the dream, however, referred to my relation to the psychotic patient. This patient was requiring of me that I should have no relation to her body at all, not even an imaginative one; there was no body that she recognized as hers and if she existed at all she could only feel herself to be a mind. Any reference to her body produced paranoid anxieties, because to claim that she had a body was to persecute her. What she needed of me was that I should have only a mind speaking to her mind. At the culmination of my difficulties on the evening before the dream I had become irritated and had said that what she was needing of me was little better than hair-splitting. This had had a disastrous effect and it took many weeks for the analysis to recover from my lapse. The essential thing, however, was that I should understand my own anxiety and this was represented in the dream by the absence of the right side of my body when I tried to get into relation to the play that the people in the stalls were watching. This right side of my body was the side related to this particular patient and was therefore affected by her need to deny absolutely even an imaginative-relationship of our bodies. This denial was producing in me this psychotic type of anxiety, much less tolerable than ordinary castration anxiety. Whatever other interpretations might be made in respect of this dream the result of my having dreamed it and remembered it was that I was able to take up this analysis again and even to heal the harm done to it by my irritability which had its origin in a reactive anxiety of a quality that was appropriate to my contact with a patient with no body.然而，梦的第二部分涉及到我和精神病人的关系。这个病人曾经要求我和她的身体不能有一点关系，甚至不能有想象的关系；她认识不到自己的身体，如果她确实是存在的，也只能感觉到自己是一种精神。因为其声称她有一个身体是在迫害自己，所以任何对她身体的提及都会（使她）产生偏执型焦虑。她只需要我与她心与心的交流。在做那个梦之前的夜晚，我的困难达到了极致，我变得恼怒，并说她需要我的并不比吹毛求疵好多少。这件事造成了非常糟糕的影响，以至于用了数周的时间，才使得我们的分析工作从我的过失中恢复过来。然而,关键是我需要懂得我自己的焦虑，这在梦中体现为，当我尝试着和座位上人们正在观看的戏剧建立起关系的时候，我右侧身体的缺失。我右侧的身体是和这个特定的病人有关的一侧，因此被她那种对我们之间哪怕是想象中的联系的绝对拒绝所影响。这个拒绝使我产生了精神病类型的焦虑，比普通阉割焦虑更难忍受。无论这个梦还能做其他什么解读，我梦到它并记住它的结果是，我能再次开始分析了，甚至修复了（因我的）易怒而对分析所造成的伤害。我的这个易怒来自于反应性焦虑(reactive anxiety)，而这个反应性焦虑对于我同那个没有身体的病人的接触而言是毫不为过的。The analyst must be prepared to bear strain without expecting the patient to know anything about what he is doing, perhaps over a long period of time. To do this he must be easily aware of his own fear and hate. He is in the position of the mother of an infant unborn or newly born. Eventually, he ought to be able to tell his patient what he has been through on the patients behalf, but an analysis may never get as far as this. There may be too little good experience in the patients past to work on. What if there be no satisfactory relationship of early infancy for the analyst to exploit in the transference?也许在很长一段时间里,分析师必须准备好在不指望病人知道他正在做什么的情况下承受内在的压力(strain)。为了能做到这一点，他必须是很容易感知到他自己的恐惧和恨.他正处于一个尚未出生或者刚出生婴儿的母亲的位置上.最终,他应当能够告诉他的病人，他以病人的名义所经历的一切,但一个分析也许永远也达不到这个境地。也许病人过往经历中可供（分析师）利用的好的体验太少。如果在婴儿早期没有令人满意的关系给分析师在转移中利用,又该如何呢?There is a vast difference between those patients who have had satisfactory early experiences which can be discovered in the transference, and those whose very early experiences have been so deficient or distorted that the analyst has to be the first in the patients life to supply certain environmental essentials. In the treatment of a patient of the latter kind all sorts of things in analytic technique become vitally important, things that can be taken for granted in the treatment of patients of the former type.在这(两种)病人之间存在着巨大的差异:（一种）病人拥有满意的早期经验（这个可以在转移中被发现）,（另一种病人）他们早期的经验是如此的匮乏或者扭曲以致于分析师不得不成为其生命中第一个提供某种环境要素的人。在后一种病人的治疗中，分析技术里的各种各样的事情，出现在治疗第一种病人时可能会被当作理所当然的事情,都变得极其重要。I asked a colleague whether he does analysis in the dark, and he said: “Why, no! Surely our job is to provide an ordinary environment: and the dark would be extraordinary.” He was surprised at my question. He was orientated towards analysis of neurotics. But this