我的最新日志

  • 宗教与精神病学(六)

    2009-5-13

    Death is the most obvious, intuitively apparent ultimate concern. Though some therapists, whenever possible, avoid the subject in therapy following Adolph Meyer’s adage, “Don’t scratch where it doesn’t itch,” most therapists realize that concerns about death are always there, percolating under the surface. Death haunts us as nothing else; we’ve been preoccupied with its dark presence, often just at the rim of consciousness, since early childhood and we have erected denial-based defenses against death anxiety that play a major role in character formation. Many philosophers have discoursed on the interdependence of life and death: to learn to live well is to learn to die well and conversely to learn to die well is to learn to live well.

    死亡是最外显、最直观的终极思虑。尽管有些治疗师跟从Adolph Meyer的 格言“不要在不痒的地方瘙痒”,大多数治疗师都意识到关于死亡的思虑一直都在,渗透于表层之下。死亡比任何其他东西更像幽灵般萦绕着我们,从我们童年早期 就以黑暗的形式占据了我们的内心,通常是在意识的边缘状态出现,我们对死亡焦虑都建立了以否认为主的防御机制,这在我们的性格形成中起到重要作用。很多哲 学家论述过生与死的相互依赖关系:学习好好地生就是学习好好地死,反过来,学习好好地死就是学习好好地生。

    A confrontation with death often creates a dramatic perspective-altering opportunity. Heidegger spoke of two modes of being. First, an “everyday” mode in which we marvel at the way things are in the world. This is a state of forgetfulness of being, of fleeing, of being tranquilized by the cornucopia of objects surrounding us. And, second, an “ontological mode,” a state of mindfulness of being in which we live authentically and marvel that things are, marvel at the very suchness of things. In this state the individual is primed for life-change.

    濒临死亡时,常常会出现戏剧化的改变视角的机会。海德格尔说到两种存在模式。一种 是“日常”模式,在这种模式中,我们对这个世界上的事物充满惊奇。这是一种对存在、对逃离、对从周遭的丰富事物中获得安宁的体验的健忘状态。另一种模式是 “本体模式”,在这种模式中我们关注存在本身,这个存在就是我们的真实生活和对事物的惊奇。在这种状态中,我们就在为生命改变做着准备。

    How do we move from the everyday state to the ontological state? Jaspers described the major vehicle as the “boundary experience” – a jolting, irreversible experience which shifts the individual from the everyday mode to a more authentic mode. Of all the possible boundary experiences, confrontation with death is by far the most potent.

    我们怎样才能从日常状态变为本体状态呢?雅思帕斯将主要的途径描述为“边界体验”——一种震动的、不可逆反的体验,将个体从日常模式转变为一种更可信的模式。在所有可能的边界体验中,濒临死亡的体验是目前来看最有力的。

    Time and again, we see individuals who in a confrontation with death make dramatic life changes. It is a familiar theme in great literature (for example, Scrooge in The Christmas Carol and Tolstoy’s Pierre in War and Peace, or Ivan Ilych). Cancer patients have described the experience of reprioritizing life values and trivializing the trivia in life, of saying “no” to the things that are unimportant, of turning full attention to loving ones about them, to the rhythms of the earth, changing seasons, to concern about the model of dying they set for others. In a macabre manner, cancer cures psychoneurosis and death bestows an unmistakable bitter-sweet poignancy to life. Still another way to put it is that though the physicality of death destroys us, the idea of death can save us.

    一次又一次,我们看到濒临死亡的个体发生重大的生命转变。这也是一个很熟悉的文学主题(比如,《圣诞颂歌》中的Scrooge, 托尔斯泰的《战争与和平》中的皮埃尔,还有伊凡伊里奇)。癌症患者描述过他们的体验:重新定位生命价值,不计较生活中的琐事,对不重要的事情说“不”,全 神贯注与身边相爱的人、大地的节奏、变换的四季、思考要为他人树立怎样的死亡的模式。癌症用一种恐怖的方式治愈了神经症,死亡安置了苦乐参半的辛酸。还可 以换种说法,即尽管肉体的死亡摧毁了我们,死亡的观念却能拯救我们。

    But I’ve so often heard patients lament, “What a pity I had to wait for wisdom until now, till my body was riddled with cancer.” This statement poses a major challenge for therapists: how do we find the leverage for such change in the absence of imminent death – in our everyday practice with our everyday patients? Therapists with a sensibility for existential issues may be able to utilize other less visible, more subtle boundary experiences- for example, life era markers, retirement, the aging body, children leaving home, the death of the other. Even such a trivial event as a birthday may be an important route into deeper ground. We generally celebrate such days but brief reflection upon the matter raises the question of what the celebration is about – isn’t its function really to deny and to neutralize the grim reminder of the inexorable rush of time?

    然而,我总是听到患者悲叹:“真遗憾,我不得不等到现在才等到智慧,等到我的身体 被癌症所困。”这种悲叹为治疗师提出了一个重要挑战:在没有濒临死亡的情况下,我们如何才能在日常的对普通案主的治疗实践中找到促成这种改变的杠杆?对存 在主义课题比较敏感的治疗师可能能够利用其他不那么显著的,更加细微的边界体验——比如,生命里程碑、退休、身体的衰老、孩子离开家、他人的死亡。即使像 生日那样很小的事件也可以成为进入深层内心的重要路径。我们通常会庆祝那样的日子,但是,简单反省一下,就会提出这样的问题:为什么要庆祝——难倒它的作 用实际上不是在否认和压制那种对无情逝去的时间的残酷提醒吗?

    Most religious doctrines, it seems to me, may make use of some of these therapeutic approaches but for the most part the believer is offered powerful consolation through the denial of the finality of death – through the idea of the survival of the soul, through judgment, redemption, and paradise, through reunion with loved ones, and with God, through reincarnation, through merging with the universal life force.

