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대인관계 정신분석 2
작성자  simonshin 작성일  2018.08.06 22:36 조회수 316 추천 0
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 발제문 (권장순님): Theoretical models and the analyst’s neutrality 2   
 

과목대인관계 정신분석

주제: Theoretical models and the analyst’s neutrality 2

지도신현근/김양자 교수

발제자권장순님

교재:

Stern, D. B, & Hirsh, I (eds.) (2018). Further Developments in interpersonal psychoanalysis, 1980s-2010s: Evolving interest in the analyst’s subjectivity. London and New York; Routledge.

 

 

Theoretical Models and the Analysts Neutrality 2

Jay R. Greenberg, Ph.D.

 

This revised definition is not simply terminological; it has important technical implications that will occupy the remainder of this paper. For one thing, as defined within the terms of the drive model, neutrality has a static ring to it; it implies that the "neutral" analyst occupies a fixed position. That is, from one analysis to another, the neutral posture would always look more or less the same. This accords well with the model of the analyst as 19th century scientist which informed Anna Freuds thinking.  개정  정의는 단순히 전문 용어가 아닙니다 논문의 나머지 부분을 차지할 중요한 기술적 함의가 있다하나는드라이브 모델의 용어로 정의된것으로 중립성에는 그것에 정적링이 있다그것은 "중립적인분석가가 고정된 위치를 점유하고 있음을 의미합니다하나의 분석에서 다른 분석으로중립 자세는 항상 동일하거나 비슷하게 보인다이것은 Anna Freud 생각을 알린 19세기 과학자로서 분석가의 모델과  일치한다.

Under my proposed reformulation, the activity of the neutral analyst is always dependent upon the quality of the patients relationships with others. The analytic behaviors which implement the goal of optimal tension between old and new necessarily vary with the openness to new experience of a particular patients internal object world. Generally speaking, the silence and anonymity which constitute unmodified classical technique enable the patient to include the analyst in his internal object world, while a more active or self-revealing posture establishes the analyst as a new object. 나의 제안된  공식화 하에서중립적인 분석가의 활동은 항상 환자의 다른 사람들과의 관계의 질에 달려있다신구 사이의 최적 긴장의 목표를 구현하는 분석적 행동은 특정 환자의 내적 대상 세계에 대한 새로운 경험의 개방성에 따라 달라집니다일반적으로 말하면수정되지 않은 고전적 기술을 구성하는 침묵과 익명성은 환자가 그의 내적 대상 세계에 분석가를 포함시키는 반면보다 적극적이거나 스스로 드러내는 자세는 분석가를 새로운 대상으로 설정한다. Thus, with a patient who is firmly encased in a closed world of internal objects, the analyst will have to assert his newness more affirmatively to achieve an optimal level of tension, while with the more open patient just such assertiveness would constitute an impediment to the development of transference and to insight about it. Neutrality is thus not to be measured by the analysts behaviors at any moment, but by the particular patients ability to become aware of and to tolerate his transference. 따라서 대상의 닫혀진 세계에 단단히 갇혀있는 환자의 경우분석가는 최적의 긴장 수준을 달성하기 위해  적극적으로 자신의 새로운 것을 주장해야 하며개방된 환자가  많으면 이러한 주장이 전이 발달  그것에 대한 통찰력의 장애를 구성할  있다그러므로 중립성은 어떠한 순간에도 분석가의 행동에 의해 측정되어질  없지만 그러나 특정 환자가  자신의 전이를 인식하고 용인하는 능력에 달려있다.

The value of establishing a neutral atmosphere is closely related to Schafers recent, stated, formulation of ego-syntonicity. Schafer wrote:

… the concept of ego-syntonicity has always referred to those principles of constructing experience which seem to be beyond effective question by

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the person who develops and applies them … Metaphorically, they are the eye that sees everything according to its own structure and cannot see itself seeing 

One might say that these principles are beyond question in so far as the person treats the relevant questions about them not as questions but as evidence 

중립적 분위기를 형성한다는 가치는 Schafer 최근에 언급된 자아 – syntonicity동조적인 공식화와 밀접한 관련이 있다. Schafer 다음과 같이 썼다:

... 자아 -동조적 syntonicity 개념은 항상  ()들을 개발하고 적용하는 사람에 의해 효과적인 질문 저쪽에 보이는 경험을 건설하는 그러한 원리를 참조했다 ... 은유적으로그들은 그것 자신의 구조에 따라 모든 것을 보는 눈이고 스스로 그것을   없다... In undertaking the analysis of a character problem, one counts on there being some diversity of experiential principles … The point of access may be some well-guarded for of thinking hopefully, some shrugged-off way of esteeming oneself realistically, or some shyly hidden but stable kind of loving (1983pp. 144146).

