In previous papers ( 1957) I have had occasion, in talking of the psychotic part of the personality, to speak of the destructive attacks which the patient makes on anything which is felt to have the function of linking one object with another. It is my intention in this paper to show the significance of this form of destructive attack in the production of some symptoms met with in borderline psychosis.
在之前的论文中,在谈到中的性部分的时候,我有机会谈及病人对任何具有将一个客体与另一个联结的功能的东西的攻击。在这篇论文中,我想要表明,这种类型的破坏性的攻击在与边缘型精神病工作中遇到的一些症状的产生有重要关系。
The prototype原型 for all the links of which I wish to speak is the primitive breast or penis. The paper presupposes假定 familiarity with Melanie Klein's descriptions of the infant's fantasies of sadistic attacks upon the breast ( 1934), of the infant's splitting of its objects, of projective identification, which is the name she gives to the mechanism by which parts of the personality are split off and projected into external objects, and finally her views on early stages of Oedipus complex (Klein 1928). I shall discuss phantasied attacks on the breast as the prototype of all attacks on objects that serve as a link and projective identification as the mechanism employed by the psyche to dispose of the ego fragments produced by its destructiveness.
我想要讲到的所有联结的原型是原初乳房或者阴茎。这篇论文假定读者对梅兰妮•克莱因的理论有一定的熟悉,比如她对幻想中对乳房的施虐攻击的描述,婴儿对客体的分裂,以及,她认为后者指的是人格的一些部分被分裂然后投射到外部客体中去的一种心理机制,还有最后她对情结早期阶段的观点。我将会讨论在幻想中对乳房的攻击是对所有有联结功能的客体的攻击的原型,并且投射性认同是精神用来处理由它的破坏性产生的碎片的心理机制。
I shall first describe clinical manifestations in an order dictated not by the chronology of their appearance in the consulting room, but by the need for making the exposition of my thesis as clear as I can. I shall follow this by material selected to demonstrate the order which these mechanisms assume when their relationship to each other is determined by the dynamics of the analytic situation. I shall conclude with theoretical observations on the material presented. The examples are drawn from the analysis of two patients and are taken from an advanced stage of their analyses. To preserve anonymity I shall not distinguish between the patients and shall introduce distortions of fact which I hope do not impair the accuracy of the analytic description.
首先,我将会描述一些临床表现,这些表现不是按照它们在咨询室中出现的时间顺序排列的,而是按照尽可能清楚地描述我的论点这一需要进行排列的。下面,我将会用经过选择的材料来展示这些心理机制呈现的顺序,而这些心理机制互相之间的关系是由分析情境的动力所决定的。我会以对所呈现的材料的理论评论作为结束。这些例子是从两位病人的分析中提取出来的,并且是从他们的分析的后期阶段中选取的。为了保持匿名性,我不会去两位病人之间作区分,会对事实做一些改写,我希望这不会削弱对分析情境的描述的准确性。
Observation of the patient's disposition to attack the link between two objects is simplified because the analyst has to establish a link with the patient and does this by verbal communication and his equipment of psychoanalytical experience. Upon this the creative relationship depends and therefore we should be able to see attacks being made upon it.
病人对两个客体之间的联结进行攻击的倾向的观察被简化了,因为分析师必须要与病人建立联结,并且通过口头交流和他的经验来做到这一点。创造性的关系取决于此,因此我们才能看到对它所做的攻击。
I am not concerned with typical resistance to interpretations, but with expanding references which I made in my paper on 'The differentiation of the psychotic from the non-psychotic personalities' (Bion 1957) to the destructive attacks on verbal thought itself.
我不会涉及对解释的典型阻抗,但是会扩展我在我的论文《人格中精神病性和非精神病性的区分》中对言语思维自身的攻击这个观点。
Clinical examples
临床实例
I shall now describe occasions which afforded me an opportunity to give the patient an interpretation, which at that point he could understand, of conduct designed to destroy whatever it was that linked two objects together.
