2022.05.01这七本书分析了治疗师和病人之间真正发生的事情。

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BOOKS
And How Do These Books Make You Feel?
These seven books analyze what really happens between therapist and patient.

By Ana Cecilia Alvarez
An ink blot in the middle of the pages of an open book.
Adam Maida / The Atlantic
MAY 1, 2022, 8 AM ET

Janet Malcolm once wrote that psychoanalysis requires the analyst and the patient to wrestle with an arrangement whose “radical unlikeness to any other human relationship” is dizzying for both parties involved. They consent to meet alone at the same time and place every week. Their mostly one-sided and confidential conversation is often staged with painstakingly positioned props: the couch, where the patient lies and lets their thoughts wander; the analyst’s notepad, where those thoughts are apprehended and transcribed, all in the service of hearing the patient’s underlying, unconscious needs.

That this therapeutic relationship—so awesomely abnormal, as Malcolm put it—has become relatively common speaks to how deeply Sigmund Freud’s ideas about analyzing the psyche saturate our world. A century and change since pairs began to meet in “sessions,” therapy is now a cultural trope. In fiction, for example, a premise that doesn’t seem to promise much narrative possibility—two people talking with each other in the same room again and again—becomes engrossing and mysterious. They vow, with a constancy unmatched by other commitments in their lives, to follow a largely unspoken contract of strict mores, and, as if casting a spell, invoke language as a cure.

More and more of us have been seeking entry into this arcane ritual. Last December, The New York Times found that nine out of 10 of more than a thousand American therapists reported that “patient demand” was growing. The realities of a pandemic, combined with the possibility of technology, have upended therapy: Many of us in treatment have reimagined the practice through our screens, sitting on our own couches. Chatbots can now offer a simulacrum of a fully objective, floating ear, incapable of judgment. Critics of these services have called attention to their glaring practical concerns: They can collect personal data, glitch, or just not be helpful. But these services also lack the grist of that risky, human relationship. There’s both threat and promise in the therapeutic encounter: the ineffable, fallible, and intimate play between two strangers, one witnessed and one witnessing, talking it out.

The books below—memoir, journalism, and scholarship—attempt to pin down what, exactly, occurs between two people in treatment. These texts are indispensable documents of human psychology for anyone who is willing to listen.

The cover of Psychoanalysis
Vintage
Psychoanalysis: The Impossible Profession, by Janet Malcolm

Malcolm remains the authority on psychoanalysis among laypeople who have written on the subject. This reported treatise on the inner sanctum of the New York psychoanalytic community in the 1970s, told through interviews with an anonymous practitioner, is a classic. It is also an excellent starting point for readers interested in a lucid summary of Freud’s thinking, and its evolution and application in America, with all of the internal splintering the profession is known for. Malcolm covers the conflicting views within the community on the relationship between analyst and patient. One view maintains that the relationship is solely bound up in transference—that the patient “transfers” their feelings, desires, and expectations originally directed toward one person, typically a parent, onto the analyst—and countertransference, in which the analyst does the same to the patient. In this view, patient and analyst are not really in a relationship with each other, but with each other’s misapprehensions and projections. Another view argues that there is a more real connection also at play, a “therapeutic alliance” that places the delusional dance of transference within “a placid relationship between two adults.” Malcolm lets the reader hear out both sides. Psychoanalysis: The Impossible Profession is the exacting work of a journalist and researcher, but it’s also a work of art, thanks to Malcolm’s position within the text. In a spellbinding reversal, it is she, the reporter, who plays the objective listener, while her subject, the analyst, bares their soul.

