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首页 *新书上架*精神分析与叙事医学

*新书上架*精神分析与叙事医学.pdf

*新书上架*精神分析与叙事医学

九月虺
2010-03-26 0人阅读 举报 0 0 暂无简介

简介:本文档为《*新书上架*精神分析与叙事医学pdf》,可适用于职业教育领域

PsychoanalysisandNarrativeMedicineSUNYseriesinPsychoanalysisandCultureHenrySussman,editorPsychoanalysisandNarrativeMedicineEditedbyPeterLRudnytskyandRitaCharonSTATEUNIVERSITYOFNEWYORKPRESSPublishedbyStateUniversityofNewYorkPress,Albany©StateUniversityofNewYorkAllrightsreservedPrintedintheUnitedStatesofAmericaNopartofthisbookmaybeusedorreproducedinanymannerwhatsoeverwithoutwrittenpermissionNopartofthisbookmaybestoredinaretrievalsystemortransmittedinanyformorbyanymeansincludingelectronic,electrostatic,magnetictape,mechanical,photocopying,recording,orotherwisewithoutthepriorpermissioninwritingofthepublisherForinformation,contactStateUniversityofNewYorkPress,wwwsunypresseduProductionandbookdesign,LaurieSearlMarketing,AnneMValentineLibraryofCongressCataloginginPublicationDataPsychoanalysisandnarrativemedicineeditedbyPeterLRudnytsky,RitaCharonpcm(SUNYseriesinpsychoanalysisandculture)IncludesbibliographicalreferencesandindexISBN(hardcover:alkpaper)ISBN(pbk:alkpaper)NarrativemedicinePsychoanalysisIRudnytsky,PeterLIICharon,RitaIIISeriesDNLM:NarrationPsychoanalysisMedicineinLiteratureWMCPRCP'dcTomysisterBetsy,wholooksatlifefrombothsidesPLRTomymother,inloveandoutoftimeRCyanuladaThispageintentionallyleftblankAcknowledgmentsxiIntroductionPeterLRudnytskyPARTICONTEXTUALIZINGNARRATIVEMEDICINEOneWhereDoesNarrativeMedicineComeFromDrives,Diseases,Attention,andtheBodyRitaCharonTwoDesireandObesity:Dickens,Endocrinology,PulmonaryMedicine,andPsychoanalysisSanderLGilmanThreePinelandthePendulumRichardLewisHoltFourNarrativeMedicineandNegativeCapabilityTerrenceEHoltPARTIIPSYCHOANALYTICINTERVENTIONSFive“ThePastIsaForeignCountry”:SomeUsesofLiteratureinthePsychoanalyticDialogueVeraJCamdenContentsSixIt’sReallyMoreComplicatedthanYouImagine:NarrativesofRealandImaginedTraumaBennettSimonSevenNarrativeandFeminineEmpathy:JamestoKristevaJanetSayersEightTheFortunatePhysician:LearningfromOurPatientsFredLGriffinPARTIIITHEPATIENT’SVOICENineLearningHowtoTellLisaJSchnellTenImaginingImmunityEdCohenElevenAPerspectiveontheRoleofStoriesasaMechanismofMetaHealingKimberlyRMyersTwelveTheDiscourseofDisease:PatientWritingatthe“UniversityofTuberculosis”JeanSMasonPARTIVACTSOFREADINGThirteenTheTeachingCureJeffreyBermanFourteenReading,Listening,andOtherBeleagueredPracticesinGeneralPsychiatryNeilScheurichCONTENTSviiiFifteenUncertainTruths:ResistanceandDefianceinNarrativeSchuylerWHendersonSixteenNarrativeandBeyondGeoffreyHartmanAfterwordMaterialandMetaphor:NarrativeTreatmentfortheEmbodiedSelfRitaCharonNotesonContributorsIndexCONTENTSixyanuladaThispageintentionallyleftblankMymosttangibledebtistotheThomasHMarenFoundation,andespeciallytoEmilySabahMaren,forwelcomingtheideaofthisconferenceandforprovidingthefinancialsupportthatmadeitpossibleSarahMallonee,myeditorialassistantonAmericanImagofrom–,wastheArielofourtempestHersuccessor,KristenSmith,expeditedthejourneyfromreveltopage,notleastbyhercompilationoftheindexCherylbelievedinmyroughmagicIamgratefultoallthosewhocametotheUniversityofFloridatoparticipateintheconferenceLynnGamwellandSilviaIvanovaoftheBinghamtonUniversityArtMuseumgraciouslyprovidedtheimageofFreud’sdrawingofthespinalgangliaandspinalcordofpetromyzonthatadornsthecoverMythanksalsotoJamesPeltzforgivingthisvolumeasuccessortoPsychoanalysesFeminismsahomeatSUNYPress,andtoHenrySussmanforagainlendinghisimprimaturtomyworkPLRAllofmyworkinnarrativemedicinestemsfromongoinggenerativecollaborationsatColumbia,especiallywithSayantaniDasGupta,CraigIrvine,EricMarcus,DavidPlante,MauraSpiegel,andPatriciaStanley,themembersoftheNationalEndowmentfortheHumanitiesprojectonnarrativemedicineIalsothankalltheeditorsandcontributorstoLiteratureandMedicinewhoaretogetherinventinganddeepeningafieldofurgentinquiryRCEarlierversionsoftheintroductionandofchapters,,,,andappearedintheFallissueofLiteratureandMedicineandarereprintedherewiththepermissionofTheJohnsHopkinsUniversityPress:PeterLRudnytsky,introduction,as“AMultipleBirth:PyschoanalysisandNarrativeMedicine,”LiteratureandMedicine,no():–TerrenceEHolt,“NarrativeMedicineandNegativeCapability,”LiteratureandMedicinexiAcknowledgments,no():–FredLGriffin,“TheFortunatePhysician:LearningfromOurPatients,”LiteratureandMedicine,no():–LisaJSchnell,“LearningHowtoTell,”LiteratureandMedicine,no():–NeilScheurich,“Reading,Listening,andOtherBeleagueredPracticesinGeneralPsychiatry,”LiteratureandMedicine,no():–GeoffreyHartman,“NarrativeandBeyond,”LiteratureandMedicine,no():–Chapter,“ImaginingImmunity,”byEdCohen,appearedas“MetaphoricalImmunity:ACaseofBiomedicalFiction,”inLiteratureandMedicine,no():–,©TheJohnsHopkinsUniversityPressPortionsofchapterandRitaCharon’safterwordappearinherNarrativeMedicine:HonoringtheStoriesofIllness(NewYork:OxfordUniversityPress,),andarereprintedherebypermissionACKNOWLEDGMENTSxii“Chanceandthepreparedmind”ThisaphorismfavoredbythepsychologistHenryMurraybestcapturestheserendipitoussetofcircumstancesthatledtotheconferenceon“PsychoanalysisandNarrativeMedicine”IorganizedattheUniversityofFloridaonFebruary–,AlongstandinginterestinpsychoanalysispromptedmetoproposeaconferenceonthistopictotheThomasHMarenFoundation,whichrespondedwithamunificencethatallowedmetobuildmyfieldofdreamswithoutcuttinganycornersIfmyyokingofpsychoanalysisandnarrativemedicinehadinitanelementofpragmatism,sinceaconferenceonpsychoanalysisalonewouldnothavebeencompatiblewiththemissionoftheMarenFoundation,thisimprovisedthemenowseemstomeinretrospecttohavebeenastrokeofgenuineinspirationItwasafterIhadannouncedthetitleoftheGainesvilleconferencethatnarrativemedicinemadeitssplashinthepopularmediainOctoberwithanarticleinTheNewYorkTimesandafeatureonNationalPublicRadioTheconference,moreover,provedtobea“first”intwoimportantrespectsNotonlywasitthefirstconferenceeveronnarrativemedicinewithanopencallforpapers,butitwasalsothefirsttimethatnarrativemedicinehadbeenconjoinedwithpsychoanalysis,therebycreatingtheopportunityforanewinterdisciplinarydialogueBybringingtogetherindividualswithbackgroundsinpsychoanalysis,thehumanities,andthehealthcareprofessions,theconferenceinGainesvillecanbesaidtohaveforgedanewintellectualcommunityIndesigningtheprogram,oneofmyprimaryobjectiveswastogetawayfromthestatusconsciousnessthatistoooftenthebaneoftheacademicworldAlthoughmybudgetpermittedmetoinviteanextraordinarylistoffeaturedspeakersRitaCharon,SanderLGilman,BennettSimon,JodyIntroductionPETERLRUDNYTSKYMesslerDavies,MarkSolms,AbrahamVerghese,JeffreyBerman,NormanHolland,DavidBMorris,LynnGamwell,GeoffreyHartman,andFransdeWaalIalsosetupseminars,eachofwhichwascodirectedbytwooftheinvitedspeakersIntheseseminars,alltheconferenceparticipantswhowishedtoofferpaperscouldhavethemdiscussedinasmallgroupformatThepaperswerepostedonourWebsiteastheycamein,assignedtoaseminarseveralweeksbeforetheconference,andmemberswereaskedtoreadtheotherpapersintheirgroupbeforearrivinginGainesvilleUnfortunately,afamilyemergencypreventedJodyDaviesfromattendingatthelastminute,andherplaceontheprogramwasablyfilledbyVeraCamden,whosepaperhadinitiallybeenslatedforinclusioninoneoftheseminarsExcursionstotheHarnMuseumofArt,ledbyLynnGamwell,toseeaspecialexhibitionofphotographsofFreud’sapartmentatBerggassetakeninbyEdmundEngleman,shortlybeforetheemigrationoftheFreudfamilyfromViennatoLondon,roundedoutthebillofculturalfareBesidesreceivingfinancialsupportfromtheMarenFoundation,onefurtherwayinwhichchancemergedwithdesignisthattheconferencewassponsoredjointlybyLiteratureandMedicine,coeditedbyRitaCharonandMauraSpiegel,andAmericanImago,ofwhichIamtheeditorandVeraCamdenisacoeditorInthiscooperationbetweenourrespectivejournals,bothofwhicharepublishedbyTheJohnsHopkinsUniversityPress,IagaindiscernedanemblemoftheinterdisciplinarysynergyIhopedtoachieveandfiveofthepapersincludedinthepresentvolumethosebyLisaSchnell,FredGriffin,NeilScheurich,TerrenceHolt,andGeoffreyHartmanaswellasanearlierversionofthisintroduction,firstappearedasaclusterintheFallissueofLiteratureandMedicine�AlthoughIamnotascholarofnarrativemedicine,IbelievethatinproposingaconjunctionwithpsychoanalysisIwasinvitingthisexcitingnewdisciplinetoclaimaninsufficientlyacknowledgedportionofitsownhistoryForwhereasnarrativemedicinearosefromadesiretobring“literarycompetence”(andthebenefitsofliterarystudygenerally)withinthepurviewofthemedicalschoolcurriculum,itis,ofcourse,psychoanalysisthatisknownasthe“talkingcure,”andthusdistillstheessenceofwhatnarrativemedicineisallaboutFromthestandpointofpsychoanalysis,conversely,analliancewithnarrativemedicineofferstheprospectofbaskinginthereflectedgloryofthisrevivalofhumanismwithinthebastionsofscience,andtherebystrengtheningitsownpositionbothintramurallywithinthementalhealthprofessionandinAmericancultureatlargeIntracingthepsychoanalyticgenealogyofnarrativemedicine,threeprominentnamescometomymindThefirst,inevitably,isFreudFreud’sfunPETERLRUDNYTSKYdamentaltheoreticalcontributionistohaveelucidatedtheinfluenceofunconsciousmentalprocesses,andthedefensesagainstthem,onthewholeofhumanlife,whilehisgreatestinventionisofanewkindofhumanrelationshipthatbetweenanalystandpatientinwhichpeoplecanseeka“soulcure”throughexploringthemeaningoftheiroftenpainfulexperienceswithatrainedprofessionalinasecularcontextAlthoughFreudwashimselfaneurologistbeforehebecameapsychotherapist,heinsistedthat“psychoanalysisisnotaspecializedbranchofmedicine”(,),butratherbelongedtopsychologyandthattheeducationoffutureanalystsshould“includebranchesofknowledgewhichareremotefrommedicineandwhichthedoctordoesnotcomeacrossinhispractice:thehistoryofcivilization,mythology,thepsychologyofreligion,andthescienceofliterature”(,)WithoutFreud,therewouldhavebeennopsychoanalysis,butinatleastoneimportantrespectheimpededratherthanabettedthecontemporaryrapprochementwithnarrativemedicineIrefertohisnotoriousrecommendationthattheanalystshouldcultivatean“emotionalcoldness”andmodelhistechniqueonthatof“thesurgeon,whoputsasideallhisfeelings”(,)whileperforminganoperationWhereasithasbeenaprincipalthrustofnarrativemedicinetoencouragephysiciansgenuinelytolistentotheirpatients,andindoingsotolearntolookuponthemnotsimplyasabundleofsymptomsbutasfellowhumanbeings,Freud’sownespousalofasurgicalmodelofpsychoanalytictherapyparadoxicallysteeredhismovementintheoppositedirection,awrongturnfromwhichitisonlynowfinallybeingrescuedTheothertwopsychoanalystswhocanberegardedasprogenitorsofnarrativemedicine,GeorgGroddeckandMichaelBalint,arecentralfiguresintherelationaltraditionthathas,inmyunderstanding,succeededinrectifyingmanyofFreud’smistakes,includinghisminimizingoftheneedforgenuinecompassionandempathyonthepartoftheanalystinorderforemotionalhealingtotakeplaceinthepatientBothGroddeckandBalintwerecloselyassociatedwithSándorFerenczi,Freud’sgreatHungariandisciple,whoasPaulStepansky()hasshowninhisstudyofthevicissitudesofthesurgicalmetaphorinFreud’sworkeffectedthe“onlybonafidetransformation”()inFreud’sconceptionwhenFerencziredefinedtheanalystnotasasurgeonbutasanobstetrician:Thedoctor’spositioninpsychoanalytictreatmentrecallsinmanywaysthatoftheobstetrician,whoalsohastoconducthimselfaspassivelyaspossible,tocontenthimselfwiththepostofonlookeratanaturalproceeding,butwhomustbeathandinthecriticalmomentwiththeforcepsinordertocompletetheactofparturitionthatisnotprogressingspontaneously(,–)Whilereservingtherighttousethe“forceps”ofactiveinterventionasalastresort,Ferencziexhortstheanalysttoadoptastanceofwisepassiveness,INTRODUCTIONthoughthisshouldnotbemisunderstoodtomeanbeingaloofordevoidofhumansympathyFerenczi’sadmonitionwasheededbyGroddeck,themaverickdirectorofasanatoriuminBadenBadenwhocheerfullycalledhimselfa“wildanalyst”andwhoinhismasterpiece,TheBookoftheIt(),recountedhow,in,he“tookoverthetreatmentofaseverelyillwomanwhocompelledmetobecomeananalyst”()Becausethepatient“sawinmethemother,”Groddeckgraduallycametorenouncethepracticeof“authoritative,infallible,fatherlysuggestion”thathehadlearnedfromhismentorErnstSchweninger,andinsteadofbeingan“active,meddlingdoctor”hesoughttobecome“apassivetool”whoplacedhimselfatthepatient’sdisposal(–)Asaresultofthisconversionexperience,Groddeckdiscoveredthathehimselfwasbeinghealedbyhisencounterwithhispatient:“ThensuddenlyIstoodbeforetheoddfactthatIamnottreatingthepatient,butthatthepatientisinsteadtreatingmeortotranslateitintomylanguage,thattheItofmyneighborseekssototransformmyIt,indeedsotransformsit,thatitbecomesserviceabletoitspurposes”()Groddecksummarizeshisemphasisonthemutualityoftherelationshipbetweenanalystandpatient,whichmakeshimafounderofcontemporaryrelationalthinking,withtheaffirmationthat“itisnotthedoctorwhoistheessentiallyactivepartner,butthepatientThedoctor’schiefenemyishubris”(a,)Andbecauseineveryhealingrelationshipthereshouldcome“astrangeturningpointwherethepatientbecomesthedoctoranddecideshimselfwhatheistodowiththedoctor’sservicesandevenwhetherhewantstoacceptthematall”(,),itfollowsthatifthetherapeuticprocessbreaksdownforanyreason,“thedoctorwillhavetotellhimself:Ihavemadeamistakewhatmattersthenistofindoutwhatkindofmistakeitwasandtodiscussithonestlywiththepatientwithoutanyembarrassmentorattemptatapology”(b,–)Inthehistoryofpsychoanalysis,Groddeckisbestknownfortheconceptofthe“It,”thatprimalsourceofthepsychesoma,underlyingeventheunconscious,ofwhichthe“I”isnomorethananinescapablemirageorsymptomInGerman,Freud’s“id”isalsocalleddasEs,whilehis“ego”isdasIch,butJamesStrachey’sdecisiontotranslatetheseordinaryGermanwordsintoEnglishwiththeirLatinequivalents,ratherthanas“it”and“I,”accuratelycapturesthedifferencebetweenFreud’spseudoscientificstructuraltheoryandGroddeck’sunabashedlysubjectivevisionofthepoweroftheIttoshapehumanlifeWhereasIrevereGroddeckbothforhisattempttodeflatethehubrisofphysicianswhethertheybepsychoanalystsormedicaldoctorsandforhisappreciationoftheunconsciousdimensionsofphysicalillness,heisattackedbythelateSusanSontaginIllnessasMetaphor()preciselybecausehePETERLRUDNYTSKYascribesdiseasestointernalcausesandtherebyseemstoholdthepatientresponsibleforhisorherownsuffering“Suchpreposterousanddangerousviews,”sherails,“managetoputtheonusofthediseaseonthepatientandnotonlyweakenthepatient’sabilitytowithstandtherangeofplausiblemedicaltreatmentbutalso,implicitly,directthepatientawayfromsuchtreatment”()Ironically,despiteherowneminenceasawriter,Sontag’scritiqueofGroddeckreflectsherinabilitytoappreciatethepositivecontributionsofeitherpsychoanalysisornarrativemedicineForthemainthesisofherbookisthat“illnessisnotametaphor,andthatthemosttruthfulwayofregardingillnessandthehealthiestwayofbeingillisonemostpurifiedof,mostresistantto,metaphoricalthinking”()ContrarytoSontag,however,itisnotnecessarytolaydownthepotentweaponsofWesternbiomedicine,or,inLouAndreasSalomé’swords,tolookupon“thesickmanasacriminaltobepunished”(FreudandAndreasSalomé,),torecognizethatevenaphysicalillnesswillbegivenunconsciousmeaningsbythepersonwhosuffersfromit,andthatthemetaphorsonefashionsarelikelytoaffecttheoutcomeofthepsychesoma’seffortsatselfhealingInherresistancetoseeingillnessasametaphor,Sontagineffectcounselspatientssupinelytoentrustthemselvesintothehandsoftheirsupposedlygodlikephysicians,andtherebyspurnswhatthereistobelearnednotonlyfromGroddeckbutalsofrombothFreudandRitaCharonUnlikeGroddeck,whowasFerenczi’sfriendandcontemporary,BalintwashismostoutstandingpupilandwhenheleftBudapestforLondoninJanuary,sixyearsafterFerenczi’sdeath,BalintprovidedalivinglinkbetweentheHungarianandBritishschoolsofpsychoanalysisTogetherwithWRDFairbairn,DWWinnicott,MarionMilner,JohnBowlby,andothers,BalintbecameamainstayoftheIndependenttraditioninBritishpsychoanalysis,whichisthemostfertileseedbedofcontemporaryrelationalthoughtBalint’stheoreticalcontributionsincludearefutation()ofFreud’smisguidednotionofprimarynarcissism,andtheelaborationofhisownmodelofthe“basicfault”()buthismostimportantachievementinthepresentconnectionistohavepioneeredinintroducingpsychoanalyticprinciplesintothepracticeofgeneralmedicineHedevelopedhisideasoutofgroupseminarsconductedinthesattheTavistockClinic,andhisbook,TheDoctor,HisPatient,andtheIllness(),inspiredafarflungmovementof“Balintgroups”thatcontinuestothepresentdayWritteninnontechnicallanguageforpracticinginternists,whoareseenasmediatingbetweenthepatientandthespecialist,TheDoctor,HisPatient,a

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*新书上架*精神分析与叙事医学

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