성격 문제의 분석을 수행함에 있어서경험적 원리의 다양성이 있음을 고려해야 한다.

접근의 포인트는 희망을 가지고  생각하고자신을 현실적으로 존중하는 약간의 어깨를  쓱하는 방법혹은 수줍어 숨지만 그러나 안정된 사랑의 종류   있다(1983pp. 144-146).

Schafers point applies equally to the representational world of many patients. The patient can become aware that he is assimilating the analyst into his world of archaic internal objects only when he has already become aware that there is an alternative possibility. Unless he has some sense of the analyst as a new object, he will not be able to experience him as an old one. The inability to achieve this balance is responsible for many analytic failures. If the analyst cannot be experienced as a new object, analysis never gets under way; if he cannot be experienced as an old one, it never ends.

Schafer 요점은 많은 환자의 표상 세계에 똑같이 적용됩니다환자는 그가 이미 대안의 가능성이 있음을 알게 되었을때만 분석가를오래된 내적 대상의 세계로 동화시키고 있음을   있다분석가에 대한 새로운 감각이 없는 그는 분석가를 옛사람으로 경험할  없을 것이다 균형을 이루지 못하면 많은 분석 실패의 원인이 된다만약 분석가가 새로운 대상으로 경험   없다면 분석은 결코 진행되지 않습니다만약 그가 오래된 것으로 경험할  없다면 분석은 결코 끝나지 않을 것이다.

In distinguishing between neutrality as a goal and the specific actions that support and implement it in my earlier paper, it was my intention to cast analytic behaviors such as emotional openness, self-revelation, and even expressing judgments in a new light. The theoretical framework developed here further clarifies these relationships.

목표로서의 중립성과 나의 초기 논문에서 그것을 지지하고 실행하는 구체적 행동을 구별함에 있어 감정적 개방성자기 계시심지어 판단을 새로운 관점에서 표현하는 것과 같은 분석적 행동을 던지는 것이 나의 의도였다여기에서 개발된 이론적 틀은 이러한 관계를 더욱 분명하게 한다. That is, I think that these behaviors, which are typically thought of as prima facie non-neutral, may actually contribute to neutrality when judiciously applied with the right patient. Conversely, the traditional, purely interpretive posture which Glover (1955), for example, feels defines neutrality may actually detract from it. 반대로 Glover(1955) 예를 들어 느낀 전통적이고 순전히 해석적인 태도는 실제로 중립성을 정의   있다. Let me develop this possibility. 나는 전형적으로  중립적인 것으로 생각되는 이러한 행동이 적절한 환자에게 현명하게 적용될  실제로 중립에 기여할  있다고 생각합니다이런 가능성을 개발하겠다반대로글로버(Glover, 1955) 예를  전통적이고 순전히 해석적인 태도는 중립성을 정의한 것이 사실 이것을 손상하는 것으로 느낄  있다.

In his important writings on relational aspects of the psycho-analytic situation, Myerson has pointed out that in bringing material into analysis, patients express "… a need or determination to know something about as well as from the analyst. The analysand wants to ascertain how the analyst would react if he were to express his desire or anger more directly as well as what the analyst thinks is the nature of his experience" (1981ap. 98). 분석가가 무엇을 생각하는가는 그의 경험의 본질로서뿐 아니라 그의 갈망이나  직접적인 분노를 표현 했다면 This fits well with my idea about the need to see the analyst as a new object. 정신 분석적 상황의 관계 측면에 관한 중요한 저서에서 Myerson 자료를 분석으로 가져 오는  있어 "환자는 ... 분석가 뿐만 아니라 무엇인가를  필요성이나 결단을 표현한다피분석자는 분석가가 자신의 경험의 본질이라고 생각하는 것뿐만 아니라  직접적으로 자신의 욕망이나 분노를 표현한다면 반응  것입니다. "(1981ap. 98). 이것은 분석가를 새로운 대상으로  필요성에 대한  생각에  맞습니다.

Let me take as an example a set of circumstances which arises

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frequently. Many analysands need to know something about the analyst because they are frightened of the impact that their transference fantasies (including the perceptions of which these fantasies are generally eleborations) have on their analysts. Transference represents an assault on the analysts sense of self, a point on which analysts as theoretically different as Levenson (1972), Racker (1968), Sandler (1976), and Searles (1965), (1979) have been especially eloquent.