Read: How Freud canonized himself

The cover of The Last Asylum
University of Chicago Press
The Last Asylum: A Memoir of Madness In Our Times, by Barbara Taylor

When Barbara Taylor first began psychoanalysis in the early 1980s, she felt “buzzed” about her status as analysand, or patient. A historian, Taylor began to experience flare-ups of anxiety when faced with a blank page; she would tear out her hair, so she began wearing a headscarf whenever she wrote. This book is a memoir of the turbulent psychoanalysis she underwent in an attempt to heal, and a history of the last gasps of England’s asylum system. Her thrill quickly corrodes into painful exchanges with her analyst: Their partnership can be marked, on her part, by a profound dependence, clouded with intense anger. Her addiction and self-destruction deepen until she commits herself to Friern Hospital; once a prominent psychiatric institution in England, by 1988 it stood partially empty and on the brink of closure. From inside, Taylor documents the state of mental-health treatment in England at a time of seismic change. She writes movingly of the life-sustaining relationships she made at Friern, with both fellow patients and psychiatrists, and mourns the larger loss of communities of mutual care that sprung up in these otherwise neglected institutions. Throughout it all, she continues her analysis, holding onto it “like a rock”: “To outsiders, the rites of psychoanalysis can look ridiculous,” she writes. “I came to see them as containers for the uncontainable, solid supports for emotional chaos.”

The cover of Citizen
Graywolf Press
Citizen: An American Lyric, by Claudia Rankine

In a single page from her poetic exploration of the everyday violence faced by Black people, Rankine captures one of literature’s most revealing encounters between a narrator and their would-be therapist. The narrator, arriving at their appointment with a trauma specialist, finds the gate to the back office locked. When they ring the front door, the counselor barks at the assumed intruder. “You have an appointment?” she asks, the truth of the meeting dawning: “Then she pauses. Everything pauses.” As in the other microaggressions Rankine documents in Citizen, the power of this scene lies in the implicating and disarming second-person address, and the stark, unspoken racial dynamics at play. Rankine doesn’t need to tell the reader that the therapist is white, or that the narrator is not, to make clear that when she saw a Black person approaching, she did not see a potential patient. Psychotherapy, Rankine’s poem suggests, is yet another white backdrop against which people of color must stave off acts of dehumanizing misrecognitions. Yet Citizen can also allude to the necessity of a therapeutic relationship—a deep need to call out, to question, to return to, to remember, to speak of the past; and the twin need for someone to listen. Rankine writes, “You can’t put the past behind you. It’s buried in you; it’s turned your flesh into its own cupboard.”

Read: Therapy voyeurism really might be doing some good

The cover of Tribute to Freud
New Directions
Tribute to Freud, by Hilda Doolittle (H.D.)

Hilda Doolittle, writing as H.D., is a pillar of modernist poetry. After Victorian norms crumbled in the face of massive technological change and a traumatic war, her poems, novels, and essays attempted to create a new language to describe modernity. She saw Freud, and his writings, as an essential blueprint, and sought him, as a teacher and a doctor, in Vienna. She was reeling from the First World War, which led to the death of one of her brothers, and, in her mind, a stillbirth, the end of her marriage, and childhood baggage. She was also, although she dared not admit it to Freud, anxious about the rise of another war, one she correctly foresaw. Tribute to Freud contains two parts: Writing on the Wall, a memoir composed 10 years after her analysis and dedicated to her “blameless physician,” and Advent, her journal from that time. H.D.’s texts are personal testaments and also revealing documents of psychoanalysis in the first decades of the 20th century. They’re also tender portraits of Freud, who, like the practice he engendered, has become ossified by the weight of historical consequence. H.D.’s “idealization” of Freud, as Adam Phillips writes in his introduction to the text, “may be one of the preconditions for collaboration (as it is for parenting, and for falling in love, and indeed for reading and writing) … It could be the aim of a psychoanalysis to enable the patient and the analyst … to be free to be so interested and interesting to each other.”

The cover of The Examined Life
W. W. Norton and Company
The Examined Life, by Stephen Grosz

This work by the London-based psychoanalyst is an exemplar of a subgenre of memoir—recollections from a professional who, through hours of absorption in the psyche of others, becomes covered with the residue of existence. Grosz refines his records of treatment into tightly woven, sparely written vignettes that linger in readers’ minds. He was careful to ask patients, when possible, for consent to write of their experiences, and then to somewhat alter them to maintain the privacy at the core of the encounter. (After the book became an unexpected best seller in the U.K., Grosz noted in an interview, some patients could have been made uneasy by the fact that he hadn’t written about them.) One of the charms of The Examined Life is how it offers a portrait of a man who wears the struggle of sitting with enigmatic and troubling people. Writing about what he has witnessed offers a way for him to “work out something still from the case that is persisting” in him, like a toothache or an aftertaste. “I think that’s a surprise sometimes to patients,” Grosz said in the interview, “that they live in their analyst or therapist, that that goes on for a long time, sometimes years.” He hopes his case histories can challenge some of the more airbrushed depictions of analysis in popular culture, he continued, letting readers who might never lie on the couch “know what the real thing was like.”

Read: The self-help that no one needs right now

The cover of Playing and Reality
Routledge
Playing and Reality, by D. W. Winnicott

This collection of essays by the cherished mid-century pediatrician and analyst explores several now-well-known psychoanalytic concepts: the transitional object, which aids a child through their detachment from the mother; the good-enough mother, whose infallible devotion gives way to instructive moments of slight frustration for her child; and the development of creativity as key to active and embodied participation in life. Winnicott also offers an illuminating examination of therapy as a form of play. To Winnicott, play allows for a fruitful “potential space” where a child’s inner fantasies become projected onto real environments, in a dance of imaginative symbolization that leads to personal growth. The possibilities of those activities persist in adulthood: “Psychotherapy,” Winnicott writes, “has to do with two people playing together.” In fact, the work that occurs is about enacting this potential. “Where playing is not possible then the work done by the therapist is directed towards bringing the patient from a state of not being able to play into a state of being able to play,” he writes. Though this is one of the denser texts on this list, and will require some patience and interest in the academic formalities of psychoanalytic theory, the perceptiveness and humility of Winnicott’s observations are worth the read.

The cover of Psychoanalyst Meets Marina Abramović
University of Chicago Press
Psychoanalyst Meets Marina Abramović: Jeannette Fischer Meets Artist, by Marina Abramović and Jeannette Fischer

Marina Abramović is celebrated for performances that enact the extreme: risking pain, testing limits. In 2015, she invited the psychoanalyst and curator Jeannette Fischer to her house in the Hudson Valley. They set up microphones and recorded four days of conversation. Their conversation meandered among an analytic session, an interview, and an exchange between friends. Selected excerpts from their conversations are interspersed with Fischer’s analytic interpretations; the reader can see some of Abramović’s most memorable performances through the prism of her relationships with her parents and former lovers. Abramović’s art lends itself, almost agonizingly, to Freudian readings; her parents’ emotional abuse led Abramović to self-effacing performance that borders on self-negation, seeking a sense of control. In her celebrated work The Artist Is Present, Abramović sat motionless across from strangers, “staring into their eyes and focusing her entire attention on them,” Fischer writes. In other words, she offered a blank mirror to receive and reflect strangers who paid the price of admission to sit with her and be witnessed. Fischer doesn’t examine this interpretation, but she is the close listener, weaving Abramović’s telling of her life and art into meaning they can both make sense of. This double portrait of analyst and analysand shows the creative potential of this duo at its fullest.

​​When you buy a book using a link on this page, we receive a commission. Thank you for supporting The Atlantic.

Ana Cecilia Alvarez is a freelance writer.



书籍
这些书让你感觉如何？
这七本书分析了治疗师和病人之间真正发生的事情。

作者：安娜-塞西莉亚-阿尔瓦雷斯
一本打开的书页中间的墨迹。
亚当-迈达/《大西洋》杂志
2022年5月1日，美国东部时间上午8点


珍妮特-马尔科姆（Janet Malcolm）曾写道，精神分析要求分析者和病人在一种安排下进行搏斗，这种安排 "与任何其他人类关系完全不同"，让参与的双方都感到眩晕。他们同意每周在同一时间和地点单独会面。他们的谈话大多是单方面的，而且是保密的，经常用精心摆放的道具进行表演：沙发，病人躺在那里，让他们的思想游荡；分析师的记事本，这些思想被捕捉和记录下来，所有这些都是为了倾听病人潜在的、无意识的需求。