    在我看来,多数宗教教义运用了这些治疗方法中的一部分,但是最重要的是,通过否认死亡的结局——通过灵魂不灭、审判、救赎、天堂、与爱人和上帝重聚、再生、与宇宙生命力融合等的观念——宗教信仰者得到了最有力的安慰。

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    Do I try to impose my views on belief upon my patients? Of course not – my task is to be of help and that means to be as empathic as possible to patient’s belief system – (look out patient’s window – elaborate).

    我试图用我的有关信仰的观点影响我的案主吗?当然不——我的任务是提供帮助,这意味着要尽可能地神入案主的信念体系(用心地从案主的视角看世界)。

    But even more than empathy is required: it is important that the therapist be well-informed about the patient’s religious views – such edification may flow from the patients themselves or from the therapists’ independent study. I’ve sometimes worked with priests or nuns and urged them to look more deeply into their religious beliefs in order to obtain the comfort that should be provided therefrom. Sometimes part of the therapist’s task is to lay bare the rationalizations that have permitted individuals to reprioritize and elevate certain religious practices over other more central ones – for example when excessive service to the letter of ritual takes precedence over expression of love, charity, and community.

    但是仅有神入还不够:治疗师对案主的宗教观点详细了解是很重要的——这种启示可以 来自个案本身,也可以来自治疗师的独立学习。我有时会与牧师和修女一道工作,这时我会促进他们更深入地关注他们的宗教信仰,以便获得他们本来可以从中得到 的安慰。有些时候,治疗师的一部分责任是明白地指出合理化过程使得有些人在排列优先顺序时把一些宗教惯例排到了其他更核心的事物之前了——例如:对宗教仪 式表面意义的过渡关注优先于对爱、慈善和分享的表达。

    That’s how I respond outwardly to an individual’s great reliance on belief in the absence of my own. And my inward, silent response? What is that like? Often I experience sheer amazement at the power and persistence of our need to believe. It does not go away: our need to believe in something beyond biology is so remarkably tenacious that we are everywhere surrounded by not only a variety of religious beliefs with many of them insisting upon the uniqueness of one particular set of beliefs, but we are also surrounded by the presences of less thoughtful and more patently irrational beliefs: past-life channelers, abduction by extraterrestrials, clairvoyance, psychic surgery, ghosts, witches, astrology, TM levitation, astral traveling, dowsers, necromancy, miracles, after-death experiences, I Ching, Feng Shui, Angels, healing crystals, palm reading, astrology, aura reading, psychokinesis, poltergeists, exorcism, Tarot cards, precognition, synchronicity and I’m sure each of you could add to this list. To repeat my earlier statement, such extraordinary claims demand extraordinary proof and no such extraordinary proof has ever been posited.

    这是我通常对特别依赖宗教信仰的人的表面回答。在我内心深处的无声的回答是什么 呢?我们对信仰的需要的力量与执着常常让我感到震惊。它不会消失:我们信仰某种超越生物之上的东西的需求是如此的顽强,以至于不论在哪里我们都会被各种不 同的宗教信仰包围,而其中很多信仰体系坚持认为自己的这套信仰是独一无二的。但同时,我们也会被一些相对浅薄或明显不合理的信念包围:前世时光隧道、来自 宇宙的诱导、透视能力、精神手术、鬼魂、巫婆、占星术、TM悬 浮、星界旅行、(特异功能)探矿、巫术、奇迹、死后体验、易经、风水、天使、疗病水晶、掌读、气味阅读、心灵制动、敲击作响闹恶作剧的鬼、咒语、塔罗牌、 预知、同步性……我确信你们中任何一个人都可以往这个单子里添加新项目。我再重复一下我前面说过的观点,这种超常的主张需要有超常的证据,而那样超常的证 据从来都没出现过。

    And sometimes I feel a deep sorrow for the underlying fragility of the human condition which begets our gullibility and our powerful need to believe that, like nascent oxygen, must and will instantaneously adhere to something. Sometimes I fear the future because of the dangers that irrational belief creates for our species. It is supernatural belief, not absence of belief that may destroy us. We need only look to the past to trace out the huge swaths of destruction that unyielding conviction has caused. Or look to contemporary conflicts in the <st1:place w:st="on">Mideast or the Indian subcontinent where conflicting and unyielding fundamentalist belief systems threaten millions. I love Nietzsche’s aphorism that it is not the courage of one’s convictions that matters but the courage to change one’s convictions.

    有时候我对人类状况的潜在脆弱感到一种深深的悲伤,这种脆弱导致我们的轻信以及对 信仰的强烈需求,就像初生态氧一样,必须并且会立刻粘附到某种东西上。有时候我为未来恐惧,因为不合理的信仰会给我们人类带来危险。超自然的信仰,而不是 缺少信仰,会毁掉我们。我们只要回首过去就可以追踪到执着的信仰造成的巨大破坏的痕迹。或者看看当前中东或印度次大陆的冲突,在那里,相互冲突的、固执的 正统教派信仰体系正威胁着成百万人的生命。我很喜欢尼采的警句:重要的不是信仰的勇气,而是改变信仰的勇气。

    There are times when I feel (but keep to myself) sorrow as I consider the amount of an individual’s life that can be spent in bondage to obsessive-compulsive behavīor, and to practices of prolonged meditation or excessive preoccupation with ritualistic practice. What is lost is some part of human freedom, creativity and growth.

    有些时候,我感觉(但我把它留在心底)难过,因为我想到一个人的相当一部分生命会处在强制性的行为、拖延时间的冥想或过度的仪式化实践的束缚中。我们失去的是一部分人类的自由、创造力和成长。

    In his four noble truths the Buddha taught that life is suffering, that suffering originates from craving and attachment, and that suffering can be eliminated by detachment from craving through meditative practice. Schopenhauer took a similar position – that the will is insatiable and that as soon as one impulse is satisfied we enjoy only a moment of satiation which is instantly replaced by boredom until another desire seizes us.