现在,我会描述让我有机会给病人一个在那个点上他可以理解的解释的场合,然后他会采取一些行动,用以破坏将两个客体联结在一起的任何东西。
These are the examples:
下面是这些例子:
(i) I had reason to give the patient an interpretation making explicit his feelings of affection and his expression of them to his mother for her ability to cope with a refractory倔强的 child. The patient attempted to express his agreement with me, but although he needed to say only a few words his expression of them was interrupted by a very pronounced stammer which had the effect of spreading out his remark over a period of as much as a minute and a half. The actual sounds emitted bore resemblance to gasping for breath; gaspings were interspersed with gurgling sounds as if he were immersed in water. I drew his attention to these sounds and he agreed that they were peculiar and himself suggested the descriptions I have just given.
(1)我有足够的理由给病人一个解释,用来阐明他对的感受,以及他的这些感受对母亲的表达,因为她应付一个倔强的孩子的能力。病人试图表达他对我的赞同,但是虽然他只用几个词就能说出来,但是他对这几个词的表达被明显的口吃干扰了,这个口吃让他的话在长达一分半钟的时间里才说完。所发出的声音有点像喘息;喘息中点缀着咕噜声,就像是他浸在水里了一样。我让他注意到这些声音,他承认这些声音很独特,而且刚才我的描述就是他所建议的。
(ii) The patient complained that he could not sleep. Showing signs of fear, he said, 'It can't go on like this'. Disjointed remarks gave the impression that he felt superficially that some catastrophe would occur, perhaps akin to insanity, if he could not get more sleep. Referring to material in the previous session I suggested that he feared he would dream if he were to sleep. He denied this and said he could not think because he was wet. I reminded him of his use of the term 'wet' as an expression of contempt for somebody he regarded as feeble and sentimental. He disagreed and indicated that the state to which he referred was the exact opposite. From what I knew of this patient I felt that his correction at this point was valid and that somehow the wetness referred to an expression of hatred and envy such as he associated with urinary attacks on an object. I therefore said that in addition to the superficial fear which he had expressed he was afraid of sleep because for him it was the same thing as the oozing away 慢慢消失of his mind itself. Further associations showed that he felt that good interpretations from me were so consistently and minutely split up by him that they became mental urine which then seeped uncontrollably away. Sleep was therefore inseparable from unconsciousness, which was itself identical with a state of mindlessness which could not be repaired. He said, 'I am dry now'. I replied that he felt he was awake and capable of thought, but that this good state was only precariously maintained.
(2)病人抱怨他无法入睡。带着一些恐惧的迹象,他说,“不能再这样下去了。”不连贯的一席话给人一种印象,他表面上感觉某个灾难将会发生,或许类似于发疯,如果他不能获得更多的话。联系到之间的时间段,我提出,他害怕如果他睡着的话他会做梦。他否认了这一点,然后说他不能思考是因为他是湿的。我提醒他,他用“湿的”这个词来表达对他认为是脆弱和伤感的人的蔑视。他不同意,并且指出他所指的状态是刚好相反的。就我对这个病人的了解,我感觉他在这个点上的纠正是正确的,并且这个“湿”是恨和嫉妒的表达,比如他对客体的尿液攻击。因此,我说,除了他所表达的表面上的恐惧之外,他害怕睡着,是因为对他来说,它和他自己的理智慢慢消失是一样的。进一步的联想表明,他感觉从我这里来的好的解释,常常被他分裂,然后它们变成了精神尿液,控制不住地渗走。因此睡眠与密不可分,而无意识自身等同于一种无法修复的精神缺失状态。他说,“我现在干了。”我回答说,他感觉他清醒了,能够思考,但是这个好的状态只是不牢靠地维持着。
(iii) In this session the patient had produced material stimulated by the preceding week-end break. His awareness of such external stimuli had become demonstrable at a comparatively recent stage of the analysis. Previously it was a matter for conjecture猜测 how much he was capable of appreciating reality. I knew that he had contact with reality because he came for analysis by himself, but that fact could hardly be deduced from his behaviour in the sessions. When I interpreted some associations as evidence that he felt he had been and still was witnessing an intercourse between two people, he reacted as if he had received a violent blow猛击. I was not then able to say just where he had experienced the assault and even in retrospect I have no clear impression. It would seem logical to suppose that the shock had been administered给予 by my interpretation and that therefore the blow came from without, but my impression is that he felt it as delivered from within; the patient often experienced what he described as a stabbing attack from inside. He sat up and stared intently into space. I said that he seemed to be seeing something. He replied that he could not see what he saw. I was able from previous experience to interpret that he felt he was 'seeing' an invisible object and subsequent experience convinced me that in the two patients on whose analysis I am depending for material for this paper, events occurred in which the patient experienced invisible-visible hallucinations幻觉. I shall give my reasons later for supposing that in this and the previous example similar mechanisms were at work.
