面对无法忍受的现实｜关于哀悼的意义

　　导语：从小到大，我们会面临很多丧失和伤害，比如，失去爱，失去亲人，被侮辱，被抛弃，失去身体健康......对于这些痛苦，我们是直面它，消化它，还是否认它、忘记它、合理化它？在精神分析看来，心理症状、强迫性重复、过度行为的背后，往往是一个人在抗拒面对之前的（特别是幼时的）丧失和伤害，拒绝完成哀悼的工作。Marsha Stark所著的“Working with Resistance”(《对阻抗进行工作》)一书中有一节关于哀悼的内容，深刻地阐述了哀悼的意义。

　　

　　首先，一般所说的哀悼到底是什么意思呢？我认为哀悼涉及到直面与某个客体有关的现实，一个让人难以忍受的痛苦现实，这个现实或许来源于过去，或许来源于现在。哀悼意味着一个人认识到该客体有一些非常真实的局限性，也意味着接受自己无力做任何事情来让痛苦的现实变得不同。哀悼需要让病人认识到——从他的灵魂深处认识到——无论他有多么痛苦和愤怒，他不得不承认：治疗师是治疗师，父母是父母，其他人是其他人，他是他。最终，病人必须感受到所有需要感受的东西，才能让他平和地面对现实是多么不完美，多么有缺陷，以及多么令人失望。

　　哀悼并不意味着抑郁，并不意味着为自己感到难过、责怪自己、指责别人，或者觉得自己是受害者。那些充满指责和控诉的病人并不在接受事物的真相。当病人抗议这很不公平，他有权得到更多时，或者病人坚持别人需要改变，变成与自身不一样的人时，他们都在抗拒接受现实。他们不是在面对现实，做一些必须做的事情以接受现实；相反，他们抗拒面对现实，拒绝哀悼。他们在做一些我称之为“伪哀悼”的事情，这包括一种模仿哀悼的情感呈现，但这些并不是真实的情感。

　　犹太教哈西德派有一句谚语（Buber 1966）充分说明了这种区别：“有两种悲伤……一个人默默地沉思降临在他身上的不幸，他躲在角落里感到无望——这是一种糟糕的悲伤。另一种是诚实的悲伤，就像一个人的房子被烧毁了，他感到自己内心深处需要一个房子，并开始重新建造房子（P. 231)。这句谚语中提到的“最糟糕的悲伤”就是我刚才所说的伪哀悼。一个深切感受到痛苦的人，他发自内心的哀悼是对失去和失望的健康反应。

　　真正的哀悼包括面对它到底有多糟糕，无论是现在还是过去。他需要接受自己无法做点什么以让事情有所不同。他也要接受这样一个事实，即无论是自己身边的客体，还是自己本身，都不会是自己想要的样子。生活也不会像人们期待的那样。他知道，因为早年的生活事件，在此时此刻留下了心理创伤，但他必须忍受它，知道并没有办法去消除那些伤害。也许有办法弥补早期的伤害，但没有办法消除它们，没有办法从此时此刻的客体中获取对当时遭受的伤害的补偿。

　　

　　哀悼意味着能够与所有的糟糕感觉在一起：愤怒、痛苦、绝望、被伤害、背叛感和受伤。它意味着接受自己在面对这一切时根本性的无能为力感；意味着一个人决定尽可能地继续前进——也许更悲伤，但也更明智。认识到事物过去和现在的样子，会带来平和的感觉。一个人不再需要自己的客体成为与自身不一样的存在，不再渴望事物与众不同，不再强迫地重复过去并希望这一次会不一样。这意味着一个人感激自己所拥有的东西。甚至可能有一天，他开始认识到，如果他成为不一样的人，那就不再是他自己了。

　　一个能够面对现实并哀悼的病人，是一个不再需要防御，因此也无需去抗拒哀悼的人。另一方面，充满防御性和抗拒的病人，是一个还没有开始哀悼，还没有面对与客体有关的痛苦现实，包括婴儿期和现在的客体。因为无法忍受失望的痛苦，他坚持他的防御。为了不知道真相，病人坚持对他的客体抱有不切实际的积极感知（幻想），对自己抱有不切实际的消极感知（扭曲）——并把它投射到客体身上。

