邻家心理医生第一季

Alex的案例应该算是一个失败的案例。当他开始接触到自己内心那些拒绝接受的部分时，他脱离了治疗，决定回到天空，回到那个一切尽在掌控让他感觉好的世界。然后，他死了，死因不详。作为一个动力学取向的咨询师，我不可能认为他的死亡和他内心未解决的冲突无关。

把Alex的七个治疗小节抽出来看了一遍，可以说Paul做得无懈可击。虽然一开始很困难，他们渐渐地开始取得进展。转折点就在Alex抓住Paul私人生活中的痛苦残忍地攻击他，Paul忍无可忍，一把抓住Alex，把他逼到墙角，把一杯咖啡泼到他脸上。治疗进入一个死胡同，然后置之死地而后生——隔周Alex回来了，两人有机会讨论Alex内心对自己的憎恨，并希望Paul以他期望的方式讨厌他，把他赶走。而Paul也改变了一直以来因为对方不断地挑战和试探而刻意在Alex面前维护的理想化形象。当Alex拿着帆船试图分析Paul的时候，Paul坦然承认自己在情感上是个失败者。这种示弱的姿态对不断地被期待更完美更强大的Alex至关重要，他终于也能够一点点地袒露自己内心的脆弱。

治疗取得进展的一个重要证据是我作为观众，和Paul一起，慢慢开始喜欢Alex，深深地被他打动，为他的痛苦而难过。心理治疗中很重要的转换是咨询师能够顶住对个案各种挑衅、试探而激起的负性情绪，慢慢地找到个案身上让人喜欢和同情的部分，从这里建立连接，并作为工作的基础。只有当我们真心地喜欢一个人，才会愿意帮他，才会设身处地地站在对方的立场考虑怎样才是对他最有利的。

但是，这条路对于Alex来说是很辛苦的。要让他面对自己的内心，那里有那么多的痛苦、恐惧、自我憎恨。一旦他放弃从小学会的用战胜整个世界来抵挡自己的内心的脆弱和无助，他的世界开始风雨飘摇，危险重重而看不到希望。他对Paul说：“我觉得自己做不到，无法完成这个治疗，到达我想要的目标。”Paul问：“你想要达到哪里？”Alex说：“让我不再那么憎恨自己。”

所以当他接到军方的电话，邀请他回去，他很自然地抓住了这根稻草。比起充满未知风险的自我探索，这条路要容易得多，也熟悉得多。对于一个在现实层面用自己的方式适应得不错，不，应该说是非常成功的人，要拥抱未知的变化确实是困难重重。对于Alex要求Paul对军方给出一个正面的评估，Paul非常为难，不管是在职业伦理上还是在和个案的感情上。可是Paul确实没得选择，拒绝只能导致治疗联盟的破裂，信任的崩塌，而对Alex不会有任何的帮助。Paul在说服无效的情况下，只能寄希望于下一次Alex在生活中再次遇到困难，产生足够继续治疗的动机。结果——是一场悲剧，Alex就此付出了仅仅39岁的生命，永远没有机会去真正看到自己的价值，过自己内心想过的生活。

公平地说，也不能说Alex的不幸结局是心理治疗导致的。在巴格达误炸平民学校事件之后，Alex内心被父亲灌输的要做个强者的信念和内心更人性的部分已经开始冲突，而在意识之外的冲突破坏性更大，所以他不断地自我惩罚，也无法继续飞行。但不管怎么样，这样的结局对于治疗师来说，是很不好受的。

在此，不仅是作为一个咨询师，更是作为一个经历了两年个人分析的病人，我想说：心理治疗是危险的。我们选择隔离一部分的自我，是因为那个部分太痛苦。一旦我们开始自我探索之路，就很难回头；当然，长程的治疗是很有价值的：最终我们会更了解自己，生活更自由，更有力量，更有弹性。改变甚至比你想象的要深远有力得多。但这需要一段很长很艰难的路程，在决定出发之前，希望你能问问自己：“我真的愿意忍受痛苦和困难来经历这一切吗？”