    在四大真理中,佛教导我们:生命是苦难,这种苦难源自渴望和依赖,消除苦难的办法是通过冥想练习超越渴望。叔本华也有类似的观点——欲望是永不满足的,一旦我们的一种冲动得到了满足,我们享受到片刻的满足后,这满足就立刻被无聊取代,直到另一个欲望抓住我们。

    To me, these views feel unnecessarily pessimistic. I appreciate the suffering in human existence but I never experience that suffering as so overwhelming that it demands the sacrifice of life. I much prefer a Nietzschian life-celebratory, life engagement, amor fati (love your fate) perspective. My work with individuals facing death has taught me that death anxiety is directly proportional to the amount of each person’s “unlived life.” Those individuals who feel they have lived their lives richly, have fulfilled their potential and their destiny, experience less panic in face of death. Therapists have much to learn from Nikos Kazanzakis, the author of so many great life-celebratory works of art, for example, Zorba the Greek and The Greek Passion. Kazanzakis was, like Nietzsche, an anti-religion religious man whose grave (placed just outside the city walls of Heraklion on <st1:place w:st="on">Crete, because of excommunication from the church) bears his chosen epitaph, “I want nothing, I fear nothing, I am free.” I love the advice he offers in his major work, A Modern Sequel to the Odyssey. His advice for life is: “Leave nothing for death but a burned-out castle.” It’s not a bad guideline for our life – and for our work in therapy.

    对我而言,这些观点过于悲观。我感激人类存在中的痛苦,但我从未感受到那种会导致 牺牲生命的无法抵抗的痛苦。我很喜欢尼采的生命庆祝、生命契约、热爱命运的视角。我对濒临死亡的个体的治疗工作让我了解到死亡焦虑与每个人的“没有活过的 生命”直接相关。那些感觉自己生活丰富多彩、实现了他们的潜能、完成了他们的使命的人在死亡面前感受到较少的恐慌。治疗师需要从Nikos Kazanzakis那里学习很多东西,他是大量伟大的生命庆祝艺术作品的创作者,例如Zorba the Greek以及The Greek Passion。像尼采一样,Kazanzakis是一位反宗教的宗教人士,他的坟墓(因为被逐出教会,他的坟墓就坐落在克里特岛的Heraklion的城墙之外)上刻着他自己选的墓志铭:“我什么都不想要,我什么都不害怕,我是自由的。” 我非常喜欢他在他的一个主要作品《奥德赛的现代版结局》中提到的建议。他对生命的建议是:“除了一个烧毁的城堡,什么都不要留给死亡。”这对我们的生命是一个不错的指引,对我们的治疗工作也是如此。

    Copyright © 2000 Irvin D. Yalom, M.D.

  • 宗教与精神病学(五)

    2009-5-13

    I’ll turn now from meaninglessness to another ultimate concerns: Existential Isolation. First we need to discriminate between the several uses of isolation in our profession.

    现在我要从无意义转向另一个终极关切:孤独。首先我们需要对我们职业中对孤独这一词汇的几种用法做一区别。

    There is Intra-psychic isolation which refers to separation from oneself. It’s an old concept – think of Binswanger’s descrīption of Ellen West where in a discussion of how she no longer knows her own opinion he says: “This is the loneliest state of all, an almost complete separation from one’s autonomous organism.” Freud described the defense mechanism of isolation as the process of stripping off affect from the memory of some unpleasant event and interrupting its associations so it is isolated from ordinary processes of thought. Many therapists, for example Fritz Perls, often described the therapeutic goal of helping patients reintegrate split-off parts of themselves. Indeed, Perls christened his approach, Gestalt therapy, to emphasize his dedication to the aim of “wholeness.” (Note the common etymological root of whole, heal, healthy, hale.)

    一种是心灵内部的孤独,指与自己隔离。这是一种旧有的概念——想想宾斯旺格对艾伦 维斯特的描述,在讨论到她如何不再了解她自己的观点时,他说道:“这是所有情形中最为孤独的状态,与一个人自身的机体几乎完全分离。”弗洛伊德把隔离这种 防御机制描述为:一种脱掉不愉快记忆的影响、阻止它的联结以使它与日常的思维过程相分离的过程。很多心理治疗师,如弗里茨佩尔斯常常把心理治疗的目标描述 为帮助个案把他们自身分裂的各部分重新整合起来。事实上,佩尔斯把他的治疗方法命名为格式塔治疗就是为了强调他对治疗目标“完整”的投入。(注意完整—whole这个词的常见词根含义:治疗、健康、强壮)

    And there is Interpersonal Isolation which is commonly experienced as loneliness, a ubiquitous issue in therapy. Loneliness issues from a variety of sources – social, geographic, cultural factors, the breakdown of intimacy sponsoring institutions in our society, lack of social skills, personality styles inimical to intimacy – for example, schizoid, narcissistic, exploitative, judgmental. We therapists are accustomed to working with loneliness and are, I am persuaded, particularly effective treating profound loneliness in a group therapy setting.