　　通过坚持幻想，例如，他的治疗师将让他变得有所不同，将使他的痛苦消失，病人防御对极度痛苦现实的认知，即无论是他的治疗师，还是其他的什么人都不能够真正地纠正错误，或者完全撤销早期发生并持续下来的伤害。

　　

　　病人通过坚持一种扭曲的感觉，认为自己早期受到了伤害，因此现在不能做任何事情让自己变得更好，以此来避免认识到一个可怕的现实——如果他想变得更好，最终只能取决于他自己。通过坚持这种扭曲，病人不必面对这是他的责任这个现实。

　　病人的一个扭曲的幻想——认为客体是好的，或者至少可能是好的，以及自己是坏——说明了他拒绝面对现实，拒绝哀悼。那些一直希望事情会改变的病人，还没有面对它们不会改变的现实。一个想象自己是坏的、糟糕的病人，还没有面对他的客体是有局限性的现实。患者将一直坚守在自己的生活和治疗中，直到他能够直面痛苦的现实，面对所有过去的好和坏，现在的好和坏，并以某种方式与它们和平相处。

　　简单地说，病人生病了，因为他还没有哀悼过他所遭受的所有丧失；相反，他保护自己不去感受这些丧失。当防御达到一定的程度，那么他将抗拒做最终需要做的哀悼工作，他无法释怀过去，无法放下婴儿般的依恋，无法放弃对婴儿般满足的不懈追求和强迫性重复，他就会无法继续生活。只有当病人哀悼时，他才会好起来。

　　在“病人—治疗师”关系的背景下，哀悼意味着直面治疗师的局限性这个极度痛苦的现实（在这种情况下，治疗师是父母的替身）。这意味着要认识到，他，这个病人，最终无力做任何事情来使现实不同——同时，他有责任做任何他必须做的事情。这意味着当他认识到他的治疗师，他的父母和周围人的局限性时，他能够允许自己去感受那些愤怒、痛苦和所有的糟糕感觉。当病人直面这些残酷的现实并哀悼它们时，他才会放弃他的防御和抵抗，才能变得更好。

　　——

　　作者：Marsha Stark

　　译者：俞林鑫

　　原文如下：

　　TOLERATING THE INTOLERABLE

　　First of all, what exactly do we mean by grieving? I think that grieving involves facing, head on, certain intolerably painful realities about one’s objects, past and present; it means recognizing that one’s objects have certain very real limitations; it means accepting that one is ultimately powerless to do anything to make those

　　painful realities different. Grieving requires of the patient that he feel, to the very depths of his soul, his anguish and his outrage that the therapist is as he is, that the parent was as he was, that the people in his life are as they are, and even that he is himself as he is. Ultimately, the patient must feel all of what needs to be felt in order to make his peace with the reality of just how imperfect, just how flawed, just how disappointing his world really was and is.

　　Grieving does not mean being depressed, feeling sorry for oneself, blaming oneself, blaming others, feeling victimized. The patient who faults, blames, and accuses is not accepting the reality of things as they are. Nor is the patient who protests that it isn’t fair, that he is entitled to more. Nor is the patient who insists that his objects change, demands that his objects be other than who they are. Such patients are not accepting reality; they are refusing to accept it. They are not confronting reality and doing what they must do to come to terms with it; instead, they are refusing to confront reality, they are refusing to grieve. They are doing something that I refer to as pseudogrieving, which involves a display of emotion that mimics grief but is not the real thing.

　　A Hasidic saying (Buber 1966) speaks to this distinction: “There are two kinds of sorrow…. When a man broods over the misfortunes that have come upon him, when he cowers in a corner and despairs of help—that is a bad kind of sorrow…. The other kind is the honest grief of a man whose house has burned down, who feels his need deep in his soul and begins to build anew” (p. 231). The bad kind of sorrow is what I am here describing as pseudogrief; the heartfelt grief of a man who feels his pain deeply is a healthy response to disappointment and to loss.

