Перевести на русский язык: In the helpless victim state of being, both agency and value are assigned to others. Self-image is as an innocent and helpless child, whereas other people are split into either all good and powerful or all bad and powerful images, thereby creating a triadic attribution system analogous to Karpman’s (1968) drama triangle of victim, rescuer, and persecutor . The triad of helpless victim, evil perpetrator, and idealized rescuer is pervasive in popular mythology and epitomized by the legend of Saint George and the dragon (Caxton, 1483). In this myth, a holy knight subdues a dragon that is about to devour a princess. The princess was wearing a wedding dress, thereby symbolizing innocence and purity, and consistent with lack of agency. The helpless victim state allows patients to maintain self-esteem through shifting the locus of responsibility for negative consequences from self to others. It also satisfies the patient’s need for unification with an idealized caregiver, though at the cost of authentic relatedness and at the cost of undercutting the patients’ autonomy and individuation. Countertransference reactions to patients in this state are generally positive, assuming that the therapist is the idealized other, rather than the devalued other, in the triad. Therapists find gratification in their patients’ idealization of them and feel effective and omniscient as patients seem to hang on their every word. At the same time, therapists feel warm, sympathetic, and protective towards the patient who so clearly is in need of help and appreciative of their efforts. Therapists often respond to such feelings with an impulse towards directive interventions, including sage advice, suggestions, and insightful interpretations in the role of the wise counselor/rescuer who is going to help steer this unfortunate person/victim in the right direction (Searles, 1961). These interventions satisfy the patient’s wish for dependency and provide a feeling of soothing and protection, but there is an unconscious expectation of intrusion and merger. The helpless victim state has advantages from a therapeutic point of view. There is a strong alliance, decreased symptoms, and improved functioning, unless too regressed. Moreover, the soothing qualities of an Ideal Other combined with externalization of patient’s inner sense of badness allows them to start examining and reflecting on distressing experiences and reconnecting with painful affect (Fonagy, 2000). Although the helpless victim state offers therapeutic opportunities, there are also pitfalls. Because this state is mutually gratifying, treatment can proceed for decades with very little progress occurring. It seems like the patient is making use of support, advice, education, and insights, but the treatment never ends. This is because therapist enactment of the role of an idealized parental figure protecting the patient from a persecutory “other” reinforces the patient’s self-image as helpless, vulnerable, and dependent. Alternatively, therapist enactment of the helpless victim state can lead to a worsening of the patient’s condition. This state can stir up deep felt longings and frustrated rage for an idealized motherfigure and infantile needy behaviors can escalate into a kind of feeding frenzy, especially if the therapist has difficulty setting clear boundaries (Kernberg, 1975). As dependency wishes are activated, separation fears and rejection sensitivity also increase, often triggering a switch into the guilty perpetrator state when the therapist inevitably fails to meet the patient’s increasingly demanding expectations for the idealized rescuer. For patients’ whose childhood experience suggests that relatedness must come at a price of authenticity (Winnicott, 1955), the patient may increasingly fear a loss of autonomy and switch into the angry victim state. In order for the therapist to be of use to a patient in the helpless victim state, the therapist must have the same qualities as transitional object, i.e. comforting and soothing like mother on the one hand, but separate or not me on the other hand (Winnicott, 1953). The therapist partially gratifies dependency wishes by a warm and soothing manner in the role of the Ideal Other, while also supporting the patient’s independent decision-making and creative exploration of his/her unique attributes in the role of the Real Other. This experience in the therapy runs contrary to the patient’s projected expectations of rejection or intrusion. It is in such transitional space between merger and separateness that patients can creatively find and explore their sense of self.
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25 декабря 2024 10:41
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