    另一种指人际间的隔离,通常被体验为孤独,一种治疗中非常普遍的问题。孤独的问题 来自很多方面——社会的、地理的、文化因素上的、我们社会亲密关系支持体制的崩溃、社交技能的缺乏、个人对亲密感的敌意模式——例如:精神分裂、自恋、剥 削性、评判。我们治疗师都很习惯于处理孤独,并且,我相信,我们在团体治疗的情境中处理深层的孤独会取得更好的效果。

    Finally, in addition to intra-psychic and interpersonal isolation, there is Existential Isolation which cuts even deeper; it is a more basic isolation which is riveted to existence and refers to an unbridgeable gulf between oneself and others, a separation not only between oneself and others but between self and world. It is a phenomenon that, in my experience, is experienced most keenly by patients facing death for it is as that time that one truly realizes that one was born alone into the world and must exit from the world alone. We may want others to be with us at death, we may die for another or for a cause but no one can, in the slightest degree, have one’s solitary death taken from him or her. Though we may wish that others accompany us in death (as did rulers in several cultures of antiquity) still dying remains the loneliest of human experiences. Consider the Everyman drama still performed after seven centuries. Remember that when Everyman was visited by the angel of death, he pleaded for respite or delay. When that was refused he pleaded to be allowed to take company on his trip. The angel of death agreed, “Sure, if you can find someone.” And for the remainder of the drama Everyman searched for a travel companion. All his friends and relatives declined with the flimsiest of excuses. A cousin had a cramp in the toe. Finally he turned to allegorical figures – beauty, wisdom, wealth – but even they declined to accompany him. With one exception – the moral of this Christian morality play – in the final denouement Good Deeds accompanied Everyman on his final journey.

    最后,除了心灵内部和人际间的隔离,还有存在主义的孤独,这个含义更加深刻,它是 一种由存在本身决定了的孤独,指自身与外界之间无法逾越的鸿沟,这种隔离不只存在于自身与他人之间,也存在于自身与世界之间。以我的经验看,这种现象在个 案面临死亡时体验得最为深刻,因为在那个时刻,人们才真的意识到人是独自来到这个世界的,也只能独自离开这个世界。我们可能会希望在死亡的时候有人陪伴, 我们可以为某个人或某个理由死去,但是没有人有任何可能性逃避掉孤独死去的命运。尽管我们可能希望其他人陪我们死去(就像古代很多文化中的君主一样),但 死亡仍然是人类最孤独的体验。想想历经7个世 纪仍在上演的戏剧“普通人”。当普通人拜访死亡天使的时候,他祈求获得暂缓。当这个请求被拒绝,他请求允许在这条路上有人陪伴。死亡天使同意了,“当然可 以,如果你能找到这样的人的话。”在戏剧的剩余部分,普通人一直在找这个旅伴。他的所有朋友和亲人都用最没有说服力的借口拒绝了他。一个表兄弟的借口是脚 趾抽筋。最终他求助象征人物——美丽、智慧、财富——但是甚至他们也拒绝陪伴他。只有一个例外——这部基督教道德剧中的道德——在最后的结局中,美德陪伴 普通人走上了他最终这段路。

    Religious consolation and psychotherapy have each developed its methods of quelling the dysphoria of the various forms of isolation. The Oxford English dictionary informs us that one of the roots of the word “religion” is re-ligare – to tie or to bind. The Romans used the term religare to connote a variety of ties – to family, to ancestors, to the state. That meaning – tying or binding together or let us refer to it as connectivity – vividly illuminates the similar missions of psychotherapy and religion. In fact, connectivity is a good common denominator for all the present forms of the contemporary spiritual search.

    宗教慰藉与心理治疗在压制各种形式的孤独感引发的烦躁不安方面都发展出了自己的方法。牛津英语词典告诉我们宗教(religion)这个词的一个词根是re-ligare,意思是绑缚或捆绑。《罗马书》中用religare这个词暗示各种不同的绑缚——与家庭、与祖先、与国家。这个意思——绑缚在一起,或者让我们说成是联结——生动地阐明了心理治疗与宗教相似的使命。事实上,联结是目前的所有形式的精神探索的一个很好的共同点。

    In any discussion of religion and psychiatry that term “connectivity” has great value. Therapists place nothing above the goal of connecting with patients as deeply and authentically as possible. The professional literature regarding the therapist-patient relationship is replete with discussions of encounter, genuineness, accurate empathy, positive unconditional regard, ‘I-thou encounter.’ And group therapists place the highest priority on establishing group cohesiveness. Once the group is cohesive each of the members is more able to examine and strengthen his/her relationship with each other member. In coping with death members of my groups for cancer patients often spoke of the great comfort they experienced from being with others who, by virtue of facing the same situation, provided a deep connection. One of these patients offered a lovely descrīption of “connectivity”: “I know we are each ships passing in the dark and each of us is a lonely ship but still it is mighty comforting to see the bobbing lights of the other nearby boats.”

    在任何有关宗教和心理治疗的讨论中,“联结”这个词都有着特别的价值。心理治疗师把与案主建立尽可能深厚、切实的联结当做至高无上的目标。专业著作中认为治疗师-案 主之间的关系中应充满面对、真实、准确的共情、积极的无条件关注,“你我相遇”。团体治疗师把建立团体内聚力放在首位。一旦团体内聚力建立起来,团体中的 每个成员就会更有能力检验和加强与其他各成员的关系。在我与癌症病人治疗团体成员的相处中,常常听他们说到跟其他成员在一起让他们体验到怎样的安慰,他们 因为敢于面对同样的困境而建立起了深层的联结。其中一位患者对“联结”提出了一种很可爱的描述:“我知道我们每个人都是在黑暗中行进的一条船,我们都是各 自独立的船,但是看到旁边船上摇摆的灯光还是让我感到莫大的安慰。”

    In work with the spousally bereaved I’ve been struck by the despair emanating from the rupture in connectivity which extends even beyond the experience of loss. Widows and widowers speak of the pain of living an unobserved life – of having no one who knows what time they come home, go to bed, or woke up. And who has not seen individuals continue a highly unsatisfying relationship precisely because they crave a life witness? And how often do we therapists provide help from becoming our patient’s life witness?

    在针对丧偶者的工作中,我强烈感受到那种由于联结的断裂所引发的绝望,那种感觉甚 至超越了丧失的体验。丧偶者谈到过着无人关注的生活的痛苦——没有人知道他们什么时候回家,什么时候睡觉或醒来。谁没见过尽力维持非常糟糕的关系的人呢? 他们这样做就是因为渴望有一个生活的目击者。我们治疗师又有多少时候是通过成为案主生活的目击者而给他们提供帮助的?

