This article aims to help psychoanalytically oriented clinicians address and manage the needs of patients in Alcoholics Anonymous and other 12-step programs, who represent an understudied population in our field. Drawing upon clinical experiences, it focuses on four challenges that arise for psychoanalytic clinicians, including conflicts between psychoanalytic considerations and the disease model, transference/countertransference dynamics that may emerge when a patient addresses a major problem of living in a separate context that is inaccessible to the analyst; considerations impacting the appropriate stance and level of neutrality clinicians might adopt in regards to AA participation; and factors that may prevent useful exploration of the spiritual components of AA. For each challenge, implications are discussed and considerations are offered for addressing these dynamics in treatment.

中文翻译：

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在房间和沙发上：对 AA 患者进行精神分析工作。

本文旨在帮助以精神分析为导向的临床医生解决和管理匿名酗酒者和其他 12 步计划中患者的需求，这些患者代表了我们领域中未被充分研究的人群。借鉴临床经验，它侧重于精神分析临床医生面临的四个挑战，包括精神分析考虑与疾病模型之间的冲突、当患者解决生活在无法接近的单独环境中的主要问题时可能出现的移情/反移情动态。分析师；影响临床医生在 AA 参与方面可能采取的适当立场和中立水平的考虑因素；以及可能阻止对 AA 的精神成分进行有用探索的因素。每一次挑战，