Laura的故事前面几集一直看得很烦躁，无效的治疗，甚至已经不是治疗。情感生活不幸福、进入中年危机的Paul在这种诱惑之下渐渐乱了阵脚。虽然心理治疗从业人士都能一眼看出，Laura在治疗室里呈现的诱惑，正是她需要面对的问题。可是对于陷了进去的Paul，治疗已经难以为继。

一直到——Laura决定采取主动，结束治疗关系。结束之前，Laura讲出了内心的秘密：15岁那年，母亲去世，父亲陷入抑郁。一个吸引她的父辈男人David出现，她希望他收养她，把她从抑郁的父亲身边带走，被拒绝了。然后，这个男人出现在她家中，她勾引了他，在父亲的眼皮底下每天和他做爱。她为此感觉得意，觉得自己能够借此成功进入成人世界，借此留在心仪的男人。

Paul恍然大悟，Laura一直以来对他的诱惑正是她拿手的方式，这种方式让她感觉自己有吸引力，成功，掌控。她习惯性地用诱惑的方式和一切她希望亲近的男人交往，掌控他们，但她却为此憎恨自己，因为她看不到，自己是值得被爱值得被关心的。

隔周，不再是病人的Laura回来见Paul，Paul承认自己被吸引，爱上了Laura。Laura想吻他，Paul拒绝了。Laura感到挫败和愤怒。Paul说：“你以为我不和你上床，就不会对你感兴趣。我不会像David一样背叛你，做出伤害你的事。”那一刻我很动容，不再是Laura的治疗师的Paul却终于站在了治疗师的位置上，把自己的愿望放在旁边，按照最有助于Laura的方式来行动。

然后Paul在治疗师那里讨论了很多被Laura激起的情感（我没看这部分，我是按照一个故事一个故事的顺序看的）。最后一集Gina终于不耐烦了，对Paul说：“你一直在说Laura对你怎样怎样重要，好像我在阻碍你似的。你能不能自己承担起责任？你要是想去找Laura，就去找啊。”

然后，是那个很荒谬的结局：Paul在Laura的卧室里，想要和她上床的时候，却惊恐发作。Paul说：“我很害怕会被吞下去。”我想，在那个地方，Paul大概也有些自己的情结需要去面对。不过，我还是很欣赏Gina的解释。她说：“你做了正确的事，对你自己，对你的病人。正确的决定从来都不是优雅地作出的，因为需要我们和自己的愿望做斗争。惊恐发作不是外来的东西，它就是你，你该为自己的行为负责，也该赞赏自己的正确决定。”

而最有意思的是，一直到当Paul决定接受Laura尝试和她在一起，她才真正意识到，自己并不是真的想和Paul在一起，而是自己习惯于用这种诱惑的方式来和男人交往。这就是Gina说的“令人讽刺的成功”。

看到这里，我开始觉得治疗师真是个可悲的职业。非得把自己卷入才能真的帮到病人。可是常在河边走，岂能不湿鞋。卷入的结果就是不断地需要和自己的欲望做斗争，不断地用理性抽离的方式来理解自己的欲望并超越自己的欲望。为了职业伦理而牺牲自己的欲望，作为一个人，这是多么可悲啊。

这个编剧确实对心理治疗理解很深，这个剧写出了身为治疗师的酸甜苦辣。如果说Alex的剧是不幸结局是苦，Laura的剧则是先辣后酸，口味很重，呵呵。虽然为了戏剧化的需要有太多破坏设置的地方，但在根本上心理治疗是怎么起作用的这一点写得非常好，可谓是艺术的真实吧。