    Religion provides powerful forms of connectivity. A religious person is offered the consolation of a personal eternally observing deity, who is not only aware of his/her existence but also promises ultimate reunion – with lost loved ones, with the Godhead, with the universal life force. And of course it is readily apparent that organized religion provides connectivity through community: the church provides a stable congregation of like-minded individuals, sponsors enormous numbers of small groups including social groups, special interest groups, bible study, book groups, marriage encounter groups, singles groups. Large numbers of individuals undoubtedly join the religious community for reasons of social connectivity rather than allegiance to the substance of a particular religious doctrine.

    宗教为人们提供了多种有力的联结形式。宗教信徒会得到一个人性化的、永恒的关注自己的神,这个神不仅知道他/她 的存在,还承诺最后的重聚——与失去的爱人、与神性、与宇宙的生命力重聚。当然,很明显,有组织的宗教还会通过团体提供联结:教堂为有着相似意愿的个体提 供稳定的聚会的场所,兴办无数的小团体,包括社交团体,特别兴趣团体,圣经学习团体,读书会,婚姻会心团体,单身团体。毫无疑问,很多人加入宗教团体是为 了建立社交联结,而不是出于对某一特定的宗教教义的忠贞。

  • 宗教与精神病学(四)

    2009-5-13


    Let me turn now to a consideration of some psychotherapeutic as well as religious efforts to assuage existence anxiety. Consider first the ultimate concern of meaninglessness.

    现在让我来谈谈一些心理治疗以及宗教对减轻存在焦虑所做的努力。首先看看终极关切中的无意义这个主题。

    <o:p> 

    We humans appear to be meaning-seeking creatures that have the misfortune to be thrown into a world devoid of intrinsic meaning. One of our major life tasks is to invent a purpose in life sturdy enough to support a life. And then next we have to perform the tricky maneuver of subsequently denying personal authorship of this purpose so as to conclude that we “discovered” it – that it was “out there” waiting for us.

    我们人类似乎是寻求意义的生物,而很不幸,我们却进入了一个本质上缺乏意义的世 界。我们的生命使命之一就是为生命找一个足够有说服力的目标以支撑我们生命的延续。然后,我们又不得不随之耍个花招来否认我们自己就是这个目标的创作者, 于是我们说我们“发现”了它——它一直“就在那里”等着我们。

    Our ongoing search for substantial purpose in life systems often throws us into a crisis. More individuals seek therapy because of concerns about purpose in life than therapists often realize. Jung, for example, estimated that one third of his patients consulted him for that reason. The complaints take many different forms: for example, “My life has no coherence,” “I have no passion for anything,” “Why am I living? To what end? Surely life must have some deeper significance.” “I feel so empty – watching TV every night makes me feel so pointless, so useless.” “Even now at the age of fifty I still don’t know what I want to do when I grow up.”

    我们不停地寻求生命体系的实质目标的过程常常令我们陷入危机。为了寻求生命的意义 而接受心理治疗的个体往往比治疗师意识到的要多。荣格就估计他的患者中为这个原因找他咨询的人占三分之一。此类抱怨有很多形式,比如:“我的生活缺乏连贯 性”,“我对任何事都没有激情”,“我为什么活着?结局是什么?生命当然要有更深层的意义”,“我觉得很空虚——每晚看电视让我觉得很无聊,很没用”,“ 即使现在我到了50岁,我还是不知道我长大了想干什么”。

    I recently read a beautiful book called “The Listener,” the memoirs of Alan Wheelis, the <st1:place w:st="on">San Francisco psychoanalyst and marvelous lyrical writer. One passage relevant to this discussion has stuck in mind. The author is walking with his dog, Monty:

    最近我读了一本很美妙的书“倾听者”,是圣弗朗西斯科的精神分析师兼抒情诗人艾伦威利斯写的回忆录。其中一段与我们的话题相关的描述让我印象深刻。作者当时在遛他的狗,蒙迪:

    If then I bend over and pick up a stick, he is instantly before me. The great thing has now happened. He has a mission. It never occurs to him to evaluate the mission. His dedication is solely to its fulfillment. He runs or swims any distance, over or through any obstacle, to get that stick.

    如果那时我弯腰拾起一根树棍,他会立刻跑到我面前。最重要的事就这样发生了。他有一个使命。他从不去评估这个使命,他的全部目的就是完成这个使命。他会跑或游很远的距离,克服或穿越一切障碍,去拿到那个树棍。

    And, having got it, he brings it back: for his mission is not simply to get it but to return it. Yet, as he approaches me, he moves more slowly. He wants to give it to me and give closure to his task, yet he hates to have done with his mission, to again be in the position of waiting.

    一旦拿到木棍,他就会把它叼回来,因为他的使命不只是拿到他,还要带回来。但是,在他向我跑来的时候,他越跑越慢。他想把树棍给我,完成任务,但是又不喜欢完成使命后的状态,那时他又要继续等待了。

    For him as for me, it is necessary to be in the service of something beyond the self. Until I am ready he must wait. He is lucky to have me to throw his stick. I am waiting for God to throw mine. Have been waiting a long time. Who knows when, if ever, he will again turn his attention to me, and allow me, as I allow Monty, my mood of mission?

    他和我一样,必须让自己服务于某种超越自身的事。在我准备好之前,他只能等待。他很幸运有我为他扔树棍。我也在等着上帝为我扔树棍,等了很久。谁知道要等多久,他才会把注意力转向我,像我满足蒙迪那样,满足我完成任务的心愿呢?也许这一刻永远也不会来。

    Why does that passage stay with me? It’s so seductive to think of a preordained concrete assignment for life. Who among us has not had the wish: if only someone would throw me my stick. How reassuring to know that somewhere there exists a true, a real, an ordained, pre-assigned purpose-in-life rather than only the incorporeal, gossamer, invented purpose-in-life which it seems to me inevitably follows from the ultimate vision of our solar system lying in ruins.