예를 들어 자주 발생하는 일련의 상황을 예로 들어 보겠다많은 피분석자들은 분석가에 대해  필요가 있습니다왜냐하면 그들의 전이 환타지가(이런 환타지들이 일반적으로 정교화하는인식을 포함하는그들 분석가에게 미치는 영향을 두려워 하기 때문이다전이가이론적으로 다른 Levenson (1972), Racker (1968), Sandler (1976), Searles (1965), (1979) 같은 분석가가 특별히 웅변하는 것으로 분석가의 자기감에 대한 공격을 나타낸다. For a patient to experience his own transference fully, including its assaultive aspects (and here I include so-called positive as well as negative transferences) he must be able to assume that the analyst will experience the impact of that transference differently than the original objects did. 환자가 공격적인 측면을 포함하여 자신의 전이를 완전히 경험할  있도록하려면 (여기서는 소위 음성 전이 만큼이나 양성 전이라 불리는 것을 포함 그는 분석가는 원래 대상이 그러했던 것과 다른 방식으로 해당 전이의 영향을 경험할 것이라고 생각할  있어야만 한다. The patient must be able to probe the analysts weak spots, to get beneath his professional calm and reserve, either with some confidence that the probing will not be murderously destructive or with a firm belief that the analysthaving promulgated the free-association ruleis significantly responsible for his own reactions to what comes up. 환자는 분석가의 약점을 규명하고 그의 전문적인 침착함과 준비 아래에 도달   있어야 하고또한 증명이 살인적으로 파괴적이지 않을 것이라는 다소의 확신과 분석가가 자유 연상 규칙을 공표하는 것의 견고한 믿음을 가지는 것은  자신의 반응에 대해 무엇이 일어나게  것인지의 자신의 반응에 주요하게 책임이 있다. anger sometimes at least, nobody will hurt him or be hurt by him or reject him and that e Compare Myersons emphasis on the childs need for parents who can allow him "to discover for himself that if he acts upon or expresses his desire or hisven when someone is

upset by his actions, that person bears some responsibility for this reaction" (1981bp. 178).

 

적어도 때때로 분노에 있어서어느 누구도 그를 다치게 하거나 그에 의해 다치거나 또는 그를 그렇게 거부할  없다. Myerson 부모에게 자녀가 필요로 하는 것에 대한 강조와 비교하여 부모가 그의 행동에 의해 자극되었을   사람은 이런 반응에 대해 다소의 책임이 있다만약 그가 행동화하거나 그의 갈망이나 분노를 표현하는 것은  자신에 대한 발견이라고“ 그를 허용해   있는 부모들에 대한 아동의 필요에 중점을 둔다 사람은 이러한 반응에 대해 다소의 책임이 있다"(1981bp, 178).

Let me suggest a few commonplace examples that arise in analyses. Levenson has mentioned that patients often have thoughts about being younger than their analysts, and more attractive, and leading more active and varied sex lives. Many patients are richer than their analysts, or plan to be. Many are more creative or ambitious; they look forward to being more successful. Many are simply younger, and have reactions organized around their having more years to live. 분석에서 발생하는  가지 평범한 사례를 제안 하겠다. Levenson 환자들은 그들의 분석가보다 젊고 매력적이며보다 적극적이고 다양한 성생활을 하는 것에 대해 종종 생각한다고 언급했다많은 환자들이 분석가보다 부유하거나계획을 세웁니다많은 사람들이  창조적이거나 열정적이다그들은  많은 성공을 기대합니다많은 사람들은 단순히 젊고 오래 사는 것에 반응을 보인다. All of these realistic perceptions intermingle with fantastic, archaic loving and hateful intentions to give the individual transference its unique character. But the patient must worry if the analyst can stand it,<s>분석가가</s><s> </s><s>설득</s><s> </s><s></s><s> </s><s></s><s> </s><s>있다면</s> both in terms of the intensity of archaic feeling involved and also in terms of the awesome reality.

이러한 현실적인 인식은 모두 개개인의 독특한 성격에 개인적 전이를 부여하는 환상적이고고풍스러운 사랑과 해로운 의도와 섞일 있다그러나 환자는 만약 분석가가 그것을 유지할  있다면오래된 감정이 포함된 강도와 놀라운 현실에 있어서 걱정을 해야만 한다.

These concerns are often at the core of what Gill (1982) has called "resistance to the awareness of transference." The patient feels responsible for destroying the analysts (presumably) fragile sense of self. Both impulse and perception must be denied in favor of maintaining the analyst and the analytic relationship. 이러한 우려는 종종 Gill (1982) "전이의인식에 대한 저항"이라고 부른 핵심에 있다환자는 분석가의 (아마허약한 자신감을 파괴하는것에 대해 책임이 있다고 느낀다충동과 인식 모두는 분석가와 분석적 관계를 유지하기 위해서는 부정해야 한다. In these

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circumstances, some analysands will hear any interpretive intervention as a condemnation, specifically, a condemnation borne of the analysts fragility and sense of having been damaged. Interpretation, whether defense, impulse, or affect is stressed, is experienced as blame, as holding the patient culpable for his transference wishes and perceptions.

