Questions of what is meaningful, what is useful, and what is honest in clinical writing intertwine with ethical considerations and professional requirements about describing what happens in our consulting rooms. In an article entitled “The Writing of Clinical Papers: The Analyst As Illusionist,” Fred Plaut looks at two angles of clinical writing: one has to do with how such articles originate out of analytic experience and the other is concerned with the foreclosure of an analyst’s intuition, feeling, and preconscious experience imposed by enforcement of certain professional publishing requirements. His work responds in part to literature focused on developing common editorial and ethical standards for clinical material (Wharton 1998; Tuckett 1993, 1998). Plaut’s discussion reveals a fresh view of how it is we might decide to write about our work and what strictures keep us from revealing what actually happens. His paper is deeply considered and quite lengthy; I will merely touch on some of his points here. Plaut explores the roots of professional writing standards, acknowledging the multiple reasons we choose to make “a private process public” (1999, 376)—on one hand, teaching, sharing ideas and discoveries with colleagues, educating the public, and on the other, shoring up the foundations of psychoanalysis and responding to publish-or-perish demands. But, he argues, analysts mainly write papers for personal reasons—something catches their fancy. Although there may be multiple reasons that motivate us, we all know there are perils in those transitions from private direct analytic experience to a published paper. Plaut emphasizes that the move from live spoken experience to written text, even in the form of note-taking, involves transforming primary process into secondary process and the risk of congealing what may be ephemeral. There are losses the moment we do so. He thoughtfully explores the dynamics of note-taking, recognizing that patient confidentiality, the right to access files, detrimental aspects of transparency, and the question of obtaining permission to write about aspects of a patient’s analysis are realities that exist along with any impulse to write about clinical experience—and they affect the outcome. Plaut reflects on the inception of a paper, a private event colored by excitement about an idea or a discovery: “an emotive spark of some kind is needed every time to fire the potential writer’s imagination and to provide sufficient fuel to last throughout the rigours of disciplined writing” (378). He goes on to describe a process that follows a path from note-taking to discussing cases with colleagues, to perhaps teaching, then to actual clinical writing. His introduction of what ignites an analyst’s enthusiasm for a particular idea caught my attention because it speaks to the analyst’s live engagement in the analytic relationship (as Plaut suggests, borrow-

中文翻译：

---

临床写作中的情感火花

在临床写作中什么是有意义的、什么是有用的以及什么是诚实的问题与描述我们咨询室发生的事情的道德考虑和专业要求交织在一起。在一篇题为“临床论文的写作：作为幻觉者的分析师”的文章中，Fred Plaut 着眼于临床写作的两个角度：一个与此类文章如何起源于分析经验有关，另一个与取消赎回权有关。分析师的直觉、感觉和前意识体验是由执行某些专业出版要求所强加的。他的工作部分回应了专注于为临床材料制定共同编辑和道德标准的文献（Wharton 1998; Tuckett 1993, 1998）。Plaut 的讨论揭示了一个全新的观点，即我们可能会决定如何写下我们的工作，以及哪些限制使我们无法揭示实际发生的事情。他的论文经过深思熟虑，而且很长；我在这里只谈他的一些观点。Plaut 探索了专业写作标准的根源，承认我们选择将“私人过程公开”（1999, 376）的多种原因——一方面是教学、与同事分享想法和发现、教育公众，另一方面，支撑精神分析的基础并响应出版或灭亡的要求。但是，他认为，分析师主要是出于个人原因写论文——这是他们喜欢的东西。虽然可能有多种原因激励我们，我们都知道，从私人直接分析经验到发表论文的转变存在危险。Plaut 强调，从现场口语体验到书面文本的转变，即使是以记笔记的形式，也涉及将主要过程转化为次要过程，以及将可能短暂的东西凝结的风险。我们这样做的那一刻就有损失。他深思熟虑地探索了笔记的动态，认识到患者的隐私、访问文件的权利、透明度的不利方面以及获得对患者分析的各个方面进行写作的许可的问题都是现实存在的，伴随着任何写作的冲动。关于临床经验——它们会影响结果。Plaut 反映了一篇论文的开始，这是一个因对一个想法或发现的兴奋而着色的私人事件：“每次都需要某种情感火花来激发潜在作家的想象力，并提供足够的燃料来维持严谨的写作过程”（378）。他接着描述了一个过程，从记笔记到与同事讨论案例，再到教学，再到实际的临床写作。他对点燃分析师对特定想法的热情的介绍引起了我的注意，因为它说明了分析师在分析关系中的现场参与（如普劳特所建议的，借用- 然后到实际的临床写作。他对点燃分析师对特定想法的热情的介绍引起了我的注意，因为它说明了分析师在分析关系中的现场参与（如普劳特所建议的，借用- 然后到实际的临床写作。他对点燃分析师对特定想法的热情的介绍引起了我的注意，因为它说明了分析师在分析关系中的现场参与（如普劳特所建议的，借用-