    为什么这段话会留在我的脑海里?想到有一个预先设定的具体的生命使命是件多么有诱 惑力的事啊。我们中有谁没有过这样的愿望:如果有人给我扔木棍该多好。要是知道在某处存在着一个真实的、规定的、预先布置好的生命目标,我们会安心很多, 而不是像现在,只有虚无缥缈的、创造出来的生命目标,在我看来,这目标必定来自于对太阳系最终毁灭的景象的恐惧。

    The problem of life meaning plagues all self-reflective beings. And, of course, religious revelation which communicates God’s ultimate personal purpose for us is, no matter how difficult, no matter how lengthy, deliciously welcome. How much more comforting is the religious solution to the problem of meaning than the more rational but bleak message sent us by nature, a message that reminds us of our miniscule place in the cosmos and in the great chain of being? I once saw a memorable and jarring cartoon containing several panels, each depicting some species, for example, an earthworm, a fish, a bird, a snake, a cow. In each panel one of these creatures was depicted as chanting the same refrain: “Eat, survive, reproduce. Eat, survive, reproduce.” The last panel depicted a man in Rodin’s “thinker” posture and chanting to himself, “What’s it all about? What’s it all about?” All the other life forms seem to get the picture but we humans just cannot get our minds around it and instead demand and then legislate the existence of some higher purpose or mission.

    生命意义的问题困扰着所有喜欢自我反思的人。当然,能传达上帝对我们每个人的特定 目标的宗教启示不论多困难、多冗长,总是让人欢迎的。在关于意义的问题上,宗教的解决方式要比自然给我们的理性而黯淡的信息令人舒服得多,自然的信息只会 让我们意识到我们在宇宙中、在生物链中的渺小地位。我看到过一套尖锐的、发人深省的漫画,这漫画由几幅小图组成,每幅图上都画着几种生物,例如:蚯蚓、 鱼、鸟、蛇、牛。在每幅画中都有一个生物在反复唱着这样的内容:“捕食、生存、繁殖。捕食、生存、繁殖。”最后一幅画画了一个人摆着罗丹的“思想者”的姿 势,自言自语地重复着:“这些都是为了什么?这些都是为了什么?”其他物种似乎都自得其乐,只有我们人类总是无法释然,一定要得到、继而严格确认某种更高 级的目标或使命的存在。

    Most clinical and theoretical explorations into sturdy and satisfying life-purpose projects point to such goals as hedonism, altruism, dedication to a cause, generativity, creativity, self actualization. It seems evident to me that life-purpose projects take on a deeper, more powerful significance if they are self-transcendent – that is, directed to something or someone outside themselves – the love of a cause, the creative process, the love of others or a divine essence.

    多数医学上和理论上对令人满意的生命目的的探索得到的成果集中于:快乐主义、利他 主义、奉献于某一事业、生产、创造、自我实现。在我看来很明显,生命目的如果能超越自我——即指向身外的事物——像对事业的热爱、创造的过程、对他人或某 神圣本体的爱,就会更深刻、更富有意义。

    The precocious success of today’s young hi-tech millionaires has often generated a life crisis that is instructive about the limitations of non-self-transcendent life meaning systems. These individuals begin their careers with clear vision – they are intent on making it: earning heaps of money, living the good life, receiving the respect of colleagues, retiring early. And an unprecedented number of young people in their thirties have done exactly that – until of course the end of the good times in the recent market collapse. But then the question arises: “What now? What about the rest of my life – the next forty years?”

    今天,高科技领域里的年轻新贵们的过早成功常常引发生命危机,这对非超越自我的生 命意义体系的有限性是个有益的启示。这些个体在开始创业时目标非常明确——他们要做到这些:挣大量的钱,过很好的物质生活、赢得同事的尊重、可以早些退 休。空前多的年轻人在三十多岁时就达到了这些目标——当然,是在近期的市场崩盘前的黄金时期结束之前。但是,这个问题紧接着就出现了:“现在呢?我后半辈 子(接下来的四十年)要干什么?”

    Most of the young hi-tech millionaires that I have seen continue doing much of the same: they start new companies, they try to repeat their success. Why? They tell themselves it is to prove it was not a fluke, to prove they can do it alone, without a particular partner or mentor. They raise the bar. To feel that they and their family are secure, they no longer need one or two million in the bank – they need five, ten, even twenty-five million to feel secure. They realize the pointlessness and irrationality in earning more money when they already have more than they can possibly spend but they do not stop. They realize they are taking away time from their families, from things closer to the heart, but they cannot give up playing the game – “the money is just lying out there” they tell me, “all I have to do is pick it up.” They have to make deals. One real estate entrepreneur told me that he felt he would disappear if he stopped. Many fear boredom – even the faintest whiff of boredom sends them right back to the game.

    我看到的多数年轻的高科技新贵们接下来做了同样的事:开新公司,他们想要重复他们 的成功。为什么?他们告诉自己这是为了证明他们的成功不是出于侥幸,没有某个合作伙伴或导师的帮助,他们也可以独自做到。他们提升标准。让自己和家人有安 全感的标准不再是银行里有一两百万存款,他们需要五百万,一千万,甚至两千五百万才能觉得安全。他们意识到当他们已经拥有花不完的钱时继续挣更多的钱是无 意义也不理性的,但他们就是不能停下来。他们意识到他们在从家人、从更贴近他们内心的事物那里抢走时间,但是他们无法放弃这个游戏——“钱就在那里”,他 们告诉我,“我要做的就是把它们捡起来。”他们不得不做生意。一个房地产商告诉我他觉得如果他停下来他就会消失。很多人害怕无聊——即使最微弱的无聊感也 会让他们立刻回到那个游戏中。

    Unlike my approach to other existential ultimate concerns (death, isolation, freedom) I find that, in my clinical practice, purpose-in-life is best approached obliquely – it is best not to pursue purpose explicitly but to allow it to ensue from meaningful and authentic engagement, from plunging into an enlarging, fulfilling, self-transcending endeavor. We therapists do most good by identifying and helping to remove the obstacles to such engagement. The explicit pursuit of purpose-in-life is, as the Buddha taught, not edifying: it is best to immerse oneself into the river of life and let the question drift away. Incidentally, I’ll point out in passing that one of the great privileges of our profession as therapists is that it inoculates us against a crisis of purposelessness – that is a complaint I very rarely hear voiced by experienced therapists.

