哈科米成长课： 找回遗失的“自我” 两位国际哈科米心理学专家RobFisher教授和胡婷婷导师，将运...
本论坛已有过极热烈的关于“移情， 反移情， 共情”的讨论，对于专业心理咨询治疗人员来说， 如果这些不是心理咨询治疗中最重要的概念， 起码也是最基本的概念。 对于非专业人员来说，如果只能选择心理咨询中的一个概念学会了带到日常生活中， 我的推荐将是：“共情”。当然要想学会共情，就或多或少迂回地到了移情反移情那里。
几个帖子的讨论， 主要还是集中与概念理论上的。当然这样的讨论还应该继续下去。 但我觉得有必要结合具体的例子来领会它了。
对有经验的咨询师来说， 不难看出这是一个相当不容易应付的个案。 因为来访者大多时间都不说话。明显的抑郁症候， 且有自杀倾向。他一直大多时间沉默，看起来象是抗拒帮助， 且不时说：“你帮不了我， 我想死”。
这种情形， 很容易让咨询师焦急起来， “对方简直是“滴水不尽”，怎么办呢？ 需要教育他生命价值吗？ 纠正其错误认知吗？棒喝吗？让他想起家人需要他吗（他估计没有什么令他留念的家人）？
THE CASE OF JIM BROWN(1962)
Carl Rogers(C.R):I see there are some cigarettes here in the drawer，Hmm? Yeah, it is hot out.(Silence of 25 seconds)
C.R: Do you look kind of angry this morning, or is that my imagination? (Jim shakes his head slightly.) Not angry, huh? (Silence of 1 minute, 26 seconds)
C.R: Feel like letting me in on whatever is going on? (Silence of 12 minutes, 52 seconds)
C.R: (softly) I kind of feel like saying that if it would be of any help at all I’d like to come in. On the other hand, if it’s something you’d rather-if you just feel more like being within yourself, feeling whatever you’re feeling within yourself, why that’s OK too- I guess another thing I’m saying, really, in saying that is, “I do care. I’m not just sitting here like a stick.”(Silence of 1 minute, 11 seconds)
C.R: And I guess your silence is saying to me that either you don’t want to or can’t come out right now and that’s OK. So I won’t pester you but I just want you to know, I’m here. (Silence of 17 minutes, 41seconds)
C.R:I see I’m going to have to stop in a few minutes. 1(Silence of 20 seconds)
卡尔 罗杰斯(C..R):我看见抽屉里有一些香烟,嗯?是的,有一支正在冒烟。 (25秒沉默)
C.R:今天早上你看来有些几分生气,或者那只是我的想象?(吉姆轻轻地摇了摇头) 不生气, 啊?( 1分钟26秒沉默)
C.R:想让我进到你的心里去吗? 不管里面有什么 ( 12分52秒沉默)
C.R: (温柔地)我有点想说只要有任何一点帮助,我都愿意进去。另一方面，如果你愿意的 - 如果你只是感觉你更愿意一个人独处，感受着你心中感受到的任何东西，那也好 - 我想我要说的另一件事，真的，要说的是，“我确实在意你。我可不只是像木头一样呆坐在这里。”（1分11秒沉默）
C.R: It’s hard for me to know how you’ve been feeling, but it looks as though part of the time maybe you’d rather I didn’t know how you were feeling. Anyway it looks as though part of the time it just feels very good to let down and-relax the tension. But as I say I don’t really know-how you feel. It’s just the way it looks to me. Have things been pretty bad lately? (Silence of 45 seconds)
C.R: Maybe this morning you just wish I’d shut up-and maybe I should, but I just keep feeling I’d like to-I don’t know, be in touch with you in some way. (Silence of 2 minutes, 21 seconds) (Jim yawns.)
C.R: Sounds discouraged or tired. (silence of 41 seconds)
Jim: No. Just lousy.
C.R: Everything’s lousy, huh? You feel lousy? (Silence of 39 seconds)
C.R: Want to come in Friday at 12 at the usual time?
