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大学译丛·卡桑德拉的女儿:欧美精神分析发展史

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从弗洛伊德到百忧解,第一部完整的精神分析发展史著作。
《大学译丛·卡桑德拉的女儿:欧美精神分析发展史》是精神分析学界百年来发展的史诗性作品,也是第一部完整的精神分析发展史著作,而不仅仅是一本回顾理论的教材。精彩呈现从弗洛伊德开始,到精神分析大师荣格、阿德勒、沙利文、克莱因、弗洛姆等人的学术争论、私人交往等细节。
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卡桑德拉是希腊神话中特洛伊城的公主,阿波罗曾赐予她预言的能力。但是后来卡桑德拉拒绝了阿波罗的爱,阿波罗就判决她的预言将永远不被相信。科学也同样赋予了精神分析预言的能力,然而,精神分析后来也拒绝了赋予它生命的学问,而且也不再被科学相信……精神分析是20世纪最重要的知识发展之一。
它涉及文学、精神医学、医学与心理学几个领域,更是唯一奋力了解人类内在世界经验的学科。我们现在常用的语汇如压抑、本我、情结、投射等,都是源自弗洛伊德对人类潜意识动机的研究。
《大学译丛·卡桑德拉的女儿:欧美精神分析发展史》是一部精神分析学百年来发展的史诗性作品,而不仅仅是一本回顾理论的教材。约瑟夫·施瓦茨描述了弗洛伊德处理心理疾病的方法,探索弗洛伊德思想演变的心路历程,继而说明分析团体的分歧与改变如何产生,以及精神分析大师荣格、阿德勒、沙利文、克莱因、弗洛姆等人参与这场划时代运动的精彩全程。通过此部作品,我们能知道在过去百余年里,先驱者为了实际了解人类主体的内在经验而分别做出的贡献。
对于人类而言,真正的问题并不在于精神分析提出的解释是否“科学”,而在于这解释对他有无帮助。不论你是弗洛伊德的拥护者或反对者,你将会发现,这是一部内容渊博、可让人了解自我、具启发性和独创性的精神分析学最佳入门书籍。
Catalogue

导读 精神分析历史和理论发展的珍贵记录
1 边界
2 弗洛伊德
3 歇斯底里症和分析时间的起源
4 初步理论
5 第一次分裂
6 移情作用
7 扩展领域:精神分析在美国(一)
8 新理论、新分裂:精神分析在美国(二)
9 儿童精神分析:新范式的开始
10 英国的突破
11 改变的冲突:精神分析、女性主义和60年代
12 未来
参考文献
Book Abstract

《大学译丛·卡桑德拉的女儿:欧美精神分析发展史》:

在企图了解人类心理的长远历史中,布罗伊尔和弗洛伊德处理歇斯底里古典医学症候群的方法是个突出的转折点。就像伽利略用望远镜探究未知夜空的结构,分析时间的研究也开创出一种崭新方法,以探讨未知的人类内在世界的结构。
1886年10月,弗洛伊德在维也纳的主要医学学会——维也纳内科医师学会的每周会议中,报告他和夏尔科的研究结果。弗洛伊德选择夏尔科的一个病患作为例证,说明在男人和女人身上都可以发现歇斯底里症状,而且在综合征上两者的病症差异不大。迈纳特挑战弗洛伊德,要求他提出男性病例,而且要能符合夏尔科描述的歇斯底里症状。乌尔班也曾参与这次会议,数年后他向琼斯描述(Clark,1980):
在场的每个人都知道,迈纳特很情绪化,他患有失语症且右臂瘫痪。这就是他要为歇斯底里症找到解剖学根据的理由,而且这可能是他画出大脑的大致部位图的原动力。当年轻的弗洛伊德说出歇斯底里症也存在于男性时,这让迈纳特感到困窘。迈纳特年轻时的凶暴性情和情绪不稳定,是大家都知道的;他年轻时常喝醉,并且常被当警医的祖父关起来。(p.91)
6周后,弗洛伊德以一位29岁雕刻师的病例作为例证,回答迈纳特的问题,这雕刻师患有半身麻痹——左半身丧失知觉(Freud,1886b)。病人名为奥古斯特,求诊原因是身体左半边丧失触觉与感觉。病人的家族历史让人悲叹:父亲脾气暴躁;母亲苦于头痛。家中有6子:大儿子因大脑染上与梅毒有关的病而死;二儿子苦于痉挛;三儿子是军中逃兵;第4和第5个儿子都在很小的时候就去世了。奥古斯特是第6个儿子,也是老幺。他的癫痫症第一次发作是在8岁被马车辗过后。现在他是个与社会隔绝的人,苦于睡眠障碍和思绪失控,而且现在他的病症又因精神创伤而加剧,原因是还活着的二哥拒绝偿还借款。他的二哥拿刀追杀他,威胁要刺伤他。这名雕刻师惊恐地跑回家,昏倒在家门口,且剧烈痉挛了2个小时。
弗洛伊德当场拿这病人做示范,证明头部左边的皮肤丧失感觉,不论刺、拧或扭捏左耳皆没反应。甚至拿小纸卷插入左鼻孔都没有感觉。弗洛伊德把手指插入病人的左喉咙深处,但并未造成病人想吐的反应。弗洛伊德还证明,身体的下半部也有类似的“绝对麻痹”症状。蒙住病人的眼睛,他就无法用右手找到左边手臂或左半边脸部的器官。要求病人用左脚站立,他就会跌倒,证明平衡感受到阻碍。此外也有歇斯底里病患会出现的色感障碍。患者右眼的色彩视力正常,但是会把紫色看成灰色。左眼只能辨识黄色和淡红色。这是个有希望治愈的病例,因为症状变化很大,这表示患病区并无基本神经受损的情况。
这个病例代表了19世纪晚期的歇斯底里症神经病学问题:如何了解看起来严重且和生理原因无明显关联的中枢神经功能障碍——疼痛、麻痹、感觉丧失。
弗洛伊德在1886年春天离开巴黎,回到维也纳成为神经领域的专“业医师,并采用当时广受接受的方法治疗歇斯底里症:运动、适当饮食、避免劳累和压力、以强制方式禁止歇斯底里症状出现、按摩、电击刺激末梢神经系统(感应电流疗法),以及冷水浴之类的水疗法。但是他也知道歇斯底里症不是神经系统的器质性疾病。在夏尔科的同意下,弗洛伊德研究歇斯底里麻痹症状与神经系统确实受损的器质性麻痹症状之间的不同,他得出结论:歇斯底里麻痹症状和真正的生理病症不一致(Fleud,1893c)。
器质性麻痹分裂成两个不同类别。第一种病因是末梢神经纤维受损,第二种病因是脑内神经细胞受损。1830年,贝尔在贝尔麻痹(Bell’spalsy)的个案中证明,脸部末梢神经被压迫的原因,可能是病毒通过耳后颞骨的狭窄通道时造成的感染发炎。受感染部位的面部肌肉不能活动,以致造成脸部松垮、合眼困难、脸部感到沉重,而且还有唾液分泌和味觉的问题。在局部麻痹的病例中,几乎所有病例的复原都是自然而然,而且好得都很完全。在完全麻痹的病例中,复原情况视神经受损的程度而定。如果面部神经对电流刺激的感觉依旧,那么90%的病例可完全康复。
反对贝尔麻痹者,认为末梢神经纤维受到感染,也可能是因为大脑本身受损,所以影响了面部神经。脑中的面部神经细胞体受损,造成了神经纤维传导的逐渐减弱。麻痹症状不再是整个面部肌肉。比起脸部下方,眼部四周肌肉的患病程度反而较轻微,这就是大脑性麻痹(脑中风)的通用法则。在四肢麻痹的病例中,肩膀麻痹的程度比手臂还低,而臀部的麻痹程度比腿部还低。
……

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