    与处理其他存在主义终极关切(死亡、孤独、自 由)的方式不同,在临床实践中我发现,生命的意义最好间接处理——最好不要追究明确的目的,而是允许允许它在有意义的、可信的投入之后自然出现,这种投入 可以是一种扩大、完成或自我超越的努力。我们治疗师在这里能给予的最大帮助是确认并帮助清除这种投入之前的障碍。正像佛教所说的,直接追寻生命的意义是无 益的:最好的办法是让自己浸入生命之河中,让这个问题自己漂走。需要顺带指出,我们做治疗师这个职业获得的重大特权之一就是免受无意义危机的困扰——我极 少听到有经验的治疗师发出这方面的抱怨。
  • 宗教与精神病学(三)

    2009-5-13

    So, existential psychotherapy is a dynamic therapy which, like the various psychoanalytic therapies, assumes the presence of unconscious forces which influence conscious functioning. However, it parts company from the various psychoanalytic ideologies when we ask the next question: what is the nature of the conflicting internal forces?

    因此,存在主义心理治疗是一种动力治疗,像各种精神分析治疗一样,假定存在着无意识力量影响着意识功能。然而,当问到下一个问题的时候,二者就分道扬镳了:这些内在的冲突力量的本质是什么?

    The existential psychotherapy approach posits that the inner conflict bedeviling us issues not only from our struggle with suppressed instinctual strivings or internalized significant adults or shards of forgotten traumatic memories, but also from our confrontation with the “givens” of existence.

    存在主义心理治疗方法认为令我们苦恼的内在冲突问题不仅来自我们与被压抑的本能欲望或者内化的重要成人或者被忘记的创伤经历的斗争,还来自我们与存在的“给定”的对峙。

    And what are these “givens” of existence? If we permit ourselves to screen out or ‘bracket’ the everyday concerns of life and reflect deeply upon our situation in the world, we inevitably arrive at the deep structures of existence (the “ultimate concerns,” to use theologian Paul Tillich’s salubrious term). Four ultimate concerns, to my view, are highly germane to psychotherapy: death, isolation, meaning in life, and freedom. These four themes form the spine of my textbook and I shall elaborate upon them as I proceed today.

    什么是存在的“给定”呢?如果我们允许自己把对生命的日常思虑像影像一样呈现出 来,然后深入反思我们在世界上所处的形势,我们就会不可避免地达到存在的深层结构(引用神学家保罗特里茨的健康术语说叫“终极关切”)。在我看来,四种终 极关切与心理治疗密切相关:死亡、孤独、生命的意义和自由。这四个词构成我的课本的主干,在我今天接下来的演讲中,我将对其详细阐释。

    What does Existential therapy look like in practice? To answer that question one must attend to both “content” and “process” – the two major aspects of therapy discourse. “Content” of course is just what it says – the precise words spoken, the substantive issues addressed. “Process” refers to an entirely different and enormously important dimension: the interpersonal relationship between the patient and therapist. When we ask about the ‘process’ of an interaction, we mean: what do the words (and the nonverbal behavīor as well) tell us about the nature of the relationship between the parties engaged in the interaction?

    在实践中存在主义治疗是怎么样的?要回答这个问题,我们必须关注“内容”和“过程 ”这两个心理治疗谈话的重要方面。“内容”当然指说了什么——使用的具体语言,表达的实际问题。“过程”指的是一个完全不同并且非常重要的维度:患者与治 疗师之间的人际关系。当我们询问一个互动行为的“过程”,我们指的是:语言和非言语行为向我们揭示了互动各方之间关系的哪些本质?

    If my own therapy sessions were observed, one might often look in vain for lengthy explicit discussions of death, freedom, meaning, or existential isolation. Such existential content may only be salient for some patients (but not all patients) at some stages (but not all stages) of therapy. In fact, the effective therapist should never try to force discussion of any content area: therapy should not be theory-driven but relationship-driven.

    如果观察我的心理治疗,你可能常常看不到关于死亡、自由、意义和存在的孤独的长篇 直接讨论。那些存在主义的内容只对某些患者(不是所有患者)在治疗的某些阶段(不是所有阶段)比较易见。事实上,有效的治疗师任何时候都不应该努力设定谈 话的内容领域:治疗不该是理论导向的,而应是关系导向的。

    But observe these same sessions for some characteristic process deriving from an existential orientation and one will discover another story entirely. A heightened sensibility to existential issues deeply influences the nature of the relationship of the therapist and patient and affects every single therapy session.

    但是,还是同样的这些治疗,如果去观察源于存在主义的典型过程,你就会发现完全不同的情况。对存在主义课题的提升的敏感度深刻地影响着治疗师和患者之间的关系,也影响着每一次会谈。

    Perhaps I can best elaborate upon that with some comments upon the basic nature of the therapeutic relationship. What’s the best term for our relationship with those we treat? Patient/therapist, client/counselor, analysand/analyst, client/facilitator, or the latest – and, by far, the most repulsive – user/provider? The choice is uncomfortable for me because none of these phrases accurately conveys my sense of the therapeutic relationship. Though I, for convenience, refer to the patient/therapist alliance, inwardly I believe there is something to be said for thinking of patients and therapists as fellow travelers, a term which abolishes distinctions between “them” (the afflicted) and “us” (the healers).