이러한 상황에서일부  분석자는 어떠한 해석적 개입을 비난특히 분석가의 취약성과 손상의 의미에서 비롯된 비난으로 듣게  것이다방어충동또는 감정이 강조되었을  해석은 비난으로 경험되고환자의 전이 소망과 인식에 대해  환자를 비난하는 것을 holding하는 것으로 경험된다. Needless to say, it will be as hard for the patient to become conscious of his anxiety or guilt about the destructive impact he is having on the analyst as it was for him to gauge his effect on his parents. The insidious effect

of the analysts anonymity will thus be to confirm the patients worst fears about intense, erotic, hateful, or even simply loving feelings.

말할 것도 없이이것은 그의 부모님에 대한 그의 영향을 평가하는 것으로서 그가 분석가에게 가지고 있는 파괴적 영향에 대한 그의 불안과 죄책감을 인식하게 되는 것으로 환자에게 어렵다고   있다따라서 분석가의 익명성에 대한 방심할  없는(교활한영향은 이처럼 환자가 강렬하고에로틱하고증오스러우며심지어 단순하게 사랑하는 감정에 대해 가장 두려워한다는 것을 확인하는 것이  것이다. The technical problem is how to avoid creating and sustaining a vicious circle. In this context, the goal embodied in the concept of neutrality becomes especially important. The central question of technique is determining the behaviors that support the neutral posture. 기술적인 문제는 어떻게 악순환을 생성하고 유지하는 것을 피할  있는가 하는 문제이다이러한 맥락에서중립성의 개념에 있어 구체화된 목표는 특히 중요하다기술의 핵심 질문은 중립적 자세를 지지하는 행동을 결정하는 것이다.

Chused has suggested recently that for child patients who had intrusive or over-controlling parents, the non-responsive posture of the classical analyst facilitates the development of a new, growth-promoting object relationship. Her formulation can be read as an updating of Hartmanns "principle of mulitple appeal of interpretations." Chused 최근에 침입적이거나 과도하게 통제하는 부모를  아동 환자의 경우 고전적 분석가의 반응이 없는 태도가 새롭고성장 촉진 대상 관계의 발달을 용이하게 한다고 제안했다그녀의 공식은 Hartmann "해석의 다양한 매력에 대한 원칙" 업데이트  것으로 읽을  있다. Hartmann suggested that "… the incidental

effects of interpretation … frequently transcend our immediate concern with the specific drive-defense setup under consideration, and … are not always predictable" (1951p. 152). Chused updates Hartmann by indicating that there is multiple appeal not only to interpretations themselves, but to all the analysts behaviors. Hartmann "... 해석의 부수적인영향은 ...종종 숙고하에서 특정한 드라이브 방어 설치에 관련된 우리의 즉각적 고려를 초월했었고그리고 ... 항상 예측 가능하지는 않다고 제안했었다(1951p, 152). Chused Hartmann 해석 자체뿐만 아니라 모든 분석가의 행동에도 여러 가지 매력이 있음을 나타냄으로써 Hartmann 업데이트 한다.

The allegiance of both these authors to the premises of the drive/structure model make it difficult for them to follow through the logic of their important insights. Hartmann, although he speaks approvingly of "… variations of our technical principles according to each patients psychological structure, clinical symptomatology, age level, and so on" (1951p. 144), is unable to develop a systematic basis for such variations, or to systematically trace their effects. 드라이브구조 모델의 전제에 대한 이런 저자들 모두의 충성은 이것이 그들에게 중요한 통찰력의 논리를 따르는 것을 어렵게 만든다. Hartmann 비록 그가 말하기를 " 환자의 정신적 구조임상 증상연령 수준 등에 따른 우리의 기술적 원리의 변화" (1951p. 144) 찬성한다고 말했지만그러한 변화에 대해 체계적 토대를 개발하거나 또는 그들의 영향을 체계적으로 추적할  없다고 말했다. Similarly, although Chused acknowledges that the analysts behavior can be the source of genuine structural change, she cannot allow that for some patients the non-responsiveness which characterizes her classical vision of neutrality may thwart the possibility of any treatment. 유사하게, Chused 분석가의 행동이 진정한 구조 변화의 원천이   있음을 인정하지만그녀는 일부의 환자들에게 있어 중립성에 대한 그녀의 고전적 시각이 어떠한 치료의 가능성을 방해할  있다고 특징짓는 무반응성을 허용할  없었다.

 

 

Reformulating neutrality within the terms of the relational

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model allows a consistent approach to these problems. For example, there are many patients for whom analytic reserve is simply too close to the aloof, self-protective posture with which their parents guarded themselves against their childrens erotic, competitive, challenging or hostile impulses. 관계형 모델의 용어 내에서 중립을 재구성하는 것은 이러한 문제들에 대한 일관된 접근을 허용한다예를 들어분석적 reserve보호지역에 대해 많은 환자들은 그들 자녀의 에로틱하고 경쟁적이며도전적이거나 적대적인 충동에 대해 그들의 부모가 그들자신을(자녀들보호하고 있는 자기 방어적인 자세가 단순히 너무 가깝기에는냉담하다. With these patients, reserve and anonymity can actually detract from neutrality, by confirming the patients sense of having harmed the analyst.  환자들에게 reserve예비  익명성은 실제로 분석가에게 해를 끼친다는 환자의 감각을 확인함으로써 중립성을 떨어뜨릴  있다. For all intents and purposes the patients rage turns the analyst into the damaged, archaic object. Self-revelation can be the road back to neutrality under these circumstances. This is an especially likely situation in the case of the patient who is most locked into the constraints of his internal object world. 모든 의도와 목적에 있어 환자의 분노는 분석가를 손상시키고고풍의 대상으로 바꿉니다자기 폭로는 이러한 상황에서 중립으로 돌아갈  있다이것은 특별히 그의 내적 대상 세계의 (제약조건에)구속에 가장  잠겨진 환자의 사례에 있어서의 상황과 비슷하다.

Along the same lines, there are some patients who were exposed to parental indifference bordering on neglect. For these people, the traditionally neutral non-judgmental attitude can be genuinely dangerous. 같은 선을 따라여기에는 부모의 무관심이 방치하는 것으로 노출된 일부 환자들이 있다 사람들에게전통적으로 중립적인 판단하지 않는 태도는 진정으로 위험   있다. Under these circumstances, passing judgment on the patients behavior (e.g., that it is provocative or self-destructive) or on important people in the patients life (e.g., a disturbed or cruel lover or relative) can be essential to the establishment of neutrality. 이러한 상황에서환자의 행동(도발적이거나 자기 파괴적인)이나 환자의 삶에서 중요한 사람들(방해 또는 잔혹한 애인 또는 친척) 있어 판단을 passing전하는 것은 중립성을 형성하는  중요할  있다. Schafer is referring to something similar when he says that "It is not a departure from neutrality to call a spade a spade" (1983p. 4). Schafer "중립성에서 출발하여 spade스페이드를 스페이드라고 부르는 것이 아니다"(1983p. 4)라고 말할  다소 비슷한 것을 언급하고 있다.

Let me conclude with an example of the sort of behavior that can support neutrality as I have redefined it within the terms of the relational model. I would stress in this connection that I dont think what I will be describing is terribly unusual from the point of view of current clinical practice.

행동의 유형의 예를 통해 결론을 맺으면 그것은 내가 관계 모델의 용어 내에서 그것을 제정의 함으로 중립성을 지지할  있다내가 무엇을 기술하는지 알지 못하는 이러한 연결에 있어 내가 강조하고자 하는 것은 현재의 임상 실습의 관점에서 몹시 드물다는 것이다. I do think, however, that these are interventions which are not typically included in case reports, because there is no theoretical framework for encompassing their effects, and that my new definition will enable them to be more comfortably included in our technical bag of tricks. 그러나  보고서는 일반적으로 사례보고에 포함되지 않은 개입이라고 생각합니다 효과를 포괄하는 이론적 틀이 

 그리고 나의 새로운 정의가 그것들을 우리의 기술적 요령들에  편안하게 포함될  있기 때문이다.

The patient is a middle aged, married man who came to analysis because of an obsession about a woman with whom he had recently had a brief flirtation that had come to nothing. Although he presented himself as simply wanting to be rid of thoughts about the woman, with very little encouragement he quickly came to care less about the obsession itself, and to become more interested in his sense of chronic dissatisfaction with his life at home and at work.

 환자는 중년의 결혼  남자로최근에 아무 것도 얻지 못한 간단한 바람을 피는 여자에 대한 집착 때문에 분석에 왔다비록 그는 단순히 여자에 대한 생각을 없애기를 원했음에도 불구하고 격려가 거의 없었기 때문에 그는 빠르게 강박  자체에 대해  보고 그리고 집이나 일에서 그의 생활에 심각한 불만족감에  관심을 가지게 되었다.