正如马尔科姆所说，这种治疗关系--如此可怕的不正常--已经变得相对普遍，这说明西格蒙德-弗洛伊德关于分析心理的想法在我们的世界中渗透得多么深。自从两人开始在 "会议 "中会面以来，一个世纪过去了，治疗现在已经成为一种文化特例。例如，在小说中，一个似乎没有什么叙事可能性的前提--两个人在同一个房间里反复交谈--变得引人入胜和神秘。他们以一种生活中其他承诺所无法比拟的恒心，发誓要遵守一个基本不言而喻的严格习俗的契约，并且，就像施了一个咒语一样，把语言作为一种治疗方法。

我们中越来越多的人一直在寻求进入这种神秘的仪式。去年12月，《纽约时报》发现，在一千多名美国治疗师中，10人中有9人报告说，"病人需求 "正在增长。大流行病的现实，再加上技术的可能性，已经颠覆了治疗。我们中的许多人在治疗中通过我们的屏幕，坐在我们自己的沙发上重新想象了这种做法。聊天机器人现在可以提供一个完全客观的模拟，浮动的耳朵，无法判断。这些服务的批评者已经呼吁注意其明显的实际问题。它们可以收集个人数据，出现故障，或者只是没有帮助。但是，这些服务也缺乏有风险的人际关系的磨练。治疗性接触既有威胁也有希望：两个陌生人之间不可言喻的、易变的、亲密的游戏，一个是见证者，一个是被见证者，把它说出来。

下面这些书--回忆录、新闻和学术研究--试图确定在治疗中的两个人之间究竟发生了什么。对于任何愿意倾听的人来说，这些文本是人类心理学不可或缺的文件。

精神分析》的封面
复古
精神分析学。不可能的职业》，作者：珍妮特-马尔科姆

在写过精神分析的非专业人士中，马尔科姆仍然是精神分析方面的权威。这篇关于20世纪70年代纽约精神分析界内部的论文，通过对一位匿名从业者的采访而讲述，是一部经典之作。对于那些对弗洛伊德思想的清晰总结及其在美国的演变和应用感兴趣的读者来说，这也是一个很好的起点，因为这个行业的内部分裂是众所周知的。马尔科姆涵盖了社区内关于分析家和病人之间关系的冲突观点。一种观点认为，这种关系只与转移有关--病人将他们原本针对一个人（通常是父母）的感觉、欲望和期望 "转移 "到分析家身上--以及反转移，即分析家对病人做同样的事情。在这种观点中，病人和分析师并不是真正的彼此关系，而是彼此的错误理解和投射。另一种观点认为，还有一种更真实的联系在起作用，一种 "治疗联盟"，将转移的妄想之舞置于 "两个成年人之间的平和关系 "之中。马尔科姆让读者听出了双方的观点。精神分析。不可能的职业》是一个记者和研究者的严谨工作，但由于马尔科姆在文本中的地位，它也是一件艺术作品。在一个迷人的反转中，她，记者，扮演着客观的听众，而她的对象，分析家，则袒露他们的灵魂。