    或许我可以用一些对于治疗关系的基本本质的论断对此做出更好的阐释。最好地描述我们与我们治疗的那些人之间的关系的词汇是什么?患者/治疗师,客户/咨询师,精神分析接受者/精神分析师,客户/辅助者,或者是最近出现的——也是目前为止最让人排斥的——享用者/提供者?这种选择对我来说很不舒服,因为这里面没有一组能准确传达我对治疗关系的感觉。尽管为了方便,我使用了患者/治疗师这一组,在内心里,我认为还需要表达出把双方看作旅伴的感觉,一个能消除“他们”(痛苦者)和“我们”(治疗者)之间差别的术语。

    Andre Malraux, the French novelist, described a country priest who had taken confession for many decades and summed up what he had learned about human nature in this manner: “First of all, people are much more unhappy than one thinks ... and there is no such thing as a grown-up person.” Everyone – and that includes therapists as well as patients – is destined to experience not only the exhilaration of life, but also its inevitable darkness: disillusionment, aging, illness, isolation, loss, meaninglessness, painful choices, and death.

    安德烈马尔罗,法国小说家,描写过一个乡村牧师,他倾听了几十年忏悔之后,这样总 结他从中了解到的人性:“首先,人们比我们以为的更不快乐……并且没有一个人是所谓成熟完善的。”每个人——包括治疗师和患者——都注定不仅要体验生命的 愉快,也不可避免要体验它的阴暗面:幻灭、衰老、疾病、孤独、丧失、无意义、痛苦的抉择,还有死亡。

    No one put things more starkly and more bleakly than Schopenhauer:

    没有人比叔本华的表述更透彻更黯淡:

    In early youth” Schopenhauer says, “as we contemplate our coming life, we are like children in a theater before the curtain is raised, sitting there in high spirits and eagerly waiting for the play to begin. It is a blessing that we do not know what is really going to happen. Could we foresee it, there are times when children might seem like condemned prisoners, condemned, not to death, but to life, and as yet all unconscious of what their sentence means.”

    “在青少年时期”叔本华说,“我们预期未来的生活,就像剧场里孩子在大幕拉开之前,兴奋渴望地等待剧目开演。我们不知道后面会发生什么,这是我们的幸运。如果我们能预见未来,我们就会像被判了刑的孩子,不是死刑,而是终生监禁,但却完全不明白这个刑罚是什么意思。”

    Though Schopenhauer’s view is colored heavily by his own personal unhappiness, still it is difficult to deny the inbuilt despair in the life of every self-conscious, free-thinking individual. My wife and I have sometimes amused ourselves by planning imaginary dinner parties for groups of people sharing similar propensities – for example, a party for monopolists, or flaming narcissists, or artful passive-aggressives we have known or, conversely, a “happy” party to which we invite only the truly happy people we have encountered. Though we’ve encountered no problems filling all sorts of other whimsical tables, we’ve never been able to populate a full table for our ‘happy people’ party. Each time we identify a few characterologically cheerful people and place them on a waiting list while we continue our search to complete the table, we find that one or another of our happy guests is eventually stricken by some major life adversity – often a severe personal illness or that of a child or spouse.

    尽管叔本华的观点染上了浓烈的个人苦闷经历的色彩,我们还是很难否认每一个有自我 觉察、自由思想的个体对于生命的内在绝望。我与妻子有时会自娱地计划一些想像中的为类似人群举办的晚宴——例如,我们认识的一些独占论者,或者热恋的自我 陶醉者,或则刁专的被动攻击者,又或者,相反的,办一个“快乐”晚宴,只邀请我们遇到过的真正快乐的人。尽管我们可以毫不费力地为其他古怪的派对邀请到足 够的人,我们从来都没能为“快乐”派对邀请到足够的人。每当我们确认了几个典型的开心的人,把他们放到邀请列表里,等待继续搜寻到可以填满桌子的人,我们 就发现我们的某个开心客人遭到了某种大的生活不幸的打击——常常是自己或孩子或配偶生了大病。

    This tragic but realistic view of life has long influenced my relationship to those who seek my help. During my training I was often exposed to the idea of the “fully analyzed therapist,” – remember that fairy tale? But as I have progressed through life, formed intimate relationships with a good many of my therapist colleagues, met the senior figures in the field, have been called upon to render help to my former therapists and teachers, and have, myself, become a teacher and an elder, I have come to realize the mythic nature of this idea. We are all in this together and there is no therapist and no person immune to the inherent tragedies of existence.

    这个悲哀的,但却现实的生活观长期影响着我与那些向我寻求帮助的人之间的关系。在 我接受培训期间,我常常接受到所谓“被彻底分析过的治疗师”的概念——还记得那个童话吗?但是,随着我生活阅历的增长,我与很多治疗师同行建立了亲密的关 系,遇到了此领域中德高望重的人物,被要求为我从前的治疗师和老师提供帮助。我知道我们都是一样,没有一个治疗师也没有一个人对存在的固有悲剧具有免疫 力。

    When I speak of the ultimate concerns, of death, meaning, freedom, isolation, I am obviously veering close to the domain which is the stuff of every religious tradition. It is indisputable that religious belief and practice has been ubiquitous throughout the ages – has there ever been a culture discovered without some form of religious observation? Sometimes it is suggested that the omnipresence of religious belief constitutes confirmation or validation of an omnipresent divinity.

    当我谈到死亡、意义、自由、孤独这些终极关切的时候,很明显我接近了宗教的领域。毫无疑问,宗教信仰和宗教实践在各个时代普遍存在——至今为止有哪一种文化是看不到任何宗教的痕迹的吗?有时