    看in treatment你需要很安静，但决非是那种端一杯咖啡点上蜡烛营造点小资氛围的静。可能你不需要有多么深刻，但是在你发觉许多看似毫不相干的事情突然在你身上有所显示的时候，你就会觉得，它确实有些神奇。可能最神奇的事情就是突然在一个陌生的环境中发现了自己，或者说有许多不能明白的事情豁然开朗起来。的确，片子里过多的心理学技巧在不断堆砌，情节似乎相当散乱。可是，这种状态却给每个人的内心一种推动，或者说是一个冲击。当你完全没有头绪的时候就会停止猜测和估计，而仅仅是任凭片子里的每一句话引导。你不会觉得那个病人就是你，因为你们完全不一样，发生的事情当然是不一样的。他们是病人，而且很严重。或者说，剧情要求他们表现的夸张。但其实，只有从那些夸大的细节中才能发现其实所有的细节，微小的细节都被还原了。其实，所有的病态和不解，都缘自你自己，很真实的自己。
     或许很无聊，很冗长。大段的对话和没有表情的交流，一个极端状态下的冷漠却催生出另一个发人深省。
     难道他们在讲着自己的故事。

第一集我是完全没有从Laura有点混乱的叙述中听出她喜欢医生。以后再重看，看看能不能分析出来。
第二集他一开始提到Dan是gay我就有点怀疑他也是gay了。医生提到他妈死亡的时候我感觉这个人肯定是对死亡的痛苦和恐惧太深，又不会疏导，所以把这种感情深深压抑下去，不敢面对。他的典型的完美主义者啊，用完美主义的表象掩盖自己的弱点。他不敢承认自己是不完美的这一事实。他害怕做决定，害怕承担责任，我也一样啊。我是如此害怕做决定，如此害怕承担后果。我其实像一个5岁的小女孩啊。
哎呀，第三集的小姑娘和我很像啊，谈论悲伤的事情时会笑，很有自杀倾向，不爱谈论自己，独生女。When she was angry, she wanted her mother to call just so she could get angry with her.
google 了erotic transference，找到这一篇

A Remedy for Family Failure

Now, one very common lack in contemporary families is the failure to treat children with unconditional nurturing guidance and protection. So instead of learning true love in their families, children—through all sorts of family manipulation and game-playing, if not outright abuse—are essentially taught to fear love. And the pain of all this loneliness, guilt, and fear will live on in the unconscious, in a sort of timeless emotional imprisonment, even as the child grows through childhood and adolescence to adulthood.

So, suffering from psychological pain, you will seek out psychotherapy. Through healthy and honest interactions with a psychotherapist, you can learn to think and act in new, emotionally honest ways, different from the psychological defenses created in childhood, and current problems and symptoms can be remedied.

In this profound interaction with the psychotherapist, however, a new problem can emerge.

 
Feeling Special

As you begin to encounter genuine concern for your well-being, the whole experience of psychotherapy can feel overwhelming and intoxicating. Once having felt ignored and misunderstood, and now feeling noticed and understood—and not rejected—you can start to feel special. Moreover, you can begin to believe that the psychotherapist is special as well.

When this happens, everything can take on a feeling of erotic “love.”

You see quote marks around the word love in the last sentence because erotic feelings are really feelings of desire, not love. I want to know more about the psychotherapist’s personal life. I want to know what he or she likes. I want to be with him or her outside the psychotherapy sessions. I want to believe that he or she feels an attraction to me. And so on. That’s desire. It’s desire because it is based in what “I want,” not in what you or someone else needs.

  
        

Think for a moment about the whole purpose of family life and wonder what any infant needs. Well, an infant, born into the world completely helpless, needs protection and guidance in order to grow and develop its own abilities, so that, in maturity, he or she can go out into the world to do good for others. That protection and guidance—which is an aspect of true love—isn’t meant to make you feel “happy”; it’s meant to help you develop your unique talents and grow into a productive member of the whole human family.
        

  

Now, true love does have a function in psychotherapy. Love can be defined as “willing the good of another,” and this is precisely what the psychotherapist is ethically bound to do for all clients. The psychotherapist wills the good of all clients by ensuring that all actions within the psychotherapy serve the client’s need to overcome the symptoms that prevent the client from living a useful and meaningful life.