Jim: (Yawns and mutters something unintelligible.) (Silence of 48 seconds)
C.R: Just kind of feel sunk way down deep in these lousy, lousy feelings, hmm? -Is that something like it?
C.R: No? (Silence of 20 seconds)
Jim: No. I just ain’t no good to nobody, never was, and never will be.
C.R: Feeling that now, hmm? That you’re just no good to yourself, no good to anybody. Never will be any good to anybody. Just that you’re completely worthless, huh? Those really are lousy feelings. Just feel that you’re no good at all, hmm?
吉姆：不是，我这人只是很不好，对任何人来说， 以前是这样， 以后也永远这样的。
Jim: Yeah. (Muttering in low, discouraged voice) That’s what this guy I went to town with just the other day told me.
C.R: This guy that you went to town with really told you that you were no good? Is that what you’re saying? Did I get that right?
C.R: I guess the meaning of that if I get it right is that here’s somebody that-meant something to you and what does he think of you? Why, he’s told you that he thinks you’re no good at all. And that just really knocks the props out from under you. (Jim weeps quietly.) It just brings the tears. (Silence of 20 seconds)
Jim:(Rather defiantly) I don’t care though.
C.R: You tell yourself you don’t care at all, but somehow I guess some part of you cares because some part of you weeps over it.(Silence of 19 seconds)
C.R: I guess some part of you just feels, “Here I am hit with another blow, as if I hadn’t like me. Here’s someone I’ve begun to feel attached to and now he doesn’t like me. And I’ll say I don’t care. I won’t let it make any difference to me-But just the same the tears run down my cheeks.”
Jim: (Muttering) I guess I always knew it.
Jim: I guess I always knew it.
C.R: If I’m getting that right, it is that what makes it hurt worst of all is that when he tells you you’re no good, well shucks, that’s what you’ve always felt about yourself. Is that-the meaning of that you’re saying? (Jim nods slightly, indicating agreement.) M-hm. So you feel as though he’s just confirming what-you’ve already known. He’s confirming what you’ve already felt in some way. (Silence of 23 seconds)
C.R: So that between his saying so and your perhaps feeling it underneath, you just feel about as no good as anybody could feel. (Silence of 2 minutes, 1 second)
C.R: (thoughtfully) As I sort of let it soak in and try to feel what you must be feeling-it comes up sorta this way in me and I don’t know-but, as though here was someone you’d made a contact with, someone you’d really done things for and done things with. Somebody that had some meaning to you. Now, wow! He slaps you in the face by telling you you’re just no good. And this really cuts so deep, you can hardly stand it. (Silence of 30 seconds)
C.R: I’ve got to call it quits for today, Jim. (Silence of 1 minute, 18 seconds)
C.R: It really hurts, doesn’t it? (This is in response to his quiet tears.) (Silence of 26 seconds)
C.R: I guess if the feelings came out you’d just weep and weep and weep. (Silence of 1 minute, 3 seconds)
C.R: Help yourself to some Kleenex if you’d like-Can you go now? (Silence of 23 seconds)
C.R: I guess you really hate to, but I’ve got to see somebody else. (Silence of 20 seconds)
C.R: It’s really bad, isn’t it? (Silence of 22 seconds)
C.R: Let me ask you one question and say one thing. Do you still have that piece of paper with my phone numbers on it and instructions, and so on? (Jim nods.) OK. And if things get bad, so that you feel real down, you have them call me. ‘Cause that’s what I’m here for, to try to be of some help when you need it. If you need it, you have them call me.2
Jim: I think I’m beyond help.
