英:treatment; 法:cure
“治疗”这一术语指的是与精神分析的理论相对而言的精神分析 (PSYCHOANALYSIS)的实践。尽管该术语是精神分析从医学那里承袭而来的,然而它在拉康派的精神分析理论中获得了一种特殊的意义,相当不同于该词在医学中被理解的方式。特别是,精神分析治疗的目标并不被拉康看作在产生完全健康的精神的意义上给人们以“医治”(healing)或“治愈”(curing)。神经症、精神病与性倒错的临床结构皆被看作在本质上“不可治愈”的,而且分析治疗的目标也仅仅是引导分析者道出 (articulate)他的真理。
拉康认为,治疗是具有明确方向的一种过程,是有其开始、中间与结束的一种结构性进程(见:分析的结束[END OF ANALYSS])。分析的开始,抑或“进入分析情境的时刻”,即分析者与分析家之间达成的某种协议或是“契约”,包括分析者对于遵守基本规则的同意。紧接着初始的咨询之后,还需要进行一系列面对面的预备性会谈。这些预备性会谈具有几个目标。首先,它们使一个严格意义上的精神分析性的症状得以被建构出来,以取代病人通常带来的大量含混不清的主诉。其次,它们给转移的发展留出了时间。最后,它们允许分析家得以探明是否真的存在一个对于精神分析的请求,同样也允许分析家得以假设分析者的临床结构。
在这些预备性会谈之后,治疗便不再面对面地来操作,而是要分析者斜靠在躺椅上,而分析家则要坐在他的身后,离开分析者的视野范围(躺椅不被用于对精神病患者的治疗)。随着其自由联想的展开,分析者便会修通那些此前在他的历史中一直决定着他的能指,并且会受到这一言说过程本身的驱使,去道出有关其欲望的某种东西。这是一种动力性的过程,涉及一种驱使治疗继续的力量(见:转移[TRANSFERENCE];分析家的欲望[DESIRE OF THE ANALYST])与一种阻碍此一过程的相反力量(见:阻抗[RESISTANCE])之间的冲突。分析家的任务在于指导这个过程(而非指导病人),并且在此一过程被卡住的时候再度让它运转起来。
(cure)The term 'treatment'designates the practice of PSYCHOANALYSIS as opposedto the theory of psychoanalysis.Although the term was inherited by psychoanalysis frommedicine,it has acquired a specific meaning in Lacanian psychoanalytic theory which isquite different from the way it is understood in medicine.In particular,the aim ofpsychoanalytic treatment is not seen by Lacan as 'healing'or'curing'people in the senseof producing a perfectly healthy psyche.The clinical structures of neurosis,psychosis andperversion are seen as essentially 'incurable',and the aim of analytic treatment is simplyto lead the analysand to articulate his truth.
Lacan argues that the treatment is a process with a definite direction, a structuralprogression with a beginning, middle and end (see END OF ANALYSIS). Thebeginning, or 'point of entry into the analytic situation', is a contract, or 'pact', betweenanalyst and analysand which includes the analysand's agreement to abide by thefundamental rule. Following the initial consultation, a series of face-to-face preliminaryinterviews take place. These preliminary interviews have several aims. Firstly, theyenable a properly psychoanalytic symptom to be constituted in place of the vaguecollection of complaints often brought by the patient. Secondly, they allow time for thetransference to develop. Thirdly, they permit the analyst to ascertain whether or not thereis really a demand for psychoanalysis, and also to hypothesise about the clinical structureof the analysand.
After the preliminary interviews, the treatment is no longer conducted face to face, butwith the analysand reclining on a couch while the analyst sits behind him, out of theanalysand's field of vision (the couch is not used in the treatment of psychotic patients). As he free associates, the analysand works through the signifiers that have determinedhim in his history, and is driven by the very process of speech itself to articulatesomething of his desire. This is a dynamic process which involves a conflict between aforce which drives the treatment on (see TRANSFERENCE, DESIRE OF THEANALYST) and an opposing force which blocks the process (see RESISTANCE). Theanalyst's task is to direct this process (not to direct the patient), and to get the processgoing again when it gets stuck.