Within a relatively short time, some fairly dramatic improvements occurred in this mans life. The obsession disappeared, but

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more importantly, he began to feel generally more open to people in a way that he described as making life far richer than it had been. The scope of his involvement with people and activities grew dramatically. He reported liking himself better and being less anxiously self-absorbed. He acquired new interests.

상대적으로 짧은 시간 내에 남자의 삶에서 상당히 드라마틱한 개선이 이루어졌었다강박이 사라졌지만그러나  중요한것은 그는 일반적으로 그가 그러했던 것보다  풍성했던 삶을  것으로 묘사함으로써 그가 기술했던 방식에 있어 사람들에게  개방적이라고 느끼기 시작했다사람들과 활동에 대한 그의 참여 범위가 크게 증가되었다그는 자기 자신을  좋아하고  불안감을 느끼고 자기 몰두되었다고 보고했다그는 새로운 관심사를 얻었다.

Despite all these changes, the patient felt that there was a distance between him and me that placed limits on his potential for full self-exploration and growth within the analysis. He felt that he had "no relationship" with me, that I was distant, aloof, and inscrutable. For instance, I didnt answer his questions, preferring instead to demand (as he saw it) his fantasies. 이러한 모든 변화에도 불구하고 환자는 자신과  사이에 거리가 있어 분석에 있어 완전한 탐험과 성장을 위한 잠재력에 한계가 있음을 느꼈다그는 나와 "관계가 없다" 느꼈고나는 멀고냉담하고  없다고 느꼈다예를 들어나는 그의 질문에 답하지 않았고대신 그의 환상을 요구하는 것을(그가 이것을 보는 것에 대해선호했다. Also, he objected to my ways of running my practice. He could not see why I charged for missed sessions. He could understand being charged if he missed for frivolous reasons, but when he did miss

it was always unavoidable. And why didnt I even tell him why I did what I did, beyond brief references to my need for some financial stability? Was I just a small-minded cheapskate who hid behind the convenient mask of analytic anonymity? 또한그는 나의 작업을 수행하는 방식에 대해 반대했다그는  내가 놓친 세션에 대해 요금을 부과하는지 알지 못했다만약 그가 사소한 이유로 놓친 경우 청구되는 것을 이해할  있었지만그러나 그가 놓쳤을 때는 항상 피할  없었습니다그리고  내가 재정 안정성에 대한 나의 필요성에 대한 간략한 언급 이외에내가 무엇을 했고 했는지를 그에게 말하지 않았습니까나는 분석 익명성의 가면을 편리함 뒤에 숨겨 놓은 작은 마음을 가진 깡패(구두쇠였을까?

As the work proceeded, more details of the transference emerged. My failure to answer questions and the demand for fantasies was, as he experienced it, fundamentally a sadistic and voyeuristic exercise for me: I loved to see him squirm and to come up with fantasies that were "wrong". Also, I used both my sadism and my analytic status to protect myself from his own assaultsfundamentally, I was afraid of him and, more pointedly, afraid of my own weakness.

작업이 진행됨에 따라 전이의  자세한 내용이 나타났다질문에 답하는 것과 환상에 대한 요구가 실패한 것은그가 그것을 경험한 것에 따르면근본적으로 나에 대한 가학적이고 관음증적 활동 이었다나는 그가 몸부림치는 것을 보는 것을 좋아했고<s> </s>환상이"잘못이다라고 제안하는 것을 좋아했다또한 나는  자신의 맹공격으로부터  자신을 보호하기 위해나의 사디즘과 analytic status분석 상태를 모두 사용했다근본적으로나는 그를 두려워 했고 그리고  신랄하게는 자신의 약함을 두려워 했다.

The elaboration of these fantasies was essentially affectless. The patient could not allow himself to feel very much about what was emerging because he was convinced that what he saw was true. 이러한 환타지의 정교함은 본질적으로 영향을 받지 않았다환자는 그가  것을 진실이라고 확신했기 때문에 새로 부상하고 있는 것에 대해서 아주  느끼게   없었다. We were able to connect the fantasies historically to his perception of his father, a weak, frightened man who had been jilted by his mother and who had carried a torch for her all his life. The father had taken a great deal of his helpless anger out on his sonfrom criticizing his penis size and taking him for hormone shots as a small child, to denigrating his very real school and work accomplishments later on우리는 환상을 역사적으로 그의 어머니에 의해 버려진 그리고 그의 삶에서 그녀의 모든 것에 대해 성화를 가져온 약하고 겁먹은 남자인 그의 그의 아버지에 대한 그의 인식에 연결시킬  있었다아버지는 그의 무력한 노여움을 그의 아들에게 크게 내었고그의 페니스 사이즈를 비판하고 작은 아이로서 호르몬 주사를 맞고그의 진짜 학교를 모독하고 나중에 작업을 수행했다. Still, he claimed, there was no real involvement. We both learned a good deal as we constructed his transferential feelings in terms of defense against and reaction to