C.R: Huh? Feel as though you’re beyond help. I know. You feel just completely hopeless about yourself. I can understand that. I don’t feel hopeless, but I can realize that you do. Just feel as though nobody can help you and you’re really beyond help.3 (Silence of 2 minutes, 1 second)
C.R: I guess you just feel so, so down that-it’s awful. (Silence of 2 minutes)
C.R：(思虑地)当我让自己沉浸进去感受你正感受到的东西时 - 在我这里有几分感觉了, 我不知道 - 不过, 好像有一个人, 你曾经联系过、一个和你一起做事的，一个你为他做事的， 对你有意义的一个人。现在, 哦! 他扇了你一巴掌，——他告诉你你真是不好。这真是伤你至深，使你几乎无法承受。(30秒沉默)
C.R: I guess there’s one other thing too. I, I’m going to be busy here this afternoon’til 4 o’clock and maybe a little after. But if you should want to see me again this afternoon, you can drop in around about 4 o’clock, OK?-Otherwise, I’ll see you Friday noon. Unless I get a call from you. If you-if you’re kind of concerned for fear anybody would see that you’ve been weeping a little, you can go out and sit for a while where you waited for me. Do just as you wish on that. Or go down and sit in the waiting room there and read magazines-I guess you’ll really have to go.
Jim: Don’t want to go back to work.
C.R: You don’t want to go back to work, hmm?
This is the end of the interview. Later in the
day the therapist saw Jim Brown on the hospital grounds. He seemed much more cheerful and said that he thought he could get a ride into town that afternoon.
The next time the therapist saw Jim Brown
was 3 days later, on Friday. This interview follows.
C.R：我想还有另外一件事情。我，我这里今天下午会一直忙到4点，也可能还要晚一点。不过如果你想今天下午再见到我。你可以在大约4点钟左右顺便来看我，好吗？- 否则，我们星期五中午见。除非我得到你的电话。如果你-如果你有些担心害怕别人会看出你流过一些眼泪，你可以出去在等我的那个地方坐一会儿，在那里你就随意了。或者往下走坐在候诊室看杂志 - 我想你真的必须得走了。
C.R: I brought a few magazines you can take with you if you want.4 (Silence of 47 seconds)
C.R: I didn’t hear from you since last time. Were you able to go to town that day?
Jim: Yeah. I went in with a kid driving the truck.
C.R: M-hm. (Voices from next office are heard in background.) (Silence of 2 minutes)
C.R: Excuse me just a minute. (Goes to stop noise.) (Silence of 2 minutes, 20 seconds)
C.R: I don’t know why, but I realize that somehow it makes me feel good that today you don’t have your hand up to your face so that I can somehow kind of see you more. I was wondering why I felt as though you were a little more here than you are sometimes and then I realized well, it’s because-I don’t feel as though you’re hiding behind your hand, or something. (Silence of 50 seconds)
C.R: And I think I sense, though I could be mistaken, I think I do sense that today, just like some other days when you come in here, it’s just as though you let yourself sink down into feelings that run very deep in you. Sometimes there’re very bad feelings like the last time and sometimes probably there’re not so bad, though they’re sort of – I think I understand that somehow when you come in here, it’s as though you do let yourself down into those feelings. And now-
Jim: I’m gonna take off.
Jim: I’m gonna take off.5
C.R: You’re going to take off? Really run away from here? Is that what you mean? Must be some-what’s the –what’s the background of that? Can you tell me? Or I guess what I mean more accurately is I know you don’t like the place but it must be that something special came up or something?
C.R：我不知道为什么，但我意识到今天你没有把你的手放在脸上，这使我某种程度上看到你更多，这使我感觉较好。我不知道为什么我感觉好像你今天人更在这里, 然后——我意识到那是因为你好像不再把自己藏在你的手背后, 或者什么别的原因。（50秒沉默）
C.R：并且我想我觉察到 - 尽管我可能是错误的，我想我觉察到，就好像其它时间你来这里的时候, 你让自己沉浸于你内心深处的情绪中。有时这些是些坏情绪，就像上次一样，有时候可能没有如此糟糕，尽管有几分 - 我想我以为当你来到这里的时候，好像你确实让自己沉浸于那些情绪中。现在-
Jim: I just want to run away and die.
