Therapeutic Crisis 治疗危机 The intensity of her feeling about this and her fear of the analytic reduction was exemplified strikingly in a perhaps inappropriate, or at least ill-timed, intrepretation. She was discussing the process of writing and how she enjoyed it even though it was terribly painful. She described it as like a flow, that you had to let run its course. It was the pain of absolute concentration and unified tension. But that when the tension was released there was a feeling of relaxation and satisfaction. I observed that her description of this process made it sound like an orgasm. My blunder became immediately obvious. She responded with hurt and offended outrage. She became defensive and angry and cried out that was typical of psychoanalysis, that I was not listening to her, that I had no sympathy with her, and she ended by saying, "Fuck you!" 她对这一点的强烈感情，以及她对分析归纳的恐惧，都在一次也许不恰当，或者至少不合时宜的解释中醒目地表现出来。她在讨论写作的过程，以及她是如何享受写作的过程，尽管写作非常痛苦。她把它描述成一种流动，你必须让它顺其自然。这是一种绝对专注和统一的紧张的痛苦。但当紧张被释放时，会有一种放松和满足的感觉。我注意到她对这个过程的描述听起来就像高潮。我的错误立刻变得显而易见。她以受伤和愤怒的回应。她开始自卫，变得愤怒，大喊大叫，这是典型的精神分析，我没有听她说话，我没有同情她，最后她说，“艹你!” The next day she returned and announced she was not going to stay in analysis. She found it fruitless, expensive, futile, and destructive. I asked her about her reaction to my comment on the previous day and she replied it was a vile reduction, a dirty joke. Moreover, she refused to accede to my superiority. I could think whatever I liked, she didn't care. She refused to trust anyone more than herself and in analysis there was need for trust, but she didn't have it and she wasn't going to get it. She went on to say it might be reasonable for me to think she was being defensive, but that wasn't true. The fact was that my remark was tasteless and deflating and demeaning. Perhaps she expected too much, but then she should get the hell out. If it wasn't helping her or making her happy, then the smart thing was to get out while the getting was good. That would make her into the great martyr female. 第二天，她回来了，并宣布她不打算继续做分析。她发现这是徒劳的，昂贵的，无用的，破坏性的。我问她对我前一天的评论有何反应，她回答说这是一个卑鄙的归纳，一个下流的笑话。此外，她拒绝承认我的优越。我可以想什么就想什么，她不在乎。她拒绝相信任何人，除了她自己。在分析中，她需要信任，但她没有，也不会得到信任。她接着说，我有理由认为她是在防御，但事实并非如此。事实是，我的话毫无品味，令人泄气，有损人格。也许她期望过高，但她应该离开这鬼地方。如果这对她没有帮助或没有让她开心，那么聪明的做法就是在得到好处的时候离开。这将使她成为伟大的殉道者女性。 I could only point out at this juncture that she seemed to be making the analytic situation into a self-fulfilling prophecy and that perhaps this was part of the problem. But she was angry and hurt and quite resistant, and she announced that she was not coming back for the rest of that week. After all, it was her life and her analysis. And she was true to her word; she stayed away from the analysis for the following three days. I use this episode here as an example of her resistance, but in fact it turned out to be a crucial turning point in the analysis. What in fact it brought into focus was the basic question of whether the analysis was a situation of conflict and submission, or whether it was in fact a cooperative venture in which she and I were involved in a collaboration rather than a competition. Moreoever, the fact that she could rebelliously and petulantly take herself out of the analysis without any recrimination or hostility on my part demonstrated graphically that she indeed had a measure of control and that she was not a helpless victim of the analytic process. More specifically, it demonstrated that she was neither as weak nor as susceptible nor as vulnerable as her fantasies might dictate. 我只能在这个节骨眼上指出，她似乎正在把分析的情况变成一个自我实现的预言，也许这就是问题的一部分。但是她很生气，很受伤，而且非常抗拒，她宣布这周余下的时间她不会回来了。毕竟，这是她的生活和她的分析。她信守诺言;在接下来的三天里，她远离了分析。我用这段插曲作为她反抗的例子，但事实上，这是分析中的一个关键转折点。事实上，它所关注的是一个基本问题，即分析是一种冲突和服从的情况，还是一种合作活动，我和她参与的是合作而不是竞争。更重要的是，她能够反叛地、任性地退出分析，而不受到我的任何指责或敌意，这一事实生动地表明，她确实有一定的控制力，而且她不是分析过程中无助的受害者。更具体地说，这表明她既不像她的幻想所要求的那样软弱、易受影响跟脆弱。 In fact, Karen's defenses took a form which was predominated by a rather paranoid quality. Her defensive posture was highly rationalized and intellectualized, but it was based upon a fundamental attempt to externalize and displace the basic conflicts into the external world about her. At times her defensiveness took on a more precisely paranoid dimension. At such times, her defensive system was under particularly intense pressure and the persecutory anxiety became elevated to the point that her responses to me bordered on panic and were cast in a modality which saw me as the primary persecutor and nemesis of her existence. 事实上，卡伦的辩护是以一种相当偏执的特质为主导的。她的防御姿态是高度理性和理智的，但它是建立在一种基本的尝试之上的，那就是将基本的冲突外化并转移到她周围的外部世界。有时，她的防御性表现得更为偏执。在这种时候，她的防御系统受到了特别大的压力，被迫害焦虑上升到一种程度，以致她对我的反应几乎到了惊慌失措的程度，她把我看作是她生存的主要迫害者和宿敌。