his relationship with his father, but nothing much changed. The "bottom line" for the patient was that I was like his father or, as he put it other times, "analysis" is too much like his father. 아직도 그는 진정한 개입은 없다고 주장했다우리는 그의 아버지와 그의 관계에 대한 반응과 방어에 대항한 그의 전이 감정을 구축함으로써 좋은 거래를 배웠다그러나 아무것도 많이 바뀌지 않았다환자의 "최종선" 내가 그의 아버지와 같았거나 또는 그가 다른 시간에 넣었던 것처럼 "분석" 그의 아버지와 너무 비슷하다는 것이다.

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Over a period of time, I came to believe that perhaps these complaints were justified; perhaps unmodified anonymity was too much like the begrudging, self-protective attitude which the patient had experienced as coming from his father. This led to a change in tone in the sessions. For example, during an exchange organized around some sessions cancelled because of bad weather, the patient again asked me why I persisted in the small-minded practice of charging him when I knew perfectly well that he had a good reason for not coming. 일정 기간 동안나는 아마도 이러한 불평이 정당했다고 믿게 되었다아마도 수정되지 않은 익명성은 환자가 그의 아버지에게서 있었던 것으로의 경험을  자기보호적인 태도와 마지못해 하는 것과 너무 흡사했다이로 인해 세션에서 톤이 바뀌었다예를 들어악천후로 인해 취소된 일부 세션에서 조직된 exchange교환  환자는 내가 그가 다시 오지 않아도 좋은 이유가 있음을  알았을   내가 그를 충전하는 편협한 연습을 계속했는지 물었었다. This time, I told him that, although I had no doubt that it would have been impossible or extremely difficult for him to make the appointments, I charged him because I didnt want to be in the position of judging whether he had good reasons or not. Further, I said that I thought it would be disrespectful for me to pass on the validity of his reasons for missing a session on any particular occasion, and that I felt most comfortable simply relying on guidelines established in advance.

이번에는나는 그에게 그가 약속을 하는 것이 불가능하거나 극도로 어려웠을 것이라는 것은 의심의 여지가 없었지만나는 그가 좋은 이유가 있는지 없는지 판단   있는 위치에 있기를 원하지 않았기 때문에 그에게 청구했다게다가나는 어떤 특별한 경우에 세션을 놓친 그의 이유에 대한 타당성을 pass지나치는 것이 무례할 것이라고 생각했으며그래서 나는 사전에 설정된 지침에 단순히 의지하는 것이 가장 편하다고 느꼈다.

The patient, surprised and pleased, responded "Oh, why didnt you tell me that before?" I said that it was because I hadnt thought it would be helpful, but that perhaps I had been wrong. This opened up a period of sustained angerthe first expressions of anger beyond the potshots or hit and run attacks that had characterized the earlier work.

환자는 놀랐고 기뻐서, " 당신은 전에  말을  했습니까?"라고 대답했다나는 그것이 도움이  것이라고 생각하지 않았기 때문에 그랬다고 말했지만그러나 아마도 나는 틀렸다이로 인해 지속적인 분노의 시기가 시작 되었다분노의  표현은 초기 작업의 특징이었던 총격타격과 공격을 넘어선 것이었다.

During this time, which lasted for several weeks, the patient thought seriously of ending the analysis. Why had I been so like his father for so long, why should be have to put up with and suffer for my mistakes. He also was clearly afraid of what he was feeling. He speculated that maybe it was all for the good, that it was better to feel something for me than nothing.   동안 지속된  시간 동안환자는 분석을 끝내는 것을 진지하게 생각했다 나는 오랫동안 그의 아버지와 너무나어울렸고 나의 실수를 참아 내고 고통 받아야 하는가그는 또한 자신이 느끼는 것을 분명히 두려워했었다그는 아마 그것이 아무 것도 아닌 것보다 나를 위해 뭔가를 느끼는 것이 낫다는 것을 추측했었다. He sought reassurance that this was a sign of analytic progress, but I did not give it to him. In fact, I said, it was possible that the anger was a first step in the end of the analysis, that it was something to be taken very seriously. 그는 이것이 분석적 진전의 징후라는 확신을 찾았지만나는 그에게  사실을 알려주지 않았다사실분노가 분석의 마지막 단계에서  번째 단계였을 가능성이 매우 높았고 이것은 매우 심각한 문제였다.