(3)在这次时间段里,病人受之前的周末休假刺激产生了一些临床材料。他对这种外部刺激的觉察在分析的相对近期阶段已经变得很明显了。之前,问题在于猜测他能在多大程度上感知现实。我知道他与现实有接触,因为是他自己来做分析的,但是这个事实很难从他在心理治疗时间段里的行为推断出来。当我对他的一些自由联想做出解释,作为他感觉到他曾经,并且现在仍然在目击两个人之间的性交的证据的时候,他的反应就像是他受到了一次猛击。那个时候,我还无法说出他是在哪里体验到的那个猛击,而且即使在回想的时候,我也没有清晰的印象。似乎合乎逻辑的假设是,这个打击是由我的解释给予的,因此这个打击是从外面来的,但是我的印象是,他感觉它是从内部来的;病人经常体验到,他所描述的从内部来的刺伤。他身体坐直,紧张地盯着空中。我说,他似乎在看什么东西。他回答说,他看不到他所看到的。我可以从我之前的经验中做出解释说,他觉得他正在“看”一个看不见的物体,并且随后的经历让我确信,我从他们的分析中获得这篇论文中的材料的两位病人身上,发生了一些病人体验到看不见的视觉幻觉的事件。我随后会给出认为在这个以及之前的例子中同样的机制在起作用的理由。
(iv) In the first twenty minutes of the session the patient made three isolated remarks which had no significance for me. He then said that it seemed that a girl he had met was understanding. This was followed at once by a violent, convulsive movement which he affected to假装 ignore. It appeared to be identical with the kind of stabbing attack I mentioned in the last example. I tried to draw his attention to the movement, but he ignored my intervention as he ignored the attack. He then said that the room was filled with a blue haze蓝色烟雾. A little later he remarked that the haze had gone, but said he was depressed. I interpreted that he felt understood by me. This was an agreeable experience, but the pleasant feeling of being understood had been instantly destroyed and ejected. I reminded him that we had recently witnessed his use of the word 'blue' as a compact description of vituperative sexual conversation. If my interpretation was correct, and subsequent events suggested that it was, it meant that the experience of being understood had been split up, converted into particles of sexual abuse and ejected. Up to this point I felt that the interpretation approximated closely to his experience. Later interpretations, that the disappearance of the haze was due to reintrojection再次内摄 and conversion into depression, seemed to have less reality for the patient, although later events were compatible with its being correct.