C.R: M-hm, m-hm, m-hm. It isn’t even that you want to get away from here to something. You just want to leave here and go away and die in a corner, m-hm. (Silence of 30 seconds)
C.R: I guess as I let that soak in I really do sense how, how deep that feeling sounds, that you-I guess the image that comes to my mind is sort of a, a wounded animal that wants to crawl away and die. It sounds as though that’s kind of the way you feel that you just want to get away from here and, and vanish. Perish. Not exist. (Silence of 1 minute)
Jim: (almost inaudibly) all day yesterday and all morning I wished I were dead. I even prayed last night that I could die.
C.R: I think I caught all of that, that-for a couple of days now you’ve just wished you could be dead and you’ve even prayed for that-I guess that- One way this strikes me is that to live is such an awful thing to you, you just wish you could die, and not live. (Silence of 1 minute, 12 seconds)
C.R: So that you’ve been just wishing and wishing that you were not living. You wish that life would pass away from you. (Silence of 30 seconds)
Jim: I wish it more’n anything else I’ve ever wished around here.
C.R：我想当我让自己处于你的位置上时，我真的感受到那是多么深的情绪，我的脑子里可以想像这种画面：有几分像, 一只想要慢慢爬开而死去的受伤的动物。听来象是这样一种感觉: 你要从这里走开，消失，死亡，不再存在。（1分钟沉默）
C.R: 我想我理解你所说的一切,那-两天来, 你一直希望自己能死,你甚至为此而祈祷 - 我想 -我突然醒悟的一个方面是，是生活对你来说是如此可怕,你只希望你能死,而不是活.( 1分12秒沉默
C.R: M-hm, m-hm, m-hm. I guess you’ve wished for lots of things but boy! It seems as though this wish to not live is deeper and stronger than anything you ever wished before. (Silence of 1 minute, 36 seconds)
C.R: Can’t help but wonder whether it’s still true that some things this friend said to you-are those still part of the thing that makes you feel so awful?
Jim: In general, yes.
C.R: M-hm. (Silence of 47 seconds)
C.R: The way I’m understanding that is that in a general way the fact that he felt you were no good has just set off a whole flood of feeling in you that makes you really wish, wish you weren’t alive. Is that-somewhere near it?
Jim: I ain’t no good to nobody, or I ain’t no good for nothin’, so what’s the use of living?
C.R: M-hm. You feel, “I’m not any good to another living person, so-why should I go on living?”(Silence of 21 seconds)
C.R: And I guess a part of that is that-here I’m kind of guessing and you can set me straight, I guess a part of that is that you felt, “I tried to be good for something as far as he was concerned. I really tried. And now-if I’m no good to him, if he feels I’m no good, then that proves I’m just no good to anybody.” Is that, uh-anywhere near it?
Jim: Oh, well, other people have told me that too.
C.R: Yeah, M-hm. I see. So you feel if, if you go by what others-what several others have said, then, then you are no good. No good to anybody. (Silence of 3 minutes, 40 seconds)
C.R: I don’t know whether this will help or not, but I would just like to say that-I think I can understand pretty well-what it’s like to feel that you’re just no damn good to anybody, because there was a time when-I felt that way about myself. And I know it can be really rough.6 (Silence of 13 minutes)
C.R: I see we’ve only got a few more minutes left. (Silence of 2 minutes, 51 seconds)
C.R: shall we make it next Tuesday at 11, the usual time? (Silence of 1 minute, 35 seconds)
C.R: If you gave me any answer, I really didn’t get it. Do you want to see me nest Tuesday at 11?
Jim: Don’t know.
C.R: “I just don’t know.”(Silence of 34 seconds)
C.R: right at this point you just don’t know-whether you want to say”yes” to that or not, Hmm?-I guess you feel so down and so-awful that you just don’t know whether you can-can see that far ahead. Hmm? (Silence of 1 minute, 5 seconds)
C.R: I’m going to give you an appointment at that time because I’d sure like to see you then. (Writing out appointment slip.)(Silence of 50 seconds)
C.R: And another thing I would say is that-if things continue to stay so rough for you, don’t hesitate to have them call me. And if you should decide to take off, I would very much appreciate it if you would have them call me and-so I could see you first. I wouldn’t try to dissuade you. I’d just want to see you.