阅读：弗洛伊德如何将自己封为圣人

最后的避难所》的封面
芝加哥大学出版社
最后的庇护所：我们时代的疯狂回忆录》，作者：芭芭拉-泰勒

当芭芭拉-泰勒在20世纪80年代初第一次开始进行精神分析时，她对自己作为分析者或病人的身份感到 "很兴奋"。作为一名历史学家，泰勒在面对空白页面时开始经历焦虑的爆发；她会撕掉自己的头发，所以她开始在写作时戴上头巾。这本书是一本回忆录，记录了她为了治愈疾病而经历的动荡的精神分析，也是一部英国庇护制度最后喘息的历史。她的激动很快就腐蚀成了与她的分析师的痛苦交流。就她而言，他们的伙伴关系可以被一种深刻的依赖性所标记，并被强烈的愤怒所掩盖。她的毒瘾和自我毁灭不断加深，直到她把自己送进弗里恩医院；弗里恩医院曾经是英国著名的精神病院，到1988年，它已经部分空置，处于关闭的边缘。泰勒从内部记录了英国心理健康治疗的状况，当时正处于震荡的变化之中。她动情地写下了她在弗里恩建立的维持生命的关系，包括与其他病人和精神病医生的关系，并对这些原本被忽视的机构中出现的相互关怀的社区的更大损失表示哀悼。在这一切中，她继续她的分析，"像岩石一样 "地坚持着。"她写道："在外人看来，精神分析的仪式可能看起来很可笑。"我开始把它们看作是无法容纳的容器，是对情感混乱的坚实支持。"

公民》的封面
灰狼出版社
公民》。克劳迪娅-兰金的《美国抒情诗》。

在她对黑人所面临的日常暴力的诗意探索中的一页，兰金捕捉到了文学作品中叙述者和他们可能的治疗师之间最露骨的一次相遇。叙述者在到达他们与创伤专家的约会地点时，发现后面办公室的门锁着。当他们按响前门时，咨询师对这个假定的入侵者大吼。"你有预约吗？"她问道，会议的真相渐渐浮现。"然后她暂停了。一切都暂停了。" 正如兰金在《公民》中记录的其他微侵犯行为一样，这一幕的力量在于隐含的、迷人的第二人称称呼，以及明显的、不言而喻的种族动力在发挥作用。兰肯不需要告诉读者治疗师是白人，也不需要告诉叙述者不是白人，就可以清楚地表明，当她看到一个黑人走过来时，她并没有看到一个潜在的病人。兰金的诗表明，心理治疗是另一种白色背景，有色人种必须在这种背景下避免非人性的误认行为。然而，公民也可以暗指治疗关系的必要性--一种呼唤、质疑、回归、回忆、谈论过去的深刻需求；以及对有人倾听的双重需求。兰金写道："你不能把过去放在身后。它埋在你的身体里；它把你的肉体变成了它自己的橱柜。"

阅读。治疗性偷窥真的可能做一些好事

向弗洛伊德致敬》的封面
新方向
向弗洛伊德致敬》，作者希尔达-杜利特尔（H.D.）

希尔达-杜利特尔，以H.D.的名义写作，是现代主义诗歌的支柱。在维多利亚时代的规范在巨大的技术变革和创伤性的战争面前崩溃之后，她的诗歌、小说和散文试图创造一种新的语言来描述现代性。她把弗洛伊德和他的著作看作是一个重要的蓝图，并以老师和医生的身份在维也纳寻找他。她从第一次世界大战中回过神来，这次战争导致了她一个兄弟的死亡，在她看来，还有一个死胎，她的婚姻结束，以及童年的包袱。虽然她不敢向弗洛伊德承认，但她也对另一场战争的爆发感到焦虑，她正确地预见到了这一点。向弗洛伊德致敬》包括两个部分。墙上的文字》是她分析后10年创作的回忆录，献给她的 "无罪的医生"；《降临》是她当时的日记。H.D.的文章是个人遗嘱，也是20世纪头几十年精神分析的揭示性文件。它们也是对弗洛伊德的温柔描写，弗洛伊德和他所创立的实践一样，已经被历史后果的重量所僵化。H.D.对弗洛伊德的 "理想化"，正如亚当-菲利普斯在他的文本导言中写道，"可能是合作的先决条件之一（就像对养育子女、恋爱以及阅读和写作一样）......精神分析的目的可能是使病人和分析者......能够自由地对对方如此感兴趣和有趣。"