(4)在心理治疗时间段的前二十分钟里,病人说了三段没什么关联的话,对我来说也没什么重要性。然后他说,他遇到的一个女孩似乎很善解人意。这之后马上是一个激烈的抽搐动作,他假装忽略掉。它似乎与我在前一个例子中的刺伤很像。我试图把他的注意力引到这个动作上,但是他忽略了我的干预,就像忽略那个攻击一样。然后他说,房间里充满了一种蓝色烟雾。过了一会会,他说烟雾没有了,但是说他很。我解释说,他觉得被我理解了。这是一个令人愉快的体验,但是这种被人理解的愉快感觉很快就被摧毁然后投射出去了。我提醒他,我们最近一起看到他用“蓝色”这个词来简洁的描述羞辱性的性谈话。如果我的解释是正确的,并且随后的事情表明确实是这样,它意味着被理解的体验被分裂了,转换成了性虐待的小词句然后射出来了。到这个点上,我觉得这个解释与他的体验很接近。之后的解释,烟雾的消失是由于再次内摄,转化成了抑郁,似乎对病人来说现实性要小一点,虽然之后的事件证明它是正确的。
(v) The session, like the one in my last example, began with three or four statements of fact such as that it was hot, that his train was crowded, and that it was Wednesday; this occupied thirty minutes. An impression that he was trying to retain contact with reality was confirmed when he followed up by saying that he feared a breakdown. A little later he said I would not understand him. I interpreted that he felt I was bad and would not take in what he wanted to put into me. I interpreted in these terms deliberately because he had shown in the previous session that he felt that my interpretations were an attempt to eject feelings that he wished to deposit in me. His response to my interpretation was to say that he felt there were two probability clouds in the room. I interpreted that he was trying to get rid of the feeling that my badness was a fact. I said it meant that he needed to know whether I was really bad or whether I was some bad thing which had come from inside him. Although the point was not at the moment of central significance I thought the patient was attempting to decide whether he was hallucinated or not. This recurrent anxiety in his analysis was associated with his fear that envy and hatred of a capacity for understanding was leading him to take in a good, understanding object to destroy and eject it—a procedure which had often led to persecution迫害 by the destroyed and ejected object. Whether my refusal to understand was a reality or hallucination was important only because it determined what painful experiences were to be expected next.
(5)这次治疗,像上一个例子中一样,以三四个事实的陈述作为开始,比如今天很热,火车上人很多,今天星期三;这占据了三十分钟。这给人一种他在努力与现实保持接触的印象,他随后说的话证实了这一点,他说他害怕会崩溃。过了一会会,他说我不会理解他。我解释说,他觉得我是坏的,将不会接受他想要放进我的东西。我故意用这些词语来做解释,因为在之前的治疗中,他感觉我的解释是试图将他想要放进我那里的感受射出来。他对我的解释的反应是说,他觉得房间里面有两个可能的云。我解释说,他试着消除掉我的坏是一个事实这个感觉。我说,它意味着他需要知道,我确实是坏的,还是我是来自他内部的某些坏东西。虽然在那个时刻并不是最为关键的,但是我认为病人是在试图决定他是否产生了幻觉。在他的分析中经常发生的这种与他的恐惧有关,他害怕对理解能力的嫉妒和恨会导致他接受一个好的,理解性的客体,然后毁灭并投射它——这个程序通常会导致被毁灭和投射的客体的迫害。我对理解的拒绝是现实的还是幻觉中的很重要,只是因为它决定了随之而来的究竟是何种痛苦体验。
(vi) Half the session passed in silence; the patient then announced that a piece of iron had fallen on the floor. Thereafter he made a series of convulsive movements in silence as if he felt he was being physically assaulted from within. I said he could not establish contact with me because of his fear of what was going on inside him. He confirmed this by saying that he felt he was being murdered. He did not know what he would do without the analysis as it made him better. I said that he felt so envious of himself and of me for being able to work together to make him feel better that he took the pair of us into him as a dead piece of iron and a dead floor that came together not to give him life but to murder him. He became very anxious and said he could not go on. I said that he felt he could not go on because he was either dead, or alive and so envious that he had to stop good analysis. There was a marked decrease of anxiety, but the remainder of the session was taken up by isolated statements of fact which again seemed to be an attempt to preserve contact with external reality as a method of denial of his phantasies.