As the anger subsided, the patient was able to react more directly to my having told him why I charged for the session and, more important, that I respected him. His reaction was, of course, not unambivalent. He had a dream in which he, an avid tennis player, was playing with John McEnroe. He had the sense that he could beat McEnroe, or at least give him a good game, but he noticed that although several of his own shots were out, McEnroe was calling them good, giving the patient a break. 분노가 가라 앉았을 환자는 내가  세션에 대해 요금을 청구했는지그리고  중요하게내가 그를 존경했다고 말한 것에 대해  직접적으로 반응   있었다물론 그의 반응은 unambivalent단호하지 않았다그는 열렬한 테니스 선수인 John McEnroe 함께 경기하는 꿈을 꾸었습니다그는 McEnroe 이길  있거나 적어도 좋은 경기를 펼칠  있다는 감각을 가지고 있었지만자신의    개가 나왔지만 McEnroe 그것들이 좋다고 했고 환자에게 휴식을 주었다.

He was able to hear and elaborate my interpretationthat he felt I was toying with

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him, letting him think he was in my league, building him up for a harsh disappointment. This was the first time that he was able to connect in a full emotional way with a transference implication of one of his dreams. 그는  해석을 듣고 정교화   있었다그는 내가 그와 놀고 있다고 느꼈고그에게  리그에 있다고 생각하게 하여 그를 가혹하게 낙담시켰다이것은 그가 자신의   하나의 전이 의미를 가지고 완전한 정서적인 방식으로 연결할  있었던 처음이었다. In the context of these exchanges, the patient rather quickly became able to experience and accept both angry and admiring or even loving feelings toward me. The analysis took a decisive turn, and the material clearly had a more powerful emotional impact on him. Moreover, he subsequently reported that during the period of greatest anger he had, for the first time in the analysis, felt "really myself."

이러한 교환의 맥락에서환자는 다소 빠르게 나를 향해 분노하고 감탄하거나 사랑하는 감정을 경험하고 받아 들일  있게 되었다분석은 결정적으로 바뀌었고 자료는 분명히 그에게 더욱 강력한 정서적 영향을 주었다더욱이 그는 계속해서 강력한 분노의 시기에 분석에서 처음으로 "정말로  자신"이라고 느꼈다고 보고했다.

I see my departure from anonymitya departure which with my new definition I can say promoted neutralityas relatively minor. It also came well into the analysis. With other patients, the more active technique must come earlier (sometimes from the first session) or be more dramatic. Notice that my intervention did not truncate the most intense or regressive transferential feelings. In fact, the patient could not have tolerated sustained rage until after I had ventured to become less anonymous. 나는 익명성에 대한 출발을 보았다새로운 정의로 증가된 중립성을 비교적 사소한 것으로 말할  있는 출발이었다그것은 또한 분석에  들어갔다다른 환자의 경우에는 적극적인 기술이  일찍 (때로는  번째 세션에서나오거나  극적이다 개입이 가장 강렬하거나 퇴행적인 전이 감정을 잘라 내지 않았다는 것을 주목하십시오사실환자는  익명화되기 전까지는 지속적인 분노를 견딜  없었다. Nor did the change in my position make things more comfortable in any conventional sense. The change enabled the patient to feel that what I did was not self-protective, hostile and small-minded in the way he had experienced his father. 또한  입장을 바꾸지 않아도 기존의 의미에서  편하게 사용할  있습니다 변화로 인해 환자는 내가  행동이 그가 자신의 아버지를 경험한 방식으로 자기 방어적이지 않으며적대감이없고 조그만 마음이라고느끼게 되었다. This enhanced his sense of analytic safety, but that in turn allowed the emergence of a range of feelings that were at least temporarily more dangerous to both of us and to the continuation of the analysis itself than the earlier indifference had been. 이것은 분석적 안전에 대한 그의 감각을 향상 시켰지만그러나 그것은 초기에 무관심했던 것보다 우리 모두에게와 분석 자체의 지속에 적어도 일시적으로  위험했던 느낌의 범위의 출현을 허용했다.

Defining neutrality as optimal tension between the patients experience of us as old or new objects gives a clear reference point in the patients experience for evaluating our interventions, and for monitoring our technique throughout the course of an analysis. By relying on this standard, we have a good chance of maintaining the neutral posture, which I continue to believe best serves the goals of psychoanalytic treatment.

중립성을 오래되거나 새로운 대상으로서의 우리 환자의 경험 사이의 최적의 긴장으로 정의하는 것은우리의 중재를 평가하고 분석 과정 전반에 걸쳐 우리의 기술을 모니터링 하는 환자의 경험에 명확한 기준점이 제공된다 기준에 의거하여 우리는 중립 자세를 유지할  있는 좋은 기회를 가지며나는 정신 분석 치료의 목표에 최선을 다할 것이라고 계속 믿는다.

 

 
 
 
 
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