An earthquake runs through the psychotherapeutic professions (Neimeyer & Taylor, 2014). Since the 1980s, psychoanalysis has lost its leading position in clinical psychotherapy and its discursive leadership (Stepansky, 2009). University chairs and professorships, once long held by prominent psychoanalysts, are now held either by clinical psychologists with a cognitive-behavioral orientation, or by neuro-scientists who are far away from theoretical positions held by the representatives of neuropsychoanalysis. Public interest and belief in psychoanalytic interpretations has decreased rapidly, even though psychoanalytic discourse particles are shattered through many public utterances. A discipline that once inspired whole artistic movements, like surrealism, is now, if not ridiculed, mostly limited to partial usage without any clear reference – ranging from the dualprocess theory in social psychology to the 2015 Pixar blockbuster animation Inside out. And many professional psychoanalytic practitioners seem to be unmoved by this threatening development. However, this bleak picture is less uniform than it may seem. There are waves of encouragement running counter to these pessimistic threads. Recent research efforts have demonstrated the efficacy and effectiveness of psychoanalytic treatments for many clinical disorders, which has surprised even “true believers” (de Maat et al., 2013; Leichsenring et al., 2016; Shedler, 2012). It has been shown that psychoanalytic treatments have high cost-effectiveness (Egger et al., 2016; Wiltink et al., 2016), not only in anxiety disorders, but in depression too (de Maat, Dekker, Schoevers, & de Jonghe, 2006), compared with either cognitive-behavioral therapy (CBT) or pharmacotherapy. Effortful years of rigorous research have paid off: they show that psychoanalysts help in many difficult treatment situations, and that their supervisory qualities are requested; and if these colleagues need support or help in personal problems, they prefer to pay a visit to a psychoanalyst (Buckman & Barker, 2010; Gelo, Ziglio, Armenio, Fattori, & Pozzi, 2016). These results have also been reaching wider audiences through more popular journals (Shedler, 2010a) and magazines (Shedler, 2010b). But what students in clinical psychology courses hear about psychoanalysis is either nothing or bad: psychoanalysis is said to be outdated, unscientific, unproven. In textbooks on personality psychology, it is described as if its development stopped around the time of World War II (Habart, Hansell, & Grove, 2011). The good news, on the other hand, is that descriptions of CBT that include concepts like “resistance” or “transference” are mentioned in many CBT textbooks (Emmelkamp, Vedel, & Kamphuis, 2007; Schlüter, 2005). CBT rediscovered the “talking cure,” again without quoting where the concepts were taken from. Behavioral therapists Aron Beck and Albert Ellis once tested the usefulness of some behavioral techniques such as “thought-stopping” in compulsive disorders and alcohol treatment, and had to admit that these techniques brought contradictory results depending on the communicative qualities of each therapist (Woolfolk, 2015). The term “rapid change phenomenon” (Ilardi & Craighead, 1994) was introduced to describe how sometimes the effects showed up even before the special techniques had been applied! Some flagged the path of hope by writing about “returning to contextual roots” (Jacobson, Martell, & Dimidjan, 2001) in the headline of their contributions. Testing the “contextual model” against the “medical model” by applying highly sophisticated statistical procedures for worldwideavailable metaprocedures was an endeavor whose results shocked the world of research (Wampold, 2001), because it attacked the medical model of (diagnostically defined) “disorders” – (defined by manuals) “treatment” – (statistically defined) “measures of outcome.” In his second edition (Wampold & Imel, 2015), Wampold held and intensified this position firmly. It is not the medical “intervention” or “dose” (of treatment) that cures, but a human relationship resting on qualities such as hope, fitting of treatment to the patient’s beliefs, remoralization, and so on. A talking cure is something going on between human persons, between people thinking about thinking people, and thinking while talking.

中文翻译：

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为生存而教学

一场地震贯穿了心理治疗专业（Neimeyer & Taylor，2014）。自 1980 年代以来，精神分析失去了其在临床心理治疗中的领先地位及其话语领导地位（Stepansky，2009）。曾经长期由杰出的精神分析师担任的大学主席和教授职位，现在要么由具有认知行为取向的临床心理学家担任，要么由远离神经精神分析代表所持理论立场的神经科学家担任。公众对精神分析解释的兴趣和信念迅速下降，尽管精神分析的话语粒子被许多公开言论所粉碎。一门曾经激发整个艺术运动的学科，如超现实主义，现在即使不被嘲笑，大多仅限于部分使用，没有任何明确的参考——从社会心理学中的双重过程理论到 2015 年皮克斯大片动画《Inside out》。许多专业的精神分析从业者似乎对这种威胁性的发展无动于衷。然而，这幅黯淡的画面并不像看起来那么统一。一波又一波的鼓励与这些悲观的线索背道而驰。最近的研究工作证明了精神分析治疗对许多临床疾病的疗效和有效性，这甚至让“真正的信徒”感到惊讶（de Maat 等人，2013 年；Leichsenring 等人，2016 年；Shedler，2012 年）。已经表明，精神分析治疗具有很高的成本效益（Egger 等人，2016 年；Wiltink 等人，2016 年），不仅在焦虑症中，而且在抑郁症中也是如此（de Maat、Dekker、Schoevers，& de Jonghe, 2006)，与认知行为疗法 (CBT) 或药物疗法进行比较。多年努力的严谨研究得到了回报：他们表明精神分析师在许多困难的治疗情况下提供帮助，并且要求他们具有监督能力；如果这些同事在个人问题上需要支持或帮助，他们更愿意拜访精神分析师（Buckman & Barker，2010 年；Gelo、Ziglio、Armenio、Fattori 和 Pozzi，2016 年）。这些结果还通过更受欢迎的期刊（Shedler，2010a）和杂志（Shedler，2010b）覆盖了更广泛的受众。但是，临床心理学课程的学生听到的关于精神分析的内容要么一无是处，要么很糟糕：据说精神分析已经过时、不科学、未经证实。在人格心理学教科书中，它被描述为好像它的发展在第二次世界大战期间停止（Habart、Hansell 和 Grove，2011 年）。另一方面，好消息是，许多 CBT 教科书中都提到了对 CBT 的描述，包括“抵抗”或“移情”等概念（Emmelkamp、Vedel 和 Kamphuis，2007 年；Schlüter，2005 年）。CBT 重新发现了“谈话疗法”，再次没有引用这些概念的来源。行为治疗师 Aron Beck 和 Albert Ellis 曾经测试了一些行为技巧的有用性，例如强迫症和酒精治疗中的“思想停止”，并且不得不承认这些技巧带来了相互矛盾的结果，这取决于每个治疗师的交流质量（Woolfolk， 2015）。术语“快速变化现象”（Ilardi 和 Craighead，1994) 被介绍来描述有时甚至在应用特殊技术之前效果就出现了！一些人通过在其贡献的标题中写下“回归上下文根源”（Jacobson、Martell 和 Dimidjan，2001 年）来标记希望之路。通过对全球可用的元程序应用高度复杂的统计程序来针对“医学模型”测试“上下文模型”是一项努力，其结果震惊了研究界 (Wampold, 2001)，因为它攻击了（诊断定义的）“疾病”的医学模型”——（由手册定义）“治疗”——（统计定义）“结果测量”。在他的第二版（Wampold & Imel，2015 年）中，Wampold 坚定地保持并加强了这一立场。治愈的不是医学“干预”或“剂量”（治疗），而是建立在诸如希望、治疗与患者信仰相适应、重新道德化等品质之上的人际关系。谈话疗法是人与人之间、人与人之间、人与人之间、人与人之间、边说话边思考。