 
Flirting with Emotional Disaster

As unpleasant as it may be to admit it, erotic “love” is based on infantile needs to be received, accepted, and satisfied. When someone feels intensely received, accepted, and satisfied, then he or she is “in love.” But sooner or later that intensity will be broken. The break doesn’t even have to be the result of malicious neglect; it can simply be the result of a need to attend to other obligations in the world, and, in the person feeling neglected, intense jealousy can flare up.

This explains why “lovers,” friends, and blog readers, with all their personal needs and desires, cannot function psychotherapeutically. And it explains philosophically—above and beyond any laws or professional ethics—why psychotherapists cannot be friends or “lovers” to their clients. If they try, it will lead to psychological disaster, for without the “third person” of the unconscious in the consulting room the psychotherapy will degenerate into emotional chaos.

 
Understanding the Erotic Transference

Erotic “love” within the psychotherapy—technically called an erotic transference—is not necessarily a bad thing, though. That is, it’s not a bad thing if it can be understood as one essential step toward learning true love.

Just as any child who receives gifts from others must first go through a phase of development characterized by a “hoarding” or “clinging” mentality—Mine! Mine!—before learning to share with others, so you, in feeling the enthralling acceptance of your psychotherapist, will at first want to hoard that feeling and claim it as your own personal possession. But that feeling can’t stop there, and your psychotherapist’s job is to make sure it doesn’t stop there.

  
        

Sadly, many psychotherapists are not very competent in dealing with subtle psychodynamic issues. In fact, many psychotherapists feel uncomfortable with a client’s erotic transference. Why? Because many psychotherapists are unconsciously caught up in their own erotic transference with the world around them. And so these incompetent psychotherapists can make a mess of the whole process. Instead of just admitting, “Sure, you’re an interesting and attractive person. But that’s not what this work is all about. So let’s get on with the real work,” they try to hide behind a forced façade of neutrality that only leaves the client exasperated and confused. And if the client tries to speak about his or her feelings, an incompetent psychotherapist will shy away from really exploring the depth and vast unconscious extent of those feelings. Or an incompetent psychotherapist will, for his or her personal satisfaction, “fan the flames” of the client’s desire. Yet none of this is psychotherapy—it’s just more of the same manipulation and game-playing that has brought the client into treatment in the first place.
        

  

So remember why someone goes into psychotherapy: to experience a sense of genuine recognition so as to overcome the lack that disturbs current social functioning. Once all the manipulation, game-playing, and dishonesty that characterize your interpersonal relationships are dissolved through the integrity and honesty of the therapeutic relationship, then you can enter into an honest life of true love for others.

Is a psychotherapist just a “paid friend”
or an “emotional prostitute”?

 
The Real Task of Psychotherapy

Your task in psychotherapy, then, after you experience that intoxicating feeling of unconditional recognition, is to recognize in the transference itself your desire to hoard that feeling. At this point it will be important to talk openly within the psychotherapy about those desires and explore their deepest unconscious significance. Talk about how good it feels to experience recognition and understanding. And talk about how painful it felt to have been unrecognized and criticized as a child.

Assuming you have a competent psychotherapist, resist the temptation to terminate the treatment so as to run from the embarrassment of honest communication. Work through the awkwardness of it all until your desires for the psychotherapist are seen for what they are: an intoxicating attempt to hoard feelings of recognition and understanding.

Then, having understood the profound difference between desire and love, and having worked through the unconscious illusions (i.e., psychological defenses) behind your intense desire for one person, you can proceed to offer genuine love to everyone.

 
Summary

When you are working to overcome the transference, keep in mind this important fact:

  
        

You are not “in love” with your psychotherapist; you are obsessed with the idea that another person can give you what has been missing in your life because of what your parents—especially your father—took away from you in your childhood.