审视的生活》的封面
W. W. Norton and Company
斯蒂芬-格罗兹的《审视的生活》。

这部由伦敦的精神分析学家所写的作品是回忆录的一个子类型的典范--一个专业人员的回忆，通过对他人的心理进行数小时的吸收，他的身上沾满了生存的残余。格罗兹将他的治疗记录提炼成严密的、饶有兴趣的小故事，在读者的脑海中挥之不去。他小心翼翼地在可能的情况下征求病人的同意，写下他们的经历，然后对其进行一定程度的修改，以保持接触的核心隐私。(这本书在英国意外地成为畅销书后，格罗兹在一次采访中指出，一些病人可能因为他没有写他们而感到不安。） 审视的生活》的魅力之一是它提供了一个人的肖像，这个人在与神秘和令人不安的人坐在一起的时候，戴上了挣扎的面具。写下他所目睹的一切为他提供了一种方式，使他能够 "从案件中找出一些仍然存在的东西"，就像牙痛或余味一样。"我认为这有时会让病人感到惊讶，"格罗兹在采访中说，"他们生活在他们的分析师或治疗师中，这种情况会持续很长时间，有时会持续很多年。" 他继续说，他希望他的案例史能够挑战流行文化中对分析的一些更夸张的描述，让那些可能从未躺在沙发上的读者 "知道真实的事情是什么样的"。

阅读。现在没有人需要的自我帮助

游戏与现实》的封面
路德维希
温尼科特（D. W. Winnicott）的《游戏与现实》（Playing and Reality）。

这本由本世纪中期著名的儿科医生和分析家撰写的论文集探讨了几个现已广为人知的精神分析概念：过渡性物体，它通过脱离母亲来帮助儿童；足够好的母亲，她无懈可击的奉献让她的孩子有了轻微挫折的启发；以及创造力的发展是积极和具体地参与生活的关键。温尼科特还对作为游戏形式的治疗进行了富有启发性的考察。对温尼科特来说，游戏允许一个富有成效的 "潜在空间"，在这个空间里，儿童的内心幻想被投射到真实的环境中，通过想象性的符号化的舞蹈导致个人成长。这些活动的可能性在成年后仍然存在："心理治疗"，温尼科特写道，"与两个人一起游戏有关"。事实上，所发生的工作是关于制定这种潜力。他写道："如果玩耍是不可能的，那么治疗师所做的工作就是要把病人从不能玩耍的状态带入能够玩耍的状态"。尽管这是这个名单上最密集的文本之一，需要一些耐心和对精神分析理论的学术形式的兴趣，但温尼科特观察的敏锐性和谦逊值得一读。

精神分析学家遇见玛丽娜-阿布拉莫维奇》的封面
芝加哥大学出版社
精神分析学家遇见玛丽娜-阿布拉莫维奇。玛丽娜-阿布拉莫维奇和珍妮特-费舍尔的《珍妮特-费舍尔遇见艺术家》。

玛丽娜-阿布拉莫维奇（Marina Abramović）因其表演的极端性而闻名：冒着痛苦，测试极限。2015年，她邀请了精神分析学家和策展人Jeannette Fischer来到她在哈德逊谷的房子。他们设置了麦克风，记录了四天的对话。他们的对话在分析会议、采访和朋友之间的交流中徘徊。他们谈话的部分节选与费舍尔的分析解释穿插在一起；读者可以通过阿布拉莫维奇与她的父母和前情人的关系的棱镜看到她最难忘的一些表演。阿布拉莫维奇的艺术几乎令人痛苦地适合弗洛伊德式的解读；她父母的情感虐待导致阿布拉莫维奇进行自我放弃的表演，接近自我否定，寻求一种控制感。在她著名的作品《艺术家在场》中，阿布拉莫维奇一动不动地坐在陌生人对面，"盯着他们的眼睛，把她的全部注意力集中在他们身上"，费舍尔写道。换句话说，她提供了一面空白的镜子来接受和反映那些支付了门票价格与她坐在一起并被目睹的陌生人。费舍尔没有研究这种解释，但她是一个近距离的倾听者，将阿布拉莫维奇对她的生活和艺术的讲述编织成他们都能理解的意义。这幅分析者和被分析者的双重画像充分显示了这对组合的创造潜力。

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安娜-塞西莉亚-阿尔瓦雷斯是一名自由撰稿人。