A remarkable degree of ambiguity, imprecision, and disagreement characterizes the literature on dissociation and the clinical theory of treating dissociative psychopathology. I admire very much, therefore, Michael Diamond’s effort to clarify some of the complex theoretical and technical issues central to the psychoanalytic treatment of people suffering the sequelae of trauma and dissociation. I particularly appreciate his position that a “psychoanalytic treatment model that addresses only linguistically represented conflict is destined to fail because the weakly symbolized traumatic material accompanying dissociative states primarily resides in somatic experience” (p. 847). In my view, psychoanalysis must address more completely and explicitly the important conceptual and technical implications of the fundamental role of unsymbolized, “somatic” experience in trauma-related psychopathology and of the nonverbal therapeutic processes relevant to its treatment. But as I read Diamond, I am also far less certain than he seems to be that it is necessary or desirable to “integrate” the technical approach that follows from conflict theory with that of trauma theory. It depends, of course, on exactly what he means by “integrate.” I am not clear on this point and find myself confused, for instance, by his initial emphasis on “integration” followed by his eventual endorsement of a “dual-track” technical approach (p. 856). Perhaps by “integration” he means something like

中文翻译：

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分离：分解还是分解？钻石评论

关于分离性的文献和治疗分离性精神病理学的临床理论具有显着的模糊性、不精确性和分歧性。因此，我非常钦佩迈克尔·戴蒙德 (Michael Diamond) 努力澄清一些复杂的理论和技术问题，这些问题对遭受创伤和分离后遗症的人的精神分析治疗至关重要。我特别欣赏他的立场，即“仅解决语言表征冲突的精神分析治疗模型注定会失败，因为伴随分离状态的弱符号化创伤材料主要存在于躯体体验中”（第 847 页）。在我看来，精神分析必须更完整和明确地解决非符号化的基本作用的重要概念和技术含义，与创伤相关的精神病理学和与其治疗相关的非语言治疗过程的“躯体”经验。但是，当我读到戴蒙德时，我也远没有他所认为的那样确定，将冲突理论中的技术方法与创伤理论的方法“整合”是必要的或可取的。当然，这取决于他所说的“整合”究竟是什么意思。我在这一点上不清楚，并且发现自己很困惑，例如，他最初强调“集成”，随后他最终认可了“双轨”技术方法（第 856 页）。也许“整合”他的意思是这样的 我也远不如他所认为的那样确定，将冲突理论的技术方法与创伤理论的技术方法“整合”是必要的或可取的。当然，这取决于他所说的“整合”究竟是什么意思。我在这一点上不清楚，并且发现自己很困惑，例如，他最初强调“集成”，随后他最终认可了“双轨”技术方法（第 856 页）。也许“整合”他的意思是这样的 我也远不如他所认为的那样确定，将冲突理论的技术方法与创伤理论的技术方法“整合”是必要的或可取的。当然，这取决于他所说的“整合”究竟是什么意思。我在这一点上不清楚，并且发现自己很困惑，例如，他最初强调“集成”，随后他最终认可了“双轨”技术方法（第 856 页）。也许“整合”他的意思是这样的