Jim: I might go today. Where, I don’t know, but I don’t care.
C.R: Just feel that your mind is made up and that you’re going to leave, you’re not going to anywhere. You’re just-just going to leave, hmm? (Silence of 53 seconds)
Jim: (Muttering in discouraged tone) That’s why I want to go, because I don’t care what happens.
Jim: That’s why I want to go, because I don’t care what happens.
C.R: 好的，在此时你只是不知道-是否说“是的”或“不”，恩？- 我想你感觉如此沮丧如此可怕以致你不知道是否你能-能向前看那么远。恩？（1分5秒沉默）
C.R: 我给你这个约会时间， 因为我确信那时我想见你。（写出约定卡）（50秒沉默）
C.R: M-hm, m-hm. That’s why you want to go, because you really don’t care about yourself. You just don’t care what happens. And I guess I’d just like to say-I care about you. And I care what happens.7 (Silence of 30 seconds) (Jim bursts into tears and unintelligible sobs.)
C.R: (tenderly) somehow that just-makes all the feelings pour out. (Silence of 35 seconds)
C.R: And you just weep and weep and weep. And feel so badly. (Jim continues to sob, then blows nose and breathes in great gasps)
C.R: I do get some sense of how awful you feel inside-you just sob and sob. (Jim puts his head on desk, bursting out in great gulping, gasping sobs)
C.R: I guess all the pent-up feelings you’ve been feeling the last few days just-just come rolling out. (Silence of 32 seconds, while Jim continues to sob.)
C.R: There’s some Kleenex there, if you’d like it--M-hm. (sympathetically) you just feel kind of torn to pieces inside. (Silence of 1 minute, 56 seconds)
Jim: I wish I could die. (Sobbing)
C.R: You just wish you could die, don’t you? M-hm. You just feel so awful, you wish you could perish. (Therapist laid his hand gently on Jim’s arm during this period. Jim showed no definite response. However, the storm subsides somewhat. Very heavy breathing.) (Silence of 1 minute, 10 seconds)
C.R: You just feel so awful and so torn apart inside that, that it just makes you wish could pass out. (Silence of 3 minutes, 29 seconds)
C.R: I guess life is so tough, isn’t it? You just feel you could weep and sob your heart away and wish you could die.8 (Heavy breathing continues.) (Silence of 6 minutes, 14 seconds)
C.R: I don’t want to rush you, and I’ll stay as long as you really need me, but I do have another appointment, that I’m really late for.
Jim: Yeah. (Silence of 17 minutes)
C.R: Certainly been through something, haven’t you? (Silence of 1 minute, 18 seconds)
C.R: May I see you Tuesday?
Jim: (Inaudible response)
Jim: Don’t know. (Almost unintelligible)
C.R: “I just don’t know.” M-hm. You know all the things I said before. I mean very much. I want to see you Tuesday, and I want to see you before then if you want to see me. So, if you need me, don’t hesitate to call me. (Silence of 1 minute)
C.R: It’s really rough, isn’t it? (Silence of 24 seconds)
C.R: Sure is. (Jim slowly gets up to go.) (Silence of 29 seconds)
C.R: Want to take that too? (Jim takes appointment slip.) (Silence of 20 seconds)
C.R: There’s a washroom right down the hall where you can wash your face. (Jim opens door; noise and voices are heard from corridor.) (Silence of 18 seconds) (Jim turns back into the room.)
Jim: You don’t have a cigarette, do you? (Therapist finds one.)
C.R: There’s just one. I looked in the package but-I don’t know. I haven’t any idea how old it is, but it looks sort of old.
Jim: I’ll see you. (Hardly audible)
C.R: OK. I’ll be looking for you Tuesday, Jim.
案主28岁, 诊断为精神分裂症.他高中教育程度. 曾住院2次.第一次在他25岁的时候.
该次(第3次)住院19个月后, 罗杰斯开始见他. 前前后后罗杰斯见了他两年半.录在以上的这两次治疗是在治疗进行到11月后.