Control 控制 Related to the issue of coping was that of control. This became very clear in the context of the analysis. In one of the earlier sessions Karen commented, "I feel that I'm fighting a helpless feeling, not knowing where I'm going." I replied that she wanted to put me in her position and herself in my own position. She replied, "It's a question of control, I'm afraid of losing control. I have a Faustian thing about knowledge and understanding. I can control something by putting it into words. It reminds me of my parents always telling me to control myself. I hated that. It gives me a Univac self-image, that I could work anything out rationally. I could rationalize my emotions, my bitterness and hostility." 与应对问题相关的是控制问题。这在分析的上下文中变得非常清楚。在早些时候的一次会谈上，卡伦说:“我觉得我在和一种无助的感觉做斗争，不知道自己要去哪里。”我回答说，她想把我放在她的位置上，把她自己放在我的位置上。她回答说:“这是一个控制的问题，我害怕失去控制。我对知识和理解有浮士德式的见解。我可以通过把事情变成语言来控制它。这让我想起我的父母总是告诉我要控制自己。我讨厌这一点。它给了我一个Univac[第一台商用电子计算机]的自我形象，我可以理性地解决任何事情。我可以为自己的情绪、痛苦和敌意找到合理的解释。” The whole pattern of the loss of control carried with it certain definite dangers and risks. Karen felt that, if she lost the rigid control that she maintained over herself, she would become violent and destructive. She would start screaming and never stop. She would throw and smash things and become uncontrollably destructive. Moreover, if she lost control she could never get it back. She recalled the fights she had had with her boyfriend as episodes in which there was a total loss of control. She could not understand the violence that would come out in these fights, and was terribly frightened by it. Her concern extended not only to the vulnerability she felt when she relinquished control to others in her environment, but to anything that was inflicted on her over which she felt no control. This extended even to the ultimate vulnerability of death. She continually returned to her concerns over growing older and of getting closer to death. Death represented the ultimate violation over which she had no control. 失去控制的整个模式，必然伴随着一定的危险和风险。卡伦觉得，如果她失去了对自己的严格控制，她就会变得暴力和破坏性。她会不停地尖叫。她会扔东西砸东西，变得无法控制地具有破坏性。而且，如果她失去了控制，她就再也无法控制自己了。她回忆起和男友的争吵，当时她完全失去了控制。她无法理解在这些打斗中会产生什么暴力，因此非常害怕。她所关心的不仅是当她试图控制她周围的其他人时所感受到的脆弱，而且还包括任何她无法控制的强加在她身上的东西。这甚至延伸到死亡的最终脆弱性。她不断地回到对衰老和接近死亡的担忧中。死亡代表她无法控制的最终的侵犯。 In the analysis the issue of control was a primary one. The instrument of her control was her intelligence, so that any of my attempts to interpret to her were taken as attempts to control. She could not tolerate the idea of relinquishing control to me. She could not allow me to be in control of the analysis, since that would mean making herself vulnerable to attack. The fear of control was particularly related to the question of relinquishing control to a doctor. Her fearful attitude was highly overdetermined. When she had been quite young, she had been living with her family in Japan and had become sick. She had been taken to a Japanese hospital and had been quite terrified of the Japanese doctors. According to her recollection they had wanted to bleed her, but she had had to be rescued and taken to the United States military hospital instead. 在分析中，控制问题是首要问题。控制她的工具是她的智慧，所以我对她的任何解释都被认为是试图控制她。她不能容忍把控制权交给我。她不能让我控制分析，因为这意味着她很容易受到攻击。对控制的恐惧尤其与把控制权交给医生的问题有关。她那可怕的态度是高度自负的。当她很小的时候，她一直和她的家人住在日本并且生病了。她被送到一家日本医院，对日本医生非常害怕。据她回忆，他们曾想给她放血，但她不得不被救出，送往美国军事医院。 On another occasion when she had been scheduled to have a tonsillectomy, the knowledge of the forthcoming operation had been kept from her due to her mother's protective anxieties. Her uncle, who was a physician, had taken her to the operating room with reassurances that nothing was going to happen to her. When the anesthesia mask was clamped over her face, she became panicked and terrified. She held this deception against her uncle with considerable bitterness and vehemence. 还有一次，当她被安排去做扁桃体切除术时，由于母亲的保护性焦虑，她对即将进行的手术一无所知。她的叔叔是一名医生，他带她去了手术室，并向她保证不会发生任何事情。当麻醉面罩卡在她脸上时，她变得惊慌失措。对她的伯父进行的这种欺骗，她怀着相当大的痛苦和强烈的感情。 Moreover, this same uncle had been looking after her father when the father died. We will have to return more in detail later to the father's death, since it took place soon after the analysis began and played a significant part in the course of the analysis. But Karen held it against this uncle that he had not been more attentive and competent in taking care of her father's heart condition. 而且，当她父亲去世时，这个叔叔一直在照顾她的父亲。我们稍后将不得不更详细地回到父亲的死亡，因为它发生在分析开始后不久，并在分析过程中发挥了重要的作用。但是卡伦认为这位叔叔没有更细心、更有能力照顾她父亲的心脏。 Her basic question in all of this concerned the competence of doctors and the uncertainties of medical diagnosis and treatment. Karen constantly complained that doctors never really knew what they were doing, and that patients were helpless and vulnerable because they had to put themselves in the doctor's hands and rely on their uncertain judgment. This necessity mobilized much of her underlying sense of vulnerability and her helpless rage at not being able to control the situation. The question also pervaded her relationship to me in the analysis. She wondered about my competence and continually questioned it, particularly when her resistance was high and when she felt threatened by any intervention I made. She repeatedly emphasized that the important thing to her was that I should be right, rather than that my intentions toward her should be good. Despite this demand for my competence in making interpretations, the equation of knowledge with power brought it about that the more correct my interpretations were, the more threatened she felt. 她的基本问题是关于医生的能力和医疗诊断和治疗的不确定性。卡伦经常抱怨说，医生从来都不知道自己在做什么，病人很无助，很脆弱，因为他们不得不把自己交给医生，依靠自己不确定的判断。这种需要激起了她内心深处的脆弱感，以及对无法控制局面的无助愤怒。在分析中，这个问题也贯穿了她和我之间的关系。她对我的能力感到怀疑，并不断地对我的能力提出质疑，尤其是当她的抵触情绪高涨，以及当她感到受到我任何干预的威胁时。她反复强调对她来说重要的是我应该是对的，而不是我对她的意图应该是好的[我需要的不是你的好心，而是你的水平]。尽管对我的解释能力有这样的要求，但把知识与权力划上等号，使我的解释越正确，她感到的威胁就越大。