　　Genuine grief involves confronting the reality of just how bad it really was and is; and it means accepting that, knowing that there is nothing now that can be done to make it any different. It means coming to terms with the fact that neither the objects in one’s world nor one’s self will ever be exactly the way one would have wanted them to be. Nor will life ever be exactly the way one would have wanted it to be. It means knowing that one may well be psychically scarred in the here and

　　now because of things that happened early on but that one must live with that, knowing that there is no way to undo the original damage done. Perhaps there are ways to compensate for the early-on injuries, but there is no way to undo them, no way to extract from one’s objects in the here and now recompense for the wounds sustained then.

　　Grieving means being able to sit with the horror of it all, the outrage, the pain, the despair, the hurt, the sense of betrayal, the woundedness; it means accepting one’s ultimate powerlessness in the face of all this; and it means deciding to move on as best one can with what one has—sadder, perhaps, but wiser too. There is a kind of peace that comes with recognizing that things were as they were and are as they are. No longer does one need one’s objects to be other than they are; no longer does one yearn for things to be different; no longer does one compulsively repeat the past in the present in the hope that perhaps this time it will be different. It means appreciating that one has what one has. There may even come a time when one begins to recognize that if it had been different, one might not have become who one is.

　　The patient who is able to confront reality and able to grieve it is a patient who no longer needs his defenses and is therefore no longer resistant. On the other hand, the defended patient, the resistant patient, is someone who has not yet grieved, has not yet confronted the painful realities about his objects, both infantile and contemporary. Unable to bear the pain of his disappointment, he clings to his defenses. In order not to know, the patient holds on to unrealistically positive perceptions (illusions) about the goodness of his objects and unrealistically negative perceptions (distortions) about the badness of himself—and, by way of projection, about the badness of his objects.

　　By clinging to the illusion, for instance, that his therapist will make up the difference to him and will make his pain go away, the patient defends himself against the excruciatingly painful reality that neither his therapist nor anyone else will ever be able, really, to right the wrong or entirely undo the damage sustained early on.

　　By clinging to the illusion, the patient does not have to confront the reality of the therapist’s limitations. By clinging to a distorted sense of himself as damaged from way back and therefore incapable now of doing anything on his own to make things better, the patient defends himself against the frightening reality that, if he is to get better, ultimately it really is up to him. By clinging to the distortion, the patient does not have to confront the reality that it is his responsibility.

　　The patient’s illusory sense of his objects as good, or at least potentially good, and his distorted sense of himself as bad speak to his refusal to confront reality, his refusal to mourn. The patient who keeps hoping that things will change has not yet confronted the reality that they will not. The patient who imagines that it is he who is undeserving and bad has not confronted the reality that it was his objects who were limited. The patient will remain stuck in his life and in the treatment until he comes to the point where he can confront, head on, the excruciatingly painful reality of all the good that was not and ail the bad that was, and can somehow make his peace with it.

　　Put somewhat simply, the patient is ill because he has not yet grieved all the losses he has suffered; instead, he defends himself against experiencing such losses. To the extent that he is defended, to that extent will he be resistant to doing the grief work that ultimately needs to be done, to that extent will he be unable to let go of the past, let go of his infantile attachments, let go of his relentless pursuit of infantile gratification and his compulsive reenactments, to that extent will he be unable to get on with his life. It will be only as the patient grieves that he gets better.

　　In the context of the patient-therapist relationship, grieving means facing, head on, the excruciatingly painful reality of the therapist’s limitations (the therapist, of course, a stand-in for the parent). It means recognizing that he, the patient, is ultimately powerless to do anything to make that reality different—at the same time that he is responsible for doing whatever he must do in order to go forward in his life. And it means feeling all his pain, all his outrage, and all his anguish about just how limited his therapist, his parents, and the people in his world really are. It will be as the patient confronts these hard realities head on and grieves them that he will let go of his defenses, let go of his resistance, and get better.

　　举报/反馈