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基于温尼科特理论：临床心理治疗中沉默技术的运用探究

Based on Winnicott Theory: An Inquiry into the Application of Silencing Techniques in Clinical Psychotherapy

心理咨询理论与实践 / 2025,7(1)：12-24 / 2025-01-21 54 36

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• 作者： 赵丞智     
• 单位：

  北京曼陀海斯心理咨询中心，北京

• 关键词： 沟通；静默沟通；沉默；解释；精神病性病人
• Communication; Silent communication; Silence; Interpretation; Psychotic patients
• 摘要： 本文从温尼科特的理论视角出发，探讨了临床心理治疗中常见的沉默现象，包括病人对沉默的需求以及治疗师运用沉默的技术。对于某些病人而言，沉默是治疗过程中不可或缺的一部分，需要得到治疗师的理解与许可。如果简单地将病人的沉默视为一种阻抗，可能会错失深入理解沉默本身所蕴含的重要细微差别与意义的机会。治疗师运用沉默的技术，可以视为对解释技术的一种补充。对于那些人格中带有精神病性成分的病人而言，在治疗的中期阶段可能会出现沉默的现象。这种沉默通常表明病人正在进入一个能够沉思的阶段，他们需要通过沉默进一步整合自身的人格。在这一过程中，治疗师需要保持沉默，并允许病人沉默，以满足其心理发展的需求。此外，有效地应用沉默与治疗师的成熟度、情绪稳定性以及自我力量密切相关。治疗师在恰当的时机保持沉默，能够为病人提供有力的支持与共情，促进人格的整合。然而，如果治疗师在错误的时机保持沉默，或者无法在必要时保持沉默，则可能对病人产生负面影响，甚至阻碍治疗的进程。
• From the perspective of Winnicott’s theoretical framework, this paper explores the phenomenon of silence commonly observed in clinical psychotherapy, including the patient’s need for silence and the therapist’s use of silence as a technique. For certain patients, silence is an indispensable part of the therapeutic process and requires the therapist’s understanding and permission. Simply viewing the patient’s silence as a form of resistance may result in missing the opportunity to deeply understand the subtle nuances and significant meanings inherent in the silence itself. The therapist’s use of silence as a technique can be seen as a complement to interpretative techniques. For patients with psychotic components in their personality, silence may emerge during the mid-phase of therapy. This silence often indicates that the patient is entering a contemplative phase, during which they need silence to further integrate their personality. In this process, the therapist must keep silent and allow the patient to be silent to meet their psychological developmental needs. Furthermore, the effective application of silence is closely related to the therapist’s maturity, emotional stability, and inner ego-strength. When the therapist keeps silence at an appropriate moment, it can provide strong support and empathy for the patient, facilitating personality integration. However, if the therapist keeps silent at an inappropriate time or fails to keep silence when necessary, it may have a negative impact on the patient and even hinder the therapeutic process.
• DOI： https://doi.org/10.35534/tppc.0701002
• 引用： 赵丞智．基于温尼科特理论：临床心理治疗中沉默技术的运用探究［J］．心理咨询理论与实践，2025，7（1）：12-24.